Palliative Care Ketamine-Assisted Psychotherapy (Pal-KAP)
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Palliative Care Ketamine-Assisted Psychotherapy (Pal-KAP)
People living with serious illness commonly experience psychospiritual distress. This may include anxiety, depression, loss of meaning, demoralization, and anticipatory grief. But existing treatments often provide only partial relief, and many continue to suffer despite therapy, medication, and other approaches.
Evolving research shows that psychedelic-assisted psychotherapy, which pairs psychedelic medicine with exploratory and supportive psychotherapy, may help some patients live more fully while facing serious illness. When the psychedelic medicine is ketamine, this approach is called ketamine-assisted psychotherapy, or KAP.
Pal-KAP is a KAP program at University of Rochester Medicine’s Palliative Care program for patients affected by serious illness.
Who is Pal-KAP For?
Pal-KAP may be appropriate for people who:
- Are affected by a serious, life-limiting illness
- Experience anxiety, depression, grief, loss of meaning, or existential distress related to illness
- Are open to exploring personal questions about identity, meaning, and values
All patients complete a medical and psychological evaluation to ensure the treatment is safe and appropriate.
How Ketamine-Assisted Psychotherapy is Bringing Peace to Patients
In 2023, Rob Horowitz, MD, of Palliative Care, started a program that harnesses a guided psychedelic journey to help people with serious illness find relief from their psychospiritual distress. The first-in-the-nation Palliative Care Ketamine-Assisted Psychotherapy (Pal-KAP) clinic has set in motion a gentle revolution in palliative care.
Our Approach
Eligible patients may be referred by their clinician to the Palliative Care Program at Strong Memorial Hospital for evaluation.
Pal-KAP is offered in series of three parts: preparation sessions, ketamine sessions, and integration sessions. Safety, informed consent, and continuous expert support are core to every session.
In a calm, art-filled room, facilitators build trust, explain what the ketamine experience can feel like, and help patients set intentions for the sessions. These may include developing a more open relationship to mortality, feeling more at home in a changing body, or regaining a sense of wholeness and connection to what matters most.
A dose of ketamine is administered, and the patient experiences a shift in awareness for 30-45 minutes as they lie back, wear an eyeshade, and listen to a curated playlist through headphones. Facilitators sit nearby, offering a supportive, quiet presence and giving gentle reassurance as needed.
Patients process their ketamine experience and identify practices that support continued self-understanding, self-acceptance and presence.
Patient Stories
Finding Calm After Cancer
Through the Pal-KAP process, Peggy was able to release overwhelming fears of cancer recurrence that once felt inescapable—and reconnect with joy, clarity, and purpose.
What Sets Us Apart?
Pal-KAP is one of the few programs in the United States that offers psychedelic-assisted psychotherapy in an academic palliative care program. Our approach is grounded in the core mission of palliative care: easing suffering in all its forms—physical, emotional, and spiritual.
What makes our program unique:
- An interdisciplinary whole-person foundation. Our facilitator team focuses on the whole person, not just symptoms.
- Two trained facilitators present during medicine sessions to provide support, guidance, and safety throughout the experience.
- Structured preparation, medicine, and integration sessions to help patients feel fully prepared and supported before, during, and after the experience.
- A safety-focused clinical design and medical oversight, ensuring each patient receives thoughtful, individualized, and closely monitored care.
Providers
Leadership Team
- Rob Horowitz, MD,
Pal-KAP Medical Director - Marc Swogger, PhD,
Pal-KAP Psychotherapy Director
PAL-KAP Facilitators
- Sharon Willow, MA
- Kelly Spahr, M Div, BCC, Chaplain
- Jennifer Sawyer, RN
- Jessica Luciano, NP
- Colleen Hunter, RN
- Cheryl Hosey, RN
- Andrea Escos, PT
- Lauren Curran, NP
- Adam Cardina, MD
- Leslie Bennett, RN