Ketamine-Assisted Psychotherapy in Outpatient Psychiatry

Background: In the 1960s, researchers developed ketamine as a surgical anesthetic. More recently, the medical community has recognized ketamine as a mental health treatment separate from the indications of pain management or anesthesia. Subanesthetic therapeutic ketamine falls into the frameworks of 1) stand-alone treatment as seen in ketamine infusion clinics and 2) part of a defined therapeutic process known as ketamine-assisted psychotherapy (KAP). The rapid rise in infusion clinics and individuals considering ketamine treatment positions mental health providers to influence the framework chosen by the patient and to offer outpatient KAP. Lack of knowledge about stand-alone ketamine and KAP is a barrier to the mental health community referring to or offering ketamine treatments. Methods: At an outpatient counseling and psychiatry practice in Salt Lake City, clinicians participated in an educational module about ketamine and KAP. Before and after the module, the clinicians completed questionnaires about knowledge, comfort recommending ketamine to patients, and willingness to incorporate KAP into their current practice. An informal discussion followed the education. Three weeks later, key stakeholders met to receive and review a toolkit for adding KAP services to their outpatient practice. Results: According to pre-and post-questionnaires, clinicians' knowledge increased on the difference between stand-alone ketamine and KAP. Clinicians' willingness to incorporate KAP services into current practice increased from 80% to 100%. Topics explored in the informal discussion included how to receive training in KAP, how the client gets the ketamine (pharmacy vs. in-house), and financial feasibility for the clinic and patients. In post-toolkit development meetings, stakeholders indicated that the education module combined with follow-up discussions made it feasible to add KAP services to their current practice. Post-intervention, one provider enrolled in KAP training. Conclusions: Education on ketamine and KAP increased one outpatient mental health clinic's clinician knowledge base and willingness to add KAP services. Outpatient mental health practices benefit from having someone trained in KAP assist them in understanding ketamine and how to add KAP services to their current practice.