How Ketamine-Assisted Psychotherapy Helps with PTSD and Trauma Recovery
How Ketamine-Assisted Psychotherapy Helps with PTSD and Trauma Recovery
Ketamine Assisted Psychotherapy (KAP) | Post-Traumatic Stress Disorder (PTSD) | Anxiety Disorders | Evidence-based psychotherapy
Post-traumatic stress disorder (PTSD) can make the past feel ever-present through flashbacks, nightmares, hypervigilance, and emotional numbness. Many people in the San Francisco Bay Area try trauma-focused therapy or medication and still struggle with lingering symptoms. That gap is one reason clinicians and researchers are paying close attention to ketamine-assisted psychotherapy (KAP) for PTSD, an approach often grouped with psychedelic-assisted therapies.
What Is Ketamine-Assisted Psychotherapy?
Ketamine is a medication long used as an anesthetic. At lower, carefully monitored doses, it produces a temporary altered state of consciousness often described as dissociative or dreamlike. In KAP, that medicine is paired with structured psychotherapy: preparation sessions beforehand, supervised dosing, and integration sessions afterward, where you reflect on the experience and apply insights to daily life.
KAP is not a standalone cure. The medication is one component of a broader treatment plan guided by licensed clinicians.
How Ketamine May Support Trauma Recovery
Trauma-focused therapy works best when a person can approach painful memories without feeling overwhelmed or shut down. Ketamine acts on the brain's glutamate system and is thought to promote neuroplasticity, the brain's ability to form new neural connections (Zanos & Gould, 2018). In practical terms, researchers hypothesize this may loosen rigid patterns of thought and emotional reactivity, creating a window in which new learning in therapy can take hold.
This is an active area of study, and the exact mechanisms in PTSD are still being clarified.
What the Research Shows
The first randomized controlled trial of ketamine for chronic PTSD found that a single intravenous infusion produced a rapid reduction in PTSD symptoms within 24 hours, compared with an active comparator, midazolam (Feder et al., 2014).
A later trial studied repeated dosing. Adults with chronic PTSD received six infusions over two weeks, and roughly two-thirds of those receiving ketamine showed a clinically meaningful response, compared with 20% of those receiving midazolam (Feder et al., 2021). Another study of repeated infusions in veterans with PTSD and treatment-resistant depression found improvements in both conditions (Albott et al., 2018).
Research on combining ketamine with psychotherapy is still emerging. A large observational study across three practices found that patients receiving KAP showed significant reductions in depression and anxiety symptoms, which commonly occur alongside trauma (Dore et al., 2019). Larger controlled trials are still needed to establish how much psychotherapy adds to ketamine's effects.
Legal Access in California
Ketamine is an FDA-approved anesthetic that licensed medical providers may prescribe off-label, which means it is not specifically FDA-approved to treat PTSD. This is why ketamine therapy in California is currently one of the more accessible options for people seeking help with trauma, anxiety, and depression. Regulations and best practices continue to evolve, so it is worth confirming current guidance with a qualified provider.
Is Ketamine Therapy Right for You?
KAP is not appropriate for everyone. A thorough screening should review your medical history, blood pressure and cardiovascular health, current medications, any history of psychosis or bipolar disorder, and substance use. Ketamine can cause temporary side effects such as dissociation, dizziness, nausea, and elevated blood pressure, so treatment should be delivered by licensed professionals in a safe, supportive setting.
For many people with PTSD, established treatments remain effective first-line options, including prolonged exposure, cognitive processing therapy, and EMDR. Ketamine-assisted approaches are best viewed as one tool within an individualized plan, not a replacement for proven care.
Trauma Therapy in San Francisco and Across California
At mindfulSF, we offer evidence-based treatment for PTSD and trauma, including CBT, ACT, and ketamine-assisted psychotherapy, through both in-person sessions in San Francisco and telehealth across California. Whether you are in San Francisco, Oakland, Berkeley, or elsewhere in the Bay Area, our clinicians can help you understand your options and build a plan that fits your needs and goals.
Ready to explore trauma treatment? Contact mindfulSF today to schedule a consultation and take the next step toward healing.
References
Albott, C. S., Lim, K. O., Forbes, M. K., Erbes, C., Tye, S. J., Grabowski, J. G., Thuras, P., Batres-y-Carr, T. M., Wels, J., & Shiroma, P. R. (2018). Efficacy, safety, and durability of repeated ketamine infusions for comorbid posttraumatic stress disorder and treatment-resistant depression. Journal of Clinical Psychiatry, 79(3), Article 17m11634. https://doi.org/10.4088/JCP.17m11634
Dore, J., Turnipseed, B., Dwyer, S., Turnipseed, A., Andries, J., Ascani, G., Monnette, C., Huidekoper, A., Strassman, N., & McGee, B. (2019). Ketamine assisted psychotherapy (KAP): Patient demographics, clinical data and outcomes in three large practices administering ketamine with psychotherapy. Journal of Psychoactive Drugs, 51(2), 189–198. https://doi.org/10.1080/02791072.2019.1587556
Feder, A., Costi, S., Rutter, S. B., Collins, A. B., Govindarajulu, U., Jha, M. K., Horn, S. R., Kautz, M., Corniquel, M., Collins, K. A., Bevilacqua, L., Glasgow, A. M., Brallier, J., Pietrzak, R. H., Murrough, J. W., & Charney, D. S. (2021). A randomized controlled trial of repeated ketamine administration for chronic posttraumatic stress disorder. American Journal of Psychiatry, 178(2), 193–202. https://doi.org/10.1176/appi.ajp.2020.20050596
Feder, A., Parides, M. K., Murrough, J. W., Perez, A. M., Morgan, J. E., Saxena, S., Kirkwood, K., aan het Rot, M., Lapidus, K. A. B., Wan, L.-B., Iosifescu, D., & Charney, D. S. (2014). Efficacy of intravenous ketamine for treatment of chronic posttraumatic stress disorder: A randomized clinical trial. JAMA Psychiatry, 71(6), 681–688. https://doi.org/10.1001/jamapsychiatry.2014.62
Zanos, P., & Gould, T. D. (2018). Mechanisms of ketamine action as an antidepressant. Molecular Psychiatry, 23(4), 801–811. https://doi.org/10.1038/mp.2017.255
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