Psychiatrist Dr. Scott Shannon shares his view on ketamine therapy integration, psychotherapy, and durability, plus advice on a philosophy of care.
Most conversations about ketamine therapy focus on the session itself. Dr. Scott Shannon is more interested in what comes after. In his view, ketamine can be a powerful way to help someone get out of a rut, but the real question is what that person does with the opening it creates.
This conversation gets into why he sees the weeks following a session as a critical window, and what integration and psychotherapy may add to the picture.
Dr. Shannon is a psychiatrist who decided in high school that he wanted to study consciousness. He completed his psychiatry residency at Columbia and a child and adolescent psychiatry fellowship at the University of New Mexico, and he has taken part in psychedelic research, including Phase III trials of MDMA-assisted psychotherapy. In 2010, he co-founded Wholeness Center in Fort Collins, Colorado, an integrative mental health clinic that describes itself as the largest of its kind in the United States. His team has offered ketamine therapy for about a decade, using multiple routes of administration over the years.
This conversation is wide-ranging and candid about where opinion ends and evidence begins. Dr. Shannon describes two things he sees working together, the experience itself and neuroplasticity. He shares why he believes durability improved at his clinic when more psychotherapy was built in, and why he thinks the field needs a large, well-designed study comparing ketamine with and without psychotherapy. He also makes the case that clinicians should experience the “terrain” before guiding others, while acknowledging the limits of that idea.
For clinicians building or growing a practice, he offers perspective on choosing business partners and developing a philosophy of care that can carry a clinic through uncertainty, including the possibility that ketamine access changes.
What You'll Learn in This Episode:
A clinician’s framework for thinking about why ketamine therapy can help someone out of a rut, and why lasting change may depend on what happens next
Dr. Shannon’s perspective on integration and psychotherapy, and why he believes the field needs a large, well-designed study comparing ketamine with and without psychotherapy
Why he encourages clinicians to experience the “terrain” before guiding others, and where he acknowledges the limits of that, such as contraindications
How his clinic’s approach to routes of administration has evolved over a decade of ketamine therapy
Questions to ask yourself about your philosophy of care before building or growing a practice
Key Takeaways:
Two possible drivers of lasting change. Dr. Shannon describes two things working together but on separate tracks: the experience itself, which can shift how someone sees the world, and neuroplasticity, which shakes up rigid patterns in the brain.
The “tow truck” window. In his view, ketamine can pull someone’s car back onto the road, but the biochemical and plasticity effects often last weeks to a couple of months. He sees the first six to eight weeks as the window to build understanding, anchors, and new direction.
Psychotherapy and durability. After adding more psychotherapy and integration, his clinic saw better durability and less need for maintenance. He is clear this is his opinion and his clinic’s data, and he’d like a large multi-site study comparing ketamine with and without psychotherapy.
Experience the terrain. He believes most clinicians should try the medicine before guiding others, using a map-versus-terrain analogy, while acknowledging it can’t be 100 percent and some people have contraindications.
Flexibility across routes. He sees ketamine’s adaptability as one of its strengths. His clinic uses several routes of administration, and he says he’d change route or dosing style before concluding someone hasn’t responded.
Philosophy of care. For practice builders, he stresses knowing who you go into business with and having a philosophy beyond delivering a service, since ketamine access could change at any point. He also describes dropping the “expert” persona to be more present with patients.
Listen to the episode on Apple Podcasts, Spotify, Overcast, or on your favorite podcast platform. Watch the discussion on YouTube here.
Episode 68 show notes:
00:00:00 Teaser - The Tow Truck Question
00:00:28 Welcome and Meet Dr. Scott Shannon
00:02:21 From a High School Psychology Class to a Question About Consciousness
00:07:36 Advice From His Father and the Path to Psychiatry
00:09:16 Early MDMA Couples Therapy and the Scheduling That Followed
00:11:43 Research With 5-MeO-DMT and LSD, and the Challenge of Recruitment
00:14:33 How Dr. Shannon Got Into Ketamine Therapy
00:17:34 Learning Ketamine Therapy From a Clinician Study Group
00:20:08 What Creates Lasting Change After Ketamine Therapy?
00:23:01 The Tow Truck Analogy and the Weeks After a Session
00:24:40 Ketamine-Assisted Psychotherapy: What Do We Know?
00:28:56 Why His Clinic Added More Psychotherapy
00:31:24 Should Clinicians Experience the Medicine Before Guiding Others?
00:35:00 A Group Ketamine Process for Healthcare Providers
00:37:06 How His Personal Journey Shaped His Care for Patients
00:41:16 Advice for Starting a Private Practice: Partners and Philosophy of Care
00:44:47 What Wholeness Means and Why He Chose the Name
00:47:20 Love, Defenses, and the Healing Relationship
00:52:28 Why He Moved Away From the "Expert" Role
00:56:15 Power Outage and Rapid-Fire Questions Begin
00:59:15 Where to Find Dr. Shannon
01:00:22 Episode Ending
Thanks for Listening
Connect with Dr. Shannon
Selected Links From the Episode:
Dr. Joe Tafur - Hear our interview with Dr. Tafur in Episode 009 - Healing Journeys: Ayahuasca, Ketamine Therapy, & Spirituality With Dr. Joe Tafur
Professional Education Disclaimer: This content is intended exclusively for licensed healthcare professionals and should not be used by patients for self-treatment or self-education. The information presented reflects individual provider experiences and should not replace clinical judgment, professional training, or comprehensive research. Healthcare providers must conduct their own due diligence, consult current literature, and evaluate treatment approaches within their specific practice context and regulatory environment. This educational content does not constitute medical advice for specific patients or clinical situations - treatment decisions should always be based on individual patient assessment and adherence to professional medical standards.
Frequently Asked Questions
What does Dr. Shannon mean by integration, and why does he see it as the real challenge after a ketamine therapy session?
Dr. Shannon describes ketamine therapy as especially helpful for people who are stuck in rigid patterns of thinking and coping. In his analogy, ketamine is the tow truck that pulls a car stuck off the road back onto it. The car is repaired, there is gas in the tank, and the fog has lifted, so the question becomes what the person does next. In his view, ketamine’s effects are very useful in the short run but tend to wear off if the experience is not integrated and reinforced through changes in behavior. He sees the first six to eight weeks as a key window to help someone make sense of what they experienced, find a few anchors to hold onto, and begin moving in a new direction, such as more connection with others, more physical activity, or more attention to diet. He also describes two things working together, the experience itself and neuroplasticity, and says they often seem to follow separate tracks. These are his clinical observations rather than established findings.
Does adding psychotherapy to ketamine therapy help results last longer?
In Dr. Shannon’s experience, it may, but he is clear that the field does not yet have the evidence to say. At Wholeness Center, his team initially delivered ketamine mostly as IV infusions, with a psychiatrist circulating during sessions. He saw great results, but felt the durability was not where he wanted it, and more people were coming back for retreatment. After building in more psychotherapy and integration, he reports improved durability and less need for maintenance. He calls this his bias and the data from his own clinic, not a controlled finding. If he could have one study, he says, it would be a large multi-site NIMH trial comparing ketamine with and without psychotherapy, and he notes that psychotherapy studies are very hard to design. His view is that psychotherapy will make a difference, which he frames as where he would put his money rather than settled science.
Why does Dr. Shannon’s clinic use multiple routes of ketamine administration?
Dr. Shannon describes one of ketamine’s strengths as how adaptable it is across routes, timing, and dosing. Over about a decade, his clinic has used IV, IM, sublingual, compounded nasal, and subcutaneous routes, and added Spravato in the last six months as the clinic moved into an insurance model. He says few clinics offer this many routes. Over time, the clinic moved away from in-office sublingual ketamine because he found the onset and duration too variable, and from compounded nasal ketamine because in his experience the response was more erratic than he would like. Clinicians at the clinic are given full latitude to choose a route for each person they evaluate. His broader point is that if someone is stuck, there is a lot that can be changed, including the route or the dosing style, before concluding that the person did not respond to ketamine therapy.
What advice does Dr. Shannon give clinicians who want to start their own private practice?
Dr. Shannon offers two pieces of advice. First, be very careful about who you go into business with. He started a couple of clinics earlier in his career, one of which was successful and one he had to leave because some of the people were not collaborative, and he credits his co-founder, Mary Rondeau, ND, of the last 16 years. Second, think about your philosophy of care. In his view, if all you are doing is delivering a service, it can become boring, frustrating, or confusing over time, while a philosophy gives you a larger mission that can carry you when things change. He raises his concern that ketamine could be pulled from use at any point and asks what a clinic does then if ketamine is its only focus. He encourages clinicians to look at the history of healthcare, where it is going, what role they want to play, and how they want to be known.