Ketamine Infusion Therapy, Session by Session: What Every Provider Should Know

Summary: Ketamine therapy isn’t linear—it’s layered, unpredictable, and deeply personal. This guide walks providers through each stage of the six-session induction process, offering insight into what clients typically experience and how to support them through both the breakthroughs and the emotional recalibration.

Ah, ketamine infusion therapy—the cutting edge of psychiatric and chronic pain treatment, where science meets psychedelia, and patients meet their own subconscious in high-definition. If you’re a provider venturing into the world of ketamine-assisted treatment, welcome. Buckle up. It’s an interesting ride.

One of the most important things to understand when guiding patients through ketamine induction is that this is not a linear process. People often come in expecting a straight shot to feeling better—like they’re hopping on an elevator to the penthouse of their own mental health. Instead, they get something more like a roller coaster with a few surprise loops and an unexpected detour through childhood trauma.

So, let’s break down the six-session induction protocol—how each infusion builds on the last, what you (and your patients) should expect, and why the middle infusions are where things get crunchy and weird.

What’s Happening?

This is the introduction. The nervous system gets its first taste of neuroplasticity. The NMDA receptors—glutamate receptors critical to synaptic plasticity and memory—begin responding. Patients often describe this session as strange but surprisingly pleasant—like emerging from the best nap of their lives, feeling rested but a bit bewildered.

Common Reactions:

The Provider’s Role:

What’s Happening?

The brain notices something’s different. By now, the amygdala—the almond-shaped structure responsible for detecting threats and triggering fear responses—is wary. It’s designed to detect and resist change, and this infusion triggers its suspicion.

Common Reactions:

The Provider’s Role:

What’s Happening?

This is where things get uncomfortable. The brain is deep in the process of rewiring. Old patterns are being disrupted, and the limbic system—a network responsible for emotional processing, motivation, and memory—is having a tantrum.

Common Reactions:

The Provider’s Role:

What’s Happening?

At this point, clients may not feel euphoric, but they feel different. The nervous system is calmer, the amygdala less reactive. There’s a sense of steadiness—foreign, but welcome.

Common Reactions:

The Provider’s Role:

Ketamine treatment is a process, not a one-time event.

As providers, we must guide clients through the discomfort and remind them: growth doesn’t always feel good in the moment. Discomfort does not mean failure—it often signals that something powerful is happening.

Understanding the predictable flow allows us to guide clients with confidence, clarity, and even a little humor to get through the crunchy middle! Prepare clients for variation. Reassure them through the emotional chaos. Help them make sense of the shift. 

Ketamine opens the door—but integration builds the new room.

Because if there’s one rule in ketamine therapy, it’s this: every journey is different—and nothing stays the same for long.