Ketamine has become one of the most promising treatments for depression, anxiety, and trauma-related conditions. But as demand has grown, so has the number of clinics offering ketamine, many of which are run by providers without psychiatric training. The difference between a standalone “ketamine clinic” and comprehensive psychiatric care isn’t just semantic; it can determine whether your treatment is safe, effective, and sustainable.
As a psychiatrist, located in Washington, D.C., I’ve seen how life-changing ketamine therapy can be when administered carefully with psychiatric expertise, and unfortunately, also how risky it can be when that expertise is absent.
This blog will briefly outline the differences between a ketamine clinic and a psychiatric clinic, before focusing on the key questions to ask when choosing a provider for your ketamine treatment.
Understanding the Difference: Ketamine Clinic vs. Psychiatric Clinic
Before I dive into specific questions, it’s important to understand what distinguishes standalone ketamine clinics and psychiatric clinics offering ketamine:
Standalone ketamine clinics often focus solely on infusions, may be staffed by anesthesiologists, emergency medicine physicians, or nurse practitioners without specialized psychiatric training, and typically lack integrated mental health services. Their business model centers on one treatment.
Psychiatric clinics offering ketamine provide comprehensive diagnostic assessment, ongoing medication management, psychotherapy, and the expertise to recognize when ketamine is (or isn’t) the right choice. They can adjust your entire treatment plan based on psychiatric response, not just vital signs.
This distinction matters because ketamine isn’t just a procedure, it’s psychiatric treatment that requires psychiatric expertise.
Now that I’ve explained the difference between the two providers, let’s discuss the key questions to consider before choosing your clinic.
1. What Qualifications Does the Ketamine Provider Have?
Ketamine is increasingly being offered by providers from various backgrounds, including anesthesiologists, emergency medicine physicians, nurse practitioners, physician assistants, and even wellness clinic staff. While these providers may know how to administer the medication safely from a medical standpoint, psychiatric training is fundamentally different from procedural training.
A psychiatrist doesn’t just deliver ketamine; they diagnose complex mental health conditions, understand how psychiatric medications interact, recognize when ketamine is or isn’t appropriate, identify potential complications such as emerging mania or worsening dissociation, and adjust your overall treatment plan based on your response.
Ask these specific questions:
- Is your provider a board-certified psychiatrist?
- How many years did they spend in psychiatric residency training?
- Do they actively treat psychiatric conditions beyond administering ketamine?
- What is their experience managing treatment-resistant depression, PTSD, or bipolar disorder?
- If they are not a psychiatrist, who provides psychiatric oversight? Is it someone actually on-site or merely “consulting”?
At Washington Interventional Psychiatry, our team includes psychiatrists trained at Yale, Cornell, Georgetown, Mount Sinai, and other top medical programs. Our clinicians have a deep expertise in both the clinical complexity of psychiatric disorders as well as the science of ketamine. We don’t just administer ketamine; we practice comprehensive psychiatric care.
2. What Is the Setting Like for Ketamine Treatments?
Your physical environment plays a meaningful role in shaping the therapeutic experience. Ketamine often produces altered states of consciousness, and the setting can significantly influence whether those experiences feel safe, therapeutic, or distressing.
A quality clinic should offer:
- Private, comfortable treatment rooms (not shared spaces or makeshift offices)
- Calming design elements that reduce anxiety
- Medical equipment that’s present but not intrusive
- An atmosphere that balances clinical safety with therapeutic intention
Red flags to watch for:
- Clinic spaces that feel rushed, sterile, or improvised
- Shared treatment areas with minimal privacy
- Environments that feel more like a spa than a medical facility (suggesting lack of proper medical infrastructure)
- Settings that feel purely transactional
Our clinic at WIP was intentionally designed with therapeutic outcomes in mind: a calming, professionally equipped environment that balances safety with serenity. Each treatment room is private and thoughtfully designed to support the inner work that ketamine facilitates.
3. How Does the Clinic Ensure Patient Safety and Monitoring?
Ketamine can temporarily raise blood pressure, alter heart rate, cause respiratory changes, and produce profound dissociation. While generally safe when properly monitored, complications can occur. And when they do, immediate medical response is essential.
Critical safety questions:
- Are vital signs monitored continuously throughout the entire infusion, or only checked before and after?
- Is a medical provider physically present and actively supervising during treatment?
- What emergency protocols are in place for adverse reactions?
- Is the staff trained in emergency response?
- What equipment is available on-site if medical intervention is needed?
Many standalone clinics or therapist-led ketamine practices only check vitals before and after treatment and worrisome, may not know what to do if something goes wrong. This approach will not identify problems developing during the infusion, when intervention matters most. Some clinics leave patients unattended during dissociative experiences, or have untrained staff or “sitters” monitoring multiple patients simultaneously from another room.
At WIP, our medical protocols ensure that each infusion is closely monitored by trained clinical staff with continuous vital sign tracking and immediate access to psychiatric and medical support if needed. A medical provider is always on-site during treatments. Safety is never compromised for convenience or cost-cutting.
4. Does the Clinic Offer a Personalized Approach to Ketamine Treatment?
No two patients are alike. Dosage, frequency, infusion duration, and integration methods should all be customized to your specific diagnosis, symptom profile, medical history, trauma history, and treatment goals.
Beware of one-size-fits-all protocols. Many ketamine clinics use standardized dosing borrowed from anesthesia settings, regardless of diagnosis or individual needs. This approach ignores the nuanced differences between treating treatment-resistant depression versus PTSD versus bipolar depression versus OCD.
Psychiatrists are uniquely trained to:
- Adjust dosing based on psychiatric presentation, not just body weight
- Recognize when to start lower for someone with dissociative tendencies
- Understand when higher doses might be therapeutically necessary for severe depression
- Know how ketamine interacts with other psychiatric medications
- Identify when the psychedelic aspects of the experience should be enhanced or minimized
- Integrate ketamine with psychotherapy effectively
Without specialized psychiatric training and clinical experience, non-psychiatric ketamine providers often default to rigid protocols that fail to capture the unique needs of each patient. They may increase doses on a predetermined schedule regardless of symptom response, or continue treatments long past the point of therapeutic benefit.
At WIP, each treatment plan is individually tailored—starting doses, escalation schedules, infusion frequencies, and integration with psychotherapy or other medications are all based on ongoing clinical assessment and your specific response. Your protocol evolves as you do.
5. What Other Mental Health Services Does the Clinic Offer?
Here’s an uncomfortable truth that this ketamine industry has: Ketamine should not stand alone. Depression, anxiety, PTSD, and other psychiatric conditions are complex and typically require a combination of approaches—therapy, medication management, and sometimes other interventional treatments.
A clinic that offers only one treatment often leads to two problems:
- Lack of true expertise. Mastery comes from treating conditions comprehensively, not from administering a single procedure repeatedly.
- Financial bias. If ketamine is the only service generating revenue, there’s an inherent incentive to keep you in ketamine therapy—even when it’s not working optimally, when you’ve plateaued, or when other treatments might be more appropriate.
Ask yourself: What happens at this clinic when ketamine isn’t enough? What if you need medication adjustments? What if trauma therapy would be more effective? What if your depression requires a different intervention entirely?
A comprehensive psychiatric practice can honestly assess whether ketamine is right for you from the start, pivot to other evidence-based treatments when needed, and provide ongoing psychiatric care that extends far beyond the infusion chair. You’re not locked into one treatment modality.
At WIP, we offer the full spectrum of psychiatric care: ketamine therapy, TMS (transcranial magnetic stimulation), stellate ganglion block (SGB) for trauma, individual psychotherapy, and comprehensive medication management. This integration allows for true continuity of care and ensures that your treatment evolves with your needs rather than being limited by what the clinic happens to offer.
6. How Should I Prepare for My First Ketamine Infusion Session?
Preparation significantly impacts both safety and therapeutic outcomes. Before your first session, your provider should conduct a thorough assessment and provide detailed guidance.
Expect your clinic to:
- Review your complete psychiatric history and current symptoms
- Discuss your current medications and potential interactions
- Explain what the ketamine experience will feel like
- Provide clear instructions about eating, drinking, and medications before treatment
- Discuss “set and setting”—your mindset and intentions going into the session
- Explain what to expect in the hours and days after treatment
- Provide aftercare guidance and integration support
- Be available for questions or concerns between sessions
Red flags:
- Minimal pre-treatment assessment or rushed intake process
- Little explanation of what to expect during the experience
- No discussion of psychological preparation or integration
- Unclear guidance about post-treatment care
- Difficulty reaching providers between appointments
At WIP, we provide comprehensive pre- and post-infusion guidance to help patients get the most from their treatments. Your first appointment includes detailed education, psychiatric assessment, and collaborative treatment planning. All clients undergoing ketamine can check in with a psychiatrist between sessions as needed. Not just on treatment days. We also have an educational blog post going over What Should You Do Before and After a Ketamine Infusion.
7. What Happens If Ketamine Doesn’t Work or Stops Working?
This question reveals whether you’re working with a one-dimensional ketamine clinic or a comprehensive psychiatric practice.
Ketamine doesn’t work for everyone. Some patients don’t respond adequately. Others respond initially but plateau or relapse. Some develop tolerance. And for some, ketamine simply isn’t the right treatment for their particular condition.
Ask the clinic directly:
- What percentage of your patients don’t respond to ketamine?
- What do you do when someone isn’t improving?
- What other treatment options do you offer?
- Will I need to find a new provider if ketamine doesn’t work for me?
A standalone ketamine clinic often has no good answer to these questions. Their only option is to continue adjusting ketamine protocols, potentially keeping you in treatment longer than therapeutically justified.
At WIP, if ketamine isn’t the right fit or stops working, we have other evidence-based interventional options (TMS, SGB, medication optimization, psychotherapy modalities) and can seamlessly continue your psychiatric care without disruption. You remain with providers who understand your complete history and can adapt your treatment plan accordingly.
Your care doesn’t end when one treatment modality reaches its limit.
Final Thoughts: Procedure vs. Psychiatric Care
Ketamine therapy should be psychiatric care, not a standalone procedure. The critical question: isn’t just “where can I get ketamine?” but rather
“Who is qualified to determine if ketamine therapy is right for me, monitor my complete mental health picture, recognize complications, integrate this treatment with comprehensive care, and provide expert psychiatric support before, during, and after treatment?”
The answer is clear: a board-certified psychiatrist in a full-service psychiatric practice.
As ketamine therapy clinics proliferate, the differences in quality, safety, and outcomes have become stark. Choosing the right provider means choosing psychiatric expertise over procedural convenience, comprehensive care over quick fixes, and a clinical team that sees you as a whole person with complex needs—not simply as a candidate for an infusion.
Your mental health deserves nothing less than expert psychiatric care. Make sure that’s what you’re getting.
Washington Interventional Psychiatry offers comprehensive psychiatric care including ketamine therapy, TMS, stellate ganglion block, psychotherapy, and medication management. Our team of psychiatrists trained at leading institutions provides evidence-based, personalized treatment for depression, anxiety, PTSD, and other psychiatric conditions.
If you are in the Washington, D.C., Maryland, or Virginia area, contact Washington Interventional Psychiatry today to schedule your consultation and take the first step toward healing. We’ll gladly take the time to answer any questions you have regarding our clinic, team, and your treatment plan!
