Description 

Ketamine is considered both a neuromodulation and a psychedelic agent in the treatment of depression and suicidal ideation. Psychotherapy with psychedelics is considered a key element in the treatment of psychiatric symptoms. In addition to the neuromodulation benefits provided by psychedelics, psychotherapy can help optimize the antidepressant effect and the risk of suicide after a ketamine experience. In fact, in the psychedelic realm, ketamine alone without psychotherapy is not recommended. This viewpoint states that psychedelic experi­ences without being prepared for it can be antigenic and traumatizing. However, there are different psychotherapy models that can be effective as an adjunct to ketamine treatment. To date, two research studies show that both psychedelic psychotherapy and cognitive behavioral therapy (CBT) can help optimize treatment effectiveness. Psychedelic psychotherapy entails a cluster of ap­proaches from different disciplines, mainly Freudian and Jungian psycho­analysis, and transpersonal psychology. In psychedelic psychotherapy, the mind­set and setting (ie, “set and setting”) are crucial for a good outcome. Therefore, patients must first be prepared for their experiences and develop trust with the provider, who is also responsible for ad­ministering the ketamine in a safe, com­fortable, and therapeutic environment. The patient can be encouraged to cover their eyes and use instrumental music to facilitate the psychedelic experience. Other researchers have proposed the use of cognitive behavioral therapy (CBT) as an adjunctive for patients re­ceiving ketamine for depression (not during the ketamine administration). There are other psychotherapy models that could well be effective. Complex Assessment and Management of Suicide (CAMS) stands out as an ideal model for patients taking ketamine for suicidal ideation. CAMS has consistently shown to decrease suicidal ideation and intention. An interesting model for patients taking ketamine is Meaning-Centered Psychotherapy (MCP). Ketamine is often used in patients with depression and pain and in palliative care settings. MCP helps patients alleviate existential distress. MCP can work synergistically with ketamine in these settings. For the purpose of this presentation, we will review different psychotherapy models in ketamine treatment. We will present preliminary data from our CAMS and ketamine treatment in youth with suicidal ideation study. We will also present a case series of patients receiving ketamine-assisted psychedelic psychotherapy and ketamine-assisted meaning-centered therapy in our hospital.

Format 

Recorded webinar.

This content was recorded during the APA 2023 Annual Meeting.

Learning Objectives 

1. To familiarize with the different psychotherapy models proposed for patients on ketamine treatment including psychedelic therapy, CBT, MCP and CAMS.
2. To acquire skills on how to recognize and address the psychological needs in patients taking ketamine.
3. To understand the needs of the most vulnerable patients like children, adolescents and youth.
4. To address challenges in finding a good therapy model for patients that can benefit from ketamine treatment through interactive idea sharing and discussions

Target Audience 

Residents/Fellows, Psychiatrists, Psychologists

Estimate Time to Complete 

Estimated Duration: 2 hours
Program Start Date: May 1, 2025
Program End Date: May 1, 2028

How to Earn Credit 

Participants who wish to earn AMA PRA Category 1 Credit™ may do so after completing all sections of the course including the evaluation. After evaluating the program, course participants will be provided with an opportunity to claim hours of participation and print an official CME certificate (physicians) or certificate of participation (non-physicians) showing the completion date and hours earned. 

Continuing Education Credit  

In support of improving patient care, the American Psychiatric Association is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 

The APA designates this live activity for a maximum of 2 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

Faculty and Planner Disclosures 

The American Psychiatric Association adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Medical Education. Any individuals in a position to control the content of a CME activity — including faculty, planners, reviewers or others — are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity. 

Instructors 

• Tatiana Falcone, MD
• Murat Altinay, MD
• Albert Yeung, MD
• Fernando Espi Forcen, MD, PhD

Planners  

• Vishal Madaan, MD, Chief of Education and Deputy Medical Director at the American Psychiatric Association.

Accessibility for Participants with Disabilities 

The American Psychiatric Association is committed to ensuring accessibility of its website to people with disabilities. Please contact the American Psychiatric Association at 202-559-3900, if you require assistance seven (7) business days prior to the start of a live webinar. 

Technical Requirements 

This internet-based CME activity is best experienced using any of the following: 

• The latest and 2nd latest public versions of Google Chrome, Mozilla Firefox, or Safari 
• Internet Explorer 11+ 

This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Acrobat Reader, Microsoft PowerPoint, and Windows Media Player. 

Optimal System Configuration: 

• Browser: Google Chrome (latest and 2nd latest version), Safari (latest and 2nd latest version), Internet Explorer 11.0+, Firefox (latest and 2nd latest version), or Microsoft Edge (latest and 2nd latest version) 
• Operating System: Windows versions 8.1+, Mac OS X 10.5 (Leopard) +, Android (latest and 2nd latest version), or iOS/iPad OS (latest and 2nd latest version) 
• Internet Connection: 1 Mbps or higher 

Minimum Requirements: 

• Windows PC: Windows 8.1 or higher; 1 GB (for 32-bit)/2 GB (for 64-bit) or higher RAM; Microsoft DirectX 9 graphics device with WDDM driver; audio playback with speakers for programs with video content 
• Macintosh: Mac OS X 10.5 or higher with latest updates installed; Intel, PowerPC G5, or PowerPC G4 (867MHz or faster) processor; 512 MB or higher RAM; audio playback with speakers for programs with video content 

For assistance: Contact educme@psych.org for questions about this activity | Contact learningcenter@psych.org for technical assistance