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As a result, training and service delivery are advancing more rapidly than the development and evaluation of research\u2011informed governance frameworks from public and academic bodies. Consequently, practitioners may rely on guidance that varies in transparency, evidence base and methodological rigour, leading to inconsistent safety and ethical expectations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>In response to this gap, we describe a competency framework developed over a 4\u2011year, practice\u2011embedded quality improvement (QI) process focused on governance, safety and accountability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Within a post\u2010graduate PaT programme at a Canadian university, we used an iterative QI approach that integrated evidence\u2011informed literature with recurring feedback from learners, faculty, supervised practice partners and cultural knowledge\u2011keeper guidance. This process is centred on developmental learning, cultural responsiveness and safeguards appropriate to non\u2011ordinary states of consciousness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The framework centres on both\n                      <jats:italic>doing<\/jats:italic>\n                      (technical and clinical aspects of practice) and\n                      <jats:italic>being<\/jats:italic>\n                      (relational presence and ethical stance). These dimensions are supported by a programme\u2011level Code of Ethics addressing safeguards related to safety, confidentiality and privacy, transparency, equity and cultural accountability, competence, environmental stewardship and power and boundary management, including touch and sexual boundaries. The framework operationalizes five competency domains: (1) therapeutic presence and trustworthiness; (2) culture and identity; (3) historical, political, and regulatory literacy; (4) evidence\u2011informed clinical knowledge; and (5) a trauma\u2011 and equity\u2011informed therapeutic process spanning screening, preparation, informed consent, team roles and integration.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Rather than a fixed consensus standard or externally validated competency model, this framework offers a practice\u2010embedded, QI\u2010derived design logic that can be locally adapted across diverse contexts. Its contribution is governance\u2010oriented: clarifying ethical guardrails, developmental competencies and revision processes for future implementation and evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jep.70556","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T18:58:27Z","timestamp":1786388307000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Competencies and Ethical Governance for Psychedelic\u2011Assisted Therapies: A Practice\u2011Embedded Quality\u2011Improvement Framework"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1609-4243","authenticated-orcid":false,"given":"Shannon","family":"Dames","sequence":"first","affiliation":[{"name":"Psychedelic\u2010Assisted Therapy Graduate Certificate (PaTGC) Vancouver Island University (VIU) Nanaimo British Columbia Canada"},{"name":"Roots to Thrive Society for Psychedelic Therapy Nanaimo British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8191-5250","authenticated-orcid":false,"given":"Keith","family":"Williams","sequence":"additional","affiliation":[{"name":"Athabasca University Athabasca Alberta Canada"},{"name":"First Nations Technical Institute Tyendinaga Mohawk Territory Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan","family":"Campbell","sequence":"additional","affiliation":[{"name":"Psychedelic\u2010Assisted Therapy Graduate Certificate (PaTGC) Vancouver Island University (VIU) Nanaimo British Columbia Canada"},{"name":"Kyuquot\/Cheklesahht First Nation Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wes","family":"Taylor","sequence":"additional","affiliation":[{"name":"Roots to Thrive Society for Psychedelic Therapy Nanaimo British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marti","family":"Harder","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Human Services VIU Nanaimo British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2287-2278","authenticated-orcid":false,"given":"Michelle","family":"Gagnon","sequence":"additional","affiliation":[{"name":"Roots to Thrive Society for Psychedelic Therapy Nanaimo British Columbia Canada"},{"name":"School of Nursing University of British Columbia Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geraldine","family":"Manson","sequence":"additional","affiliation":[{"name":"Roots to Thrive Society for Psychedelic Therapy Nanaimo British Columbia Canada"},{"name":"Faculty of Health Sciences and Human Services VIU Nanaimo British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Kryskow","sequence":"additional","affiliation":[{"name":"Psychedelic\u2010Assisted Therapy Graduate Certificate (PaTGC) Vancouver Island University (VIU) Nanaimo British Columbia Canada"},{"name":"Roots to Thrive Society for Psychedelic Therapy Nanaimo British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"\u201cDiscussion Document: Public Health Perspectives on the Future of Psychedelics \u201d Canadian Public Health Association October 22 2024."},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/acps.13249"},{"key":"e_1_2_10_4_1","unstructured":"\u201cPsychedelic Drugs: Considerations for Clinical Investigations: Guidance for Industry [Draft guidance] \u201d US Food and Drug Administration 2023 https:\/\/www.fda.gov\/regulatory-information\/search-fda-guidance-documents\/psychedelic-drugs-considerations-clinical-investigations."},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.14650"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00213-014-3714-z"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12152-025-09596-3"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lana.2022.100410"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/anoc.12161"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13412-012-0086-8"},{"key":"e_1_2_10_11_1","volume-title":"Thirdspace: Journeys to Los Angeles and Other Real\u2011and\u2011Imagined Places","author":"Soja E. 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