A Blueprint for Implementing Ketamine-Assisted Psychotherapy in Palliative Care: Design, Process, and Treatment...

Area of Science:

• Palliative Care
• Psychiatry
• Pharmacology

Background:

• Psychospiritual distress (PSD) significantly impacts individuals with serious illnesses, with limited effective treatments.
• Preliminary research suggests psychedelic-assisted psychotherapy (PAP), including ketamine-assisted psychotherapy (KAP), may alleviate anxiety, depression, and existential distress.
• Clinical frameworks for integrating PAP/KAP into palliative care are scarce.

Purpose of the Study:

• To describe the development, implementation, and clinical experience of Pal-KAP, a safety-centered and equitably accessible KAP program within outpatient palliative care.
• To provide a practical blueprint for other institutions seeking to implement similar programs.

Main Methods:

• Detailed program design: team, operations, patient selection, consent, session structure, safety, and financial models.
• Summarized patient characteristics and treatment patterns over 28 months.
• Included illustrative clinical vignettes.

Main Results:

• 59 patients screened, 30 participated in the Pal-KAP program (May 2023-September 2025).
• Patients (mean age 53) received a median of 1.5 ketamine sessions (0.93 mg/kg IM).
• Minor adverse effects (anxiety, headache, nausea) were reported; no serious adverse events occurred.

Conclusions:

• This study represents the largest published cohort of KAP in an academic palliative care setting.
• The Pal-KAP program demonstrates that KAP can be delivered safely and ethically.
• The findings offer a practical model for addressing psychospiritual distress in palliative care.