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Advancing Psychedelic-Assisted Treatments in a Clinical Setting at CIIS

CIIS plans to expand its community health services with the launch of a new psychedelics clinic that will provide patients with ketamine-assisted treatments, the first of its kind to be associated with a university in the United States.

October 10, 2024

For more than five decades, CIIS has helped to transform clinical care for San Franciscans through its six award-winning community mental health clinics where CIIS students provide in-person and virtual psychotherapy to qualified clients under the supervision of faculty. The services, which are available to city residents at little or no cost, are just one example of the University’s efforts to provide much-needed healthcare throughout San Francisco.

In 2025, CIIS has plans to expand its community health services with the launch of a new psychedelics clinic that will provide patients with ketamine-assisted treatments. The clinic will be the first of its kind to be associated with a university in the United States.

Dr. Jason Butler, a professor in CIIS’ Integral Counseling Psychology program and psychotherapist and supervisor at Sage Integrative Health, specializing in depth-oriented ketamine-assisted psychotherapy, and Dr. Rene Dumetz, Chair of CIIS’ Clinical Psychology department, will help to develop the new clinic.

Dr. Butler said it was the perfect moment to launch a psychedelic-assisted therapy clinic because psychedelics are poised to become legally accessible through federal rescheduling over the next few years, pending FDA approval. Moreover, he said there is an expanding body of research supporting the efficacy of psychedelic-assisted therapy treatments.

“Once these therapies are made federally legal, there will be a great need for clinics who are already established through offering ketamine-assisted psychotherapy and have the capacities to provide the infrastructure needed for a psychedelic-assisted therapy treatment, including trained therapists and prescribers who can offer these treatments,” Dr. Butler said. “Because ketamine is already a legal substance that can be prescribed to patients as an off-label medication for a variety of disorders, ketamine-assisted psychotherapy has led the way in terms of making medicine-assisted psychotherapy accessible to clients in need.”

Ketamine has emerged as a significant treatment option for several mental health challenges, particularly conditions that may not respond adequately to traditional therapies. The most notable include major depressive disorder (MDD): Ketamine is particularly effective for patients with treatment-resistant depression, providing rapid relief of symptoms, often within hours. Also, bipolar disorder: For individuals experiencing depressive episodes, ketamine may offer a rapid response, especially when conventional mood stabilizers are ineffective, and post-traumatic stress disorder (PTSD): Research suggests ketamine can help reduce symptoms in those with PTSD, offering an alternative for patients who struggle with traditional therapies.

The idea of developing a ketamine-based clinic came about because of growing student interest in ketamine-assisted psychotherapy and the strong emphasis on psychedelics at CIIS.

“A great number of students have expressed interest in training in ketamine-assisted psychotherapy, and there is a paucity of opportunities to do so. Because of the strong emphasis on psychedelics at CIIS and the wealth of experience amongst faculty in researching psychedelic-assisted therapies and providing ketamine-assisted psychotherapy, CIIS is well positioned to be the first university to have a psychedelic-assisted therapy clinic open and available for the public (outside of research contexts),” Dr. Butler explained.

He added that “ketamine-assisted psychotherapy is cost-prohibitive for a number of individuals due to the high cost. With CIIS’ mission to advance diversity, equity, inclusion, and social and ecological justice, there is a natural bridge to the mission of making psychedelic-assisted psychotherapy accessible for those who otherwise could not afford it.”

Dr. Dumetz said without the encouragement and support of CIIS President S. Brock Blomberg, a ketamine clinic might not exist.

“In addition to our student’s passionate desire for this type of clinical training, I must mention the strong concerted effort by our president, Brock Blomberg, who created and guided the formation of the working committee of various faculty members and consultants, who are presently in the process of creating our first ketamine assisted psychotherapy clinic. Without his vision and strong support none of this would have been possible,” he said.

Dr. Dumetz also said the ketamine, which comes in the form of lozenges, will be assessed and prescribed by a licensed medical doctor or a nurse practitioner, who will have sole responsibility for these functions. He did say current CIIS students will have an opportunity to assist but only under the watchful eyes of medical professionals.

“Students will be involved with patient treatment but will not prescribe and will be supervised through all aspects of the treatment process. Patient safety will be ensured through individual and group supervisors, as well as the medical doctor and clinic director. Additionally, only students who have had at least three years of clinical work will be allowed to participate in the clinic,” he said. “They will therefore have 2,000-2,500 hours of regular clinical work and supervision before their participation. This will initially be offered only to students in the Clinical Doctoral Program who have fulfilled the requirements and have been determined to have a very strong clinical training and theoretical background in their previous clinical work. Students who do not match those requirements will not be allowed to participate in the clinic.”

Both Dr. Dumetz and Dr. Butler said the clinic will take every step to ensure patient safety and will be overseen by both federal and local regulatory agencies.

“The regulatory agencies/guidelines in place to ensure patient safety include the Drug Enforcement Administration (DEA), which regulates the use of controlled substances, ensuring compliance with federal laws; State Medical Boards, which enforce state-specific regulations regarding the practice of medicine and the use of controlled substances, the American Psychiatric Association (APA) and American Society of Ketamine Physicians (ASKP), who have created clinical guidelines and best practices for administering ketamine therapy,” Dr. Butler said.

Additionally, he said that patient safety is ensured through rigorous training in ketamine-assisted psychotherapy (in addition to the education CIIS interns have received in standard psychotherapy) as well as ongoing supervision by experienced clinicians well-versed in the nuances of ketamine-assisted therapies.

He said safety is also supported by the practices of informed consent, which involves clearly communicating risks and benefits to patients before treatment, monitoring protocols, which includes establishing protocols for monitoring patients during and after administration, including vital signs and mental state assessments, as well as emergency procedures, which prepare for potential adverse reactions with established emergency protocols and access to resuscitation equipment.

“By following these steps and adhering to regulatory guidelines, a ketamine-based clinic can be established in a manner that prioritizes patient safety and effective treatment outcomes,” Dr. Butler said.

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