More Than Medicine: The Clinical Setting Advantage in Ketamine-Assisted Therapy
By Mary Kate Keller | June 12, 2025Consciousness-expanding substances like ketamine or Spravato® (esketamine) can open a critical window for neuroplasticity—a time when the brain is especially capable of forming new connections. But what makes ketamine-assisted therapy (KAT) in a clinic different from at-home psychedelic experiences? At Sub Rosa Therapy, we believe that the combination of a supported mindset, a carefully curated setting, and integration counseling is essential for the success of psychedelic therapy.
Creating a Safe Space for Psychedelic Experience
The physical and social environment in which psychedelic experience takes place (e.g., location, comfort, support system) is just as important as the mental state of the individual undergoing the psychedelic experience (e.g., expectations, mood, past experiences, intentions for the session). A professionally guided experience—anchored by trained staff and counseling support—can greatly enhance the therapeutic benefits of treatment.
Physical Environment
Ketamine-assisted therapy (KAT) and Spravato sessions at Sub Rosa Therapy take place in a safe and comfortable environment, specially curated to provide ease during psychedelic experiences. Treatment rooms are prepared with floor mats layered in clean sheets, eye shades, and soothing music—played both aloud in the room and through noise-cancelling headphones. Additional pillows, blankets, and knee bolsters are readily available for added support.
Tailoring sensation perception in this way serves as a barrier to external distractions—such as lights, noise, and movement—and allows individuals the opportunity to journey inward with a sense of comfort, emotional safety, and therapeutic readiness.
Social Support
Our team at Sub Rosa Therapy is made up of trained staff and counselors who value holding space for those undergoing psychedelic journeys. During sessions, an onsite medical provider is present to take vitals and monitor the physical well-being of clients. This facilitates not only the health and safety of our clients, but also helps ease any anxiety the individual may have regarding their well-being during a vulnerable and introspective state.
Additionally, another member of our staff is present as a “sitter” during all sessions. The sitter offers a calming presence, therapeutic support when appropriate, and is responsible for note-taking throughout the session. Sitters are also trained to recognize when gentle, in-the-moment supportive insight or emotional reassurance may help a client feel grounded. Clients are encouraged to share insights, emotions, or personal reflections as they feel comfortable, allowing them to make the most of this critical period of neuroplasticity. Sitters may also offer grounding touch, such as a hand hold, if requested by the client.
We know that interactions with psychoactive substances like ketamine or Spravato can be deeply moving and sometimes intense, so our team is trained in offering nonjudgmental support and responsive counseling throughout the experience—never imposing beliefs, but remaining fully present as facilitators of healing and integration.
Integration and Counseling
Following sessions, clients must be driven home by a prior-arranged ride. After treatment, clients are encouraged to refrain from mentally heavy activities, such as working, scrolling through social media, or making significant decisions for the rest of the day. Light activities, such as journaling, taking a nature walk, making art, or resting are recommended.
We believe that the treatments we offer hold healing potential and the capacity to shift deeply held mindsets. To support that growth, all clients undergoing KAT or Spravato treatments at Sub Rosa Therapy either (1) meet with one of our trained psychedelic-integration counselors, or (2) are under the care of another trusted counselor in whom they feel safe discussing and integrating their experience. This continuity of care through counseling ensures that insights gained during the session can be processed, understood, and applied in meaningful ways.
Intentional Setting as a Catalyst for Healing
At Sub Rosa Therapy, we understand that healing doesn't happen in isolation—it happens in context. By intentionally shaping both the physical space and the counseling-based interpersonal support surrounding ketamine-assisted therapy or Spravato sessions, we aim to create a container for insight, emotional safety, and meaningful transformation. Whether it’s the music playing through your headphones, the presence of a calm and compassionate sitter, or the integration counseling that follows, every detail is designed to honor the profound potential of this therapeutic work. In doing so, we help ensure that clients are not only safe—but also empowered to carry the wisdom of their experience into everyday life.
