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Integrative Psychiatry

Ketamine Psychotherapy: Treatment Resistant Depression By Will Van Derveer, MD

By August 31, 2020November 18th, 2020No Comments

Getting proper training in Ketamine psychotherapy practice in order to help decide when patients might be appropriate for referral and to consider offering of Ketamine in the practice.

Ketamine has been known to have low and tolerable risks with common dosing ranges. It is not just a chemical treatment by itself but is considered as a tool which means its impact is short-lived and is not to be considered as a substitute for lifestyle changes.

Psychiatry is the only specialty wherein the rates of the illness increase overtime compared to other specialties where the illness has become more controlled.

FULL TRANSCRIPT:

Our goal here today is to really give you information that will help you decide, when your patients might be appropriate for referral for ketamine psychotherapy. We are also going to talk about how you can be inspired to consider offering ketamine in your practice. It really is not that complicated to set up. It is a good idea however to get some good training, as you know, listening to one lecture on ketamine therapy is probably not enough to get started. But if you are interested in training, we could put one together if there’s enough group of people interested in that.

Treatment resistant depression is common. 100 million people in the world have treatment resistant depression. We really haven’t seen new mechanisms in psychiatry since this 80s. One thing that Thomas Insel has said is that, psychiatry is the only specialty where the rates of the illness are increasing over time. You look at cardiology or oncology, you see big changes in terms of how those specialties are controlling the illnesses that they’re working with and depression is really out of control and we need better tools. In a nutshell, depression can come from anywhere on that map, whether it’s from diet, exercise deficiencies, dysbiosis, food sensitivities, and cold infections, toxic exposures, autoimmune problems, psychological issues like disconnection, spiritual problems, unresolved grief.

Treatment resistant depression are really interesting thing for us to work with in integrative psychiatry because it calls on us to use every tool that we have every place on the map we need to look into. The studies on IV ketamine show consistently show a 70% response rate. This is much higher than what you see and study for conventional antidepressants. And the other advantage of ketamine is that, like MDMA, you’re looking at a handful of exposures for most people. We don’t really like the idea of ketamine as a chemical treatment by itself, but we think ketamine is a catalyst. It’s a tool. But when it’s provided as a standalone treatment, and then the person is now getting maintenance, ketamine, it’s a little bit like pumping up somebody’s tire but not patching the hole. You can go down the road for a few days or a few weeks, a few months, and then you’re using the tool again, so I think that should be a lesson to us that we’re not getting to the bottom of things. We’re not addressing what needs to be addressed. And what are the underlying causes.

The most ideal situation for psychotherapy is someone who has fertilizer in their brain and their rumination or their obsessive locked in thought jail that they’re in has a door that’s open. So we can actually look at what’s going on with them and what are their assumptions about reality. How does reality work? What do they want? Who are they?

Ketamine acts like a catalyst. Its chemical impacts are short lived, but it does open up an opportunity for people who are very stuck, who don’t have any motivation to actually begin to execute on the lifestyle changes that we all know are critical for long lasting well-being  to start to happen Ketamine is not a substitute for the lifestyle changes. So, I’m just going to leave you the question How does ketamine fit into your integrative psychiatry perspective? And we want to encourage you to consider for people who are really stuck, that this can be an amazing opportunity for opening. If you’re not interested in providing ketamine yourself, that’s fine. But get to know people in your community who might be well trained and who are doing ketamine therapy in a safe and effective way.

Sara Reed, MS, LMFT

Sara Reed is a Licensed Marriage and Family Therapist and CEO of Mind’s iHealth Solutions, a digital health company that provides evidence based and culturally responsible mental health services for underserved groups. As a mental health futurist and clinical researcher, Sara examines the ways culture informs the way we diagnose and treat mental illness. Sara’s prior research work includes participation as a study therapist in psychedelic therapy research at Yale University and the University of Connecticut’s Health Center. Sara was the first Black therapist to provide MDMA-assisted psychotherapy in a clinical trial and continues to engage in ongoing advocacy work around health equity in psychedelic medicine.

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Jeffrey Guss, MD is a psychiatrist, psychoanalyst, and researcher with specializations in psychoanalytic therapy and the treatment of substance use disorders. He was Co-Principal Investigator and Director of Psychedelic Therapy Training for the NYU School of Medicine’s study on psychedelic-assisted psychotherapy in the treatment of cancer-related existential distress, which was published in Journal of Psychopharmacology, 2016. He currently is a study therapist in the NYU study on Psychedelic-Assisted therapy in the treatment of Alcoholism, a collaborator with Yale University’s study on psychedelic-assisted therapy for Major Depressive Disorder and a study therapist with the MAPS (Multidisciplinary Association for Psychedelic Studies) study on treatment of Post Traumatic Stress Disorder with Psychedelic-Assisted Psychotherapy. 

Dr. Guss is interested in the integration of psychedelic therapies with contemporary psychoanalytic theory and has published in Studies in Gender and Sexuality and Psychoanalysis, Culture and Society. He has published (with Elizabeth Nielson, PhD) a paper on “the influence of therapists’ first had experience with psychedelics on psychedelic-assisted psychotherapy research and therapist training” in The Journal of Psychedelic Studies, August, 2018. He is an Instructor and Mentor with the California Institute of Integral Studies’ Center for Psychedelic Therapies and Supervisor in NYU’s Fellowship in Addiction Psychiatry. 

Dr. Guss maintains a private practice in New York City.

Will Van Derveer, MD

Will Van Derveer, MD is Co-Founder of Integrative Psychiatry Institute and Integrative Psychiatry Centers. Dr. Van Derveer was co-investigator on a phase 2 MAPS study of Psychedelic-assisted psychotherapy for treatment-resistant PTSD, and co-authored the publication of this study in 2018. He has also provided Psychedelic-assisted psychotherapy in two MAPS training studies. An active provider of KAP at his clinic in Boulder, CO, he has been teaching others KAP therapy for several years. Dr. Van Derveer contributed a chapter on mescaline in the 2021 "Handbook of Medical Hallucinogens" (edited by Charles Grob and Jim Grigsby). He is co-host of the Higher Practice Podcast.

Dr. Van Derveer regards unresolved emotional trauma as the most significant under-recognized root cause of psychiatric symptoms in integrative psychiatry practice, along with gut issues, hormone imbalances, inflammation, mitochondrial dysfunction, and other functional medicine challenges. He is trained in Somatic Experiencing, EMDR, Internal Family Systems, and other psychotherapy techniques. His current clinical passion is psychedelic-assisted psychotherapy, which he mentors interested doctors in providing. An avid meditator, he has been a meditation instructor since 2004.

For the past several years Dr. Van Derveer has taught psychiatrists and other psychiatric providers integrative psychiatry in a number of settings, including course directing the CU psychiatry residents’ course as well as with Scott Shannon and Janet Settle at the Psychiatry MasterClass.


Scott has been a student of consciousness since his honors thesis on that topic at the University of Arizona in the 1970s under the tutelage of Dr. Andrew Weil. Following medical school, Scott studied Jungian therapy and acupuncture while working as a primary care physician in a rural area for four years. Psychedelic-assisted psychotherapy became a facet of his practice before this medicine was scheduled in 1985. He then completed a psychiatry residency at Columbia program in New York. Scott studied cross-cultural psychiatry and completed a child/adolescent psychiatry fellowship at the University of New Mexico.

In 2010 he founded Wholeness Center in Fort Collins. This innovative clinic provides cross-disciplinary evaluation and care for all mental health concerns. Scott serves as a site Principal Investigator and therapist for the Phase III trial of psychedelic-assisted psychotherapy for PTSD sponsored by (MAPS). He has also published numerous articles about his research on (CBD) in mental health. Currently, Scott works extensively with psychedelic-assisted-psychotherapy. He lectures all over the world to professional groups interested in a deeper look at mental health issues, safer tools, and a paradigm-shifting perspective about transformative care.

Will Van Derveer, MD is co-founder of Integrative Psychiatry Institute (IPI), along with friend and colleague Keith Kurlander, MA. He co-created IPI as an expression of what he stands for. First, that anyone can heal, and second that we medical providers must embrace our own healing journeys in order to fully command our potency as healers.

Dr. Van Derveer spent the last 20 years innovating and testing a comprehensive approach to addressing psychiatric challenges which transcends the conventional model he learned in medical school at Vanderbilt University and residency at University of Colorado, while deeply engaging his own healing path.

He founded the Integrative Psychiatric Healing Center in in 2001 in Boulder, CO, where he currently practices. Dr. Van Derveer regards unresolved emotional trauma as the most significant root cause of psychiatric symptoms in integrative psychiatry practice, along with gut issues, hormone imbalances, inflammation, mitochondrial dysfunction, and other functional medicine challenges. He is trained in Somatic Experiencing, EMDR, Internal Family Systems, and other psychotherapy techniques. His current clinical passion is psychedelic-assisted psychotherapy, which he mentors interested doctors in providing. An avid meditator, he has been a meditation instructor since 2004.

For the past several years Dr. Van Derveer has taught psychiatrists and other psychiatric providers integrative psychiatry in a number of settings, including course directing the CU psychiatry residents’ course as well as with Scott Shannon and Janet Settle at the Psychiatry MasterClass. In addition to his clinical work and teaching, he was co-investigator in 2016 a Phase II randomized clinical trial, sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS). He continues to support this protocol, now in a Phase III clinical trial under break-through designation by FDA.

Dr. Van Derveer is a diplomate of the American Board of Integrative and Holistic Medicine (ABoIHM) since 2013, and he was board certified in the first wave of diplomates of the new American Board of Integrative Medicine (ABIM) in 2016.