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Background: The therapeutic benefits of ketamine have been demonstrated for a variety of psychiatric disorders. However, the role of ketamine induced psychoactive experiences in mediating the therapeutic effects is unclear. Despite the growing quantitative research on the efficacy of ketamine treatment, very few studies examined participant experiences of ketamine infusions in a treatment setting.Aims: The current study aimed to examine participant experiences of ketamine infusions and how these relate to therapeutic mechanisms in a clinical trial setting.Methods: We conducted semi-structured interviews with 12 participants who received up to three ketamine infusions (0.8 mg/kg) as part of a Phase II double blind, randomised controlled trial. The interviews explored participants' acute experiences of ketamine infusions, experiences of psychotherapy/education, and the lasting effects of the trial. The interviews were transcribed verbatim and analysed using thematic analysis.Results: Six key themes were identified. (1) Participants reported multifaceted motivations for trial participation. (2) The set and setting was found to be influential in determining acute ketamine experiences. The acute ketamine experiences included: (3) the inherent contradictions of the experience (e.g., dissociation vs feelings of connection), (4) rapidly fluctuating and changing experiences, (5) meaningful, mystical and spiritual experiences. Finally, the final theme (6) relates to the transformational effects of the infusions and the trial.Conclusion: Provided in a supportive and professional environment, ketamine treatment led to a significant change in relationship with alcohol. Ketamine induced ego dissolution and dissociation were reported to be related to the transformational effects on relationship with alcohol. The extent to which the acute psychoactive effects of ketamine mediate therapeutic effects on drinking outcomes remain to be investigated in the trial data. The acute effects of ketamine reported by our participants transcend its traditional conceptualisation as a “dissociative anaesthetic”; therefore, we suggest the development or use of new measures alongside ketamine infusions to fully capture the spectrum of these effects which may be crucial in its therapeutic and transformative effects.

The present study examined age-related differences in bystander reactions within the context of peer exclusion of national ingroup (British) and immigrant outgroup (Australian or Turkish) peers. The immigrant peers were from nations that varied in terms of their perceived intergroup status in Britain. Participants were British children ( n = 110, 8–11 years) and adolescents ( n = 193, 13–16 years) who were presented with one of three scenarios in which a British national, Australian immigrant, or Turkish immigrant peer was excluded by a British peer group. Participants indicated their bystander responses. Perceived similarity and bystander self-efficacy were examined as possible correlates of bystander reactions. Findings revealed that children were more likely to directly challenge the social exclusion when the excluded peer was British or Australian compared with when they were Turkish. In contrast, adolescents did not differentiate in their response—they were equally likely to directly challenge the exclusion regardless of the excluded peer’s nationality. Importantly, when the excluded peer was Turkish, moderated mediation analysis showed that, with age, there was higher bystander self-efficacy for challenging the exclusions. In turn, higher bystander self-efficacy was related to higher direct challenging. These novel findings demonstrate the importance of intergroup relations, perceived similarity, and bystander self-efficacy in the emergence of age-related differences in bystander reactions to the exclusion of immigrant peers.

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