Ketamine-Assisted Psychotherapy (KAP)

KAP Phases and Components 

• Preparation: The KAP process begins with preparation. The therapist and client review the treatment process, discuss expectations and intentions, begin planning for integration, and talk through ways to respond if the experience becomes challenging. Preparation may also cover mindset and setting, potential effects of ketamine, and the role of the KAP therapist. The number of preparation sessions varies by client. 

• KAP Session: During a KAP session, the role of the therapist changes from a more directive stance to a supportive, following stance.  Because patients in a NOSC may have access to challenging and meaningful insights that are important for their long-term healing, this stance seeks to ensure that whatever insights arise during the session arise solely from the patient’s perspective and not the therapist’s.

The therapist helps facilitate the patient entering into a NOSC and provides support for challenging emotional and somatic experiences that may arise.  As the patient is emerging from the NOSC, the therapist meets them with warm support and waits for the patient to engage the therapist as they are able and responds in non-directive ways that help the patient consolidate and collect the insights, feelings, and somatic experiences from their journey.  During this phase of the KAP session, patients are encouraged to stay thoughtfully engaged with their experience and may talk with the therapist, journal, do art therapy, or engage in gentle movement or breathwork.  

• Integration: After the acute effects of ketamine have resolved, the client and therapist can meet for integration. These sessions provide time to reflect on the treatment experience, consider thoughts or emotions that arose, revisit the integration plan developed during preparation, and identify topics that may warrant further therapeutic attention. Integration may also help clients consider how the experience relates to their goals, routines, relationships, coping strategies, or ongoing mental health care. The number of integration sessions varies by client and clinical need.
   

Benefits 

• Helps prepare patients for managing the challenges of NOSC 

• Provides a framework for integrating cognitive, emotional, and somatic experiences 

• Supports reflection on lifestyle changes that may align with the patient’s goals

• Provides space to explore thoughts, emotions, and experiences that may arise during treatment

• Assists patients with developing a positive and growth-oriented mindset 

• Supports planning for future treatment and ongoing care

Is It Safe? 

Ketamine has known risks and is not appropriate for everyone. Screening, clinical supervision, and monitoring are used to help determine whether treatment may be appropriate for an individual. In addition, psychotherapy, including KAP, can create short term discomfort as the patient begins to engage with painful thoughts, feelings and experiences.  A thorough medical and psychological evaluation is necessary before beginning KAP. 

Who Might Benefit? 

KAP may be considered for patients receiving ketamine treatment who would benefit from additional therapeutic preparation, support during treatment, or structured integration afterward.

It may also be helpful for patients who have concerns about experiencing non-ordinary states of consciousness, who do not have a current psychotherapist, or who have limited access to supportive resources.