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.
A narrative review synthesizes evidence on ketamine-assisted psychotherapy (KAP) for palliative care patients, who often suffer existential distress, loss of meaning, and emotional pain beyond physical symptoms. The authors present a novel, time-limited KAP model tailored to end-of-life settings, integrating neurobiological, psychological, and experiential effects. 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—the Salience Network (embodied self-awareness) and Default Mode Network (narrative self-construction)—to address bodily and narrative dimensions of distress. The approach emphasizes psychological safety, meaning-making, and patient-centered care to enhance quality of life at the end of life.