A Cohort-Based Case Report: The Impact of Ketamine-Assisted Therapy Embedded in a Community of Practice Framework for Healthcare Providers With PTSD and Depression
Shannon Dames, Pamela Kryskow, Crosbie Watler
Frontiers in Psychiatry January 12, 2022 DOI: 10.3389/fpsyt.2021.803279 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Quality improvement evaluation with mixed methods Qualitative Case report Peer reviewed |
|---|---|
| Sample size | 94 |
| Population | Healthcare providers |
| Intervention | Ketamine-assisted psychotherapy |
| Duration | 12-week program, outcomes measured within 1–2 weeks after completion |
| Topics | Depression Psychedelic-assisted therapy Esketamine Ketamine PTSD |
| Keywords | Ketamine-assisted psychotherapy Healthcare providers hcp Resilience Group therapy Community of practice Post-traumatic stress Mental health Recovery |
| Citations | 38 |
| Key points | A ketamine-assisted psychotherapy program delivered in a community-of-practice group model led to clinically significant improvements in depression, PTSD, generalized anxiety, and work/life functionality among healthcare providers. |
Abstract
Amid an international pandemic and a worsening mental health crisis, ketamine-assisted therapy is emerging as a promising solution for those deemed “treatment resistant.” Post-traumatic stress disorder (PTSD) and depression are on the rise, with accelerating direct (e.g., burden of suffering) and indirect (e.g., disability/role impairment and impact on family) costs. Psychedelic-assisted therapies show significant promise in the treatment of a number of clinically challenging conditions, including depression, anxiety, PTSD, addiction, and end-of-life distress. Ketamine is currently the only safe, effective and legal widely available psychedelic-like medicine. To address the echo pandemic of health care provider distress, a multi-disciplinary team was charged with developing a ketamine-assisted psychotherapy program, delivered in a community of practice (CoP) group model and evaluated in a quality improvement framework. Program evaluation occurred through mixed methods. Quantitative mental health assessments included the PHQ-9 for depression, the PCL-5 for PTSD, GAD-7 for generalized anxiety disorder (GAD), and B-IPF for work/life functionality. Participant narrative feedback was collected to evaluate outcomes and for quality improvement purposes. Mean mental health scores were collected across three cohorts, totaling 94 patients. The mean aggregate scores of participants meeting the mental health assessment cut-off criteria (screening positive) were analyzed to assess clinical significance. Mean aggregate results comparing baseline vs. outcome measures (measured within 1–2 weeks after completion of the 12-week program) were clinically significant, demonstrating significant improvements in depression, post-traumatic stress disorder, generalized anxiety disorder and work/life functionality. In summary, 91% saw improvements in generalized anxiety, 79% saw improvements in depression, 86% of those who screened positive for PTSD now screen negative, and 92% had significant life/work functionality improvements. Qualitative feedback was overwhelmingly positive, with several unsolicited self-reports of transformation. Participant and team feedback enables the program to continue improving with each iteration. Results speak to the effectiveness of ketamine for psychedelic-assisted therapy, supported by a CoP framework. Outcomes are relevant for mental health programming, education and healthcare policy.
In the evidence
This study is part of the evidence base for 2 syntheses in the library. Here is how each one recorded it.
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A community-of-practice KAP program was associated with clinically significant improvements in depression, PTSD, anxiety, and work/life functionality.
Synthesized
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A ketamine-assisted psychotherapy program in a community-of-practice model was associated with clinically significant improvements in PTSD, depression, anxiety, and work/life functioning.
Synthesized
Comparable studies
Other qualitative studies on ketamine and psychedelic-assisted therapy, most cited first.
Citations in the library
Cited by 30
- Ketamine and psychotherapy for the treatment of psychiatric disorders: systematic review BJPsych Open May 1, 2023
- Toward Synergies of Ketamine and Psychotherapy Frontiers in Psychology March 25, 2022
- The potential of ketamine for posttraumatic stress disorder: a review of clinical evidence. Therapeutic Advances in Psychopharmacology 2023
- The Montreal model: an integrative biomedical-psychedelic approach to ketamine for severe treatment-resistant depression Frontiers in Psychiatry September 19, 2023
- Safety and tolerability of intramuscular and sublingual ketamine for psychiatric treatment in the Roots To Thrive ketamine-assisted therapy program: a retrospective chart review. Therapeutic Advances in Psychopharmacology 2023
and 25 more in the library
Cites 9
- The effect of a single dose of intravenous ketamine on suicidal ideation: a systematic review and individual participant data meta-analysis American Journal of Psychiatry October 3, 2017
- The Therapeutic Potential of Psychedelic Drugs: Past, Present, and Future. Neuropsychopharmacology April 26, 2017
- Efficacy of Intravenous Ketamine for Treatment of Chronic Posttraumatic Stress Disorder JAMA Psychiatry April 16, 2014
- Ketamine Assisted Psychotherapy (KAP): Patient Demographics, Clinical Data and Outcomes in Three Large Practices Administering Ketamine with Psychotherapy Journal of Psychoactive Drugs March 15, 2019
- Psychedelic medicine: a re-emerging therapeutic paradigm Canadian Medical Association Journal September 8, 2015
and 4 more in the library