Ketamine-assisted psychotherapy is being introduced as a new approach for patients with serious illnesses who experience psychospiritual distress. The program, initiated by Rob Horowitz, MD, aims to address the anxiety and existential dread that often accompany advanced cancer, heart failure, or neurological disease. Traditional treatments such as antidepressants and counseling do not always provide relief for these symptoms.
The Pal-KAP clinic offers a three-phase process: preparation in a calm environment where facilitators build trust and help patients set intentions; administration of ketamine in a controlled setting with supportive facilitators; and integration sessions to discuss insights gained during the experience. Patients report outcomes such as reduced fear of death, feelings of serenity, disembodiment experiences described in spiritual terms, and greater agency over their suffering.
One patient with terminal cancer noted after three sessions that they no longer feared dying and felt prepared to say goodbye on their own terms. The program’s progress has been supported by philanthropic funding totaling $1 million, which supports both patient care and research efforts.
Research led by Marc Swogger, PhD at the University of Rochester Medical Center (URMC), is underway to study different models of ketamine-assisted psychotherapy. The four-year study will compare various practices—from low-dose nasal sprays without therapy to full integration models like Pal-KAP—and assess psychological outcomes. The goal is to gather data necessary for Food and Drug Administration approval so that trials can be expanded to other life-threatening or psychiatric conditions.
Pal-KAP also focuses on training clinicians from diverse backgrounds. Recent workshops have included training for serving deaf patients, with additional facilitator courses planned for the future.
Although only 25 patients have participated so far, the program continues at a measured pace while seeking sustainable growth through ongoing research and training initiatives.
