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REVIEW article

Front. Psychiatry
Sec. Psychological Therapy and Psychosomatics
Volume 15 - 2024 | doi: 10.3389/fpsyt.2024.1376646

A Novel Framework for Ketamine-Assisted Couple Therapy

Provisionally accepted
Chandra Khalifian Chandra Khalifian 1,2*Katerine Rashkovsky Katerine Rashkovsky 1Emmaline Mitchell Emmaline Mitchell 1Andrew Bismark Andrew Bismark 1Anne C. Wagner Anne C. Wagner 3Kayla Knopp Kayla Knopp 1,2
  • 1 VA San Diego Healthcare System, Veterans Health Administration, United States Department of Veterans Affairs, San Diego, United States
  • 2 University of California, San Diego, La Jolla, California, United States
  • 3 Remedy. Mental Health Care, Toronto, Ontario, Canada

The final, formatted version of the article will be published soon.

    Intimate relationship distress is prevalent and is associated with poorer health, mental health, and mortality outcomes. Evidence-based couple therapies target cognitive, behavioral, and emotional processes that underlie relationship dysfunction. Increasing research and clinical evidence supports the efficacy of ketamine-assisted psychotherapy (KAP) for addressing clinical mental health concerns, including depression, anxiety disorders, posttraumatic stress disorder, and more. The purported mechanisms of KAP are also likely to improve psychosocial and relational functioning for patients and may be useful for supporting change mechanisms in couple therapy. However, no published work has yet addressed the use of KAP in a couple therapy context. This paper reviews the current evidence for therapeutic ketamine and KAP and outlines how the mechanisms of ketamine therapy may also augment the cognitive, behavioral, and emotional interventions in the most commonly used evidence-based couple therapies. Key mechanisms include increased neuroplasticity, changes in functional connectivity, adaptive dissociation, decreased inhibition, and reduced avoidance. Given the reciprocal interaction between relationship dysfunction and mental health problems, ketamine may also help alleviate relationship distress by directly treating clinical mental health symptoms. We then outline a proposed framework for ketamine-assisted couple therapy, addressing the application of KAP preparation, dosing, and integration to a dyadic intervention framework in a way that can be applied to different couple therapy modalities. This clinical framework for couples’ KAP may be useful for clinicians and researchers working to improve the efficacy of couple therapy, particularly when one or both partners has accompanying mental health concerns.

    Keywords: Couple therapies, psychedelic therapies, ketamine-assisted psychotherapy, psychedelic-assisted couple therapy, relationships

    Received: 25 Jan 2024; Accepted: 17 Jul 2024.

    Copyright: © 2024 Khalifian, Rashkovsky, Mitchell, Bismark, Wagner and Knopp. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Chandra Khalifian, VA San Diego Healthcare System, Veterans Health Administration, United States Department of Veterans Affairs, San Diego, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.