"This is you teaching you:" Exploring providers' perspectives on experiential learning and enhancing patient safety and outcomes in ketamine-assisted therapy.

Abstract

This study explores therapists' perspectives on experiential learning, competencies, and training in ketamine-assisted therapy (KAT), a form of psychedelic-assisted therapy (PAT). We aim to understand how therapists' personal psychedelic experiences influence their self-perceived competency and therapeutic relationships regarding KAT. Licensed therapists from Numinus Wellness clinics in Canada and the USA who were trained in KAT were invited to participate in the study. Participation included a 60-90-minute semi-structured interview conducted remotely via secure videoconferencing. The interviews focused on the professional and personal impacts of providing KAT, its mechanisms, and the role of therapists' personal psychedelic experiences in delivering KAT. Data analysis utilized Interpretative Phenomenological Analysis (IPA) and a mix of deductive and inductive coding with Nvivo software. Eight therapists (62.5% female, 37.5% male) were interviewed. All had formal training in KAT, with many also trained in other forms of PAT. All respondents endorsed the value of personal psychedelic experience for deepening understanding of clients' experiences and strengthening the therapeutic alliance. They all also expressed a desire for formal experiential training in KAT, which they viewed as a missing element in their training. Additional themes identified included the importance of relational safety and the therapeutic container, KAT's impact on professional development, competency, and purpose, and navigating risks and challenges in KAT, particularly with complex trauma clients. Our findings highlight the need for enhanced therapist training and evidence-based standardization of PAT programs that incorporate experiential learning. Such training has the potential to optimize safety and therapeutic outcomes.