Why does 'set and setting' matter?
In Ketamine-Assisted Psychotherapy (KAP), "set and setting" isn't just a concept—it’s a clinically significant variable. Research has consistently shown that the environment profoundly influences the therapeutic efficacy of psychedelics, including ketamine (Carhart-Harris et al., 2018). A well-prepared, intentional space can reduce client anxiety, encourage introspection, and improve therapeutic outcomes.
What is Ketamine-Assisted Psychotherapy?
KAP consists of preparation, dosing, and integration sessions. During a Ketamine-Assisted Psychotherapy (KAP) dosing session, the KAP patient self-administers their prescription and has an inward journey, which usually lasts about 45 minutes. During this journey, the patient typically reclines and wears an eye mask and headphones, where they listen to a supportive playlist.
Where does a dosing session take place?
KAP sessions can take place in-person (typically in a therapist’s office) or remotely (the patient is in their own home). They can be individual, or take place in a group setting, including within the context of a retreat. Whether you're setting up your office or your home for a KAP session, this guide will walk you through the steps of creating a comfortable, intentional, and well-prepared space for a KAP dosing session.
Step 1: Gather Essential Materials
What materials are required for a Ketamine-Assisted Psychotherapy (KAP) session?
Required Items
- Comfortable couch, mat, or reclining chair
- Pillows and blankets
- Blood pressure monitor (wrist cuff recommended)
- Cup for spitting medicine
- Facial tissues
- Lined wastebasket (in case of nausea)
- Eye mask
- Headphones or speaker
- Downloaded music playlist (without advertisements)
- Notepad and pen
- Chair for therapist (in-person sessions)
- Fully charged laptop and strong Wi-Fi (remote sessions)
Optional Items
- Additional blankets
- Small dishes to place lozenges
- Candle, essential oils, or incense
- Healthy snack for after the session
- 'Do Not Disturb' sign
- Chair or stool to sit closer to client as needed
- Nourishing drink (tea, smoothie, etc.)
- Ginger lollipops (for after spitting)
- Art supplies for creative expression
- Journal for client reflection
Step 2: Set Up Your Space for a KAP Session
Once you have your materials ready, it’s time to set up your space for the KAP dosing session. A well-prepared space should foster a sense of safety, encourage introspection, and minimize outside distractions as much as possible. Thoughtful details—like lighting, sound, scent, and furniture arrangement—are key for enhancing the experience and shaping the therapeutic container.
Checklist for preparing your physical space
- Set up a comfortable couch/bed with blankets and pillows
- Ensure the space is private and quiet with minimal external stimuli
- Create an aesthetically pleasing environment (fresh flowers, greenery)
- Adjust lighting to be dimmable
- Ensure temperature is comfortable (slightly warmer than normal)
- Have a clear path to the bathroom
- For group sessions: Create separate, comfortable breakout spaces
- For remote sessions: Guide client to prepare a private, comfortable space
Day-of setup tasks
- Set up all session materials
- Adjust the space to be calm and relaxing
- Review client notes and their intentions
- Put away distractions, including devices
- Center and ground yourself before the session
- Have pen and notepad ready to record vitals
- Turn your phone/devices to 'Do Not Disturb' mode
- Prepare dishes to keep lozenges ready for swishing
- Prepare a cup for spitting the medicine
- Have refreshments ready for after the session
Remote/Self-Guided Considerations
When experiencing KAP remotely or doing self-guided sessions, the KAP patient prepares their own space. As a therapist, you can help your clients create a suitable home setup by providing clear guidance on navigating the experience without you physically there to hold space.
Important considerations for remote/self-guided KAP
- Ensuring the space is free from interruptions or distractions
- Having a door that can be closed for privacy
- Comfort level if the space is in a shared dwelling
- Chaperone's ability to support throughout the experience
- Having a plan to manage potential interruptions
- Putting phone on airplane mode and disconnecting potential interfering noises
- Having strong Wi-Fi and fully charged devices for remote sessions
Creating an intentional, comfortable, and supportive space lays the foundation for a safe and effective KAP experience. With the proper set and setting, KAP patients can fully engage in the psychedelic experience, unlocking deep emotional processing and lasting mental health outcomes.