KAP

Ketamine Assisted Psychotherapy

I offer a therapeutic modality called Ketamine-Assisted Psychotherapy (KAP) in partnership with an organization called Journey Clinical. Ketamine-Assisted Psychotherapy (KAP) is a holistic modality in which ketamine is used as a complement to psychotherapy to help eligible clients experience more frequent breakthroughs and sustained improvement in symptoms. I take on the psychotherapy portion of the experience, while Journey Clinical’s medical team supports you on all medical aspects. This includes determining eligibility, developing a custom treatment plan, prescribing the medicine and monitoring outcomes. Below is more information about KAP to help you navigate if it may be a good fit for you.

KAP 101

  • What is Ketamine?

    Ketamine is a legal, safe and effective medicine used to treat a variety of mental health conditions, including depression, anxiety and PTSD. Ketamine has rapidly-acting antidepressant and mood-enhancing effects, which can begin to take effect within 1-2 hrs. after treatment and last for up to 2 weeks. It works by blocking the brain’s NMDA receptors as well as by stimulating AMPA receptors, which are thought to help form new synaptic connections and boost neural circuits that regulate stress and mood. Ketamine has also been shown to enhance overall neuroplasticity for lasting symptom improvement.

    Ketamine can be administered in a variety of ways, including IV infusion, intramuscular injection, via nasal spray and using sublingual lozenges. In my work with Journey Clinical we only use the sublingual lozenge form.

  • How does Ketamine Feel?

    The effects of ketamine, which most patients find pleasant, last for approximately 45 minutes. These effects can make you feel “far from” your body, and facilitate shifts in perception that can often feel expansive in nature. Your motor and verbal abilities will be reduced, so you’ll be lying down in a comfortable position during the experience. Once these effects subsided, we’ll spend the remainder of our appointment giving you space to process and discuss your experience. While it may feel hard to articulate what happened during the experience, patients feel like the insights gained are none-the-less clear. Studies have shown that the benefits to mood and neurological growth can last up to two weeks after the Ketamine experience.

 How Does Ketamine Psychotherapy Work?

  • You schedule an initial evaluation with a clinician from the Journey Clinical medical team via zoom. They will go over your medical and psychiatric history with you, provide education on the treatment and determine if you are eligible for KAP.

    If Journey Clinical’s medical team determines that you are eligible for KAP, they will develop a personalized Ketamine prescription and outcome monitoring plan for you.

    Journey Clinical’s medical staff will write a ketamine prescription for you, and a small amount of oral ketamine will be sent to your home, enough for the first 2 KAP sessions. You will be taught to take your vitals and self-administer the ketamine lozenges by Journey Clinical’s medical team in advance of our KAP sessions.

  • Once you receive your ketamine lozenges, we will schedule time together for our KAP preparation, dosing and integration sessions. Preparation session(s) will be scheduled just like regular therapy sessions prior to the KAP dosing session. The goal of a preparation session(s) is to align on the process, set intentions for our KAP sessions together and have a very thorough discussion on our ongoing informed consent process.

  • A typical ketamine dosing session lasts between 2.5 to 3 hours and can takes place in-person. The period of time where the medicine is in effect lasts approximately 45 min to an hour.

    During a dosing session, you will self-administer your ketamine lozenge in my office. You will be in a comfortable, reclining position wearing an eye mask and listening to calming music. Although a KAP dosing session may be largely an internal experience, I will be present with you the entire time to hold space and provide support as needed.

  • After our KAP dosing session, we will meet for multiple integration therapy sessions to review the memories, thoughts & insights that arose during your dosing session, and to prepare for the next dosing session.

    We will meet the day after your dosing session for a period of 30-50 minutes to revisit what you learned in the dosing and begin setting up a plan for you to integrate what you learned into your life. Due to the neuroplasticity window that becomes available after dosing, the medicine allows you to learn more quickly and have more motivation so setting goals that support you can be achieved with more ease in the following two weeks. We will meet the following week for another 50 minute session to continue to support this shift and begin preparing for your second dosing session if you desire to continue the treatment.

  • After our first KAP session, Journey Clinical’s medical team schedules regular follow ups with you to monitor outcomes and prescribe ketamine lozenge refills, as appropriate. The frequency of follow ups depends on your unique treatment plan, at a minimum of once per quarter.

  • Ketamine-Assisted Psychotherapy is a moderately affordable, accessible modality. Although the medical intake and follow ups are not covered by insurance, they are eligible for out-of-network reimbursement.

    The first initial prep session and the dosing session will take place in-person.

    Ketamine-Assisted Psychotherapy:

    ■ Initial preparation session(s) | 1 hour: $200

    ■ KAP Dosing Session | 2.5-3 hours: $350 -400

    ■ Integration Session(s) | 1 hour: $200

    **Some Sliding Scale available

    Keep in mind that the number of preparation sessions is tailored to each individual client. Typically, we meet for three prep sessions to build an alliance, comfortability, get to know your needs, intentions for the treatment and to go through the dosing process in more detail.

    Journey Clinical Medical Costs:
    *I am not a prescriber. All medication assessment and prescribing is done through a trusted outside provider, Journey Clinical. If you are assessed as eligible, medication will be sent directly to your home to bring with you for your KAP dosing appointment in my office.

    ■ Medical Intake: $250 (One time fee, reimbursable through out-of-network)

    ■ Follow-up Sessions: $150/Session (minimum of 1/quarter, reimbursable through out-of-network)

    ■ Cost of Ketamine Lozenges: $75 for approximately 4-6 lozenges

    (not covered by insurance)

  • Journey Clinical is a platform for licensed psychotherapists to incorporate science-based psychedelic therapies in their practice safely and effectively, starting with Ketamine-Assisted Psychotherapy (KAP). Journey Clinical’s in-house medical team takes on patient eligibility, prescriptions and outcome monitoring, while I take on the therapy. Their collaborative care model is designed to deliver personalized treatment plans to meet your individual needs and improve long-term outcomes.

Further Resources

  1. Paradigms of Ketamine Treatment by Raquel Bennett, Psy.D. for MAPS

  2. Ketamine Assisted Psychotherapy (KAP): Patient Demographics, Clinical Data and Outcomes in Three Large Practices Administering Ketamine with Psychotherapy - research study by Jennifer Dore et al, 2018

  3. Yale Scientists Explain How Ketamine Vanquishes Depression within Hours, Article in Yale News 2012.

  4. Ketamine, A Transformational Catalyst by Michael Zeigler.

  5. Toward Synergies of Ketamine and Psychotherapy by David Mathai, Victoria Mora & Albert Garcia-Romeau.

  6. Ketamine—50 years in use: from anesthesia to rapid antidepressant effects and neurobiological mechanisms by Samuel Kotala.

  7. Ketamine treatment for depression: a review by Mani Yavi, Holim Lee, Jolene Henter, Lawrence Park & Carole Zarate.