In the world of psychedelics, many roles coexist under names that are used as if they were synonyms: trip sitter, guide, facilitator, therapist, companion, shaman. They are not. Each one does different things, has different training and is accountable for different things. Confusing them leads to asking someone for what they cannot give.
This article puts the terms in order and explains what to expect from each role and when each one makes sense. It is not an invitation to use substances, and it does not go into the legal situation, which we cover in the legal status of psychedelics in Spain.
Why it matters to tell them apart
None of these names, except those that correspond to healthcare professions, is regulated. Anyone can present themselves as a facilitator or guide. That does not mean they all do it badly, but it does mean that the title alone guarantees nothing. What counts is exactly what that person does, with what preparation and within what limits.
Trip sitter
What it is
A sober person who is present while someone else goes through a psychedelic experience. Their job is to look after things: the surroundings, physical safety and the peace of mind of the person tripping.
What they do
- Stay sober and available the whole time.
- Take care of the basics: water, temperature, music, light, making sure nobody goes out into the street or drives.
- Offer presence and calm if fear comes up.
- Know when medical help needs to be called.
What they do not do
They do not direct the experience, they do not interpret and they do not do therapy. A good trip sitter intervenes very little.
Who can be one
Often it is a trusted friend with common sense and some information. There are also people who offer it with more experience. We talk about this in trip sitter: what it is and why it can transform your experience and about how to act in a crisis in bad trip: what to do in the moment.
Facilitator
What it is
The person who organizes and leads an experience, usually in a group: a ceremony, a retreat, a guided session. Unlike the trip sitter, they play an active part in designing what happens.
What they do
- Prepare the space and the structure of the session.
- Screen, or should screen, the participants.
- Lead the ritual, the music or the group activities.
- Hold the group and attend to anyone having a hard time.
What you should know
The word covers very different realities: from people with decades of learning within a tradition to someone who has attended three ceremonies and decides to organize them. There is no official qualification. Quality shows in what surrounds the session: whether there is prior screening, questions about health and medication, an emergency plan and follow-up afterward.
Shaman, healer (curandero) or guide are related terms. The first two refer to specific cultural traditions, with their own systems of learning, and are often used outside them with little rigor.
Therapist
What it is
A healthcare professional licensed to treat mental health problems: psychologists with a healthcare license or a clinical specialty, and psychiatrists.
What they do
They assess, diagnose and treat. In relation to psychedelics, they can be involved in two ways:
- In authorized clinical trials, where the substance is administered within a protocol, with preparation and integration sessions.
- Outside them, offering preparation or integration therapy, without substances, to people who have decided to have an experience or have already had one.
What you should know
In Spain, therapy assisted with psilocybin, MDMA or LSD is not available as a treatment outside research. Anyone advertising psychedelic therapy with these substances outside a clinical trial is using the term improperly. Nor does being a therapist mean that someone knows about psychedelics: it is worth asking about their experience in this field.
Companion
What it is
A person who offers a space for conversation and personal work before and after the experience, and sometimes presence during it. It is not a healthcare role.
What they do
- Help you prepare: intention, expectations, fears, context.
- Help you integrate: making sense of what you experienced and translating it into daily life.
- If they accompany you during the experience, their role is one of presence and harm reduction, similar to that of the trip sitter.
What they do not do
They do not diagnose, they do not treat and they do not replace a healthcare professional. We go into this in what emotional support is and how it differs from psychotherapy.
The differences at a glance
- When they are involved. The trip sitter, during. The facilitator, mostly during, with some before and after. The therapist and the companion, mainly before and after.
- Role. The trip sitter looks after you. The facilitator leads. The therapist treats. The companion helps you prepare and make sense of things.
- Training. Variable and unregulated for the trip sitter, the facilitator and the companion. Formal and healthcare-based for the therapist.
- What they can handle. Only the therapist can treat a mental health problem.
When to choose each one
- You are going to have an experience on your own and want basic safety: a trusted trip sitter.
- You want to arrive well prepared or you do not know what to do with what you experienced: a companion, or a therapist with experience in integration.
- You have a mental health diagnosis, take psychiatric medication or carry a trauma: a therapist, before deciding anything. Also check who should not take psychedelics.
- After an experience you have symptoms that do not ease: healthcare. The signs are in when to seek help.
- You are interested in a ceremonial or group setting: find out thoroughly who is facilitating, using the questions below.
What to ask any of them
- What training do you have, and how much experience in this?
- What do you ask me about my health, my history and my medication?
- Who do you not accept or not accompany?
- What would you do if the experience gets complicated? And in a medical emergency?
- What happens afterward? Is there follow-up?
- What are your limits? What do you not do?
- How much does it cost and what exactly does it include?
Someone serious answers all of this naturally and without taking offense.
Red flags common to all the roles
- They do not ask about your health or your medication.
- They encourage you to stop a treatment.
- They promise healing or results.
- They play down the risks or say that nothing has ever gone wrong with them.
- They mix support with unclear personal, sexual or financial relationships.
- They use titles they cannot back up.
- They foster dependence: more sessions, more ceremonies, more courses.
- They discourage you from talking to other people or to healthcare professionals.
Where RILOFU stands
At RILOFU we offer support: preparation, integration and, if the person requests it, presence during the experience in a role limited to care and harm reduction. We do not sell, supply or provide substances, and we do not offer healthcare treatment. The details are in what happens in a support session.