The Integration Gap in Ketamine Care
The medicine is widely available. The therapy around it often is not — and that difference shapes outcomes.
By Dr. Ana Sallis · Contributing Clinician
Ketamine clinics multiplied quickly. Integration support did not keep pace, and the gap between the two is now the clearest dividing line in the field.
Infusion-only versus assisted
An infusion-only model provides the medicine and monitoring. A ketamine-assisted psychotherapy model provides the medicine, a therapist during the session, and structured integration afterward. Both are legal. Both are marketed with similar language.
The second costs considerably more and takes longer.
Why integration matters
The prevailing clinical view is that ketamine opens a window of increased neuroplasticity lasting days. What happens in that window plausibly shapes whether change holds.
Research here is still developing, and honest clinics say so.
Questions worth asking
Is a therapist present during dosing? How soon after a session is the first integration appointment? Who do I talk to if something difficult surfaces at two in the morning?
The last question is the one that separates practices.
Keep sharpening the protocol.
One protocol breakdown every other Tuesday.