Ketamine-Assisted Psychotherapy for Depression: A Survey of Current Practices, Rationales, and Future Directions.
Jack H Buchanan, Brandon Reynante, Michael T Dinh, Joseph Zamaria
Journal of psychoactive drugs June 10, 2026 Peer reviewed DOI: 10.1080/02791072.2026.2685515 via PubMed
Summary
Ketamine-assisted psychotherapy (KAP) is being used to treat depression, with a survey of fifty licensed providers revealing that most administer ketamine intramuscularly or sublingually and conduct psychotherapy before, during, and after treatment. Commonly used modalities include Internal Family Systems and humanistic/existential approaches. Despite the diversity in practices, no significant link was found between the types of therapy used and treatment goals. This highlights the variability in KAP practices and the need for more structured clinical trials.
Study at a glance
| Design | cross-sectional survey |
|---|---|
| Sample size | 50 |
| Population | licensed KAP providers treating depression |
| Key finding | The study found broad variability in real-world KAP practices, with no significant association between psychotherapy modalities and treatment goals. |
Abstract
Ketamine-assisted psychotherapy (KAP) is an emerging treatment approach that may enhance ketamine's antidepressant effects through neuroplastic synergism or transformative psychological experience. Despite growing clinical use, real-world KAP practices remain understudied. This cross-sectional survey examined the practices of fifty licensed KAP providers treating depression, recruited from a U.S.-based online provider network. Participants represented a professionally diverse sample, including physicians, clinical psychologists, social workers, and other practitioners. Ketamine was most commonly administered intramuscularly (42%) or sublingually (40%), often at psychedelic-dose ranges. Most practitioners (74%) conducted psychotherapy before, during, and after ketamine administration. The most frequently used psychotherapy modalities were Internal Family Systems (74%), humanistic/existential (62%), and supportive (58%), with most practitioners employing an eclectic approach blending three to four different modalities on average. The most commonly endorsed overall treatment goals were fostering inner healing intelligence, leveraging neuroplastic effects of ketamine, and facilitating a transformative experience. No significant association was found between psychotherapy modalities and treatment goals, revealing unclear logic for how therapeutic approaches are matched to desired outcomes. Findings reveal broad variability in real-world KAP practices, underscoring the need for comparative clinical trials to establish evidence-based standards. These insights may inform the development of protocols for emerging psychedelic-assisted psychotherapies more broadly.