Medicine assisted approaches to mental health treatment featuring insights from Amanda Baker, LCSW

What happens when you combine two of the most effective treatments for depression, PTSD, and trauma? In a recent conversation on The Self Carepist Therapist Podcast, Amanda Baker, LCSW, a clinical social worker and EMDR therapist in Colorado Springs, shared her journey into ketamine-assisted psychotherapy (KAP) and why pairing it with EMDR therapy creates breakthrough results for clients who have struggled with traditional treatment approaches.

The Unexpected Path to Psychedelic-Assisted Therapy

Amanda Baker didn’t set out to become a ketamine-assisted psychotherapy provider. In fact, like many therapists, she approached the topic with healthy skepticism. As someone who describes herself as “non-interested in adding chemicals into my life,” the idea of incorporating psychedelics into her therapeutic practice seemed counterintuitive at first.

But then something clicked. While watching a CBS Sunday Morning segment about ketamine, Baker learned about its mechanism of action in the brain. Her immediate reaction? “That’s exactly like EMDR.”

This realization became the catalyst for her deep dive into ketamine-assisted psychotherapy, ultimately leading her to discover how powerfully these two evidence-based approaches work together to treat depression, PTSD, and complex trauma.

Understanding Ketamine-Assisted Psychotherapy (KAP)

What Is Ketamine-Assisted Psychotherapy?

Ketamine-assisted psychotherapy combines the use of ketamine (a dissociative medication with powerful antidepressant properties) with psychotherapeutic support. Unlike traditional medication management where a pill is prescribed and the patient goes home, KAP involves intentional, supported experiences that create opportunities for profound psychological healing.

Baker explains that ketamine works by opening neural windows in the brain, stimulating GABA receptors, and allowing the nervous system to feel less defended. This creates the perfect conditions for therapeutic breakthroughs that might otherwise take months or years to achieve through talk therapy alone.

The Connection Between Ketamine and EMDR Therapy

The similarity between ketamine and EMDR therapy lies in their shared mechanism: both create new neural development in the brain. Research shows that both interventions activate specific brain regions associated with relaxation, healing, and emotional processing.

When combined, ketamine and EMDR therapy work “like two parts of a locomotive functioning down the track, supporting one another,” as Baker describes it. The ketamine opens the neural pathways, while EMDR therapy for trauma, depression, or PTSD helps process and integrate the material that emerges.

Why This Combination Works: Both EMDR therapy and ketamine change the brain’s ability to process traumatic memories and negative beliefs. EMDR uses bilateral stimulation to help the brain reprocess stuck memories, while ketamine temporarily reduces psychological defenses, making it easier to access and work with difficult material. Together, they create a “supercharged experience” that can reduce the intensity often associated with EMDR therapy for PTSD or complex trauma.

Types of Ketamine Treatment: Understanding Your Options

Not all ketamine treatment is created equal. Baker outlines several delivery methods, each with different applications and levels of psychotherapeutic integration:

IV Ketamine Infusion

This method involves intravenous administration of ketamine, typically in specialized infusion centers. Clients receive higher doses that create psychedelic experiences. While some centers provide well-curated environments with intention-setting support, others operate more like dialysis centers with multiple clients receiving infusions simultaneously.

During IV ketamine sessions, clients are generally on a “psychedelic journey” and not actively participating in talk therapy. However, a therapist may be present to hold space and ensure safety.

Intramuscular (IM) Ketamine

IM ketamine involves injections at specialized treatment sites. Like IV administration, this requires medical oversight and prescription, and typically produces psychedelic-level experiences.

Oral Lozenges (Psychedelic Dose)

This is the primary method used at Baker’s practice, Mindful Springs Counseling. Clients attend three to four-hour dosing sessions where they take ketamine lozenges that create a psychedelic experience at a lower intensity than IV or IM administration.

Oral Lozenges (Low-Dose Psycholytic)

This is Baker’s preferred method for integrating ketamine with EMDR therapy. Clients receive 25 to 100 milligrams of ketamine, allowing them to walk, talk, and actively participate in therapy while benefiting from the ketamine running “in the background.” This approach is particularly effective when combining ketamine with EMDR therapy for depression or anxiety.

Esketamine Nasal Spray

Esketamine (brand name Spravato) is the only FDA-approved form of ketamine for treatment-resistant depression. It’s administered as a nasal spray, typically in clinical settings, though some at-home use is permitted.

Self-Paced/Self-Dosing

Some clients receive prescriptions for at-home dosing with therapeutic support. However, Baker emphasizes that ketamine treatment without psychotherapy integration misses the crucial component of helping clients make meaning of their experiences.

The Essential Role of Preparation and Integration

One of the most important aspects of effective ketamine-assisted psychotherapy is what happens before and after the dosing session. This is where Baker’s expertise in EMDR therapy becomes particularly valuable.

Preparation: Laying the Groundwork

Preparation in ketamine-assisted psychotherapy mirrors the first two phases of EMDR therapy: history-taking and resourcing. Before any ketamine session, clients need to:

Establish therapeutic relationship and safety. Baker emphasizes that your nervous system needs to know the therapist’s nervous system well enough to trust it during vulnerable moments. This is why she doesn’t recommend ketamine treatment without adequate preparation, even for clients who arrive eager to start immediately.

Set clear intentions. What does the client hope to work on? Common intentions include radical acceptance, self-compassion, releasing specific traumas, or healing relational wounds.

Create optimal set and setting. “Set” refers to the client’s mindset and intention. “Setting” refers to the physical environment where the dosing will occur. For at-home sessions, clients work with their therapist to create a space that supports their intention. If the intention is self-compassion, how can the environment reflect that?

Understand what to expect. Informed consent includes discussing potential side effects (like nausea), what the experience might feel like, and how the therapist will provide support.

Address specific concerns. For example, if a client has fear of nausea, extra preparation addresses this to prevent it from dominating the experience.

Integration: Making Meaning of the Experience

Integration is where the real therapeutic work happens, and it’s where EMDR therapy shines in combination with ketamine.

Research shows that the brain has an optimal window for neural growth following ketamine treatment: 24 to 48 hours. This is when integration work is most powerful. Baker uses EMDR therapy phases three and four (assessment and desensitization) to help clients process what emerged during their ketamine journey.

For example, if a client’s intention was self-compassion, the integration session might target the positive cognition that emerged (like “I am worthy of love”) and use bilateral stimulation to strengthen and install it. If traumatic material surfaced unexpectedly (which can happen with both ketamine and EMDR therapy), the integration session provides an opportunity to process it safely.

The Power of Integration: Without integration, ketamine experiences can feel profound in the moment but fail to create lasting change. With skilled integration using EMDR therapy for trauma or depression, clients not only have the experience but develop new neural pathways that support sustainable healing. As Baker notes, even material that surfaces unexpectedly can be therapeutically valuable when there’s a trained professional to help integrate it.

How EMDR Therapy Enhances Ketamine Treatment

For therapists trained in both modalities, EMDR therapy provides a perfect framework for ketamine-assisted psychotherapy.

The Eight Phases Applied to KAP

Phases 1-2 (History and Preparation): These become the preparation phase for ketamine work, establishing safety, gathering history, building resources, and setting intentions.

Phase 3 (Assessment): During integration, the therapist helps identify what target emerged from the ketamine journey and pairs it with the appropriate positive cognition.

Phase 4 (Desensitization): Bilateral stimulation helps process and integrate the material that surfaced. Importantly, Baker uses tactile bilateral stimulation (tapping) rather than eye movements during and immediately after ketamine sessions to avoid triggering nausea.

Phases 5-8 (Installation, Body Scan, Closure, Reevaluation): These continue in subsequent sessions to strengthen positive beliefs, ensure complete processing, and monitor progress.

Why Low-Dose Psycholytic KAP Works Well With EMDR

Baker has gravitated toward low-dose ketamine (25-100mg) specifically because it allows for active EMDR therapy during the session. Unlike high-dose psychedelic journeys where clients are largely internal and non-verbal, low-dose sessions enable clients to:

Remain conversational and responsive

Actively participate in bilateral stimulation

Process material in real-time with therapist support

Maintain dual awareness (one foot in the memory, one foot in the present)

Experience the benefits of reduced psychological defenses without losing the ability to engage therapeutically

Clients often report breakthrough insights like “I’ve never thought that before. Wow, I actually am worthwhile.” What might have taken months to penetrate through defenses happens in a single session because, as Baker explains, “the dial has turned down just enough that the intended self, that more self-energy, can come up.”

Conditions Effectively Treated With Ketamine and EMDR Therapy

Treatment-Resistant Depression

This is considered the “gold standard” application for ketamine-assisted psychotherapy. Baker reports seeing the most significant responses in clients with chronic, treatment-resistant depression. People who experienced passive or active suicidal ideation for years often find relief after ketamine treatment, especially when combined with EMDR therapy for depression to process underlying causes.

PTSD and Complex Trauma

The combination of ketamine and EMDR therapy for PTSD is particularly powerful. Ketamine reduces the intensity of traumatic material, making it more accessible for processing. Clients can “turn down the trauma volume” enough to actually work with memories that previously felt too overwhelming.

For complex trauma (multiple traumatic experiences over time), this approach allows for gentler processing while still achieving significant results. The ketamine creates a safer container for EMDR therapy for trauma, reducing the risk of overwhelm.

Anxiety Disorders

Generalized anxiety, social anxiety, and panic disorder can all respond well to this combined approach. Research supports ketamine for anxiety, and when integrated with EMDR therapy to process anxiety-driving memories and beliefs, results can be particularly robust.

OCD (Obsessive-Compulsive Disorder)

Emerging research shows promise for ketamine in treating OCD. When combined with EMDR therapy targeting the memories and beliefs underlying compulsive patterns, some clients experience significant symptom reduction.

Adjustment Disorders and Life Transitions

Major life transitions (divorce, career change, relocation, loss) can be processed more effectively with this combined approach, helping clients move through stuck points more quickly.

Couples and Relational Healing

Baker mentions the potential for couples to dose together in therapeutic settings or on couples’ retreats. This can facilitate deeper empathy, communication breakthroughs, and processing of relational wounds in ways that traditional couples therapy might not access.

Negative Self-Concept and Self-Compassion Challenges

Many clients struggle to think positively about themselves despite years of therapy. Baker describes seeing “cracking in that sense of self where more positive thoughts are emerging” when ketamine is combined with EMDR therapy. The internal critical voice softens, allowing space for self-compassion and acceptance.

The Innovative Virtual Group KAP Model

One of the most exciting developments Baker shared is her virtual ketamine-assisted psychotherapy group model. This approach addresses one of the biggest barriers to ketamine treatment: accessibility and cost.

How the Group Model Works

Up to four clients meet virtually for group sessions. Each participant doses at home with a chaperone present (more on this below). The therapist leads the group through intention-setting, reads relevant material, then sends participants into individual breakout rooms for their journey.

The therapist can see all breakout rooms simultaneously and circulate to provide support as needed. Crucially, participants cannot see each other during dosing, maintaining privacy while still benefiting from the group container.

After dosing, participants reunite to share and process. Baker reports that even when working on different issues, common themes of “kindness, self-love, and nurturing the inner child” emerge, creating powerful connections.

Why the Group Model Works

Cost reduction: By seeing multiple clients in one three-hour session, the per-person cost decreases significantly, making this treatment more accessible.

Reduced isolation: Many people struggling with depression, PTSD, or trauma feel profoundly alone. The group format provides connection and normalization.

Amplified healing: Witnessing others’ healing journeys can catalyze one’s own process. The group container holds powerful energy for transformation.

Flexibility: The model works both virtually and in-person (with clients on yoga mats in a dedicated space).

The Critical Role of the Chaperone

Whether dosing in a group or individually, at home or in-office, ketamine-assisted psychotherapy requires a chaperone when done outside a medical setting. This person provides physical safety support and creates another opportunity for healing.

Chaperone Responsibilities

Chaperones ensure clients don’t try to drive or move around unsafely while under the influence. They can provide physical comfort (with consent) if the client experiences nausea or anxiety. They respond if the therapist needs them to check on the client. Most importantly, they hold space with presence and care.

The Reparative Attachment Opportunity

Baker points out something profound about the chaperone role: it creates opportunities for reparative attachment experiences. Often, clients choose a partner, parent, or friend to be their chaperone. This person then shows up for them in a deeply caring way during vulnerability.

For clients whose trauma stems from attachment wounds (not having needs met, not being cared for properly), having someone present who is “really showing up for them” can be powerfully healing in itself. This aligns beautifully with attachment-focused EMDR therapy and other relational healing approaches.

Preparing the Chaperone

As part of preparation, therapists meet with chaperones to explain what to expect, how to support the client, and what to watch for. Clients sign releases allowing this communication. Sometimes, the therapist might recommend a different chaperone if the initially chosen person doesn’t seem well-suited to provide attuned support.

Safety Considerations and Contraindications

While ketamine-assisted psychotherapy shows tremendous promise, it’s not appropriate for everyone. Baker emphasizes the importance of thorough medical and psychological screening.

Psychological Contraindications

Schizophrenia or schizoaffective disorder: People with “scattered minds” should not use psychedelics, as these can worsen disorganization and psychosis.

Active mania: Ketamine can potentially trigger or worsen manic episodes.

Bipolar disorder: Baker personally has not felt comfortable providing KAP to clients with bipolar disorder, though some prescribers will if the condition is very well-regulated. The risk of triggering mood cycling is significant.

Severe personality disorders: People with very fixed, rigid personality features may not benefit from ketamine and could potentially have adverse reactions.

Medical Contraindications

Uncontrolled hypertension: Ketamine can raise blood pressure, making it dangerous for people with high blood pressure that isn’t well-managed.

Cardiac issues: Irregular heartbeats or hearts that spike with stimulation pose risks.

Thyroid disorders: Unregulated thyroid conditions are contraindications.

The Importance of Medical Collaboration

Unlike standard psychotherapy or even EMDR therapy alone, ketamine-assisted psychotherapy absolutely requires collaboration with a medical prescriber. Therapists need to gather detailed medical history during preparation to avoid the disappointment of referring a client to a prescriber only to discover they’re not eligible.

Understanding Addiction Risk and Safety

In the wake of high-profile cases of ketamine misuse, many people have legitimate concerns about addiction potential. Baker offers important clarification based on current research.

The Science of Ketamine and Addiction

Unlike opioids, alcohol, or other commonly addictive substances, ketamine doesn’t hit dopamine receptors in the same way. It doesn’t create the same physiological addiction pathway.

However, people can become psychologically dependent on the “feel-good feeling” ketamine provides. This is different from chemical addiction but still requires attention and appropriate boundaries.

The Real Risk: Human Fallibility

Baker reflects that examining high-profile misuse cases reveals “the risk really is in the fallibility of humans more than it is in the actual substance.” When prescribers operate with ill intentions or inadequate boundaries, misuse becomes possible.

This is why she emphasizes the importance of prescribers who won’t prescribe to a client without first speaking to the therapist. This collaboration closes gaps and prevents potential misuse.

Therapeutic Dosing vs. Recreational Use

The dosages used in therapeutic settings (especially low-dose psycholytic work) are dramatically lower than recreational use or the amounts involved in overdose cases. Responsible prescribers and therapists maintain clear boundaries about dosing frequency and amounts.

Important Distinction: Ketamine-assisted psychotherapy involves carefully titrated doses, medical oversight, therapeutic support, and clear treatment plans. This is entirely different from recreational use or situations where prescribers operate outside ethical boundaries. The substance itself, when used appropriately, has significant therapeutic potential with manageable risks.

The History of Psychedelic Medicine and Ketamine

Understanding the historical context of psychedelic-assisted therapy helps explain both the promise and the caution surrounding this work.

Ancient Roots and Modern Development

Psychedelics have existed “forever,” as Baker notes. Plant-based medicines like psilocybin mushrooms have been used intentionally (and sometimes accidentally) throughout human history for healing, spiritual purposes, and consciousness exploration.

Ketamine, unlike these plant medicines, is entirely pharmaceutical. It was developed in the 1960s to provide pain relief for soldiers in the field without causing respiratory suppression (a dangerous side effect of opioids and narcotics).

The War on Drugs and Lost Decades

In the 1960s and early 1970s, promising research emerged on using ketamine and other psychedelics to treat various conditions, including alcohol addiction. Russian scientists conducted particularly interesting work in this area.

Then came the War on Drugs. FDA funding was pulled, and psychedelic research went underground for decades. An entire generation of potential treatments and understanding was lost.

The Recent Renaissance

In the last decade, interest in psychedelic-assisted therapy has resurged. Baker speculates this happened because “people were realizing we needed to go further.”

Pre-EMDR trauma treatment offered only about 50-50 odds of improvement. Antidepressants help many people but raise questions about long-term implications of 20 to 30 years of use. The mental health field needed new tools, leading researchers to revisit abandoned lines of inquiry.

The push for military-focused research on MDMA for PTSD also contributed to renewed interest in psychedelic medicine more broadly. As society began questioning strict prohibitionist stances on substances, space opened for legitimate therapeutic exploration.

Training and Resources for Therapists

For therapists interested in adding ketamine-assisted psychotherapy to their practice, several training pathways exist.

Primary Training Programs

Journey Clinical partnered with Fluence: Baker completed her training through this program. It offers over 20 hours of self-paced online learning including videos, information modules, and forums for questions. She found it accessible and comprehensive.

Integrative Psychiatry Institute (IPI): Offers both plant-based medicine and ketamine programs.

Prodoby (Colorado-based): Provides ketamine training with a local Colorado focus.

Continuing Education and Specialization

Baker recommends ongoing learning through:

Sunny Strasburg’s work: Particularly her integration of ketamine with Internal Family Systems (IFS) and her “Panther Model” for combining ketamine with EMDR therapy’s eight phases. Her book provides excellent framework for implementation.

Online communities: Facebook groups focused on ketamine-assisted psychotherapy and psychedelic therapy offer peer support and learning.

Podcasts: Numerous psychedelic-focused therapy podcasts provide ongoing education and diverse perspectives.

Investment and Accessibility

Baker acknowledges that ketamine training is “more expensive even than EMDR.” She expresses appreciation that her practice owner covered training costs, making it accessible to her. For therapists considering this work, the financial investment is significant, so strong motivation is important.

A Critical Warning

Baker is adamant: if you’re not trained in ketamine-assisted psychotherapy, don’t try to provide it, even if clients request it. The training teaches crucial elements of how to use the psychedelic experience therapeutically, how to handle challenging moments, and how to ensure safety.

If clients want ketamine work and you’re not trained, refer them to someone who is. You can support them with general EMDR therapy for depression or trauma while they work with a ketamine-trained provider, but don’t attempt integration without proper training.

The Future of Psychedelic-Assisted Therapy

Baker’s journey into this work exemplifies what happens when we remain open to evidence even when it challenges our preconceptions. Her initial skepticism transformed into expertise because she was willing to investigate rather than dismiss.

The “Wild West” Problem

One concern Baker raises is the frequent characterization of psychedelic therapy as “the Wild Wild West,” suggesting lawlessness and lack of structure. She pushes back on this framing, pointing out that Westward expansion caused tremendous suffering for many people.

Instead, she advocates for approaching this emerging field through frameworks of social justice, accessibility, and responsible development. The goal should be healing, not profit-driven exploitation of vulnerable people.

Accessibility and Economic Justice

The group model Baker developed directly addresses accessibility concerns. Ketamine treatment typically isn’t covered by insurance, making it prohibitively expensive for many people who could benefit. By seeing multiple clients simultaneously, costs decrease while maintaining (or even enhancing) therapeutic effectiveness.

This creative problem-solving represents the kind of innovation the field needs: maintaining integrity and safety while expanding access.

Integration With Established Approaches

The synergy between ketamine and EMDR therapy points toward future developments. As Baker notes, these modalities work together “like two parts of a locomotive.” Rather than competing approaches, we’re seeing integration that amplifies effectiveness.

This same principle likely applies to ketamine and other evidence-based therapies. Internal Family Systems, Acceptance and Commitment Therapy, attachment-focused approaches—all might pair beautifully with ketamine when thoughtfully integrated.

For Clients Seeking Treatment

If you’re interested in ketamine-assisted psychotherapy combined with EMDR therapy for depression, PTSD, or trauma, look for providers who are trained in both modalities. Ask about their preparation and integration process, their prescriber partnerships, and their experience with your specific concerns. The investment in finding the right provider pays dividends in treatment effectiveness and safety.

The Social Work “I Got a Guy” Mindset

One of the most valuable insights from Baker’s interview has nothing to do with ketamine specifically. It’s her articulation of what she calls the social work “I got a guy” mindset, that is, the commitment to connecting people with exactly the right resource, even if that resource isn’t you.

Beyond Scarcity Thinking

In a saturated therapy market, it’s tempting to hold onto every client. But Baker argues for a different approach: “What if I could connect you with someone who would be an even better fit for timeline, for expertise, just for personality?”

This abundance mindset recognizes that you’ll attract your ideal clients when you’re not trying to be everything to everyone. And more importantly, it puts the client’s needs genuinely first.

The Cartographer Role

Baker references EMDR training where the therapist is described as a cartographer, someone drawing the map for the client’s journey. But different clients need different cartographers. Maybe you’re not the person meant to take someone “to the moon.” Maybe your colleague is perfect for that journey.

Understanding this releases therapists from the impossible burden of being all things to all people. It also creates a network of trusted referrals that benefits everyone.

Ethics-Based Self-Care: A New Paradigm

When asked about self-care, Baker offers a perspective grounded in her ethics-focused consultation practice. Rather than treating self-care as separate from clinical work, she integrates it into decision-making.

Alignment With Self

Baker’s self-care practice involves checking whether her clinical decisions align with her sense of self. After a session, she asks: “Is that decision I made with that client today in alignment with who I am?”

This isn’t about perfectionism. It’s about integrity and congruence. When our actions align with our values, we experience less moral distress and burnout.

Intentional Choices in a Busy World

Even in downtime, Baker practices intentionality. Would playing a game on her phone or reading her magazine better serve her? The magazine brings her back into attunement with herself, so that’s the choice that constitutes self-care in that moment.

She recommends The Age of Overwhelm by Noreen Van Newton Lipski (name pronunciation uncertain) for synthesizing how to stay true to intentionality in our very busy modern world.

Ethics as Self-Care

Baker’s upcoming presentation at the National Perinatal Social Work Convention in April 2026 explores this theme: “We can’t just talk about the rules and laws of what we do, we actually have to talk about who are the heart of the people doing that work.”

When we understand ethics not as external constraints but as expressions of who we are, ethical practice becomes self-care. We’re not just following rules; we’re living in alignment with our values.

Bringing It All Together: The Power of Integration

The conversation with Amanda Baker reveals several powerful themes that extend beyond ketamine or EMDR specifically:

Remaining open to evidence, even when skeptical. Baker’s journey from skepticism to expertise in ketamine-assisted psychotherapy happened because she was willing to investigate rather than dismiss. This openness serves clients and advances the field.

Integration amplifies effectiveness. Whether combining ketamine with EMDR therapy for trauma, pairing preparation with integration, or bringing together different therapeutic frameworks, thoughtful integration creates results greater than the sum of parts.

Accessibility matters. Innovation in service delivery (like the group model) can expand access to life-changing treatments without compromising quality or safety.

Collaboration is essential. From therapist-prescriber partnerships to chaperone involvement to peer consultation, effective mental health care is fundamentally collaborative.

Ethics and self-care are intertwined. When we practice with integrity and alignment, we protect both our clients and ourselves.

Next Steps: Resources and Recommendations

For Clients

If you’re struggling with treatment-resistant depression, PTSD, or trauma that hasn’t responded adequately to traditional approaches, ketamine-assisted psychotherapy combined with EMDR therapy might offer new possibilities. Look for providers who:

Are trained in both ketamine-assisted psychotherapy and EMDR therapy

Work collaboratively with medical prescribers

Emphasize preparation and integration, not just the dosing experience

Can clearly explain their approach and answer your questions

Operate with transparency about costs, contraindications, and what to expect

For Therapists

If you’re considering adding ketamine-assisted psychotherapy to your practice:

Get proper training through reputable programs (Journey Clinical/Fluence, IPI, or similar)

Develop relationships with ethical prescribers before you need them

Start with clients you know well and build experience gradually

Engage in ongoing consultation and continuing education

Consider how your existing therapeutic orientation (especially if you practice EMDR therapy) can integrate with psychedelic work

Be mindful of accessibility and economic justice in how you structure services

Links for therapy in Texas, Arizona, or Colorado.