In this episode, Thomas Kim, MD joins to discuss ketamine-assisted psychotherapy for anxiety. Dr. Kim is the Chief Medical Officer of Noma Therapy, which is a ketamine-assisted psychotherapy program available via telehealth and in-person with licensed therapists. He has devoted 20 years of his professional life to realizing a value-based approach to healthcare through telehealth.

In this conversation, Dr. Kim shares his journey of working in early telehealth contexts to now working with ketamine. He discusses the research on ketamine treatments for anxiety and explains the significant comorbidity of anxiety, depression, and PTSD, stressing that anxiety is best understood from a more holistic perspective that considers the social determinants of health. Dr. Kim also emphasizes the importance of psychotherapy alongside ketamine dosing sessions, explaining that therapists have a window of opportunity in the days following the ketamine dose to best take advantage of the state of ketamine-induced neuroplasticity the patient is experiencing. In closing, Dr. Kim shares his philosophy of prescribing the least amount of medicine which produces the largest impact for the patient to ensure that side effects are mitigated and financial burdens are reduced. 

In this episode you'll hear:

• Balancing maximal safety and maximal accessibility in medicine
• The research on ketamine treatments for anxiety
• How psychotherapy fits with ketamine treatments
• The neuroscience of why patients can have strong emotional reactions following ketamine sessions
• Stories of success from Dr. Kim’s practice
• The importance of understanding how adverse childhood experiences and social determinants of health significantly contribute to mental health struggles
• Collaborative ketamine-assisted psychotherapy with a patient’s existing therapist

Quotes:

“Over time, continued effort in the field [of telehealth] has led to cost-effective, scalable solutions that can reach more people. I’m really hopeful that we can find solutions in the psychedelic and ketamine landscape to do a similar thing.” [5:36]

“A thing that I say routinely to patients is ‘there is no cure in the bottom of the pill bottle—ketamine included.’ They are all incredibly useful and, when used effectively, can provide you meaningful relief from your psychological distress but make no mistake, there is not a cure—which is why I’m such a huge advocate of therapy and which is why ketamine-assisted psychotherapy also needs to be distinguished from ketamine therapy.”  [14:21]

“[We created] an intentionally time-limited plan which places the emphasis on the fact that, one day, you’re going to drive your own bus and you’re not going to need me. It’s a terrible business model—in fact it’s a wonderful business model because it gives us an opportunity to take care of more people because we set the intention of ‘Ketamine is not forever. You’re not broken. You’re struggling and we’re going to get you to a place where you might not need us.’”  [34:04]

Links:

Dr. Kim on LinkedIn

Noma Therapy website

Psychedelic Medicine Association

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