Ketamine Assisted Therapy (KAP)

Ketamine has different effects at different doses. Many people think of Ketamine outside of a therapeutic setting because it has been used in various different setting throughout history. It has been seen as a street drug (at lower does), and as an anesthetic (in higher does). Discussing Ketamine assisted therapy can be scary for some and exciting for others. If this is a therapeutic style that interest you please feel free to discuss questions and concerns openly. This is a tool for therapy and not a requirement.

What is Ketamine and why would we use it?

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. As the neuropathways are more open and accessible it can speed up the effects of therapy and break through blocks in a lasting way.

Why do I like to provide KAP?

I decided to pursue training in KAP after noticing several clients who received it getting extremely positive results. I began to research more and ultimately decided that it is a tool that is worth training to utilize. I view Kap has an additional tool that can enhance therapy and potentially work through difficult parts of therapy in a more productive way. Sometimes there are strong protective parts, destructive core beliefs or other strong obstacles that can make EMDR more difficult. While it is not impossible to work through obstacles without KAP, I notice that sometimes it can work faster and better using KAP. The insight that can be gained and the opening of neuropathway networks allow for a strong compliment to the therapy. Ketamine also expands dendrite for several weeks. This means that changes that are made and therapy that is done can be enhanced for those weeks.

How and where would I receive it?

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 I only use the sublingual lozenge form. I deliver KAP in my practice in partnership with an prescriber who has specialized training. You will work with this prescriber to ensure you are a good candidate and understand the medicine. You will administer the medicine while in the safety of my office.

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.

What is the process like?

1.Discuss interest and expectations with me.

2. You will receive contact information for a prescriber and will attend an initial evaluation with this prescriber. 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 they determines that you are eligible for KAP, they will develop a personalized Ketamine prescription. 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 the prescriber in advance of our KAP sessions.

3. Preparation sessions:

We will then 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. You will learn to connect with your intention in this session.

4. KAP Dosing Session:

● A typical ketamine dosing session lasts between 2-3 hours and will take place in my office

● During a dosing session, you will self-administer your ketamine lozenge. 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. As the medicine wears off we will spend time grounding in your experience and developing a small plan to integrate.

5. 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 utilize the neuroplasticity for more effective therapy.

What is the price for KAP?

○ Ketamine-Assisted Psychotherapy ■ My typical hourly rate is 150/hr (prepratory sessions, integrations sessions and part of the dosing session can be billed through insurance. Insurance is currently not covering the full dosing session. )

○ Prescriber estimated 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)

Is there Valid Research regarding effectiveness?

I could fill this page with research studies following Ketamine Assisted therapy. While it is currently growing in popularity, we have been researching it’s effectiveness since the 70s'. I am obviously bias because I believe in the effectiveness of this treatment and it’s benefits. However, I encourage you to do your own research. Here are some articles to get you started.

Paradigms of Ketamine Treatment - Multidisciplinary Association for Psychedelic Studies - MAPS

Full article: Ketamine Assisted Psychotherapy (KAP): Patient Demographics, Clinical Data and Outcomes in Three Large Practices Administering Ketamine with Psychotherapy (tandfonline.com)

Ketamine for Depression and Mood Disorders - Townsend Letter

Ketamine Assisted Psychotherapy For Anxiety & Depression | goop

Ketamine Assisted Psychotherapy with Jonathan Sabbagh of Journey Clinical (spreaker.com)