Ketamine-Assisted Psychotherapy for Treatment-Resistant Generalized Anxiety: A Program Evaluation

Abstract

Purpose: This project evaluated the effectiveness of Tucson Counseling Associates’ (TCA) ketamine-assisted psychotherapy (KAP) program in treating treatment-resistant generalized anxiety (TRGA) through retrospective analysis of patients' Generalized Anxiety Disorder-7 (GAD-7) scores. Background: Generalized anxiety disorder (GAD) represents a pervasive and burdensome health concern that often proves difficult to effectively treat. KAP has emerged as a promising treatment option for a variety of mental disorders that have proven refractory to other interventions. Limited research suggests ketamine-based interventions (e.g., KAP) are well-tolerated and efficacious in relieving symptoms of generalized anxiety. Methods: Using a Donabedian framework, this project provides an overview of the structures and processes comprising TCA’s KAP program. De-identified data collected by TCA staff was analyzed to evaluate the impact of KAP participation on GAD-7 scores. Paired t-tests and Cohen’s d tests were used to assess statistical significance and effect sizes, respectively. Project findings were compiled into a summary presentation to be shared with TCA stakeholders in an effort to inform current and future practice. Results: Mean GAD-7 total scores for all 51 participants in the KAP program decreased from 9.51 to 7.04 after participating in the KAP program, a statistically significant improvement (p = 0.01) with a small effect size (d = 0.44). Those participants with a GAD diagnosis saw GAD-7 scores improve from 11.46 to 7.15 (p < 0.01, d = 0.80). Those with major depressive disorder experienced similar and significant reductions in anxiety (p = 0.02, d = 0.57), while the effect was smaller and non-significant for participants with post-traumatic stress disorder (p = 0.26, d = 0.28). Individual item analysis revealed reductions on mean scores for each of the seven GAD-7 questions, with five of the seven being statistically significant. Conclusions: Participation in TCA’s KAP program was associated with an effective reduction in symptoms of generalized anxiety. This reduction was most pronounced in those individuals diagnosed with GAD, with the decrease in scores being indicative of remission from GAD. The improvement in GAD-7 scores seen across individual items further suggests a positive impact spanning many core GAD symptoms.