[Solved] BIG-registered therapist offering psychedelic sessions (psilocybin, LSD, MDMA)

A BIG-registered healthcare professional is currently unable to offer treatment with psilocybin, LSD or MDMA as part of mainstream mental healthcare outside of recognised scientific research or other specific legal frameworks. There are currently no recognised treatment guidelines for psilocybin within mainstream mental health care in the Netherlands.

However, this does not mean that a BIG-registered professional can never be involved in psychedelic programmes. Under certain circumstances, a BIG-registered professional may fulfil a role outside their BIG-registered profession, provided there is a clear and demonstrable separation between their professional care role and any non-medical support. The recent disciplinary ruling by the Amsterdam Regional Disciplinary Tribunal of 8 May 2026 emphasises that, in fact, role confusion poses a significant disciplinary risk.

What was the disciplinary tribunal’s ruling?

In this case, a clinical psychologist was suspended on a conditional basis after the board found, amongst other things, that:

• the use of psilocybin during therapy sessions was permitted;
• there was insufficient consultation amongst colleagues;
• the record-keeping was inadequate;
• the BIG registration remained visibly linked to activities relating to a psilocybin retreat.

According to the board, there was insufficient separation between the standard treatment role, the professional status as a BIG-registered healthcare provider, and activities relating to psychedelics. This could have led to confusion amongst clients regarding the nature of the care provided and professional responsibility.

What does this mean for other BIG professionals?

The ruling makes it clear that healthcare professionals registered with the BIG must exercise the utmost care when carrying out activities relating to psychedelics.

The risk of disciplinary action increases in particular when:

• clients from our own practice take part in psychedelic sessions;
• the BIG title is used for promotional or recruitment purposes;
• psychedelic counselling is presented as a medical or psychotherapeutic treatment;
• expertise gained from an existing treatment relationship is utilised within a non-medical programme;
• conventional care and psychedelic support are often confused with one another in organisational or communication terms.

What does seem possible?

On the basis of current legislation and regulations and recent disciplinary case law, it would appear to be more legally tenable if:

• there is no treatment relationship;
• participants are not current or former clients;
• the BIG registration is not used for marketing purposes or to validate the sessions;
• no medical treatment or psychotherapy is claimed;
• the activities are clearly separated from the regular practice in organisational, legal and communication terms.

At the same time, the ruling does not provide a blanket licence. The disciplinary tribunal always assesses the specific facts and circumstances of each individual case. The precise interpretation of that distinction therefore remains of great importance.

The role of BIG-registered professionals within Triptherapie

Various professionals with backgrounds in psychology and mental health care work at Triptherapie. A distinction is made between therapists who actually conduct sessions and BIG-registered professionals who primarily fulfil an advisory or supportive role.

An example of this is Ylva Doorewaard Boekhout, BIG-registered health psychologist. She supports the organisation in the areas of psychological care, mental health care frameworks, safety and integration. She does not facilitate psychedelic sessions herself and is called upon as a consultant when additional psychological expertise is required.

It is precisely this kind of supportive role that is in line with the principle that psychological expertise can be made available without a psychedelic session being presented as standard mental health care or psychotherapy.

Practical general rule

Recent disciplinary case law confirms two key principles:

1. In the absence of recognised guidelines, research protocols or a legal basis, a healthcare professional registered with the BIG cannot currently use psilocybin as a standard mental health treatment.

2. The clearer the distinction between the BIG role and any non-medical activities relating to psychedelics, the lower the disciplinary risk.

3. Make sure that even the most stupid person in the world understands that working with truffles is not part of standard mental health care by being careful with terms such as ‘therapy’ and ‘treatment’.

The central theme of the ruling is therefore not primarily the substance psilocybin itself, but the prevention of a conflict of interest and the protection of the trust that patients and clients are entitled to place in BIG-registered healthcare professionals.