Unfolding States of Mind: A Dissociative-Psychedelic Model of Ketamine-Assisted Psychotherapy in Palliative Care.
Healthcare (Basel, Switzerland) October 27, 2025 Alessandro Gonçalves Campolina, Marco Aurélio Tuena De Oliveira 1 citation
Patients in palliative care often suffer from existential distress, loss of meaning, and emotional pain beyond physical symptoms. Ketamine-assisted psychotherapy (KAP) has emerged as a promising intervention for this complex suffering, but models tailored to palliative populations are scarce. This narrative review synthesizes evidence on ketamine's neurobiological, psychological, and experiential effects relevant to end-of-life care and presents a novel, time-limited KAP model. The model includes preparatory and integrative psychotherapy, two ketamine dosing sessions (one low-dose and one moderate-dose), concurrent psychotherapy, goals of care discussion, and optional pharmacological optimization. It leverages ketamine's effects on self-processing networks to address both bodily and narrative dimensions of distress, offering a compassionate, pragmatic approach to enhancing meaning, emotional resolution, and quality of life at the end of life.