Intravenous ketamine infusion clinics

Domain VII · Transpersonal, psychedelic & altered states

What it is

An intravenous ketamine infusion clinic is a service model, not a psychotherapy. A medical team gives ketamine, mostly off-label, for mood and other psychiatric conditions. No founder or manual defines it. The APA statement presents itself as expert opinion, not a practice guideline. This guide…

Format

• Phase B: Consent and preparation (therapy, typically 1–2 sessions). Goal: an informed, documented consent and a prepared client. Consent covers off-label status, limited evidence, risks, alternatives, cost, that outcomes are not guaranteed, and that ketamine is "a treatment, not a cure".…
• Phase C: Infusion course (medical team leads; psychotherapy alongside). Goal: safe treatment with symptoms tracked. The prescriber sets and limits the course. The APA statement advises the fewest treatments needed for response, aiming at eventual taper and stopping. Psychotherapy during this phase…

Who practises it, and how they are trained or regulated

• Format. Psychotherapy is individual in all the sourced protocols, delivered by trained therapists (psychologists or certified CBT therapists). It sits in a team-based model with medical and psychiatric competence.
• Legal and regulatory status (as of the sources' dates).
• USA: Racemic ketamine is a Schedule III controlled substance approved as an anaesthetic. Psychiatric use is off-label, and consent must say so. Esketamine (Spravato) is FDA-approved for treatment-resistant depression and for depressive symptoms in adults with MDD and suicidal thoughts or behaviour. It is restricted under a REMS: it may be given only in certified healthcare settings, outpatients must be enrolled, a…

Evidence status, as the guide reports it

• Phase B: Consent and preparation (therapy, typically 1–2 sessions). Goal: an informed, documented consent and a prepared client. Consent covers off-label status, limited evidence, risks, alternatives, cost, that outcomes are not guaranteed, and that ketamine is "a treatment, not a cure".…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Escalating use and worsening mood between uses.
• Being drawn into deep processing during peak effects. Leave it for integration.
• Fear of ending treated as a reason to keep infusing. Work with that fear directly.
• Hopes of a cure or of never needing therapy again; pressure from family or clinic marketing.
• Hopelessness tied to the infusion ('if this fails, nothing will work'). Name it and plan for it in advance.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.