Ketamine-assisted psychotherapy: who it's for and what a session is like

Ketamine-assisted psychotherapy (KAP) combines a medically supervised dose of ketamine with psychotherapy before, during and after the experience. It's mainly used for treatment-resistant depression, trauma and PTSD when other approaches haven't helped enough.

The therapy part matters. Ketamine can loosen rigid patterns for a while. Therapy is where you use that window.

What ketamine does

Ketamine is an anesthetic that has been used in medicine for decades. At lower doses, it can produce a dissociative state: a sense of distance from your usual thoughts, and sometimes from your body. Research suggests it can also support neuroplasticity, meaning the brain may be more able to form new connections for a short time afterwards.

Using ketamine for mental health is off-label, which means it's legal and prescribed by a medical provider but not specifically FDA-approved for that use. (A related drug, esketamine, is FDA-approved for treatment-resistant depression.)

Who it may help

KAP may be worth considering if you:

• Have depression that hasn't responded well to medication and therapy
• Have trauma or PTSD and feel stuck despite good therapy
• Find it very hard to access emotions or memories in talk therapy

It isn't right for everyone. Medical screening checks for things like uncontrolled high blood pressure, certain heart conditions, a history of psychosis, pregnancy and some substance use concerns.

How it works with me

I offer KAP in partnership with BetterU, which handles the medical screening and prescribing. My role is the therapy.

1. Preparation. We meet before any dosing session to talk about your goals, what to expect and how to handle anything that comes up.
2. The dosing session. You'll be in a calm, comfortable setting following your medical provider's guidance. Many people use an eye mask and music. The effects usually last under an hour.
3. Integration. This is where most of the work happens. We meet afterwards to make sense of what came up and connect it to your life and your therapy goals.

People describe the experience in many ways: dreamlike, peaceful, strange, sometimes emotional. It's rarely what anyone expects, which is one reason preparation helps.

What it isn't

KAP isn't a quick fix or a substitute for therapy. It's also not something to try on your own. The medical oversight and the therapy around it are what make it safe and useful.

Common questions

How many sessions does KAP usually involve? It varies by program and by person. Many involve a series of dosing sessions over several weeks, with preparation beforehand and integration sessions afterwards. Your medical provider and therapist will talk through a plan with you.

Will I be unconscious? No. At the doses used for KAP, people remain conscious. Many describe feeling detached from their body, dreamlike or very relaxed. Effects usually last under an hour for lozenge-based sessions.

Can I drive afterwards? No. You shouldn't drive or make major decisions for the rest of the day. You'll need a plan for getting home and someone available afterwards.

Is ketamine addictive? Ketamine can be misused, which is why medical screening, controlled dosing and monitoring matter. In supervised therapeutic settings, the risk is managed carefully. Bring any history of substance use to the screening conversation.

Can I keep seeing my regular therapist? Often yes. KAP works best when integration connects to the rest of your therapy. Read questions to ask before you start or learn about KAP with me.

When to get support

If you've been in therapy for a while and feel stuck, KAP might be worth a conversation. You can book a free 15-minute consult to talk about whether it's a fit, or read more about my provider profile on BetterU.

Start with a conversation. A free 15-minute video call to see whether we're a good fit. Questions first? Email [email protected]. Book a free consult