Should You Try Ketamine-Assisted Psychotherapy? A Clinical Psychology Podcast Episode.

Over the past few years I’ve noticed something in people interested in clinical psychology that I didn’t expect. More and more people are coming up to me at university Open Days asking about ketamine-assisted psychotherapy and whether universities offer any education on this form of psychological therapy. When I used to work at the University of Kent, talking to, guiding and supporting Open Days, I would explain that we didn’t and I would pass these questions over to the academics. Yet people are still becoming more interested in ketamine-assisted psychotherapy and it is only going to become more popular over time. Therefore, in this clinical psychology podcast episode, you’ll learn how does ketamine-assisted psychotherapy work all over the world, should you try ketamine-assisted psychotherapy and a whole bunch of other great topics. If you enjoy learning about mental health, new forms of psychotherapy and advances in psychology then this will be a great episode for you.

Today’s psychology podcast episode has been sponsored by Biological Psychology. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca.

Introduction Ketamine-Assisted Psychotherapy

Even if you haven’t been paying much attention to the use of ketamine in clinical psychology circles, you might be aware that it is interestingly being used in a wide range of health settings. Up until March 2019 though, it was only really used as an anaesthetic. Yet in March 2019, the United States’s FDA (Food and Drug Administration) approved the use of ketamine for the treatment of severe depression. Also, it is worth noting that the media loves to talk about ketamine from time to time.

The drug, ketamine, was developed in 1962 because it’s a tamer alternative to the hallucinogen PCP, so its psychoactive effects have been known for decades. The use of ketamine can lead to alterations in thoughts, mood, sense of bodily boundaries as well as meaning. It can lead to perceptual distortions too. Knowledge about these effects have also been confirmed by the less than 1% of Americans that use the drug recreationally.

In terms of research into ketamine’s uses for mental health conditions, this started in the mid-2000s because researchers started to notice that it can have very strong positive impacts on people with depression. This led to the US’s National Institutes of Mental Health to affirm that ketamine is effective as an anti-depressant and medical professionals have even started to recommend ketamine to severely suicidal clients. Then in 2010, Americans started to see the first wave of ketamine clinics pop up around the United States.

How Does Ketamine-Assisted Psychotherapy Work In The United Kingdom?

I always like to look at the cross-cultural context when I can. Therefore, in the United Kingdom, according to the Oxford Health NHS Foundation Trust website, ketamine can be an anti-depressant but it isn’t licensed for this use by the National Health Service. This is mainly because the cost of ketamine to the NHS instead of there being a lack of evidence on its effectiveness. Although, it is possible to get self-paid ketamine service but this is only really available to people with depression who have not responded to other forms of psychological treatments. This costs at least £3,000 per year and the NHS uses this money to fund NHS care in the Trust.

After an initial assessment, the initial treatment consists of three to six ketamine infusions over a three-to-six-week period. 10% of clients have a negative experience with their first infusion whereas over 90% have a pleasant or neutral experience, and 50% of clients respond well as well as continue with their treatment.

Finally, like all anti-depressant treatments, ketamine needs to be used for several years regularly in order to effectively treat severe depression.

How Does Ketamine-Assisted Psychotherapy Work In China?

As an afterthought by me, ketamine-assisted psychotherapy works in China similar to how it works in the United Kingdom and United States. The rest of this podcast episode also applies to China to in terms of effectively, what a typical session looks like and how it works. China uses it similar to the West in terms of treatment for severe depression and severely suicidal clients and they mainly use it at hospitals and other treatment clinics throughout the country under the supervision of healthcare professionals. There isn’t a great difference between how the West and China use ketamine to treat mental health conditions.

How Does Ketamine-Assisted Psychotherapy Work In Australia?

In Australia, a quick internet search reveals that ketamine-assisted psychotherapy seems to be much more widespread and privatised with a wide range of healthcare settings offering ketamine treatment for depression in a range of different ways. Yet the website of the Royal Melbourne Hospital explains that the clinic provides a 3-week course of low-dose intravenous ketamine treatment for clients with severe depression. Nonetheless, this treatment is only available for people who are seeing mental health services or are currently “engaged with a psychiatrist who is overseeing their care”.

In other words, you cannot simply go to the hospital or clinic and say you want ketamine-assisted psychotherapy without a referral from a psychiatrist.

How Does Ketamine-Assisted Psychotherapy Work In Brazil?

Brazil mainly uses the global approach to ketamine that all the other countries, like the United States, China, United Kingdom use. Yet Brazil uses ketamine-assisted psychotherapy in hospital-based mental health services because they administer ketamine for treating severe depression under strict medical supervision with standard monitoring. Even though, there is a problem in Brazil because as much as they would ideally like to combine ketamine and psychological therapy for their clients. This cannot always happen, because the distribution of trained psychologists and other mental health professionals is so uneven in the country.

In addition, when research is conducted into ketamine in Brazil, university and academic trials

commonly use intravenous or intramuscular administration with hospital oversight.

Finally, similar to the United States and Australia, Brazil uses ketamine-assisted psychotherapy in private outpatient clinics where they typically combine medication sessions with psychological therapy and assessment. Even though, the formality of the psychotherapy really does differ between providers.

How Effective Is Ketamine-Assisted Psychotherapy?

Building upon this in more depth, a wide range of studies show that ketamine is an effective treatment for severe depression (Marcantoni et al., 2020) and it can be useful for other mental health conditions. For example, Post-Traumatic Stress Disorder (Stein and Simon, 2021), anxiety disorders (Tully et al., 2022), Obsessive-Compulsive Disorder (Rodriguez et al., 2013) and Parkinson’s disease.

However, as you can probably imagine, the effects of ketamine are greatly improved if a client works alongside a therapist before, during and after ketamine treatment. This led to the creation of ketamine-assisted psychotherapy.

How Does Ketamine-Assisted Psychotherapy Work?

As I explain in my podcast episode titled “How can psychotherapy be combined with ketamine?” from 2023. “Ketamine engages the neurotransmitters glutamate and GABA. Due to N-methyl-D-aspartate (NMDA) is a glutamate receptor and ketamine effectively blocks NMDA receptors from action so this allows more glutamate to be present in the synapses of a client (Furikawa et al., 2005). Therefore, with glutamate being an excitatory neurotransmitter and GABA being an inhibitory neurotransmitter, the client’s other neurotransmitters can reach an optimal homoeostasis. Then this leads to a reduction in depression and anxiety symptoms as it decreases hyperarousal as well as rumination.

As a result from a psychotherapist’s perspective, this allows them to focus on the underlying events that are causing the client’s affective and cognitive dysfunction with a client that is calmer and more able to focus constructively on finding better ways to effectively manage their condition.”

Is Ketamine Addictive?

Generally, no, ketamine is not an addictive substance because in the United States, it is classed as a Schedule III controlled substance. It is a hallucinogen and anaesthetic, so it doesn’t produce chemical dependence. Yet there are some people who report cravings for the feelings and sensations that ketamine gives them.

Personally, I would like to remind people that as a side note, addiction is a treatable condition and if you or anyone you love is experiencing any kind of addiction then it can be useful to reach out to mental health professionals.

What Does A Typical Ketamine-Assisted Psychotherapy Session Look Like?

Earlier in the podcast episode when I was exploring how different countries deal with ketamine-assisted psychotherapy, you were able to see that it really does differ between the providers to some extent. Yet the core basis of ketamine treatment is that you will meet with a medical professional and they will work with you to determine dosage, your eligibility as well as a method of administration. Since ketamine can be given to you intramuscularly, intranasally, sublingually and intravenously.

In case, like me, you are not aware of not what sublingually means. It is the process of you being given ketamine under the tongue.

Personally, for me, the idea of anything going up your nose, like a tube or spray, is just awful and I would hate that. That was probably because I was on life support as a baby and I almost died within the first three weeks of being born. And intravenously doesn’t sound great either.

This is important to note because depending on the dosage and the method used your treatment can last about one and three hours per session.

Moreover, because ketamine is classified as a “dissociative anaesthetic”, so you can dissociate and disconnect from your body and your normal reality, depending on your dosage, you are likely to experience these effects. You might experience mild or severe anaesthetic, anxiolytic as well as anti-depressant effects. This is why a trained psychotherapist will support you throughout your treatment.

After the ketamine has worn off, you would complete an integration phase with your therapist and this might include journalling, somatic, art or dance therapy or verbal reflection or something else entirely. This integration section is flat out critical because it helps you to process new insights and any new information that you learnt through your ketamine experience.

Who Doesn’t Benefit from Ketamine-Assisted Psychotherapy?

If you’re pregnant or nursing people or you have a history of addiction and/ or psychosis or untreated hyperthyroidism or hypertension then you should not do ketamine-assisted psychotherapy.

Who Would Benefit From Ketamine-Assisted Psychotherapy?

People with a range of mental health conditions like anxiety, severe depression, chronic pain and PTSD can benefit from ketamine-assisted psychotherapy. The traditional treatment for these conditions to be have talking therapy and take an SSRI, and whilst this is useful for a lot of people, this doesn’t work for everyone. This is why ketamine-assisted psychotherapy can be very useful for people who haven’t responded well to other treatment options. Especially, because clients can see improvements in their mental health even after a single session and they can start to see massive improvements after four to six sessions.

Clinical Psychology Conclusion

Overall, at the end of this psychology podcast episode, I’m really happy, excited and pleased because I haven’t looked into cross-cultural research for ages and I miss it. I seriously enjoy looking at how different countries are similar and different from one another in how they use ketamine to treat mental health conditions. Thankfully, we were able to cover all continents on the podcast except Africa and the Antarctic. Granted, I am pretty sure the Antarctic doesn’t use psychological treatment too much.

Therefore, as a little recap, ketamine-assisted psychotherapy is shown to be an effective treatment for severe depression by a wide range of studies (Marcantoni et al., 2020) and it can be useful for other mental health conditions. For example, Post-Traumatic Stress Disorder (Stein and Simon, 2021), anxiety disorders (Tully et al., 2022), obsessive-compulsive disorder (Rodriguez et al., 2013) and Parkinson’s disease. As well as ketamine-assisted psychotherapy can be very useful for people who haven’t responded well to other treatment options. Especially, because clients can see improvements in their mental health even after a single session and they can start to see massive improvements after four to six sessions.

Here are three questions for you to consider at the end of this episode:

·       Would you ever try ketamine-assisted psychotherapy?

·       Would you ever be interested in being trained in this form of psychotherapy?

·       What do you think the future of ketamine-assisted psychotherapy is in your country?

I really hope you enjoyed today’s clinical psychology podcast episode.

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Clinical Psychology References and Further Reading

Drozdz, S. J., Goel, A., McGarr, M. W., Katz, J., Ritvo, P., Mattina, G. F., ... & Ladha, K. S. (2022). Ketamine assisted psychotherapy: A systematic narrative review of the literature. Journal of Pain Research, 1691-1706.

https://www.oxfordhealth.nhs.uk/ips/ketamine-trd/

https://www.psychologytoday.com/gb/blog/the-truth-about-exercise-addiction/202212/should-you-try-ketamine-assisted-psychotherapy

https://www.thermh.org.au/services/mental-health/our-research/advanced-interventions-in-mood-disorders

Joneborg, I., Lee, Y., Di Vincenzo, J. D., Ceban, F., Meshkat, S., Lui, L. M., ... & McIntyre, R. S. (2022). Active mechanisms of ketamine-assisted psychotherapy: A systematic review. Journal of Affective Disorders, 315, 105-112.

Marcantoni, W. S., Akoumba, B. S., Wassef, M., Mayrand, J., Lai, H., Richard-Devantoy, S., & Beauchamp, S. (2020). A systematic review and meta-analysis of the efficacy of intravenous ketamine infusion for treatment resistant depression: January 2009 - January 2019. Journal of affective disorders, 277, 831–841. https://doi.org/10.1016/j.jad.2020.09.007

Reilly-Harrington, N. A., Falcone, T., Jobes, D. A., Deisz, C., Flannery, C., Wolf, A., ... & Anand, A. (2025). Ketamine treatment in youth for fast reduction of suicidality and engagement in psychotherapy: a randomized placebo-controlled trial protocol. Contemporary Clinical Trials, 149, 107777.

Rodriguez, C. I., Kegeles, L. S., Levinson, A., Feng, T., Marcus, S. M., Vermes, D., ... & Simpson, H. B. (2013). Randomized controlled crossover trial of ketamine in obsessive-compulsive disorder: proof-of-concept. Neuropsychopharmacology, 38(12), 2475-2483.

Sholevar, R., Kromka, W., & Beaussant, Y. (2025). Ketamine and Ketamine-Assisted Psychotherapy for Psychiatric and Existential Distress in Patients with Serious Medical Illness: A Narrative Review. Journal of Palliative Medicine.

Stein, M. B., & Simon, N. M. (2021). Ketamine for PTSD: well, isn’t that special. American Journal of Psychiatry, 178(2), 116-118.

Tully, J. L., Dahlén, A. D., Haggarty, C. J., Schiöth, H. B., & Brooks, S. (2022). Ketamine treatment for refractory anxiety: A systematic review. British journal of clinical pharmacology, 88(10), 4412-4426.

Witt, K., Potts, J., Hubers, A., Grunebaum, M. F., Murrough, J. W., Loo, C., ... & Hawton, K. (2020). Ketamine for suicidal ideation in adults with psychiatric disorders: a systematic review and meta-analysis of treatment trials. Australian & New Zealand Journal of Psychiatry, 54(1), 29-45.

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