Erica Bonham was trained in Ketamine Assisted Psychotherapy at the Psychedelic Research and Training Institute (PRATI).

Below you will find important information about Ketamine Assisted Psychotherapy (KAP) work.


Background: Medical and Psychiatric Use of ketamine

Ketamine is only available by prescription from a medical provider, a physician or nurse practitioner. It is a drug regulated by the Drug Enforcement Agency (DEA) as a Schedule III medication and as such has long been used safely as an anesthetic and analgesic agent.

Ketamine is also approved for use by the FDA, which has conducted evaluations of the risks and benefits associated with its use. The administration of ketamine in sub-anesthetic doses to treat depression, alcoholism, substance use disorders, post-traumatic stress disorder, obsessive compulsive disorder, and other psychiatric diagnoses is a relatively new, off-label use of ketamine. Ketamine is increasingly used as a treatment for various chronic treatment-resistant mental and emotional conditions, often used after other treatment approaches have been unsuccessful.

While the scientific data is not completely clear, research suggests ketamine may help grow new neural connections once diminished by chronic stress, leaving many people feeling relief. The literature indicates a 70% response rate to ketamine of patients with treatment resistant depression, and a remission rate of 40-50%.

Ketamine as a current psychopharmacological treatment

Ketamine for depression has become popularized through medical infusion clinics. At infusion clinics, a patient is administered ketamine through intravenous (IV), intramuscular (IM), or intra-nasal routes. Symptoms can be relieved through this process alone, but the underlying issues that caused the symptoms may persist. Ketamine treatment is generally considered inappropriate for persons with a history of psychosis, mania or schizophrenia, or who are currently taking benzodiazepines, stimulants, or MAOI’s.

Ketamine taken during psychotherapeutic treatment (KAP)

Interested in providing the most advanced and effective care for their patients, psychotherapists as well as physicians have studied the science and benefits related to ketamine. Some psychotherapists have begun integrating ketamine into their psychotherapeutic practices as an effective adjunctive path for healing, with the benefits of ketamine enhanced by a personalized approach and the support of a trusted psychotherapist. While ketamine administered without psychotherapeutic assistance has helped with symptoms of mental and emotional problems, it is the belief of many clinicians that KAP with a skilled and experienced therapist can enhance the benefits of ketamine so that healing occurs at a deeper and longer lasting level.

The use of ketamine within a personal therapeutic relationship can help the patient better identify and work through difficult experiences and behavior patterns, providing new insights and healing that might not have been possible otherwise. Ketamine assisted psychotherapy may allow a person to gain access to the causes of their struggles that were previously outside their awareness.

Becoming a KAP patient

Your medical provider, a physician or nurse practitioner who practices independently from, but coordinates your treatment plan with, your KAP therapist, will medically assess you to diagnose you and to ensure your safety when using ketamine. Your medical provider will also ask you to read and sign an informed consent document, much like this one, but with additional information about the physical and medical effects and potential side effects of ketamine. If in the judgment of that medical provider, you are assessed as an appropriate candidate for treatment with ketamine and KAP, you will then authorize your medical provider and your KAP psychotherapist to consult about how KAP might best work for you. You and your prescribing medical provider (not your KAP therapist) will decide on the dose and frequency of your ketamine; professional responsibility for those medical decisions lies exclusively with your prescribing medical provider.

Your KAP therapist will consult with your medical provider whose assessment will assist your KAP therapist to formulate a psychotherapeutic treatment plan to meet your particular KAP needs. Please be aware that while your medical provider and KAP therapist will be working in consultation with each other to assist you, they are each separate independent practitioners, each making their own independent assessments and each having exclusive responsibility for the separate aspects of your care that they each provide. The licensure and competence of your KAP psychotherapist is in providing psychotherapy including KAP, but not in prescribing or administering medications such as ketamine.

What to Expect in the KAP experience

2.5-3 hours will be reserved for your KAP session. After you self-administer your prescribed sublingual ketamine in our office in accordance with the instructions given to you by your medical provider, your KAP psychotherapist will support and guide you as you encounter and explore emotional issues that arise during the KAP session. You agree to follow any direct instructions that your psychotherapist gives to you until the therapist determines that the session is over, and to remain at the location of the session until the therapist decides that you are ready to leave.

Ketamine is formally classified as a “dissociative” anesthetic, dissociation meaning a sense of disconnection from one’s ordinary experience of reality and self. At the dosage typically self-administered during KAP, most people experience mild anesthetic, anxiolytic (anxiety reducing), antidepressant and, potentially, psychedelic effects though these latter effects are typically minimal. The antidepressant effect tends to have a cumulative effect, that is, be more sustained with repeated use. It has been speculated that dissociative experiences are associated with greater and longer lasting beneficial effects. This may also include a positive change in outlook and character that some describe as profound and transformative.