Therapists & Ketamine Therapy: Keep Your Modality, Add Support
Therapists often ask the same quiet question when a client begins ketamine therapy or esketamine (Spravato) treatment:
“Do I have to change the way I work?”
The answer, as Dr. Ben Yudkoff put it, is no.
“Therapists have the particular task of helping patients make sense of their experience — or suggesting re-examining it — so that relief follows. The world of therapy doesn’t need to change when ketamine enters the picture.”
— Benjamin Yudkoff, MD, Chief Medical Officer and Co-Founder of Lumin Health
The goal is to stay anchored in your modality — psychodynamic, CBT, somatic, EMDR, DPT, or otherwise — and allow the ketamine to open what therapy already knows how to hold: insight, meaning, and the possibility of change. This helps notably as a constant that your patient can rely on throughout the potentially impactful changes that may arise during ketamine treatment.
Ketamine may alter perception, and therapy can help integrate it into understanding. Ketamine may bring relief; and therapy helps sustain it. Together, they speak two languages of the same healing process.
Making Sessions Count During Ketamine-Induced Neuroplasticity
What to ask your client — and our team at Lumin Health
Dr. Yudkoff described ketamine and esketamine as treatments that “impact a person’s experience and how they think about the world around them,” but not in the same way therapy does. They can shift old patterns suddenly or bring forward memories that feel newly charged.
“The improvements can be quite dramatic,” he explained, “and that dramatic and sudden improvement can be bewildering.”
That’s where the therapist’s role becomes essential. When your client begins ketamine treatment, Lumin Health recommends asking questions like:
- “What are you noticing in your thoughts or emotions between sessions?”
- “Are there memories, images, or sensations that feel stronger — or softer — than before?”
- “Is anything surprising about what’s changing, or what isn’t?”
If questions or concerns arise — about mood swings, anxiety, or unexpected reactions — Dr. Yudkoff emphasizes that communication is immediate and two-way:
“There’s always somebody on the other line. Lumin Health communicates with partnering therapists in those moments of inflection when we see change happening.”
Lumin Health sees it’s role as a partner to therapists who are seeing their patients struggle and have difficulty taking steps toward recovery.
Grounding strategies for ketamine dose-day and the week after
Clients often describe the ketamine therapy experience as dreamlike, detached, or emotionally vivid. What they may need most from you isn’t a new technique, but the same steady scaffolding you already provide:
- Normalize the strangeness: “You might feel distant during or after sessions. That’s expected — it’s your brain working in a new way.”
- Encourage gentle observation: Journaling, voice notes, or simply noticing thoughts without forcing interpretation can help patients stay grounded.
- Stabilize routines: Regular sleep, meals, and physical grounding (walks, hydration, movement) are subtle but powerful regulators in the post-dose period.
- Keep session cadence steady: Most patients benefit from keeping therapy on schedule, especially during induction — this anchors the unfolding process in continuity.
When in doubt, Dr. Yudkoff’s guidance applies: presence before expertise. The therapist is uniquely positioned to sit in curiosity and reflection, and that posture helps make sense of the treatment and it’s meaning.
Measuring change without pressure
Therapists often feel an unspoken pressure to track whether the medicine “worked.” But as Dr. Yudkoff reminded colleagues, improvement in ketamine for depression can feel nonlinear.
“The treatments can bring up memories, recollections, feelings that may have been blocked — or thoughts that have been running in a certain line of interpretation that are beginning to shift. All of those things benefit from the hard processing that a therapist does with a patient to help make sense.”
In practice, this means letting change unfold at the patient’s pace. Relief may come quickly, but the meaning of that relief — the “what now?” — takes time.
You can help measure progress by noticing:
- Greater emotional flexibility or curiosity
- Re-engagement with daily life
- Softening of long-held cognitive loops
- The patient’s own words: “I feel different, but I don’t yet know how”
These are signals of change in action — subtle markers that therapy can shape into lasting recovery.
When to adjust pace
Every now and then, the shifts are intense. A patient may report sudden hope, or old trauma memories that reappear in sharper relief.
Those moments, Dr. Yudkoff said, do not have to be red flags — but instead inflection points.
“Sometimes the change is coming with some anxiety or some difficulty. That’s exactly when communication matters most.”
If that happens, slow down. Briefly shift the therapy frame from exploration to stabilization — grounding, reassurance, pacing. We also recommend reaching out to Lumin Health to discuss intervention strategies if necessary. Updates flow both ways for this reason.
Your consistency — the calmness of your familiar therapeutic rhythm — becomes the patient’s frame during a time of new wiring and new feelings.
The Therapist’s Steady Hand as part of Ketamine Treatment
You don’t need a new certification to support clients receiving ketamine treatment or Spravato treatment. You need what you already have: the capacity to listen deeply, to make meaning, and to anchor a client’s change in safety and understanding.
As Dr. Yudkoff put it, “We really enjoy the relationships we have with therapists. We hope that some of the work we do helps deepen the conversations they’re already having with their patients.”
That’s the partnership: Lumin Health handles dosing, vitals, and clinical safety. You continue the work of helping the patient integrate what shifts — whether that’s relief, surprise, or uncertainty — into the enduring fabric of their life.
