Ketamine-Assisted Psychotherapy & Support

These materials and related websites do not constitute or replace medical advice from your licensed medical provider.

Psychedelic Cognitive Behavioral Therapy: On Ketamine, Context and Competencies in “Assisted-Psychotherapy”

There are many tools to help a psychotherapist help clients learn to speak the language of cognitive behavioral therapy, especially tools which may help facilitate therapeutic alliance, including, but not limited to telehealth.

Psychedelic Institute of Mental Health & Family TherapyPlanetMedicines

Ketamine was FDA approved for use in humans and animals in 1970, as a dissociative anesthetic at very high doses. Ketamine may be prescribed off-label by medical clinicians who specialize in this medicine’s sub-anesthetic doses for mental health and pain management in collaboration with a mental health provider specializing in psychedelic-assisted psychotherapy.

"Because ketamine is used as an elective treatment for a non–life-threatening condition (ie, pain), it is prudent to heed these relative contraindications and precautions, even though the likelihood of complications is low."

• Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Chronic Pain From the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, and the American Society of Anesthesiologists (Cohen, et al, 2018)

Considering Ketamine

Ketamine-assisted psychotherapy may be prescribed by a knowledgeable medical provider and referred to a psychedelic mental health practitioner or other types of practitioners of the body, mind, heart and spirit in a way that makes sense to you and your experience. Learning to integrate psychedelic experiences for improved mental health and well-being in your daily life is how psychedelic-assisted psychotherapy brings these transformative substances and experiences to the wider population, incorporating a bio-psycho-social-spiritual approach.

Routines keep you alive, until they turn into ruts. Rituals of introspection and inward journeying may lead towards transformation, especially when paired with informed care and community support. Approaching this medicine work with careful intention, screening, medical clearance, and multi-modal clinical and social support is how we strive to maximize this medicine’s benefits for as many people as possible who’ve yet to find relief with other medicine practices or approaches.

Finding the minimal amount of medicine and dose needed for the most amount of improved quality of life is key. The medical provider will decide the setting — whether in an office being monitored, or at home with a sober sitter of your choice.

Preparation and integration continues to be provided via telehealth, in-home or on-location

Supervised practicums for chaplains, ketamine therapists, ketamine sitters, hospice providers, medical providers, shamanic practitioners which include 6-12 medicine experiences, scholarships & work study available.

At very low doses ketamine is sub-perceptual. At moderate doses it is used in psycholytic therapy where the client is communicating with a therapist. At doses considered in the psychedelic, yet still sub-anesthetic range, people report a meditative state with a range of experiences from terrifying to mystical, that, when properly prepared for, supported, and integrated, can lead to a marked change in quality of life.

These experiences happen with a variety of medicines and other types of practices from around the world, throughout human history, but generally not without some sort of supportive wisdom approach. One system of support is through psychotherapists trained in psychedelic-assisted psychotherapy. Another system of support of these experiences are through curanderos, taitas, sangomas, and other types of cultural practitioners, although these types of practitioners aren’t usually working with ketamine.

Ketamine for mood disorders, anxiety, and suicidality in children and adolescents: a systematic review - PubMed

Mood disorders, anxiety, and suicidality in youth are increasing and rapid-acting treatments are urgently needed. One potential is ketamine or its enantiomer esketamine, which was FDA approved in 2019 to treat major depressive disorder with suicidality in adults. This systematic review evaluated the …

PubMedAlisha M Bruton

Ketamine for mental health - A naturalistic inventory of prescribing practices, safety, and adverse effects

Ketamine is an NMDA receptor antagonist, long used for its anesthetic and pain reducing properties, but has more recently demonstrated efficacy for treating depression. Evidence is also emerging for other psychiatric indications including posttraumatic stress disorder, anxiety disorders, obsessive compulsive disorder, and to support psychotherapy. In this context, there is greater demand for its use in various forms including intravenous, intramuscular, subcutaneous, intranasal, oral, and sublingual administration. While intravenous administration typically requires administration and monitoring in a healthcare setting, the safety precautions for other forms of ketamine are unclear. Limited data in this regard may elicit controversy among prescribers, who wish to improve patient access, and among regulatory bodies, who may impose limitations based on IV ketamine data. This project aims to bridge the gap between current literature and the clinical experience and opinions of ketamine prescribers. This information was obtained in the form of a survey and answered: “How do prescribers of ketamine, with emphasis on psychiatric care providers, find its safety profile and in what ways have they prescribed ketamine?” Information was gathered on prescriber profiles, indications for ketamine use, doses and routes of ketamine prescribed, side effects and adverse events, and prescribers’ opinions regarding monitoring requirements. Results were obtained from 45 providers with more than 1000 patient encounters over two countries. Non-IV forms of ketamine were commonly used, and the survey reported a favorable safety profile for ketamine. Non-IV Ketamine was reported to be safely utilized in a clinic setting with minimal monitoring and safety equipment, or at times, for home use. While survey results carry limitations, it appears that safety is dependent on dose and route, and strict universal regulations for all formulations may unnecessarily limit patient access.

PLOS Mental HealthMaegan Stuart,

Physician Consultation

KETAMINE-ASSISTED PSYCHOTHERAPY IS A PROCESS THAT BEGINS WITH REFERRAL FROM A MEDICAL PROVIDER

Psychedelic-Assisted Psychotherapy — Rates, Referrals & Registration

Psychotherapy via telehealth from the Psychedelic Institute of Mental Health & Family Therapy is available for residents of CA, NY, UT and VT. Local appointments available in the Greater Palm Springs | Joshua Tree area.

Psychedelic Institute of Mental Health & Family TherapyPlanetMedicines

Ketamine - “psychedelic” or “dissociative”? Experts weigh in

Closed caption (no audio) from a recent Harvard Medical School training on psychedelic medicines. Read what this panel has to say on the problematic categorization of ketamine as a “dissociative anesthetic”. Ronald D. Siegel, PsyD: When we talk about the dissociative aspect of ketamine, what are we dissociated from? What

Psychedelic Institute of Mental Health & Family TherapyMichael DeMarco, PhD

Ketamine Cost Considerations & Comparisons

IV Ketamine Infusion Clinic

• 40 minute medicine session
• est cost $500-$1500 per session, not covered by insurance
• may or may not have a mental health specialist as part of treatment

Ketamine-Assisted Psychotherapy & Support - 18 hours - $3,150.00 (Institute rate)

• Preparation and Goal Setting for Treatment with psychotherapist (1 hour)
• 2.5 hour medicine sessions
• 1 hour integration session (within 4 days of the medicine session)
• possible insurance reimbursement for preparation & integration sessions *Outside Medical Visit + Pharmacy are outside cost considerations
  • Racemic ketamine is an FDA approved generic medicine that has been prescribed off label for myriad uses ranging from mood disorders to pain management, and has been studied nonstop for over 60 years. Your medical provider prescribes your medicine, after a thorough medical / psychiatric assessment. Your PCAB-accredited compounding pharmacy will dispense your medicine to you. Talk to your medical provider about a Referral or check out one of the independent psychedelic practitioners listed here.

Psychedelic-Assisted Psychotherapy — Rates, Referrals & Registration

Psychotherapy therapy, support, and case management via telehealth from the Psychedelic Institute of Mental Health & Family Therapy

Psychedelic Institute of Mental Health & Family TherapyMichael DeMarco, PhD

Compare to one psilocybin session, upwards of $2500 for a single dose, delivered without mental health or medical support (Oregon model)

Cost Considerations in Psychedelic Therapy

As a psychotherapist practicing for over 23 years, I’ve found this work comes with the responsibility of educating and advocating for cost-transparency and fair pay. Psychedelic-assisted psychotherapy with mental health specialists might be with one therapist, or a second therapist during the medicine session. One or both of those

Psychedelic Institute of Mental Health & Family TherapyMichael DeMarco, PhD

Ketamine ameliorates post-traumatic social avoidance by erasing the traumatic memory encoded in VTA-innervated BLA engram cells (LI, et al, 2024)

Post by @PsychedelicInstitute@mastodon.social

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Ketamine-Assisted Psychotherapy Provides Lasting and Effective Results in the Treatment of Depression, Anxiety, and Post-Traumatic Stress Disorder at 3 and 6 Months: Findings from a Large Retrospective Effectiveness Study (Yermus, et al, 2024)

At-home, telehealth-supported ketamine treatment for depression: Findings from longitudinal, machine learning and symptom network analysis of real-world data (Mathai, et al, 2024) — over 11,000 patients followed over multiple years is largest real-world study of ketamine therapy to date.

At-home, telehealth-supported ketamine treatment for depression: Findings from longitudinal, machine learning and symptom network analysis of real-world data - PubMed

At-home, telehealth-supported ketamine administration was largely safe, well-tolerated, and associated with improvement in patients with depression. Strategies for combining psychedelic-oriented therapies with rigorous telehealth models, as explored here, may uniquely address barriers to mental heal …

PubMedDavid S Mathai

Patient preference effects in a randomized comparative effectiveness study of electroconvulsive therapy and ketamine for treatment resistant depression: An ELEKT-D trial secondary analysis - PubMed

Our findings suggest treatment preference-matching affects treatment effectiveness, adverse event reporting and possibly adherence. However, these associations may be contextual, modality dependent, and complex.

PubMedGerard Sanacora

You are not REQUIRED to take this medicine, or ANY medicine, for that matter. Our team is here to support you in minimizing any harm that may come from medicines, practices and experiences that may evoke an altered state of consciousness, and maximize any potential benefits.

The goal of mental health counseling is to restore some sense of balance in your mental health and personal well-being without relying on a daily pharmaceutical treatment.

A harm reduction model supports the least amount of medicine for the most amount of observed benefit paired with psychotherapy to maximize any positive effects, and reduce the likelihood of harm.

Your dosing may depend on the route of administration.

Ongoing collaboration with your medical team and compounding pharmacy helps reduce the likelihood of misuse or abuse of medicines.

Ketamine Harm Reduction

Ketamine prescribed off label is a legal possibility for some use cases. Your medical provider and pharmacist will discuss the various indications and risks involved. Talk to your independent medical provider to see if you might be a candidate for medicine in conjunction with psychotherapy.

Psychedelic Institute of Mental Health & Family TherapyMichael DeMarco, PhD

Spotlight: On “Rare but relevant: Ketamine-induced cystitis - an in-depth review for addiction medicine” (Abdelrhamen, et Belal 2025) and psychedelic harm reduction psychotherapy, support

Rare in ketamine use disorder. Rarer still in ketamine psychedelic assisted psychotherapy as prescribed by your medical provider with support from a mental health specialist, supportive cognitive behavioral therapy approaches to mental health, recovery and harm reduction.

Psychedelic Institute of Mental Health & Family TherapyMichael DeMarco, PhD

Psychedelic Therapy: Does the psychedelic experience matter?

Psychedelic medicines have been studied in the Western medical literature consistently for over 100 years, over 60 of which in the ongoing study and practice of racemic ketamine. Psychedelic experiences are described similarly and often felt as profoundly meaningful.

Psychedelic Institute of Mental Health & Family TherapyPlanetMedicines

Ketamine + Couples (Relational) Therapy

Psychedelic ketamine is being used in relationship counseling, couples counseling, marriage therapy, family therapy and group therapy

Psychedelic Institute of Mental Health & Family TherapyPlanetMedicines

Ketamine Group Therapy

Community is such an important aspect of the integration process. Group therapy can be a cost-effective way to build on what you’ve started with the medicine and individual integration with psychotherapy. Group members will be accessing their ketamine treatments along the same arc together over 8 weeks.

Slouching towards engagement: interactions between people using psychedelics naturalistically and their healthcare providers - PubMed

Our results show that psychedelic use is generally disconnected from primary and psychiatric clinical care. This disconnection may result in safety issues, including inadequate screening for contraindicated conditions, lack of support during emergent adverse events, and drug interactions. Enhanced c …

PubMedKevin F Boehnke

Racemic Ketamine has been studied in humans and animals since 1962, and was FDA approved in 1970. — Psychedelic Institute of Mental Health & Family Therapy

Psychedelic Institute of Mental Health & Family TherapySkip to Content

Ketamine - “psychedelic” or “dissociative”? Experts weigh in

Closed caption (no audio) from a recent Harvard Medical School training on psychedelic medicines. Read what this panel has to say on the problematic categorization of ketamine as a “dissociative anesthetic”. Ronald D. Siegel, PsyD: When we talk about the dissociative aspect of ketamine, what are we dissociated from? What

Psychedelic Institute of Mental Health & Family TherapyMichael DeMarco, PhD

Spotlight: Ketamine’s Rapid Antidepressant Effects Mapped Brain-Wide + μ-opioid receptor?

“The deployment of mesoscale brain-wide fluctuation analysis unveils the complex, multiregional neural orchestration underlying ketamine’s rapid antidepressant effects, a blueprint for future therapeutic innovation... insights gained from this research hold transformative promise...”

Psychedelic Institute of Mental Health & Family TherapyMichael DeMarco, PhD

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