The Hidden Cost of Tokenism: Ethics in Psychedelic Medicine and Mental Health Research

As psychedelic medicine emerges as a promising field for mental health treatment, especially in addressing PTSD, addiction, and other conditions, there is growing interest in engaging marginalized communities in this research.

However, without careful ethical practices, this interest risks falling into the trap of tokenism—an insidious barrier that undermines the very equity and inclusivity such efforts claim to promote.

Tokenism, defined as "the practice of making perfunctory or symbolic efforts to engage communities or patients" (Hahn et al., 2016), is an abuse of power that perpetuates harm. It often manifests in superficial collaborations with researchers or clinicians of color, serving only to check a box rather than fostering genuine partnership.

As a clinician of color, I urge all communities to critically evaluate the ethics of research targeting marginalized populations for studies in psychedelic medicine, especially when such research excludes intentional collaboration with other researchers, scientists, and clinicians of color.

The Ethics of Collaboration

Culturally competent research requires more than token inclusion; it demands meaningful engagement and partnership. Researchers who fail to collaborate with professionals of color reveal a troubling lack of cultural competency, raising questions about the ethical foundations and efficacy of their work.

Ethical research must prioritize the creation of safe, inclusive spaces where people of color can explore psychedelic-assisted therapies without fear of racial trauma, clinical mistreatment, or systemic bias (Racial Trauma, Policing, and Black Mental Health Workshop Attendee Handout, 2015; Geier et al., 2023).

Beyond Tokenism: Building Trust and Competency

To reduce stigma and foster trust, systems of care must implement intentional practices that prioritize ethical collaboration, cultural competency, and equitable access.

This includes:

Equitable Training and Education: Increasing access to education and training for underrepresented mental health and healthcare providers to ensure cultural competency in both research and treatment.

Culturally Competent Spaces: Creating environments where patients of color feel safe to engage in alternative therapies without fear of direct or indirect punishment or harm.

Commitment to Ethical Models of Care: Aligning research practices with established ethical principles, such as those outlined by the American Counseling Association’s Advocacy Competencies which encourage clinicians to find ways to collaborate with systems on behalf of their clients and community to identify systemic factors that create barriers to equitable access to resources and care.  ACA Liberty and Justice for All 

As well as, the American Mental Health Counselors Association "Clinical Mental Health Counselor Declaration" which states, “I will advocate for the betterment of others, for equality, inclusion, and the intrinsic dignity and the inherent rights of every person, and for the advancement of health and well-being.”  AMHC Hippocratic Pledge

Research demonstrates ethical efficacy, when these standards and approaches are intentionally implemented. For example, studies have shown significant symptom improvement in psychotherapy for people of color with PTSD when culturally informed practices are implemented (Wiedemann et al., 2020).

The Path Forward

Addressing tokenism in mental health and psychedelic medicine requires a systemic shift toward authentic collaboration and ethical responsibility. By fully embracing ethical models of care and fostering meaningful engagement with communities of color, researchers can pave the way for equitable access to mental health resources, education, and treatment.

Ultimately, the goal is not just to engage marginalized communities in research but to empower them with knowledge, agency, and access to healing practices that honor their experiences and identities. Only then can we truly begin to dismantle the barriers of tokenism and build a future of equitable care.

Fanicy Sears, LPC-S, LMFT, NCC

Clinical Director

eMotion Therapy, LLC