Ketamine psychotherapy delivery

The manuals converge on ketamine psychotherapy as a structured therapeutic process, not a medication-only intervention. Across the extracts, the therapist or facilitator is present during dosing, supports the acute altered state, and then helps translate the experience into integration, insight, or behavioural change. Several sources also emphasise preparation, intention setting, and a clear session sequence, with ketamine embedded within psychotherapy rather than separated from it. The manuals differ in how prescriptive and how experiential the delivery is. Some describe a highly structured model with fixed numbers of sessions, specific routes and doses, or a defined preparatory, dosing, and integration format, while others allow adaptation across psychedelic and psycholytic approaches, office-based or at-home settings, or different psychotherapy frames such as CBT. They also vary in the degree of therapist directiveness, from non-directive support and minimal stimulation during dosing to more active verbal guidance, music modulation, and use of patient self-reports as therapeutic material.