Ketamine Integration: One of Our KAP Educators Explains How to Support Clients Post-Treatment

By Bri Bendixsen, MA, Psychotherapist and Psychedelic-Assisted Therapist

Each person’s healing journey is unique, and so ketamine integration should be personalized too. In the context of ketamine for mental health, integration support can take various forms, from developing healthy practices and building community to being supported by psychotherapy.

Ketamine has long been used in psychiatric care as a largely standalone intervention for depression or suicidality, but researchers are increasingly emphasizing that this clinical application overlooks the importance of psychotherapeutic support. Without structured integration and therapeutic work after dosing sessions, the benefits may be temporary, sometimes only lasting days or weeks after administration.

That may be why ketamine-assisted psychotherapy (KAP) – the combination of low-dose ketamine with therapeutic support – first resonated with you as a clinician. Perhaps you recognize that healing and growth lie not solely in the medicine journey itself but in the integration that follows. Findings from a large retrospective effectiveness study found that four to six sessions of KAP “produced sustained reductions in anxiety, depression, and PTSD, with symptom improvement lasting well beyond the duration of dosing and integration sessions.”  Adding psychotherapy to ketamine administration can create more robust improvements for clients but, in our experience, the sustainability of those improvements can be supported further by good integration.

During ketamine-assisted psychotherapy training for clinicians, we model the practice of ongoing integration too. In fact, at Elemental Psychedelics, we structure our experiential KAP training the way we would sequence the actual KAP therapy process, condensed across four days. We allow time for preparation, the medicine experience, and integration practices, highlighting how clinicians’ own integration work can help them support their clients’ healing processes more skillfully.

In this piece, you’ll read about the role of integration, how integration starts with good preparation, setting integration goals, how ketamine integration compares to other psychedelics, and more. 

Why Ketamine Integration Is Vital

Only one intravenous infusion can lead to rapid relief from depressive symptoms, for example, but improvements often last only one to two weeks. Although ketamine opens up a temporary neuroplasticity window, it’s just a brief phase where the brain can really adapt. So integration after the sessions, including therapy, could be key for many people to translate insights from journeys into meaningful and more long-term changes.

Also, as you may know from your own experiences with ketamine, a session can surface difficult emotions, overwhelming material, novel outlooks, or unexpected memories. Due to ketamine’s dissociative anesthetic effect, people may feel like a distant observer or as if their consciousness is drifting away, which can feel both relieving or confusing. Integration provides structure and more clinical context to the ketamine experience, helping clients feel less disoriented and reducing psychological risk.

Effective ketamine integration can involve a range of practices tailored to each client’s needs, including therapy, journaling, mindfulness, meditation, movement practices, and more. These approaches can help ground the client’s experience and reduce any tendency to seek continuous peak or intense experiences. Different from more conventional psychiatric approaches based on long-term daily use of medications for symptom management, good ketamine integration helps embody insights from ketamine sessions to provoke healing, growth, and sustainable changes.

Set Integration Goals at the Preparation Stage

 

As well as psychiatric evaluation, medical history, and a medication review, KAP providers should set integration goals with clients before medicine sessions.

To establish a trusting and positive relationship with clients, I usually guide at least three psychotherapy sessions before introducing the medicine. During these preparatory sessions, we map out strategies in case the ketamine experience starts becoming difficult, plan for what to do after the KAP experience, and create space to speak to family or friends about potential post-session changes to watch out for. 

Short and long-term ketamine integration goals

In my practice, during preparation, we establish clear goals. Short-term goals are generally more measurable, like practices that clients want to start from scratch or bring back into their life. Our role is not to tell clients what they should adopt, but to gently guide and explore options. Generally, integration goals fall into the following categories:

• Physical Health. This can include making changes to nutrition and diet or integrating some type of physical exercise or movement practice. Unless somebody mentions wanting to exercise directly, I try to use the words intentional movement instead. That could look like going to the gym, but also dancing, boxing, walking, etc.

  
  

• Internal reflective practices. It's useful to have a journaling practice established before we start KAP to document reflections. But not everybody resonates with that. Reflective practices can also look like meditation, painting, art, or other creative endeavors (e.g., something a client loved as a kid but left behind). 

  
  

• Community Building. Maybe your client wants to find a local community, establish a relationship with a professional mentor, or have more friends in their life. Connection, belonging, accountability, and supportive relationships can help clients sustain growth outside of KAP sessions.

  
  

• Spiritual component. Often, questions about meaning, purpose and interconnectedness can surface in KAP work. Some KAP therapists may mention meditation, breathwork, or time in nature to help clients align with their values. But some clients may also voice an interest in other types of spiritual traditions or practices, like yoga philosophy, Buddhism, or nature-based ritual.

Longer term goals may be more abstract and exploratory like: “I want to invite more joy into my life” or “I want to explore my relationship with my inner child.” These goals often involve wanting to learn about one's self, one's relationships or one's place in the world, all of which also correlate with spirituality on some level. 

What Integration Looks Like in Ketamine-Assisted Psychotherapy (and How Long It Lasts)

1. Preparation sessions to create a safe and supportive space

Integration starts at preparation. In my practice, I require a minimum of three psychotherapy sessions before we start working with ketamine. If clients have extensive trauma or PTSD, we might need many more sessions to establish rapport and understand the client’s unique background and needs. Getting to know people and their histories takes time, as does building trust in us as therapists and in how we hold space. 

2. Ketamine sessions with processing time & post-session grounding

Usually, I recommend six (or eight) KAP sessions over about six weeks, followed by continued psychotherapy as needed. The six sessions could happen once a week, or every other week, and they last about three hours. 

Depending on how an individual responds to ketamine, they may choose to continue their relationship with the medicine over a much longer period or, sometimes, clients decide to discontinue prior to completing six sessions. For those who seem to benefit from the ketamine experience, I guide six sessions and then we take a one-month break to let everything settle. I have some clients who then continue one or two KAP sessions quarterly or seasonally as a booster of sorts. Other clients may request a one-off session to check in with the medicine again when facing something difficult or are struggling more. The frequency with which clients choose to do booster ketamine sessions is often similar to how regularly someone may get a massage or acupuncture. 

3. Psychotherapy and integration to translate insights into daily life

The length of this part totally depends on the person. Sometimes, clients go through the KAP sequence, we meet for a few integration sessions on the backside, and they don’t feel the need to continue afterwards. A larger number of clients find that integration is an ongoing, constantly evolving process as life continues. Clients often reflect on realizations and insights that emerged during their KAP sessions, holding onto those themes to ground themselves as life unfolds. 

Ketamine Integration Compared to Other Psychedelics and Psychotherapy

KAP sessions are much shorter compared to other psychedelic medicine experiences, like with Iboga or psilocybin mushrooms. Ketamine sessions typically last around three hours, with the medicine experience itself only lasting around one hour and a half. That leaves time for preparation beforehand and to gently begin reflecting on the experience at the end. 

Ketamine integrates into the psychotherapy process and fits in with people's day-to-day lives. Usually, clients will take a partial or full day off work the day of their session. Many also prefer to minimize plans or obligations the day after a session, as this is an especially fruitful time for prioritizing deeper reflection and self-care practices, which often leads to more sustained benefit.

This is quite different to other psychedelics that sometimes involve a necessary week-long

retreat or other more intensive preparation protocols, which not everybody can do regularly. My recommendation is: The longer the medicine experience or retreat lasts, the more time you might need for slowness and spaciousness post-experience. 

During ketamine integration, clients can also move much more quickly compared to traditional psychotherapy. A wide range of tools and resources is important to effectively support clients. But the most important quality to have in your toolkit is to be flexible and recognize how to guide clients through relatively rapid growth. It’s about being able to listen and then offer the appropriate tools based on what someone is sharing, rather than pushing our idea of what they should be doing. 

It’s also essential for KAP providers to have a strong support system themselves, including a clinical supervisor or a peer consultation group. Clients may experience rapid change, emotional breakthroughs, or material that can feel complex or unfamiliar, and providers need spaces where they can process cases, receive guidance, and strengthen their clinical approach. Meetings with colleagues can help ensure ethical, grounded, and effective support for clients.

How Elemental Psychedelics Ketamine Training Incorporates Integration 

As mentioned, Elemental’s KAP training for clinicians is structured in a similar way to the actual KAP sessions. And integration is a large part. That’s useful for clinicians coming from different backgrounds – across traditional CBT, DBT, psychodynamic, humanistic, and more interpersonal styles of therapy. Shifting into psychedelic medicine work can be complex, and although the standard protocols offered in traditional academia are valuable, they don’t always prepare therapists for the relational and experiential aspects of psychedelic therapy. Personally, I found I learnt how to be really human with clients after my psychedelic training, especially in relation to integration work.

So, before anyone takes any medicine at the KAP training, we have clinicians pair up and go through preparation questions with their dyad partner. And the preparation is usually twofold; some personal material might come up, as well as professional aspects about how to integrate this work into their practice.

Then, trainees experience sitting with the medicine themselves and holding space for someone ingesting the medicine too. We believe a clinician must connect with their “own grief, joy, inner guidance, ethics, and shadow work” to have a solid foundation to provide this service to their communities. 

Integration is blended into our training weekend, including discussing ways clinicians might offer integration to their clients and what practices trainees might want to start exploring themselves. Movement and dance, for example, have become really essential somatic integration practices for many of us at Elemental, and are now staples at all our trainings.

We know psychedelic-assisted psychotherapy can help clients make meaning of their experiences and create lasting changes for long-term healing. And integration expands well beyond the therapist’s office, including a wide menu of lifestyle practices to support a non-linear integration process for clients. Structured support and integration are vital components in this larger pathway of psychedelic healing.

Interested in joining a psychedelic training program that prioritizes integration? Take a look at our Ketamine-Assisted Therapy Training.

Frequently Asked Questions: Ketamine Integration & KAP Training

Where can I find a quality ketamine-assisted psychotherapy training?

A quality KAP training should combine clinical education, experiential learning, ethics, trauma-informed care, preparation/integration practices, and supervised skill development. Programs that prioritize small cohorts, community connection, and hands-on learning often give clinicians a solid foundation for practicing KAP.

When evaluating a KAP training program, look for opportunities for consultation or supervised practice and ongoing professional support from other KAP providers.

As interest in ketamine for mental health continues to grow, clinicians benefit most from programs that prepare them to support clients through the full therapeutic process, not just the medicine session itself. 

What core components should every KAP training include?

KAP training should prepare providers to support clients before, during, and after medicine sessions. And clinicians would benefit from a training that emphasizes both clinical competency and therapeutic presence.

Core elements of effective ketamine-assisted psychotherapy training often include:

• Ketamine safety, screening, and contraindications

• Preparation and intention-setting practices

• Understanding set, setting, and therapeutic container-building

• Trauma-informed and nervous system-aware care

• Facilitation skills during altered states of consciousness

• Ketamine integration frameworks and practices

• Guidance around safety, ethics, and scope of practice

• Working with transpersonal, symbolic, or emotionally complex experiences

Why is ketamine integration so important?

Ketamine integration is essential because meaningful change often happens in the days and weeks after a medicine session. While ketamine can lead to expanded awareness, emotional openness, and new perspectives, integration helps clients translate those experiences into lasting shifts in daily life. Integration may involve processing emotions, exploring behavioral patterns, strengthening relationships, or reinforcing new ways of relating to oneself.  In the context of ketamine for mental health, integration helps bridge the space between the medicine experience and long-term healing or practical change.

What practices support ketamine integration?

Each person’s experience is unique, so integration is most effective when approached with flexibility and curiosity rather than rigid expectations.

Practices that may support integration include:

• Journaling

• Mindfulness practices and meditation

• Somatic awareness and breathwork

• Time in nature and intentional rest

• Therapy

• Community support and authentic connection

• Gentle movement practices such as yoga or walking

• Ecstatic dance 

• Rituals or reflective practices 

Establishing both short- and long-term goals can help anchor the ketamine integration process. Rather than being a one-time conversation or checklist, integration is an ongoing practice of deepening self-awareness and translating insights into change.