Co-therapist and multidisciplinary team coordination

The manuals converge on the need for tightly coordinated teamwork across co-therapists and wider clinical or research staff. Across the extracts, the common pattern is clear role clarity, shared responsibility, and active communication during preparation, dosing or session work, integration, and follow-up. Several sources also emphasise maintaining continuity across phases, timely sharing of safety concerns, and coordinated responses to adverse events or participant destabilisation. They also converge on the importance of a stable therapy dyad, often with both therapists present during key sessions and at least one clinician available when medical or psychiatric issues may arise. Many manuals describe regular debriefing, supervision, or case review as part of team functioning. Sources differ in how broad the team is, some focus mainly on two co-therapists, while others include physicians, psychiatrists, nurses, study coordinators, independent raters, attendants, or even somatic and ceremonial practitioners. The manuals also differ in how strictly they define role separation and continuity. Some protocols specify distinct therapist functions, such as alcohol-focused and hallucinogen-focused roles, or require the same co-therapist team across sessions. Others allow more flexible arrangements, such as one therapist handling some preparation or debriefing alone when necessary, or using substitutes only if they have already met the participant.