Amanda Vogel, board-certified Psychiatric Mental Health Nurse Practioner breaks down the differences between Ketamine Assisted Psychotherapy (KAP) & Ketamine Infusion Treatment (KIT)

As ketamine gains recognition as a powerful tool for mental health, understanding the options for treatment can help you make an informed choice.

Ketamine Assisted Psychotherapy (KAP) and Ketamine Infusion Treatment (KIT) both use ketamine’s therapeutic effects but offer different approaches to healing.

Whether you’re looking for an in-depth therapy experience or targeted symptom relief, this guide breaks down the key differences to help you decide which path may be right for you.

Understanding Ketamine Assisted Psychotherapy (KAP): A Holistic Approach to Healing

What to Expect in a KAP Session: Preparation, Administration, and Integration

KAP (Ketamine Assisted Psychotherapy) refers to a holistic treatment course that includes ketamine administration sessions combined with psychotherapy. Sometimes, KAP clinicians start with preparation, which occurs before the ketamine administration course begins and aims to help you manage expectations and set intentions for your journeys. However, the type of therapy most commonly associated with KAP is referred to as integration, which occurs after each ketamine experience.

The Importance of Integration Therapy for Lasting Transformation

Integration therapy is a specialized framework that utilizes specific modalities to help you integrate the ketamine experience into your daily life. The idea is to identify cognitive insights or emotional breakthroughs that may have occurred during the ketamine session and translate them into action plans to optimize healing and growth going forward.      

When Should Integration Therapy Happen? Timing for Optimal Neuroplasticity

Integration can be done with your already-existing long-term therapist or with a therapist who has a short-term role only during the course of ketamine. Some people choose to have integration directly following the journey as soon as the medicine has worn off, and some choose to have integration later that day or the next day.

It all depends on preference regarding when you feel most able to articulate and express your experience. The gold standard, however, is that integration should happen within 48 hours of administration.

This is when you are most able to reach insights and maximize any shifts that may have occurred in your inner life. These 48 hours are referred to as the neuroplastic window, when your brain is in a ketamine-induced malleable and fluid state (more on neuroplasticity below).

In some instances, a therapy session can occur during the actual ketamine administration. In these cases, the ketamine is given at a lower dose, which allows you to remain able to engage while on the medicine verbally. This is referred to as a psycholytic dose, whereas the larger doses are considered to be psychedelic or dissociative.

What Is Ketamine Infusion Treatment (KIT)?

How KIT Works Without a Psychotherapy Component

KIT (Ketamine Infusion Treatment) refers simply to a course of treatment in which ketamine is administered via intravenous infusion without psychotherapy officially attached.

This usually takes place in a ketamine clinic and is less integrative and more focused on symptom reduction. This doesn’t mean, however, that therapy does not occur; many ketamine clinics do not provide therapy but do encourage you to pursue integration and facilitate this by providing referrals.

Combining KIT with Therapy for Better Results: How to Find Support

You can always purchase a KIT series and find an integration therapist on your own, or continue with your pre-existing therapist.

Many people choose this option, especially if their therapist has training or literacy in ketamine or other psychedelic medicines.

How Does Ketamine Promote Neuroplasticity?

What Neuroplasticity Means for Mental Health and Emotional Well-being

Basically, neuroplasticity is a state in which our brains are easily influenced, sensitive, and impressionable.

As children, for example, our brains are highly neuroplastic, but that neuroplasticity decreases with age as our brains become more fixed and rigid.

It is theorized that developmental trauma and depression accelerate the process of rigidity, locking our brains into negative thinking patterns from which breaking free is very difficult.

Depression actually changes the structure of our brains, causing faulty neural connections that restrict neurons from communicating and connecting.

The good news is that our brains have an innate ability to change function and structure—to increase neuroplasticity—in response to environmental inputs and experiences.

The Role of BDNF and Glutamate in Ketamine Therapy

One of these “environmental inputs” is ketamine.

Ketamine increases two important constituents of our brains: BDNF (brain-derived neurotrophic factor), a protein responsible for learning and memory, and glutamate, a neurotransmitter involved in mood regulation.

Both BDNF and glutamate work to form new circuits between neighboring neurons, promote the formation of new synapses, and improve communication between neural receptors.

All of these actions ultimately improve overall brain functioning and flexibility, especially in promoting an enhanced capacity to break free from habitual negative thinking.

In turn, new neurochemical and psychological pathways are unlocked, the brain’s ability to learn and change increases, and we become open to developing new patterns of cognition, feeling, and behaving.

Research suggests that these changes can be maximized and sustained by taking certain actions when our brain is most neuroplastic, responsive and adaptable.

These actions include integration therapy and ongoing psychotherapy to encourage and support the undertaking of positive life changes.

It is believed that when a post-ketamine patient puts effort into new self-care practices, including changing daily habits over time, this strengthens and sustains the new synaptic connections.

This symbiotic relationship between physiological brain growth and dedication to changing habits is what creates durable positive shifts in thought, outlook, mood, and behavior.

Exploring Bioavailability: Which Ketamine Administration Method Is Best?

The Four Methods of Ketamine Delivery and Their Effectiveness

There are four different ways to deliver ketamine, referred to as routes of administration:

• Oral/sublingual

• Nasal spray

• Intramuscular (IM)

• Intravenous (IV)

Understanding Bioavailability Rates: Which Option Is Right for You?

Bioavailability refers to the proportion of a drug which enters the circulation of your body and therefore has an active effect.

For example, if the route of administration provides 100% bioavailability, 100% of the medicine is utilized by your body.

If the route of administration provides 30% bioavailability, 30% of the medicine is utilized, and 70% is eliminated as waste.

For this reason, all of the routes of administration have different dosing protocols to get you into a therapeutic or dissociative state.

The differing bioavailability is:

• Intravenous (IV): 100%

• Intramuscular (IM):  93%

• Intranasal: 25 – 50%

• Oral / Sublingual: 10 – 30%

Choosing Between Ketamine Assisted Psychotherapy and Ketamine Infusion Treatment

Both Ketamine Assisted Psychotherapy (KAP) and Ketamine Infusion Treatment (KIT) offer unique pathways for mental health treatment, but they cater to different therapeutic goals.

KAP combines ketamine administration with psychotherapy, creating a holistic experience that uses preparation, integration, and ongoing therapeutic support to deepen the healing process.

This approach is well-suited for individuals seeking to uncover insights, process emotions, and work toward long-term change.

In contrast, KIT is focused on immediate symptom relief through intravenous ketamine infusions without an attached psychotherapy component.

Although it doesn’t formally include integration, many clinics encourage patients to seek additional therapeutic support for lasting benefits. This flexibility appeals to those who may already have a therapist or prefer to access psychotherapy separately.

Choosing the right approach will depend on your needs and goals and whether you seek an in-depth therapeutic experience or targeted symptom relief.

In any case, both KAP and KIT offer promising options to support mental health and pave the way for sustainable healing and growth.

If you’re considering ketamine therapy in New York City, reach out to Third Nature Therapy for a holistic KAP approach, or connect with Stella Center for targeted KIT support.

More notes on psychedelics:

Amanda Vogel is a board-certified Psychiatric Mental Health Nurse Practitioner with over 16 years of clinical experience working in behavioral health and emergency psychiatry. She received her Bachelor of Science degree from New York University and her Master of Science degree from Stony Brook University. In 2019, she helped initiate, design, and operate the ketamine infusion service for psychiatric inpatients at New York-Presbyterian Hospital/Weill Cornell Medical Center. Convinced of this medicine’s potential to catalyze true healing, she has moved into working with ketamine as her primary focus. Naturally inclined toward humanistic care, she approaches her work every day with empathy, curiosity, and compassion.