Ketamine Assisted Psychotherapy for Frontline Workers Image

Ketamine-Assisted Psychotherapy for Frontline Workers

Truffle Report Connects with Dr. Reid Robison of Novamind to Discuss Treating the Pandemic’s Other Casualties

The COVID-19 pandemic has been long and exhausting, and frontline workers have had to witness the worst of things since the onset. As cases skyrocketed, so did the pressure. As they continued to risk their lives and health, their psychological well-being also deteriorated drastically.

Courtesy of Vice

The Psychedelic Renaissance — the reemergence of psychedelics for their therapeutic benefits — is intervening in mainstream mental healthcare at a crucial time, when many of us are struggling with heightened anxiety, depression, and substance use arising from living through COVID-19. In an attempt to provide novel treatment protocols to frontline workers, one mental healthcare company has launched a psychedelic therapy pilot with ketamine.

Novamind, a mental healthcare organization working to ensure access to psychedelic medicine through a network of clinics, retreats, and clinical research sites, is providing free-of-cost ketamine-assisted therapy to frontline workers in Utah and Colorado.

“We really paid attention to the trauma, stress and burnout experienced by frontline workers,” shares Dr. Reid Robison, Chief Medical Officer of Novamind. “There’s a significant risk of burnout among healthcare workers, worsening during the pandemic.”

Explaining the common symptoms of psychological distress, Dr. Robison says, “Healthcare workers helping others experience fatigue, burnout, or exhaustion spilling into everyday life. Along those lines, there’s ‘compassion fatigue’ that can happen by giving so much of yourself and not recharging your own batteries, which is hard to do in times of crisis like the peak of a pandemic. The last thing would be trauma. Vicarious trauma is sometimes brought on by helping others who have been through difficult things and taking that on as an empathetic professional in the healing arts.” 

A survey published by The Lancet in May 2021 revealed that 61 percent of U.S. healthcare professionals reported fear of exposure transmission, 38 percent reported anxiety, and 43 percent experienced work overload while 49 percent had burnout. The survey polled over 20,000 healthcare professionals representing 42 organizations.

Frontline ketamine-assisted psychotherapy, or ‘Frontline KAP’, is a first-of-its-kind program designed to treat frontline workers with ketamine as their work-related stress and trauma continue to grow. 

Ketamine has moved from being a party drug to a medicalized substance for treating symptoms of depression and trauma. Since Spravato’s (esketamine) approval by the U.S . Food and Drug Administration (FDA), healthcare professionals have been using a combination of therapy and ketamine — ketamine-assisted psychotherapy— for mood disorders and suicidal ideation.

Dr. Robison shared that the protocol for frontline workers differs from the regular intake for patients seeking relief through ketamine-assisted psychotherapy. 

Delivering the substance through six treatment sessions, the therapy will be conducted in small group settings. Group therapy in particular is expected to play a strong role in the healing process among these individuals, Dr. Robison said. 

“The Frontline KAP project in a group setting is to not only provide ketamine as a medicine for depression and trauma that acts quickly, but to offer a group therapy session where individuals can see they’re not alone in this,” he told Truffle. “The individuals can open up safely and work through things to get back and thrive more in their lives and their jobs.”

As a part of the protocol, the first session is dedicated to preparation, with participants hearing each other’s stories, building relationships and focusing on set and setting. The following session is to consume low doses of ketamine. 

“This is a low dose where there’s interaction but more openness and to help build trust and ease defences. You might call this a psychoanalytic dosing, or greasing the wheels of therapy. After each dosing session, the next group will be able to make sense of those experiences, draw wisdom from them into everyday life,” Dr. Robison shares.

Medium doses are about exploring personal experiences, with the final dosing session involving injections rather than oral doses. Dr. Robinson adds, “We’re still in a group setting, but the individuals have eyeshades, headphones and music. They’re supported by at least two therapists and other support as needed to help sit for the person, and guide them through anything difficult.” 

The sessions are then followed by integration where individuals process their experiences as a group. 

“The last step is to take these insights we’ve had collectively and manifest them in their fullest expression. With a fresh perspective, where cups are filled up from focusing on our mental health, we can go forward with a follow-up plan to do whatever we can to sustain these positive changes,” Dr. Robison explains. 

Through this, he adds, “We set up the path in a sustainable way so people can get back to the profession they love without it being overwhelming or all-consuming.”

The pilot program began with a screening process, collecting information from the frontline healthcare workers through a questionnaire designed around areas of burnout, compassion, fatigue, and trauma. This was then followed by a one-to-one video chat to get familiar with the two facilitators. Since ketamine is a controlled substance in the U.S., the organization is required to maintain records of diagnosis.

“We’re all about accessibility, and treating or helping groups who might be traditionally overlooked. This clinical pilot program will help us inform whether or not we can or should offer it more broadly at our clinics, or even in our hybrid clinic/retreat model,” Dr. Robison says.

He adds that if the program stands as a success, Novamind would attempt to get the clinical treatment covered by either employers of the frontline workers, or by insurance providers.

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