Understanding The Three Elements of Ketamine-Assisted Psychotherapy

Currently RVA Counseling is working towards integrating elements of Ketamine-Assisted Psychotherapy (KAP) into our services. In this article, we’ll be discussing the 3 main elements of KAP in order to provide structured expectations for anyone considering pursuing this treatment.

Ketamine-Assisted Psychotherapy recognizes the experiential qualities of ketamine as a beneficial support to traditional talk therapy for people struggling with depression, PTSD, as well as challenges with recurrent and ruminative thoughts like OCD and SUD. It is important to remember that ketamine serves as a tool adjunct to therapy and has lower treatment efficacy without the use of a professional therapeutic environment. Moving toward self-compassion is where so much healing lies, but it can be very difficult to rewire our way of thinking. Varying degrees of feeling removed from one’s experiences can make curiosity without self-judgment more accessible. By breaking out of our rigid thinking, having the rapid antidepressant effect of ketamine, along with production of new neural pathways, ketamine paired with therapy can be an optimal way to sustain therapeutic benefits over time. 

Eli Mick, LCSW, is seen in session with a client.

The first major element of KAP is preparation. Preparation is where the safety of KAP is established and secured. During this a medical professional will work with an individual to discuss their personal health history, any concerns that they may have, dosages, and medically clear them to participate in KAP. When a mental health professional, such as a therapist, social worker, or counselor, is a part of the process, their responsibility in preparation is about setting expectations. A piece of the mental health professionals’ role in this expectation setting includes discussing and practicing coping tools, intention setting, and preparing for potential emotional or trauma-related content to arise. This potential is why strong, therapeutic trust and rapport plays a significant part in the success of this work.

Image from https://healthjade.com/endorphins/

After the preparation stage has been wholly addressed by both a medical professional and a mental health professional, an individual can then move towards the second main element of KAP: the journey. This is where ketamine is administered by a medical professional. They will administer an established intramuscular dose to the individual or prescribe a sublingual or intranasal administration option. Once administered, an individual’s brain waves will then slow toward theta waves enabling creativity and deep intuitive insights. Additionally, the brain will release norepinephrine and dopamine, which increases heart rate and focus. It will also activate pattern recognition, helping to find new links in information. Parts of the prefrontal cortex will temporarily shut down and, as the ego is weakened, one may experience selflessness, timelessness, and effortlessness. The brain will also release endorphins and decrease pain which boosts lateral thinking and can further perpetuate seeing information in a new light.

Once the individual has gone through the ketamine journey, they will then transition to engaging with Integration, the third main element of KAP. Integration sessions take place with a mental health professional 24-48 hours after the infusion. These sessions provide a safe environment for the experiences to be processed so that new insights are not fleeting but discussed in depth to support long-term change. During the period following a psychedelic experience, individuals may be more susceptible to new ways of seeing themselves or the world, allowing for a greater exploration into old thoughts, beliefs and habits and allowing for psychological flexibility to create new ways of being. 

It is crucial to acknowledge that both KAP experiences and results are not generalized and can be experienced by individuals in many different ways. But despite this experiential variability, intentional and collaborative engagement with these three stages of KAP has the potential to aid individuals' healing journey in a significant way. If you feel that you would benefit from KAP or would like to further explore the potential benefits, please reach out to us here at RVA Counseling.

Email us at scheduling@rvacounseling.com or call us at (804) 716-0428.