At-Home Ketamine Therapy: What Your Support Person Needs to Know

If someone you care about has asked you to be their support person during at-home ketamine therapy, you are playing a critically important role in their treatment. This guide is written specifically for you -- the partner, family member, or trusted friend who will be present during treatment sessions. Understanding what to expect, what your responsibilities are, and what to avoid will help you provide the best possible support while keeping your loved one safe.

Why You Are Required, Not Optional

At-home ketamine therapy requires an adult support person to be physically present during every treatment session. This is not a recommendation or a nice-to-have -- it is a non-negotiable safety requirement that Tovani Health enforces as a condition of treatment.

During a ketamine session, the patient enters a dissociative state. This means their awareness of their surroundings is significantly altered, their coordination is impaired, and their ability to respond to emergencies is reduced. They are not unconscious, but they are not in a state to take care of themselves or make decisions about their safety.

You are the bridge between the patient's therapeutic experience and the physical world around them. Your presence ensures that if anything unexpected happens -- a medical concern, a household emergency, or simply the need to use the bathroom -- someone alert, sober, and capable is immediately available.

Your Responsibilities Before the Session

Good preparation makes the session smoother for both of you.

Confirm the plan. Know what time the session starts, approximately how long it will last (typically two to three hours from start to full recovery), and that you are committed to being present for the entire duration.

Prepare the space. Help ensure the treatment area is comfortable, quiet, and safe. This means:

• Comfortable seating or reclining position for the patient (bed, recliner, or couch with pillows)
• Dim or soft lighting
• Minimal noise (turn off TV, silence phones, manage pets)
• Water and a bowl or bag available in case of nausea
• A clear, safe path to the bathroom
• Remove tripping hazards from the immediate area

Have emergency contacts ready. Know how to reach the patient's Tovani Health clinician. Have the clinic's contact information easily accessible -- not buried in an email you would need to search for during a stressful moment. Also have 911 on speed dial, though the need for emergency services is extremely rare.

Eat and be comfortable. You will be present for a couple of hours. Make sure you are fed, hydrated, and comfortable. Have something quiet to do -- a book, your phone, a puzzle -- so you can stay nearby without being bored.

Your Responsibilities During the Session

Once the patient takes their medication, the session has begun. Here is what to expect and what to do:

The first 15 minutes. Effects begin gradually. The patient may become quiet, close their eyes, or comment that they feel something changing. This is normal. Simply be present and calm.

During peak effects (approximately 15 to 60 minutes). The patient will be in a deeply altered state. They may:

• Appear very still with eyes closed
• Move their hands or body slowly
• Speak, sometimes incoherently or emotionally
• Laugh or cry
• Seem unaware of your presence
• Have their eyes open but appear unfocused

Your role during this phase is primarily observational:

• Stay in the same room or immediately adjacent. Do not leave the house, go to a different floor, or become unreachable.
• Monitor their breathing. It should be regular and unlabored. If breathing becomes very slow, shallow, or irregular, contact the clinician immediately.
• Watch for nausea. If the patient shows signs of nausea (swallowing repeatedly, grimacing, or saying they feel sick), help position them on their side and provide a bowl. Nausea is the most common side effect and usually passes quickly.
• Note any significant distress. While some emotional processing during sessions is normal and therapeutic, extreme agitation, panic, or confusion that escalates rather than resolving may warrant contacting the clinician.
• Assist with bathroom needs. If the patient needs to use the bathroom, help them stand slowly and walk with them. Stay close for balance support. Do not let them walk alone while effects are strong.

Keep track of time. Having a general sense of how long it has been since the medication was taken helps you gauge where the patient is in the experience. If effects seem unusually prolonged (lasting well beyond 90 minutes), note this for the treatment team.

What NOT to Do During a Session

This section is as important as the responsibilities above. Well-meaning support people can inadvertently interfere with the therapeutic experience.

Do not try to have conversations. The patient is in an internal experience that is therapeutically valuable. Talking to them, asking how they feel, or providing a running commentary pulls them out of this experience. Silence from you is supportive, not neglectful.

Do not touch them without necessity. Unless the patient asks for contact, or you need to reposition them for safety (such as turning them on their side for nausea), avoid unnecessary physical contact. Unexpected touch during dissociation can be startling or distressing.

Do not play music or change the environment unless pre-arranged. If the patient has set up their environment with specific music, lighting, or an eye mask, leave it as they arranged it. Changes to the sensory environment during a session can be jarring.

Do not film, photograph, or record. The patient may say or do things during the experience that they would not want documented. Respect their privacy absolutely. This also means not sharing details of what happened during the session with others without the patient's explicit permission.

Do not offer food or drink during peak effects. Wait until effects have clearly begun to wear off before offering water. The risk of choking is present during deep dissociation, and nausea makes eating inadvisable.

Do not panic if the experience seems intense. Ketamine sessions can involve strong emotions, unusual body movements, or statements that sound alarming out of context. These are typically part of a normal therapeutic process. Unless there is a genuine safety concern (breathing difficulty, severe blood pressure issues, or unmanageable distress), the most helpful thing you can do is remain calm.

Do not leave before the patient is fully recovered. "Fully recovered" means they are alert, oriented, able to walk steadily, and can carry on a normal conversation. This typically takes two to three hours from the start of the session.

What to Watch For: When to Contact the Clinician

Contact the patient's Tovani Health clinician if you observe:

• Breathing that becomes very slow (fewer than 8 breaths per minute), labored, or irregular
• Severe, uncontrollable vomiting
• Blood pressure readings outside the parameters provided by the treatment team
• Extreme agitation or panic that does not resolve within 10 to 15 minutes
• Loss of consciousness (different from deep dissociation -- in dissociation, the patient will respond to loud voice or gentle shoulder touch)
• Effects that persist well beyond the expected duration
• Chest pain or complaints of chest tightness

These situations are rare at prescribed therapeutic doses, but knowing what to watch for allows you to respond quickly if needed.

After the Session: Recovery Support

As effects wear off, the patient will gradually return to their normal state. During this recovery period:

• Offer water when they are alert enough to drink safely
• Keep the environment calm and quiet
• Allow them to rest if they feel tired
• Be available for conversation if they want to talk about their experience, but do not press
• Help them to the bathroom if they are still unsteady
• Remind them of activity restrictions: no driving for 24 hours, no operating machinery, no major decisions

Many patients feel emotionally open and reflective after a session. Your calm, nonjudgmental presence during this period is valuable. Some patients want to talk; others prefer quiet. Follow their lead.

Understanding the Bigger Picture

Being a support person for ketamine therapy is a meaningful act of care. The person who asked you to fill this role is taking a courageous step toward addressing a condition that may have caused them significant suffering. Your willingness to be present, attentive, and steady during their sessions directly contributes to their safety and the therapeutic value of their treatment.

You do not need medical training. You do not need to understand how ketamine works at a neurochemical level. You need to be reliable, present, calm, and willing to follow the straightforward guidelines in this article.

Questions About Getting Started?

If your loved one is considering ketamine therapy and you have questions about the support person role, those questions are welcome during the evaluation process. Tovani Health clinicians are happy to speak with support people to ensure everyone feels prepared and comfortable.

Encourage your loved one to check their eligibility to take the first step. Your willingness to be their support person may be exactly the reassurance they need to move forward with treatment that could genuinely change their life.