If you have done therapy before, maybe a lot of it, and you still feel stuck, this post is for you. I added ketamine-assisted psychotherapy (KAP) to my practice to add another method of helping people who had already done real work and had not been able to move. It is not perfect and it is not magic. It is a growing, promising option, and I want to tell you what it looks like.
What KAP is
KAP pairs a customized dose of ketamine with psychotherapy. It has three parts: preparation, a dosing session, and integration.
- Preparation. We talk about what you want to be different, what’s getting in the way, and how to set the intention for dosing session.
- Dosing. You take the ketamine and spend time with whatever comes up with my help.
- Integration. We process your journey with the dosing session and how to integrate that into daily life.
At Discovering Self Group, the ketamine is a quick-dissolving lozenge that you take yourself, with a chaperone present that you choose. Afterwards, many people describe feeling more detached from their usual thoughts and worries for a while. For some that feels calm. For others it feels strange. Most people find it manageable with good preparation. For most clients KAP includes has 6-8 dosing and integration sessions over the course of several weeks.
Why I added it as an option
I have worked with clients who used KAP in several forms, and I have seen mostly positive results. They had more distance from old traumas and from the feelings attached to them. They were kinder and more accepting toward themselves. And they got unstuck, which is the description I heard most. The change was most dramatic with clients living with complex PTSD who had struggled for years to make progress.
That made me want to learn more. So, I trained in KAP, went through the treatment myself, and partnered with a medical team I trust. While there is more to learn, the more clinicians use KAP, the more we learn about who it helps and how, and that is important to me. This isn’t a fever to be brought down trauma, depression, anxiety and other mental health challenges are complex and don’t fit in simple boxes and treatments.
What the research says
Ketamine has been studied for depression for more than 20 years. A small 2006 trial found that a single dose lifted symptoms in people with treatment-resistant depression within hours (Zarate et al., 2006). Since then, the field has grown. A version of the drug, esketamine, is now FDA-approved for treatment-resistant depression, and in January 2025 it became the first approved as a standalone treatment for adults who had not responded to at least two antidepressants (Johnson & Johnson, 2025).
Studies of ketamine combined with therapy are newer, and the early results are encouraging. In one large review of 1,806 adults treated with ketamine and psychotherapy, depression, anxiety, and PTSD symptoms improved at three months, and the gains were still there at six (Field Trip Health study, 2023). Other reviews of the research conclude that combining ketamine with therapy can reduce depression, anxiety, and pain, and that benefits may last longer when therapy happens before, during, and after dosing (Drozdz et al., 2022).
Not every study is a slam dunk, and I will not pretend otherwise. Many of these studies had no control group, and some were funded by ketamine providers. A recent review found KAP did not yet clearly beat comparison treatments in the few controlled studies available (KAP systematic review, 2026). That is what an emerging treatment looks like. The research is moving, and I will keep sharing what I learn.
How it works here
I provide the psychotherapy. Journey Clinical, my medical partner, handles the medical evaluation and prescribes the ketamine if KAP is right for you. Journey operates in Florida, Oregon, and Washington, so KAP at DSG is available to clients in those states. In-home sessions are coming soon for people in and around Celebration, Florida.
Because ketamine is FDA-approved as an anesthetic and not for mental health, the FDA has urged caution with compounded products and unmonitored use (FDA, 2023). That is why every client is screened medically and why we plan the setup carefully.
Who is a good fit?
No treatment is effective or right for everyone - KAP is no different. It may be a good conversation to have if:
- You have been through therapy before and still feel stuck.
- You are open to treatments that step outside the traditional therapy box.
- Depression, anxiety, trauma, or grief has stayed heavy for a long time.
- You want to heal but are not ready to dive into the details of what happened, or you do not want to at all.
That last one matters to me. Many people avoid therapy because they assume it means retelling the worst moments of their lives. KAP does not require that. You also do not need to be in ongoing therapy with me. KAP can be the only work we do together.
As a friend of mine likes to say, your mileage may vary. For some people KAP is a turning point. For others it helps a little. I would rather tell you that up front and then work with you to find out.
Taking the next step
The first step is a conversation. We can talk about what you are hoping for and whether KAP seems worth exploring. If it does, Journey's team will complete a medical evaluation to decide whether it is safe for you.
Schedule a time to talk with me: Click here to schedule a consultation
If you are a provider who would like to refer a client, please call or email.
This post is for general information and is not medical advice. KAP is not right for everyone, and a medical evaluation is required before treatment. If you are in crisis, call or text 988.
References
- Zarate CA Jr, Singh JB, Carlson PJ, Brutsche NE, Ameli R, Luckenbaugh DA, Charney DS, Manji HK. (2006). A randomized trial of an N-methyl-D-aspartate antagonist in treatment-resistant major depression. *Archives of General Psychiatry*, 63(8), 856-864. https://pubmed.ncbi.nlm.nih.gov/16894061/
- Johnson & Johnson. (2025, January). U.S. FDA approves SPRAVATO (esketamine) CIII nasal spray as the first and only monotherapy for adults with treatment-resistant major depressive disorder.
- 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 single-arm retrospective effectiveness trial. (2023). Preprint, *medRxiv*. Not peer reviewed. https://www.medrxiv.org/content/10.1101/2023.01.11.23284248v3
- Drozdz SJ, Goel A, McGarr MW, et al. (2022). Ketamine assisted psychotherapy: A systematic narrative review of the literature. *Journal of Pain Research*, 15, 1691-1706.
- Effectiveness of ketamine-assisted psychotherapy as a treatment for treatment-resistant depression: a systematic review. (2026). PubMed ID 41652217. https://pubmed.ncbi.nlm.nih.gov/41652217/
- U.S. Food and Drug Administration. (2023, October). FDA warns patients and health care providers about potential risks associated with compounded ketamine products, including oral formulations, for the treatment of psychiatric disorders.
- Journey Clinical. What is ketamine? https://www.journeyclinical.com/resources/what-is-ketamine