Treating job-related stress with psychedelic group therapy: a case series on group ketamine-assisted psychotherapy for healthcare workers and first responders.

Abstract

<h4>Background</h4>Job-related stress and its extreme form, burnout, continue to affect almost half of all frontline healthcare workers and first responders. Current treatments are inadequate.<h4>Objectives</h4>To evaluate a model of ketamine-assisted psychotherapy (KAP) delivered in a group format to address symptoms of anxiety, depression, trauma, and burnout via repeated measures of the Generalized Anxiety Disorder (GAD)-7, Patient Health Questionnaire (PHQ)-9, PTSD Checklist (PCL)-5, and Maslach Burnout Inventory (MBI).<h4>Design</h4>A retrospective cohort analysis of KAP's effect on GAD-7-item scale, PHQ-9-item scale, PTSD Checklist for DSM-5 (PCL-5), and MBI. GAD-7, PHQ-9, and PCL-5 were administered prior to the first group meeting, on the last group date, and 2 weeks after the completion of the final session. MBI was measured twice, as a pre- and post-intervention test. Mystical Experience Questionnaire (MEQ-30) was collected at each integration.<h4>Methods</h4>Participants were recruited via self-referrals and professional collaborations. Participants were screened into groups of six after completing a medical evaluation to rule out contraindications. The seven-week program included three ketamine sessions and four group psychotherapy sessions. Descriptive statistics of the cohort, pre- and post-KAP measurement comparisons, regression modeling, and visualizations were prepared.<h4>Results</h4>Median age was 41 years (24-60), 44% female, and 3% transgender. Participants were 97% White and 3% Hispanic. Many were receiving treatment for depression (59%), anxiety (50%), PTSD (34%), addictive disorders (37%), and other behavioral health conditions (37%). Median pre- versus post-KAP scores for GAD-7 (9.5 vs 6, <i>p</i> = 0.003), PHQ-9 (12 vs 5, <i>p</i> < 0.001), PCL-5 (27 vs 10, <i>p</i> < 0.001), and all three subcomponents of MBI were improved. The last value of MEQ-30 (75 vs 105, <i>p</i> < 0.001) was higher than the first.<h4>Conclusion</h4>KAP in group settings may offer a rapid reduction in depression, anxiety, and trauma-related symptoms. Adverse events were rare. This psychedelically oriented treatment model may represent a viable intervention for epidemic job-related stress in the healthcare workplace and larger controlled studies are warranted.

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