A cohort-based case report: The impact of ketamine-assisted therapy embedded in a community of practice framework for healthcare providers with PTSD and depression
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Issue Date
2022-01-12
Authors
Dames, Shannon
Kryskow, Pamela
Watler, Crosbie
License
Subject
Abstract
Amid an international pandemic and a worsening mental health crisis, ketamine-assisted
therapy is emerging as a promising solution for those deemed “treatment
resistant.” Post-traumatic stress disorder (PTSD) and depression are on the rise, with
accelerating direct (e.g., burden of suffering) and indirect (e.g., disability/role impairment
and impact on family) costs. Psychedelic-assisted therapies show significant promise
in the treatment of a number of clinically challenging conditions, including depression,
anxiety, PTSD, addiction, and end-of-life distress. Ketamine is currently the only safe,
effective and legal widely available psychedelic-like medicine. To address the echo
pandemic of health care provider distress, a multi-disciplinary team was charged with
developing a ketamine-assisted psychotherapy program, delivered in a community of
practice (CoP) group model and evaluated in a quality improvement framework. Program
evaluation occurred through mixed methods. Quantitative mental health assessments
included the PHQ-9 for depression, the PCL-5 for PTSD, GAD-7 for generalized anxiety
disorder (GAD), and B-IPF for work/life functionality. Participant narrative feedback
was collected to evaluate outcomes and for quality improvement purposes. Mean
mental health scores were collected across three cohorts, totaling 94 patients. The
mean aggregate scores of participants meeting the mental health assessment cut-off
criteria (screening positive) were analyzed to assess clinical significance. Mean aggregate
results comparing baseline vs. outcome measures (measured within 1–2 weeks after
completion of the 12-week program) were clinically significant, demonstrating significant
improvements in depression, post-traumatic stress disorder, generalized anxiety disorder
and work/life functionality. In summary, 91% saw improvements in generalized anxiety,
79% saw improvements in depression, 86% of those who screened positive for PTSD
now screen negative, and 92% had significant life/work functionality improvements.
Qualitative feedback was overwhelmingly positive, with several unsolicited self-reports
of transformation. Participant and team feedback enables the program to continue improving with each iteration. Results speak to the effectiveness of ketamine for
psychedelic-assisted therapy, supported by a CoP framework. Outcomes are relevant
for mental health programming, education and healthcare policy.
Description
This article was originally published as: Dames, S., Kryskow, P., & Watler, C. (2022). A cohort-based case report: The impact of ketamine-assisted therapy embedded in a community of practice framework for healthcare providers with PTSD and depression. Frontiers in Psychiatry, 12, 1-7. https://doi.org/10.3389/fpsyt.2021.803279