Ketamine Integration Chaplaincy: A Novel Spiritual Care Approach to Psychedelic Integration

Abstract

Ketamine and esketamine are regularly prescribed in the United States as pharmaceutical interventions for treatment-resistant depression. Although ketamine's mode of action is distinct from classic psychedelics, patients frequently report similar alterations in consciousness, including experiences described as spiritual or religious. This article provides an overview of the Ketamine Integration Chaplaincy (KIC) program developed at a university teaching hospital, which provides spiritual care and integration support to patients receiving ketamine. This pilot program offers virtual, one-on-one support to patients and may be one of the first instances of a major hospital providing ketamine integration modeled on spiritual care. The program supported 50 patients and trained four student chaplains from 2022 to 2025. This article reviews the current literature on ketamine-assisted psychotherapy and discusses hospital chaplaincy's longstanding relationship to altered states of consciousness. It articulates why contemporary hospital chaplaincy techniques are well-suited for patients receiving ketamine and other psychedelic treatments. The article then presents the KIC program, including its genesis, training structure, and approach to integration. The article details the theory and practice of six chaplaincy competencies deployed by the KIC program: nondirective presence, facilitating meaning-making, spiritually supportive listening, altered states support, ritual design, and community care.