Ketamine Assisted Psychotherapy
I offer a therapeutic modality called Ketamine-Assisted Psychotherapy (KAP), the use of ketamine as a complement to psychotherapy. Ketamine Assisted Psychotherapy (KAP) is a practice that utilizes the benefits of the medication to allow for a loosening of the ego-based mind to support the treatment of trauma, depression, anxiety, OCD, addictions, and other presentations of mental health distress.
Ketamine-Assisted Psychotherapy (KAP) is a holistic modality in which ketamine is used as a complement to psychotherapy to help eligible patients 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.
Why 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.
The properties of Ketamine at a psychotherapeutic dose, when utilized in a psychotherapy session, allows a unique window into the aspects of memory emotional processing that is not often possible during a talk therapy session. Due to the mechanism of action of the medication, the Default Mode Network or how the brain works without alteration, becomes more fluid and pliable. This allows us to go into aspects of mental health distress in a fresh way. Often clients report that they had not realized that various experiences and past events were also linked to the challenges they are currently facing. Ketamine provides a tool to lower the veil to a fuller understanding of what the mind fully knows about one’s own pain. This can be both startling, and deeply meaningful as people begin to see in a clearer way the pain they have been enduring.
These same properties also provide the brain with a high flow of Brain Derived Noortropic Factors (BDNFs) for 10 days following the KAP session. Usually, when not using a psychedelic paired with therapy there is no BDNF change, and we are actually working on changing the nervous system one neuron at a time. Due to the BDNF benefit a unique stage is then created to support robust new neural growth allowing for greater ease in integrating the understanding gained during the KAP appointment, and more easily change thoughts, behaviors, and emotions related to that processing.
Finally, as an anesthetic at high doses, even low doses are supportive for reducing chronic pain and inflammation. When working with KAP for chronic illness and chronic pain, often more information becomes available about how the subconscious mind is relating with this illness/pain state. Opening up this understanding can be extremely helpful for making meaning out of the challenges that one faces while living with Chronic Pain and/or Illness.
How Does Ketamine-Assisted Psychotherapy Work?
1. 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.
2. 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.
3. KAP Dosing Session:
● A typical ketamine dosing session lasts between 1-2 hours and can remotely via telehealth.
● During a dosing session, you will self-administer your ketamine lozenge 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.
4. 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.
5. 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.
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.
What is the Cost of Treatment?
● 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.
○ Ketamine-Assisted Psychotherapy - My KAP hourly rate is $180/hr
○ 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 treatment doses (not covered by insurance).
Helpful 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. Ketamine for Depression and Mood Disorders by Erica Zelfand, ND for Townsend Letter
4. Ketamine-Facilitated Psychotherapy for Trauma, Anxiety, and Depression by goop
5. Ketamine Assisted Psychotherapy with Jonathan Sabbagh of Journey Clinical - Psychology Talk Podcast
