Ketamine Assisted Psychotherapy 101

What is Ketamine?

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, clients feel like the insights gained are nonetheless clear.

Studies have shown that the benefits to mood and neurological growth can last up to two weeks after the ketamine experience.

How Does KAP Work?

Initial consultation with Journey Clinical

● 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.

Preparation 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 and set intentions for our KAP sessions together.

KAP Dosing Session

● A typical ketamine dosing session lasts between 1-2 hours and can take place either in-person at my office, or remotely via telehealth.

● During a dosing session, you will self-administer your ketamine lozenge either in my office or in your home. 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.

Integration Sessions

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.

Follow-up consultations with Journey Clinical

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.

The Cost

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

Journey Clinical Medical Costs

■ 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)

My fees

■ Preparation and/or Integration Sessions: Your standard 1hr appointment fee (typically $150), paid through Ivy or your insurance provider (one integration session per dosing session, preperation sessions on an as needed basis)

■ KAP Dosing Session: Twice your standard 1hr appointment fee (typically $300), paid through Ivy. Unfortunately insurance does not cover a KAP dosing session (typically once or twice per month or less, as needed)

Resources

• Yale scientists explain how ketamine vanquishes depression within hours
• An Introduction to Ketamine-Assisted Psychotherapy
• Why Ketamine-Assisted Therapy Has Gone Mainstream
• Ketamine’s Role in Spirituality: How One Synthetic Drug Catalyzes a Natural Experience
• Making “bad trips” good: How users of psychedelics narratively transform challenging trips into valuable experiences

Research

• Ketamine Assisted Psychotherapy (KAP): Patient Demographics, Clinical Data and Outcomes in Three Large Practices Administering Ketamine with Psychotherapy
• Ketamine Assisted Psychotherapy: A Systematic Narrative Review of the Literature
• At-home, sublingual ketamine telehealth is a safe and effective treatment for moderate to severe anxiety and depression: Findings from a large, prospective, open-label effectiveness trial
• The effect of a single dose of intravenous ketamine on suicidal ideation: a systematic review and individual participant data meta-analysis
• Ketamine-assisted psychotherapy for trauma-exposed patients in an outpatient setting: A clinical chart review study
• Ketamine Psychedelic Therapy (KPT): A Review of the Results of Ten Years of Research

KAP Prep Guide

• Your KAP session may include many elements, some to help you go inward, some to help you feel grounded and safe and many to help you answer the questions or explore the challenges that brought you here in the first place. In preparing for your session consider your answer to the following questions- 

  • What are my reasons for doing KAP? Do I feel I understand my goals, and does my therapist understand them? 

  • Do I feel like I understand the process and what to expect? Have I been clear with my therapist about my boundaries and needs?

  • What is my dosing plan? Do I feel comfortable and confident with how to handle the medication itself?

  • What are some questions I have for myself during this session?  

  • What is something I would like to better understand or learn on a marrow deep level thanks to my session? 

  • How flexible do I feel about my goals? Am I holding on tightly or am I willing to go where the session takes me? 

  • What sort of mood, attitude or mindset am I hoping to cultivate before/during my session? 

  • Are there mindful strategies that can help me get there? What sort of pre-session yoga, meditation, exercise or even favorite TV show may help prime me? 

  • What sorts of things may help guide me during the session? Do I want to gather any totems or special objects, poems or paintings that inspire me or put together a playlist for my session? 

  • Do I have everything I need to feel comfortable and safe? Should I put together a bag with blankets, eye mask, headphones or other items to feel comfortable?  

  • What kinds of things help me to feel safe when I’m overwhelmed? Are there any grounding exercises or emotional distress skills I should practice?

  • Do I want to practice any meditation or hypnosis during my session? Am I practiced and prepared to work with these exercises?  

  • Do I have a safe ride home, an unhurried afternoon or evening to look forward to and everything I need to recuperate and protect this sacred space after my session?  

  And, most importantly— 

  • Do I need to go to the bathroom?  

Some items you may wish to bring include;

• Blankets, pillows

• Headphones

• Personal totems; stuffed animals, family jewelry, old love letters… anything that might help you to feel safe or prime specific memories, states or experiences.

Common mantras for psychedelics:

• Trust, Let Go, Be Open

• Soften, soothe and allow

• If you see a door open, walk through it

• I invite whatever thoughts and feelings arise

• May I feel safe, may I be free from harm, may I live happily, and at ease