KetamineAssisted Psychotherapy versus Ketamine infusions: What Is the Difference?

Ketamine has received growing attention as a treatment for depression and other mental health conditions, particularly when conventional antidepressant medications have failed to provide adequate relief. However, the terms “ketamine infusion therapy” and “ketamine-assisted psychotherapy” (also known as “KAP”)  describe two distinct approaches.

Our practice offers Ketamine-assisted psychotherapy, or KAP,  which combines ketamine administration with psychotherapy as an approach to trauma-related illness. In our practice KAP  may mean a quick intramuscular injection, or it may be given as a sublingual (under the tongue) lozenge, depending on the client preference. The central purpose of KAP is therapy as a kind of self-exploration.  Although vital signs (blood pressure, pulse oximetry) are measured before and after ketamine administration, KAP is designed to create a healing experience in a non-medical, home-like environment.  This is an evidence-based approach to trauma therapy, with the understanding that “it takes an experience to heal an experience”.  Ketamine as a drug has the capacity to create a kind of  “non-ordinary state of consciousness” that lasts for about an hour.   This effect is followed by a period of “neuroplasticity” in the brain that creates a window of opportunity to view one’s life with a new perspective.  The therapy that occurs during and after a KAP session is highly individualized because it pivots on the person’s experience.

KAP begins with careful preparation for the medication session, with attention to a sense of safety and to support during ketamine experience,  Preparation helps to create the goals for KAP, to build trust, and to learn how to respond if difficult emotions or memories arise. The actual ketamine experience is scheduled for later. When the KAP experience takes place,  the client and therapist are together for a few hours. Typically on the day after KAP, follow-up sessions begin, to explore the meaning of the experience.  These follow up sessions are known as ‘integration’. After a KAP session, it is common to see clients relax rigid patterns of thinking, and even to find a new understanding of emotions around traumatic experiences.  Integration sessions often help translate insights into practical changes for everyday life.

In contrast, Ketamine infusion therapy is available from other providers in our community. Ketamine infusions are conceived of as a medical treatment for things like depression. With ketamine infusion, a patient typically receives a low dose of ketamine intravenously over approximately 40 minutes while blood pressure, heart rate, oxygen level and overall responsiveness are monitored. Treatment often consists of a series of infusions administered over several weeks, sometimes followed by maintenance sessions. Ketamine infusion treatments may include supportive conversation, but formal psychotherapy is not necessarily part of the ketamine infusions.

The principal goal of infusion therapy is to harness ketamine’s antidepressant effects to reduce the symptoms of depression. Ketamine affects the brain’s glutamate system and  has been documented to relieve the symptoms of major depression, even when traditional antidepressants have failed.  In some patients with treatment-resistant depression, improvement may occur within hours or days. IV ketamine is a well-established method of treating major depressive disorder (MDD).

These two approaches differ in their intention. Infusion therapy focuses mainly on ketamine’s pharmacological effects, in order to correct brain chemistry. In contrast, the focus of KAP is to heal trauma-related illness as a form of experiential therapy.  Both types of therapy should be delivered by appropriately trained professionals in a setting with suitable monitoring and follow-up.