Exploring Cultural Competence, Inclusivity, and Diversity in Ketamine Assisted Psychotherapy: A Phenomenological Study.

Black, Indigenous, and People of Color (BIPOC), and other minoritized populations are insufficiently represented in research on therapeutic psychedelics. This research was a phenomenological qualitative exploration of a culturally diverse (Hispanic, African American, Asian, Native American, biracial, or LGBTQIA+) and low-income sample of 15 individuals receiving ketamine-assisted psychotherapy (KAP) at a sliding-scale fee community clinic. Participants were interviewed after a ketamine session, after a ketamine integration session, and one month later. The interviews inquired about mental and emotional state prior to treatment and the treatment context (traditionally called set and setting), preparation for treatment, experiences during the ketamine and integration sessions, barriers to treatment, perceived stigma if any, reflections on KAPs' impact, and relevance of culture to the treatment. The current analysis, which focuses on participant comments related to diversity, equity, and inclusion that are uniquely relevant to this sample and the research goals, yielded four major themes: Insufficient Financial Resources, Race, Ethnicity, and LGBTQIA+, Stigma, and Culture and Ritual. Themes and subthemes are presented accompanied by representative quotes. Results demonstrate the high salience of culture in the KAP experience and the need to incorporate issues of race, culture, stigma, ritual, and socioeconomic status into treatment planning and outcome research.