How Does Ketamine Assisted Therapy Work?
You've probably been hearing more about psychedelics in the news lately. In fact, the White House recently released an executive order aimed at accelerating access to promising treatments including psychedelic-assisted therapies. If you've found yourself wondering what that actually means, and whether any of it could help with what feels stuck in your own life, you're not alone.
One of the most accessible and legally available treatments at the forefront of this shift is Ketamine-Assisted Psychotherapy, commonly known as KAP. If you've heard the term but aren't sure what it actually involves, this post is for you.
What ketamine is and its legal/medical status
Ketamine is a dissociative anesthetic that has been used safely in medical settings since the 1970s. It is FDA-approved as an anesthetic and, in its nasal spray form (esketamine, brand name Spravato), as a treatment for treatment-resistant depression. Because ketamine is already an approved medication, physicians can legally prescribe it “off-label” for conditions including depression, anxiety, PTSD, and OCD. This means that ketamine is available as a treatment immediately while other psychedelic drugs are still being developed and tested in clinical trials.
Difference between ketamine infusion clinics and KAP with psychotherapy
Ketamine infusion clinics have become popular in recent years, offering intravenous ketamine for depression and pain management. These are medically supervised, but they are primarily medical interventions with the focus is on the drug's neurological effects, and therapy is generally not part of the protocol. So, you are placed in a room, provided with the drug, then left until it is time for you to leave.
KAP is different. It is a protocol that involves three phases: preparation, dosing, integration. Let’s take each one individually:
Preparation: Before any medicine is administered, the therapist and client build a working relationship, explore intentions, address fears, discuss what to expect, and establish a sense of safety. This setting of an intention allows the client to begin to engage the experience with curiosity rather than fear, entering the session with a sense of direction that can anchor them if the journey becomes disorienting.
Dosing: Our practice uses medication that you swish in your mouth for 10-12 minutes to allow it to absorb. Other practices may use IV or intramuscular injections to administer the medication. The therapist is present throughout, offering a grounding, supportive presence without directing or interpreting the experience in the moment. Music, an eye mask, and intentional environment design are common elements. The client is encouraged to turn inward and allow whatever arises.
Integration: This is arguably the most important phase, and the one most often absent from many ketamine protocols. Integration sessions help the client make meaning of their experience, connect insights to their daily life and therapeutic goals, and metabolize anything that was emotionally difficult or confusing. Without integration, even a profound experience can fade without producing lasting change.
What Does the Experience Feel Like?
The ketamine experience is different for each individual. It is often described as a dream-like, floating state of deep physical relaxation and mental detachment. While you remain fully awake, you may feel disconnected from your body, experience shifts in how you perceive time and sound and occasionally see vivid colors or patterns when your eyes are closed. Many people experience a profound sense of calm, relief from anxiety, or even euphoria. It often feels like the daily "mental noise" or stress has been completely quieted.
Because your usual, deep-rooted thought patterns are suspended, you may gain sudden, clear insights into your emotions or past memories.
One of the most clinically significant aspects of ketamine is what happens in the brain during and after the experience. Ketamine promotes neuroplasticity — the brain's capacity to form new connections. This creates what researchers sometimes call a "window of opportunity" following a session, during which the brain may be more open to new patterns of thinking, feeling, and responding. Therapy during this window can be particularly potent.
How We Deliver KAP at Aligned Connections
At Aligned Connections, our KAP program is delivered in partnership with Journey Clinical, a specialized telehealth platform that connects clients with licensed medical providers who handle all prescribing, medical screening, and clinical oversight. This collaborative model means that the medical and therapeutic components of care are handled by professionals trained specifically in psychedelic medicine not pieced together across providers who may have little experience with this work.
Who May Benefit from KAP?
KAP has shown particular promise for:
· Treatment-resistant depression, such as people who have not responded adequately to traditional antidepressants
· PTSD and complex trauma
· Anxiety disorders
· Existential distress, including in the context of serious illness
· People who feel "stuck" in patterns they understand intellectually but cannot seem to shift
It is important to emphasize that KAP is not a standalone cure. It is a tool that works best within an ongoing therapeutic relationship with a clinician who understands both the medicine and the psychological process.
Curious Whether KAP Might Be Right for You?
If this post has sparked questions about the process, about whether you might be a good candidate, or simply about what a first conversation would look like, we would love to hear from you.
At Aligned Connections, we offer a free consultation to anyone considering KAP or any of our other services. There is no pressure and no obligation. It is simply a conversation, and a chance for you to ask questions, get a feel for our approach, and decide whether this feels like a fit. We look forward to hearing from you!
About the Author
Christine Giffin is a trauma-focused therapist-in-training providing therapy services in Western New York under licensed supervision. Before entering the mental health field, she spent almost a decade as Chief County Toxicologist directing the Forensic Toxicology Laboratory in Erie County, NY — a background that informs her evidence-based, scientifically grounded approach to care. Christine works from an integrative, trauma-informed framework drawing on parts-work, somatic approaches, and psychedelic-assisted modalities including Ketamine-Assisted Psychotherapy. She is passionate about helping analytically minded, high-functioning people who are quietly struggling to reconnect with themselves, navigate life transitions, and find healing that honors the whole person. Schedule a consult with Christine today.
