Journal of psychopharmacology (Oxford, England)
January 1, 2025
Henry A MacConnel, Mitch Earleywine, Steven Radowitz
5 citations
Intravenous ketamine administered in a supportive environment with preparation, intention-setting, integration sessions, eye shades, and evocative music—paralleling psychedelic therapy—was associated with large reductions in PTSD symptoms. In a retrospective sample of 117 outpatients, mean PCL-5 scores dropped from 52.54 to 28.78, with 75% showing clinically meaningful improvement and 62% suggesting remission. No serious adverse events occurred, and concomitant psychotherapy was a significant moderator. The findings suggest that environmental factors may account for variation in previous ketamine studies and that this approach may be a promising option for PTSD unresponsive to other treatments.
Psychotherapy and psychosomatics
June 19, 2026
Judith Rohde, Tyler M Moore, Kathryn Walker et al.
A systematic review and individual participant data meta-analysis of 12 studies (533 participants) found that higher baseline PTSD severity was the most robust predictor of symptom reduction after combined ketamine and psychotherapy. More psychotherapy sessions, more ketamine sessions, and shorter treatment duration were also associated with greater improvement, but these findings are tentative because most studies were of poor quality. The analysis showed that for each additional psychotherapy session, PTSD symptoms improved by an average of 1.03 points on the PCL-5, and for each additional ketamine session, improvement was 1.15 points. The results require confirmation in well-designed prospective trials.
Cognitive and Behavioral Practice
April 1, 2025
M. Earleywine, Henry A MacConnel, Joseph A. de Leo
Metaphors used in psychedelic-assisted therapy (PAT) shape client expectations and outcomes, yet few publications address their deliberate use within a cognitive-behavioral framework. Common metaphors like journeys, brain rewiring, and medicines may not suit all clients or align with learning-focused interventions. This paper introduces baseball's "batting practice" as an alternative metaphor, emphasizing autonomy, agency, responsibility, and the incremental skill-building nature of PAT. Depicting the therapist as a coach reimagines therapy as active engagement, ongoing effort, gradual improvements, and periods of progress and stagnation, paralleling integration processes. The metaphor highlights process over outcomes, persistence, patience, mindfulness, and teamwork. Potential shortcomings are noted to encourage flexibility and collaborative metaphor selection for optimizing outcomes in psychedelic-assisted CBT.