Evaluating Group Ketamine-Assisted Psychotherapy for Treatment-Resistant Depression and Trauma-Related Symptoms

Abstract

Purpose: This Doctor of Nursing Practice (DNP) project evaluates the efficacy of group ketamine-assisted psychotherapy (KAP) in treating depressive symptoms, trauma-related symptoms (i.e., intrusion, avoidance, cognition and mood, arousal and reactivity), and suicidality in comparison to individual KAP and a mix of individual/group KAP.Background: Adjunct group psychotherapy may enhance ketamine’s efficacy and facilitate enduring therapeutic outcomes. A Treatment Clinic in the Southwest (TCSW) offers group KAP for clients predominantly presenting with depressive and trauma-related symptoms. To date, an evaluation of TCSW’s group KAP program outcomes has not been conducted to assess its effectiveness in addressing depressive symptoms, trauma-related symptoms, and suicidality. Methods: This evaluation, adhering to CDC guidelines, employed paired t-tests to assess group KAP efficacy by comparing pre-and post-intervention changes in depressive (PHQ-9), trauma-related (PCL-5), and suicidality (PHQ-9 Q9) symptoms. A one-way ANOVA compared group KAP effectiveness to individual and mixed KAP approaches. The study spanned from June 2021 to May 2024, examining improvements in depression, trauma symptoms (intrusion, avoidance, cognition/mood changes, arousal/reactivity alterations), and suicidality, aiming to elucidate group KAP's efficacy in treating depressive symptoms, trauma-related symptoms, and suicidality. Results: Statistical analysis using paired t-tests revealed that group KAP proved to be the most effective in addressing trauma-related symptoms, encompassing intrusion, avoidance, cognition and mood changes, and alterations in arousal and reactivity. Clients with depressive symptoms also showed improvement through group KAP. However, suicidality, as assessed by the ninth question of the PHQ-9 focusing on suicidal thoughts, remained largely unchanged in this treatment modality. ANOVA findings indicate comparable effectiveness across the different KAP formats (group KAP, individual KAP, or mixed individual/group KAP) in treating depressive symptoms, trauma-related symptoms, and suicidality. Discussion: The results demonstrated the efficacy of group KAP, with optimal effectiveness in addressing trauma-related symptoms and moderate improvement in depressive symptoms. The impact on suicidality was less evident. Comparable effectiveness across KAP formats (group, individual, mixed) suggests similar therapeutic benefits, enabling treatment flexibility based on client preferences, practical considerations, and specific therapeutic goals without compromising efficacy.