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Choosing a guide or a retreat: the questions people ask

The question here is what published lists name as questions and warning signs about choosing a facilitator or a retreat, and whether any of it is known to relate to outcomes. This card reports what others have published. It is not a checklist.

Published Information current to 7 November 2026Review due by 5 February 2027

Read this first. This page is education, not instructions to use. Metanoia does not supply any substance. In the United States, most of the substances discussed here are Schedule I under federal law (21 CFR 1308.11). State programs such as Oregon's and Colorado's operate under state law only, and federal law still applies. Legal status differs between countries, and none of this is legal advice. Nothing here is medical advice, and nothing here gives or recommends a dose. People who host, supply or take part in sessions involving controlled substances can face criminal liability under federal and state law. This page does not advise on that. "Healthy adults" means people with no diagnosed psychiatric or major medical condition, the population Metanoia studies. This page reports what published sources say about work done outside supervised programs, and it takes no position on the legality of any setting, practice or person.
Not an emergency resource. Metanoia is not an emergency service. In a medical or mental health emergency in the United States the number is 911, and the 988 Suicide and Crisis Lifeline is available by call or text. Elsewhere, local emergency numbers apply. Nothing on this card is a reason to delay or avoid care. This card describes what sources report. It is not a screening tool, it does not say who should take part in a session or in what setting, and it is not medical guidance. Metanoia does not receive or investigate complaints about guides or retreats.

The short answer

What do published guides list as questions about choosing a facilitator or retreat, and is any of it known to relate to outcomes?

Public bodies and harm-reduction groups have published lists of questions and warning signs about choosing a guide or a retreat. The topics overlap, and the lists rest on experience and reports. In a documented search, no study was located that tested whether any listed item, checked before a session, relates to outcomes or harms. This entry is not a checklist and does not say how anyone should choose.

What was found?

Reported findings, not recommendations.

  • Official pages. As shown on 7 November 2026, Oregon’s state psilocybin program page says licensed centers and facilitators appear in a public directory, that the state does not set prices, and that a facilitator may decline a client for any reason. Colorado’s Natural Medicine Division page points to a healing center directory and a state license look-up for facilitators. Neither page says that a license predicts outcomes. Sources 1, 2, level 1
  • Lists from harm-reduction and education groups. Three published lists, from a US peer-support line with a psychotherapy center (2021), a UK group (undated) and a US research nonprofit (2025), name warning signs or questions, and their topics overlap. The 2021 list was written for people who had already decided on a guided session and states that serving as an underground facilitator is illegal. The UK page gives a numerical group-size cutoff with no stated basis. None of the three pages cites a study that tested its items. Sources 3, 4, 5, level 1
  • What retreats publish. A 2025 analysis of 298 retreat organizations’ online material found it often incomplete, and eight did not name the substances offered. The authors say such gaps may hinder an informed choice. Source 6, level 1 Interviews with 49 of the same organizations led the authors to describe safety protocols as inconsistent and poorly documented. They also caution that stressing professional credentials may overlook other kinds of experts, such as Indigenous shamans or peer support specialists. Source 7, level 1
  • An ayahuasca survey, with limits. In a 2021 survey of 6,877 people who had drunk ayahuasca in more than 40 countries, higher ratings of the support and safety felt during the ceremony, and of preparation activities, were associated with better scores on most of the wellbeing and mental-health measures used. The authors report limited evidence that one set of practices is superior. These were ratings made afterward, not checks made before booking. The sample was self-selected and the design cross-sectional, and the authors raise the possibility that people with better mental health report better growth. Source 8, level 1

What is not known?

Searches on 7 November 2026 covered PubMed (10 strings), Europe PMC (2) and the pages named in the sources, several scanning only the first 25 to 40 titles. “Not located” means the searches did not return it. They are not exhaustive.

  • Whether any item on these lists, asked before a session, relates to later outcomes or harms. Not located.
  • How people actually choose. No survey of selection factors was located.
  • Whether a provider’s answers can be verified, or how the lists apply across traditions. The 2026 interview authors write that conceptions of safe practice from a Western medical view may vary from norms in Indigenous, religious or neo-shamanic settings.
  • A 2026 focus-group study of experts on credibility and accountability was found and could not be opened in full. The statements above do not extend to it.

What this card does not say

Send a correction

If this card reports something wrongly, tell us. Write to main@metanoia-ca.org and keep the card name in the subject line. Accounts of what happened in a session belong in the field reports channel, not in email. Please leave out names and anything that identifies a person or a place. We read every message.

Where does this come from?

Grade key: 1 = peer-reviewed publication or official page, 3 = community or organization publication, reported as the source states it. A grade names the type of source and says nothing about its quality. “Read in full” means Metanoia read every sentence of the part cited on the date given, and any part not read is named.

Review due by 5 February 2027. The official and organization pages are live pages and are checked again before then.

  1. Oregon Health Authority, Oregon Psilocybin Services. Access Psilocybin Services. oregon.gov page. Grade 1. Official page, undated, as shown on 7 November 2026. Read in full 7 November 2026. Linked fact sheets and forms not opened.
  2. Colorado Natural Medicine Division. Accessing Regulated Natural Medicine. dnm.colorado.gov page. Grade 1. Official page, as shown on 7 November 2026. Read in full 7 November 2026, and read again in the gate the same day. Linked directory and look-up tool not opened.
  3. White J, Mulligan J. 10 Warning Signs When Selecting a Psychedelic Facilitator. Fireside Project blog, 14 April 2021. firesideproject.org. Grade 3. Community harm-reduction publication, not peer reviewed. Read in full 7 November 2026. The companion question list was not read.
  4. The Psychedelic Society (UK). Finding Psychedelic Facilitation. psychedelicsociety.org.uk. Grade 3. Organization page, undated. Read in full 7 November 2026. Linked resources not opened.
  5. Lightle D. Before You Book: 15 Questions and 5 Red Flags for Psychedelic Retreats. Unlimited Sciences, 30 September 2025. unlimitedsciences.org. Grade 3. Nonprofit education page, not peer reviewed. Read in full 7 November 2026.
  6. Neitzke-Spruill L, Beit CS, Robinson JO, Singh N, Kambala S, Ramesh R, McGuire AL. A landscape analysis of psychedelic retreat organizations advertising online. PLoS One 2025. DOI 10.1371/journal.pone.0321648. PMID 40315211. Grade 1. Descriptive study of public web information, English only. Read in full 7 November 2026 (PMC12047835). Figures, search-term appendix and references not read.
  7. McGuire AL, Neitzke-Spruill L, Robinson JO, Beit CS, Singh N, Mathai DS, Averill LA. Reported Safety Practices of Publicly Advertised Psychedelic Retreats. JAMA Netw Open 2026. DOI 10.1001/jamanetworkopen.2025.52505. PMID 41499117. Grade 1. Interviews, self-reported by organizations, same sampling frame as source 6. Read in full 7 November 2026 (PMC12780929). Methods appendix and data-sharing statement not read.
  8. Perkins D, Schubert V, Simonová H, Tófoli LF, Bouso JC, Horák M, Galvão-Coelho NL, Sarris J. Influence of Context and Setting on the Mental Health and Wellbeing Outcomes of Ayahuasca Drinkers: Results of a Large International Survey. Front Pharmacol 2021. DOI 10.3389/fphar.2021.623979. PMID 33967757. Grade 1. Cross-sectional online survey, self-reported, ayahuasca only. Read in full 7 November 2026 (PMC8097729), including tables 1 to 5. Figures and supplement not read.