Ketamine-Assisted Psychotherapy for Depression: A Survey of Current Practices, Rationales, and Future Directions

Area of Science:

• Psychiatry
• Neuroscience
• Psychology

Background:

• Ketamine-assisted psychotherapy (KAP) shows promise for depression treatment by potentially enhancing antidepressant effects through neuroplasticity and psychological experiences.
• Real-world KAP practices are not well-documented despite increasing clinical application.

Purpose of the Study:

• To investigate current clinical practices among licensed KAP providers treating depression.
• To identify common administration methods, psychotherapy modalities, and treatment goals in KAP.

Main Methods:

• A cross-sectional survey was conducted with fifty licensed KAP providers in the U.S.
• Data collected included ketamine administration routes, psychotherapy techniques used, and desired treatment outcomes.

Main Results:

• Ketamine was most frequently administered intramuscularly (42%) or sublingually (40%), often at psychedelic doses.
• Psychotherapy was integrated before, during, and after ketamine administration by 74% of providers.
• Internal Family Systems (74%), humanistic/existential (62%), and supportive (58%) were common modalities, often blended eclectically.
• Treatment goals included fostering inner healing, leveraging neuroplasticity, and facilitating transformative experiences.
• No significant association was found between specific psychotherapy modalities and treatment goals.

Conclusions:

• Significant variability exists in current KAP practices.
• There is a lack of clear rationale for matching therapeutic approaches to specific outcomes.
• Further comparative clinical trials are essential to establish evidence-based standards for KAP and inform protocols for psychedelic-assisted therapies.