By Gregory Loewen, DO, FCCP 

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

Our office offers ketamine-assisted psychotherapy (KAP), which combines ketamine administration with psychotherapy to address trauma-related illness. KAP may involve a quick intramuscular injection or a sublingual (under-the-tongue) lozenge, depending on the client’s preference. KAP’s central purpose is 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. Grounded in the understanding that “it takes an experience to heal an experience,” KAP is an evidence-based approach to trauma therapy. Ketamine can induce a “non-ordinary state of consciousness” that lasts about an hour, followed by a period of brain “neuroplasticity,” creating a window of opportunity to view one’s life from a new perspective. Therapy 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 support throughout the ketamine experience. The goal is to build trust and respond appropriately if difficult emotions or memories arise. Thereafter, during the scheduled KAP appointment, the client and therapist spend a few hours together. Sessions are typically scheduled for the following day to explore the meaning of the experience. During these follow-up sessions, known as “integration,” it is common to see clients relax rigid patterns of thinking and even gain a new understanding of emotions related to traumatic experiences, which often helps translate insights into practical changes in everyday life.  

In contrast, ketamine infusion therapy, available from other providers in our community, is a medical treatment for conditions such as depression (known as major depressive disorder). During a ketamine infusion, a patient typically receives a low intravenous dose of ketamine over about 40 minutes while their vitals and overall responsiveness are monitored. A series of infusions can be administered over several weeks, sometimes followed by maintenance sessions. The treatments may include supportive conversation but usually don’t include formal psychotherapy, as the primary goal is to harness ketamine’s antidepressant effects to reduce symptoms of depression. By affecting the brain’s glutamate system, ketamine has been shown to relieve symptoms of major depression when traditional antidepressants have failed. In patients with treatment-resistant depression, improvement may occur within hours or days.  

These two approaches differ in intent. Infusion therapy focuses primarily on ketamine’s pharmacological effects to correct brain chemistry. In contrast, KAP focuses on healing trauma-related illness through experiential therapy. Both therapies should be delivered by appropriately trained professionals in settings with appropriate monitoring and follow-up. Nearly one million people in the United States suffer from depression that is unresponsive to medication. 
Gregory Loewen, DO, FCCP, is a physician specializing in KAP therapy. To contact him, call 509-844-8476 to schedule an evaluation. Learn more at www.gregoryloewen.com.