Psilocybin vs. Ketamine Training: Which is Right For Your Practice?

If you are a mental health practitioner seeking to integrate psychedelic therapy into your practice, you may be wondering:

Where do I even start? Should I train in ketamine-assisted therapy (KAP) or psilocybin-assisted therapy (PAT)?

The reality is that this is not an either/or situation – it’s more about where you’re at right now and what you feel would better serve your client base.

In fact, both medicines can complement each other in a therapeutic practice, and one is not inherently better than the other.

In this article, we delve into the nuances of selecting which psychedelic therapy training to pursue, the importance of meeting your clients’ needs, and how to develop skills and gain experience with each medicine.

Building Practitioner Readiness and Relationship with the Medicine

With both ketamine and psilocybin, we believe at Elemental Psychedelics that practitioners should have personal experience with the medicines they’re holding space for.

In the case of ketamine, the fact that the journeys are shorter in duration and generally not as spiritually profound as psilocybin  (that being said, clients can have profoundly spiritual experiences with ketamine) makes it a good option for practitioners who are still developing their altered space-holding skills.

If you’re considering training in KAP, it’s best practice to have at least a handful of personal experiences under your belt and through different modes of administration, such as oral lozenge and intramuscular. In psychedelic therapeutic work, it’s important to understand firsthand the terrain of the altered state that you’re taking clients into.

Meanwhile, facilitating psilocybin journeys requires a deeper, longer-term relationship with the medicine. Ideally, you have built a deep and personal relationship with mushrooms and across different doses, strains, and settings. We believe that psilocybin mushrooms have the potential to carry deeply spiritual and mystical experiences. There’s a certain level of readiness, inner awareness, and a greater degree of preparation that, when achieved, can make mushroom work so much more robust and profound.

Taken together, at Elemental Psychedelics, we generally suggest that practitioners new to psychedelic therapies consider starting with ketamine to learn the foundation of psychedelic facilitation, and then expand into psilocybin mushrooms as your capacity for longer, deeper journeys grows.

Understanding the Medicines: Characteristics and Client Experience

In addition to developing your own relationship with each medicine you intend to hold space for, it’s of course important to understand the essential characteristics of each medicine.

Ketamine

Ketamine is a synthetic medicine with multiple modes of administration, including oral, intravenous, or via intramuscular injection. Each route offers different onset times and intensities.

Ketamine-assisted therapy sessions using oral lozenges or intramuscular injection last between 90 minutes and two hours, making them relatively short compared to psilocybin. This shorter arc allows you to focus on core space-holding skills, such as presence, attunement, and safety, without the physical and emotional demands of an all-day journey.

For clients, too, ketamine can feel like a “toe in the water.” They may describe feelings of lightness, floating, or disconnection from ordinary thought patterns, which can provide relief from depressive ruminations.

The dissociative quality of ketamine can act as a gentle bridge into altered states, making it a good entry point for clients who don’t have a lot of (or any) psychedelic experience.

Because ketamine sessions are shorter and metabolized more quickly, integration often begins within 24-72 hours. You can guide your clients in consolidating insights soon after the experience, helping them to integrate these shifts without a long delay.

Psilocybin

Psilocybin mushrooms are a natural medicine with a long history of ceremonial and spiritual use. They are often seen as carrying a “spirit” or wisdom that invites deeper, relational connection over time.

Psilocybin journeys typically last five to eight hours. For facilitators, this requires significant stamina, preparation, and the ability to stay present through the client’s entire process. Unlike ketamine, psilocybin requires an all-day commitment and more spaciousness in scheduling.

In terms of effects, psilocybin tends to open clients to profound emotional, spiritual, and transpersonal experiences – more “jumping into a lake” than dipping a toe. These journeys can catalyze powerful breakthroughs, but also surface complex material that requires skillful support.

Integration with psilocybin is also longer and multi-layered. Clients may need weeks, months, or even years to fully metabolize their experiences. Practitioners with a breadth of personal experience are better equipped to guide clients through this ongoing unfolding.

So, while ketamine offers accessibility and digestibility for those new to altered states, psilocybin offers more depth, spiritual connection, and longer-term relational work with the medicine.

Understanding these distinctions allows you to align your choice of medicine with both your skill level and your clients’ needs.

To learn more about the specific differences between ketamine and psilocybin mushroom therapies, read our blog post on Why Use Ketamine When We Have Psilocybin Mushrooms?: The Case for Ketamine-assisted Therapy.

Accessibility and Client Considerations

When evaluating which medicine to bring into your practice, it’s important to look beyond your own readiness and ask: Who are the clients I’m serving?

As a legally prescribable medicine across the US, ketamine may be covered by a client’s insurance if they have a relevant diagnosis, such as treatment-resistant depression. And even if KAP is not covered by the client’s health plan, a single session is much more affordable than a psilocybin journey.

Currently, psilocybin sessions require out-of-pocket payment. With sessions lasting six to eight hours, the cost of facilitator time, preparation, and integration quickly adds up, making it less accessible to many people.

However, centers like Reflective Healing Center in Fort Collins, Colorado (our sister organization) do offer sliding scale options for psilocybin therapy based on the client’s financial circumstances.

Ketamine is also more convenient when it comes to time investment. The shorter sessions mean clients can often return to some of their day-to-day responsibilities after resting for a few hours, making it manageable for working parents or professionals.

Meanwhile, psilocybin requires an entire day, plus recommended time for spaciousness afterward. For clients with demanding schedules, this may be impractical without significant planning and support.

Clients with major depressive disorder, PTSD, or who are taking several psychotropic medications may find ketamine to be a safer, more manageable first step, especially if they are already embedded in medical care systems.

People who are suffering from depression, but have already done some inner work and gained tools to navigate altered states, may be a good fit for psilocybin. Psilocybin mushrooms will also resonate more with people seeking out a natural medicine that’s served in a ceremonial container and rooted in a spiritual, earth-based practice.

Location and Legality

As of 2025, only Oregon and Colorado have legalized supervised psilocybin therapy via state ballot initiatives. Practitioners in these states must complete approved training and obtain state facilitator or clinical licenses to legally provide psilocybin services. Read more on what that looks like in Colorado from our blog here.

Meanwhile, ketamine-assisted therapy is legal nationwide when prescribed by licensed healthcare professionals under mostly off-label psychiatric use. To prescribe ketamine for KAP, a doctor or nurse practitioner must have a valid medical license. To practice KAP as a therapist, you only need to have a collaborative relationship with a prescriber who can evaluate clients for appropriate indications and safety of ketamine and, of course, appropriate training to stay within professional ethical requirements of competence.

Once prescribed ketamine, clients generally are instructed to pick up their prescription from a pharmacy and bring it with them to their next therapy session with you. (Remember, ketamine-assisted therapy sessions should be scheduled as two to three-hour sessions.)

Bridging Worlds: Complementary Use of Ketamine and Psilocybin

Many practitioners often feel pressure to “pick a side” between synthetic Western medicines and natural plant and fungi medicines. But this binary imposes unnecessary limits. Both ketamine and psilocybin mushrooms have unique contributions, and when held together, they create a more complete therapeutic toolkit.

Especially in New Age psychedelic spaces, there’s a tendency to elevate plant and fungi medicines as “pure” and dismiss synthetic medicines as “less spiritual.” Yet this hierarchy ignores the profound benefits that both offer.

While psilocybin mushrooms can connect us with earth-based traditions and greater relationality with the world, ketamine represents the power of human innovation in the chemical sciences.

Starting clients with ketamine can help them acclimate to altered states in shorter, more manageable sessions. Then, transitioning to psilocybin invites them into longer, deeper journeys once they’ve developed trust in the process – and themselves.

Holding both options as equally valid empowers practitioners to meet clients where they are, rather than pushing them into a medicine they may not be ready for.

Choosing the Right Fit for You and Your Clients

Whether you decide to begin with ketamine or psilocybin, we encourage you to view this choice not as about which is “better,” but about which is right for you and the people you serve.

As you make this decision, we invite you to…

• Reflect on your own relationship with each medicine. Have you developed the depth of experience required to hold safe and ethical space?

• Consider your readiness to manage different journey lengths and intensities. Are you ready for a full day of presence and space-holding? Are you ready to maintain a calm presence for deep grief and other intense expressions of internal pain?

• Think about the type of practice you want to create – clinical, spiritual, integrative, or a blend.

• Take into account the financial realities, time availability, and psychological readiness of your clients.

• Recognize that ketamine and psilocybin are not mutually exclusive, and that each can play a role in a client’s healing journey at different points in time. For more on this, listen to Elemental’s Clinical Director, Dori Lewis, on this Back From the Abyss podcast episode.

At Elemental Psychedelics, we offer training programs to become a ketamine-assisted therapist and/or psilocybin mushroom facilitator.

Our focus is on helping you tap into your inner wisdom and help you birth your own unique offering in the psychedelic space. Safety and ethics are at the heart of our training, as well as an unwavering commitment to doing our own inner work, so that we may show up in full integrity as we hold space for others.

If you’re considering integrating either ketamine-assisted therapy or psilocybin journey facilitation into your practice, we invite you to explore our offerings and reach out to us if you have any questions.