📋 Crisis Response Protocols for Trip Sitters

Before the Session: Screening and Preparation

Effective crisis prevention starts before the session begins. A thorough screening conversation reduces the likelihood of crisis and ensures you are prepared if one occurs.

Screening Checklist

• Medical history: Any cardiovascular conditions, seizure history, or liver problems?
• Psychiatric history: Personal or family history of psychosis, schizophrenia, bipolar I disorder, or severe PTSD?
• Medications: Currently taking any SSRIs, SNRIs, MAOIs, lithium, or other psychiatric medications?
• Current mental state: Are they in a period of acute grief, trauma processing, or significant life stress?
• Substance experience: Have they used psychedelics before? Any previous difficult experiences?
• Intentions: What are they hoping for from this experience?
• Emergency contacts: Who should be called if something goes wrong?

Session Preparation

• Document substance, dose, and time of ingestion in writing
• Save emergency numbers: 911, Fireside Project (1-623-473-7433), 988, person's emergency contact
• Ensure the space is safe, comfortable, and stocked with water and light snacks
• Establish communication agreements: how they can signal if they need help, if they want silence vs. conversation
• Know the expected duration and effects of the specific substance and dose

During the Session: Monitoring and Intervention Thresholds

Your primary role during the session is attentive, non-intrusive presence. Most of the time, this means doing very little — watching, being available, and trusting the process.

Routine Monitoring

• Visual check every 10–15 minutes: observe breathing, color, position
• Periodic gentle check-in: a look, a quiet question if they seem distressed
• Note the time relative to ingestion — know when the peak is expected and when resolution should occur

Intervention Thresholds

• Low threshold (gentle check-in): Person appears distressed, is silent for extended period, seems physically uncomfortable
• Medium threshold (active engagement): Expressing significant fear, confusion, or that something is wrong; approaching hazardous areas; requesting help
• High threshold (call Fireside Project 1-623-473-7433): Distress is severe and not responding to grounding; situation exceeds your confidence to handle alone; person is at risk of leaving unsafely
• Emergency threshold (call 911): Unconsciousness, seizure, breathing problems, very high fever, severe physical symptoms, violent self-harm

Grounding Protocol: Step-by-Step

When someone needs active support, follow this sequence:

1. Regulate yourself first: Take 3 slow breaths. Your state is contagious.
2. Make contact: Move close, make eye contact if welcomed, offer your name: "I'm [name]. I'm right here with you."
3. Orient: "You took [substance] about [X hours] ago. You're at [location]. You're safe."
4. Invite the body: "Can you feel your feet on the floor? Let's both take a slow breath."
5. 5-4-3-2-1 if needed: Guide through: 5 things you can see, 4 you can feel, 3 you can hear, 2 you can smell, 1 you can taste.
6. Reduce stimulation: Lower music, adjust lighting, move to a calmer space if appropriate.
7. Continue monitoring: Stay close, reassess every few minutes.

Medical Escalation Decision Tree

• Is the person conscious and responsive? If NO → Call 911 immediately, begin recovery position if breathing, CPR if not.
• Is breathing normal? If NO → Call 911 immediately.
• Are there physical symptoms (seizure, very high fever, rigidity)? If YES → Call 911 immediately.
• Is distress severe and not responding to 10 minutes of grounding? If YES → Call Fireside Project (1-623-473-7433) for real-time guidance.
• Is the person physically safe and distress manageable? If YES → Continue supportive presence, reassess every 15 minutes.

Documentation and Reporting

After any session involving active crisis intervention, document while events are fresh:

• Substance, dose, and time of ingestion
• Timeline of events: when distress began, what you observed, what interventions were used
• Whether emergency services were called and what happened
• Person's condition at end of session and any follow-up arranged
• Your observations about what contributed to the difficulty and what helped

This documentation is private. It is valuable for your own learning, for any professional supervision you receive, and for the person's own integration work if they choose to share it.

Self-Care for Trip Sitters After Difficult Sessions

Witnessing someone in acute psychological or medical crisis is demanding. After a difficult session:

• Allow yourself time to decompress before driving or engaging in demanding tasks
• Debrief with a trusted person who understands the context
• Seek supervision or consultation if you are in a professional role
• Monitor yourself for secondary trauma responses over the following days: intrusive memories, heightened anxiety, difficulty sleeping
• Access your own support resources — the Fireside Project can also support people who have served as crisis supporters

Training Resources

• Zendo Project: zendoproject.org — harm reduction training for volunteers and professionals
• MAPS Psychedelic Support Training: maps.org — professional training programs
• Psychedelic Support: psychedelic.support — directory of training programs and practitioners
• Mental Health First Aid: mentalhealthfirstaid.org — general mental health crisis response certification

FAQ

What qualifications do I need to be a trip sitter?

For informal personal settings, there are no legal requirements, but completing training significantly improves your effectiveness and reduces harm. At minimum: basic first aid and CPR, knowledge of the substance's expected effects and duration, emergency contact information prepared in advance, and ideally completion of a harm reduction training program from organizations like Zendo Project or Psychedelic Support. Professional trip sitters operating in therapeutic or ceremonial contexts typically have much more extensive training requirements.

How do I handle it if someone wants to call their family or friends during a difficult session?

Gently assess whether this is a grounded decision or a fear-driven impulse. Sometimes contact with a loved one can be grounding; other times it introduces complexity (worried family members who don't understand psychedelics can escalate the situation). Ask: "What do you hope will happen if you call them?" Help them think it through rather than immediately facilitating or blocking the call. If they are in genuine distress and insist, support their autonomy.

What is the difference between holding space and actually intervening?

"Holding space" means being calm, present, and available without imposing direction on the experience. "Intervening" means actively changing something — speaking, providing grounding, moving the person, or calling for help. Most of the time, holding space is the right approach. Intervene when: there is a safety risk, the person requests help, or distress is severe and clearly not moving toward resolution on its own. The bias should be toward less intervention rather than more, except when physical safety is at stake.

What do I do if someone screams, cries, or makes other intense sounds?

Intense emotional expression — crying, screaming, moaning — is often part of the experience and not inherently a crisis. Assess: is the person responsive and engaged with their experience (versus disconnected and not responding to you)? Are they physically safe? Is the sound expression or is it distress? If they are physically safe and engaged with their experience, allow the expression. Move closer and offer presence without trying to stop or redirect unless they indicate they want help. Provide reassurance that they are safe and you are there.

How do I maintain my own grounded state during a long, difficult session?

Self-regulation strategies for trip sitters: slow, deliberate breathing throughout; brief grounding check-ins with your own body (feet on floor, feeling your weight); step briefly away to another room for 2-3 minutes if needed and the person is safe; hydrate and snack lightly to maintain physical stability; avoid checking your phone frequently as this disrupts presence; and remind yourself of your role and training. If you feel you are losing your composure, it is appropriate to call the Fireside Project for real-time support and coaching.

Should I allow or encourage the person to go outside during a difficult experience?

Going outside can be powerfully grounding, especially access to nature, fresh air, and natural light. However, it also introduces unpredictable elements — other people, traffic, navigation challenges. Assess the dose, the duration into the experience (high-peak moments are riskier outdoors), and the specific outdoor space available. A private garden or yard is much more appropriate than a public street. If going outside, go with them and maintain close supervision.

What screening factors should lead me to decline trip sitting for someone?

Decline or strongly discourage if the person: has an untreated or unstable psychiatric condition (especially psychosis history); is taking lithium or MAOIs; has severe cardiovascular disease; is in acute grief or crisis without proper preparation time; is very young (under 21); has a history of severe adverse reactions to psychedelics that were not resolved; or if you feel for any reason that you are not the right person for this role in this situation. Your own limits and capacity matter — turn down requests when you do not feel equipped.

How do I handle documentation without violating someone's privacy?

Keep documentation private and under your control. Do not share it with third parties without explicit consent from the person. Use initials or pseudonyms rather than full names. Store notes securely. If you are a professional operating under licensing, follow your professional ethical guidelines for documentation of non-licensed activities. The purpose of documentation is learning and continuity of care, not record-keeping for external parties.

What training programs are specifically designed for psychedelic crisis response?

The Zendo Project (zendoproject.org) offers the most widely available harm reduction training for lay people and professionals. MAPS offers professional clinical training in psychedelic-assisted therapy. Psychedelic Support (psychedelic.support) lists numerous training programs ranging from weekend intensives to year-long certification programs. The Synthesis Institute and California Institute of Integral Studies (CIIS) offer academic and certificate programs. For baseline preparation, the Mental Health First Aid certification (mentalhealthfirstaid.org) is a valuable foundation regardless of specialty.

What is secondary trauma and how might it affect trip sitters?

Secondary trauma (also called vicarious trauma or compassion fatigue) occurs when someone develops trauma responses from witnessing or supporting another person's traumatic experience. Signs include: intrusive memories of the difficult session, heightened anxiety, difficulty sleeping, emotional numbness, and changes in how you view the world. If you experience these symptoms after a particularly difficult session, seek your own support — talk to a trusted person, consider speaking with a therapist, and take time to restore before serving in a support role again.