The integration of psychedelic substances into modern Western therapeutic practice has sparked a critical examination of many topics including: efficacy of psychedelics to treat mental health diagnoses without psychotherapeutic intervention, what models of therapy to use, and ethical implications related to altered states of consciousness. Of utmost concern are issues of power dynamics leading to incidents of sexual abuse. These issues underscore the importance of understanding therapeutic dynamics within the context of psychedelic-assisted therapy. This paper aims to explore these intersections, (...) addressing sexual abuse issues in Western psychedelic-assisted therapy while elucidating pathways towards ethical practice and regulatory frameworks. (shrink)