Ketamine-Assisted Psychotherapy and Integration Psychotherapy

Ketamine-Assisted Psychotherapy

Ketamine-Assisted Psychotherapy (“KAP”) is a novel approach to mental health. Research on KAP indicates that it can have profound and meaningful effects on healing trauma and helping with anxiety and depression, among other things. We are only beginning to understand the potential healing impacts of KAP.

I have trained in KAP through Polaris Insight Center, Fluence, and S-KAP (“Somatic KAP”). In addition, I received individualized training and supervision at Temenos Center for Integrative Psychotherapy, a KAP clinic. I regularly consult with other KAP providers and continue to train in this technique.

What is ketamine, and how can KAP help me?

Ketamine is currently the only FDA-approved psychedelic medicine. At high doses, it is used as an anesthetic. In the lower doses that we use in KAP (which is an “off-label” use), it is considered anxiolytic, meaning that it helps calm the parts of us that tend towards worry or anxiety. This is one reason why psychotherapy incorporating ketamine can be so effective. Sometimes, those parts of us that need the most healing are hard to reach because other parts of us signal to our brains and bodies that reaching them will be overwhelming. KAP can allow people to access those hard-to-reach parts because the ketamine soothes those more protective parts and helps them step aside momentarily.

Ketamine is also associated with lifting what has been called the Default Mode Network (“DNM”). The DNM is a network of neural pathways that, through time and repetition, have become entrenched in our brains. Most of the time, the DNM is helpful. Our brains would be overwhelmed if every time we did something we had to learn it all over again. Sometimes, though, the DNM pathways can point us towards beliefs or habits that are no longer helpful. For example, the belief that “I’m not lovable,” or that “I need to be perfect,” or that “I can’t trust anyone” (to name a few) can become engrained as neural pathways in the DNM. This means that those beliefs become more available and, over time, more of the default (i.e., Default Mode Network).

Many people who have experienced feeling stuck in other healing modalities (including psychotherapy) may be there because their brains have simply wired them towards, for example, depression. Ketamine temporarily eases the DNM, allowing people to have some distance and perspective from these beliefs. Ketamine has also been associated with neuroplasticity, meaning the ability of the DNM to change, to grow new and different pathways that can help transform those beliefs.

KAP can help with anxiety, depression, processing trauma, and increasing self-compassion, among other things. Clients have reported increased energy to pursue other self-care activities such as exercise or healthy eating. They have also reported feeling more confident, reducing addictive behaviors such as cannabis or alcohol, and reducing chronic stress or fatigue. Many clients report that it is as if a burden they have been carrying does not feel so heavy and that, for the first time, they feel a sense of relief.

The experience of being on ketamine can be transformative. I have worked with clients who have felt joy for the first time in a long time or been able to connect to that child part of them that felt so incredibly alone. Beyond that, the brain retains its neuroplasticity for a period of time afterwards. This is why KAP with me involves integration following the experience. We want to work together to find meaning from the experience and to use that precious period of time when your neural pathways can change to bring true transformation into how you feel.

The difference between KAP with me compared to ketamine clinics and online ketamine services

Ketamine has become increasingly popular in the media, and so too have different treatment options. It is important to understand the different options so you can choose which one is appropriate for you. Here are some questions to keep in mind:

Is therapy a component of the treatment?
Many clinics, particularly infusion or intravenous/IV clinics, do not incorporate psychotherapy as part of the treatment. The same is true for online treatment options, which frequently do not have any psychotherapy component, or have you work with a “guide” who is not trained in psychotherapy and/or is only for a portion of the experience. Ketamine has a physiologic effect, and there is merit to receiving solely the medicine. What many people experience, though, is that receiving only the medicine is not enough. For example, some people experience euphoria through ketamine. This can be extremely helpful, particularly if your DNM needs rewiring towards joy. What can happen, though, is that the underlying trauma that wired the DNM away from joy is not approached, so the medicine is not as effective as it could be. It can also be helpful to process that euphoric experience with someone who understands it so that you can bring additional meaning to it and understand how to integrate that meaning long-term. Sometimes ketamine can take people to more challenging places, and it can bring up historic wounding around, for example, abandonment to have no one to turn to in those moments. Working with a trained therapist like me can be incredibly healing in those moments because this time is different, because this time, somebody is there. KAP with me is typically more expensive than ketamine infusion/IV clinics and/or online ketamine treatment options. This is because I spend many hours with you preparing for the experience, staying with you during the ketamine experience itself, and integrating. This can help with a different type of healing than that available solely from the medicine. One thing to consider when you are comparing costs is how much provider time each option provides you.

Is the therapist trained in KAP? What other trainings do they have?
KAP is currently not regulated, meaning (for these purposes) that there is no particular license or certification that a psychotherapist needs in order to practice KAP. For that reason, it is important to ask if the therapist with whom you might work has KAP training. In addition, the therapist’s overall training and orientation is relevant. After all, that therapist is bringing all of their training to their work with you. It is important to consider, at a minimum, whether that therapist’s training includes modalities of trauma healing.I have particular training in KAP, including individualized training and supervision. I also regularly consult with other KAP-trained clinicians regarding KAP. In addition, I have extensive training in trauma-informed modalities, including (but not limited to) somatic techniques. I invite you to visit my Trainings and Somatic Therapy pages for more information.
Does the therapist incorporate somatic therapy?
Somatic Therapy can be incredibly healing, separate and apart from KAP. Combined with KAP, it can lead to powerful results. I incorporate my somatic knowledge into my work with KAP. This may or may not involve touch, which we will discuss in detail before and after if so. This is why I offer both virtual and in-person options for KAP. Sometimes, that healing touch is essential, and that can only be accomplished in-person. Consider asking your therapist whether they incorporate any somatic therapy into their KAP work. If you’re interested in learning more about somatic therapy, the books The Body Keeps the Score by Bessel van der Kolk or Waking the Tiger by Peter Levine are great places to start.

What does KAP with me look like?

I emphasize the psychotherapeutic component of KAP. Accordingly, I meet with you before any medicine/ketamine sessions as well as after each medicine session. If you are in therapy outside of KAP, I am also happy to consult with your outside therapist, should that be helpful for you.

Here is the typical KAP protocol:

Initial Consultation Call: I offer a complimentary 15-20 minute introductory call where we can learn more about each other and see if we are a fit. You may also have additional questions about KAP, which we can discuss as time allows.
Pre-KAP Sessions: I meet with you at least three times before we begin a KAP cycle. These sessions are opportunities for us to further get to know each other and to identify what is bringing you to treatment and how our work during the KAP cycles can help. KAP is an intensive process, and how much I understand about what you might need and how much our relationship has had time to build matters. These sessions are also opportunities for you to ask additional questions you might have about KAP. Pre-KAP sessions are each 50 minutes long. The cost for each pre-KAP session is $210 for virtual, $225 for in-person.
Medical Evaluation and Prescription (from an M.D.): I work with a prescribing medical doctor who is responsible for the medical side of treatment. The M.D. will conduct a comprehensive medical evaluation to make sure you are an appropriate candidate for KAP from a medical perspective. This evaluation will happen during the pre-KAP period. If you are medically cleared, our M.D. will coordinate a prescription to be filled by a pharmacy that we trust to provide quality medicine. The pharmacy will send the medicine directly to you. The cost for the medical evaluation is $300, and the cost of the medicine is around $150-$200. The medicine will be a rapid-dissolve troche (“RDT”), sometimes referred to as a sublingual lozenge, and it is administered orally. Many clients appreciate that KAP with me does not involve needles.
KAP Cycles: Each KAP cycle consists of at least three sessions: Preparation, Medicine, and Integration. Clients will typically undergo between three and six cycles as part of their initial treatment. Many clients choose to continue with periodic booster cycles after the initial treatment if they have found their initial treatment helpful.
- Preparation sessions happen before the medicine session (usually a day or two before) and are 50 minutes long. These sessions are opportunities for us to talk about your intention for the medicine session, to assess your mental state entering into the medicine session (mindset, a.k.a. the “set” of “set and setting” being an integral component of the medicine session), and to develop plans for any logistical needs. These sessions are also time for us to assess whether physical touch may be a component of our work and to develop clear parameters around that to ensure respect and safety. The cost for each preparation session is $210 for virtual, $225 for in-person.
- Medicine sessions are where you take the ketamine and experience its effects. These last about three hours long, and I am with you the entire time. The material that comes up during each medicine session varies. I am there to support you and, where appropriate, to provide gentle guidance. I will select a playlist conducive to KAP for you to listen to, and you will have eyeshades on as this tends to create a deeper experience. The experience of being on ketamine is specific to you and hard to put into words. We can discuss more of what might happen during our pre-KAP and preparation sessions. The cost for each medicine session is $900 for virtual, $950 for in-person (we can discuss whether virtual is appropriate for your specific treatment).
- Integration sessions typically happen one to two days after the medicine session and are 50 minutes long. These sessions allow us to revisit the material that arose during the medicine session, with an eye towards incorporating themes into the larger picture of your life. Ketamine has been described as opening a window, a period of time in which that increased neuroplasticity can be used to launch long term change. Integration is a key part of that. Together, we identify the themes that emerged, how those themes apply to your life, and what you can do to incorporate those teachings. Many people consider integration to be the most important part of KAP. The cost for each preparation session is $210 for virtual, $225 for in-person. At least one integration session is part of each medicine cycle; however, clients often benefit from more than one integration session. I will discuss this with you and identify whether that would be most helpful for your treatment.
Booster Cycles: As noted above, the initial phase of treatment consists of three to six KAP cycles. Many people find that, over time, they would like to return for additional booster cycles. This may be because they have integrated the material from the initial phase of treatment and would like insight into a new area. This may also be because they found the experience so valuable that they would simply like to deepen the work from the initial phase of treatment. Together, you and I will identify whether booster cycles would be beneficial and establish an ongoing treatment plan. Each booster cycle is the equivalent of one KAP cycle, i.e., one preparation session, one medicine session, and at least one integration session.

Is KAP covered by insurance?

I am not on any insurance panels; however, if you have a PPO insurance plan, some portion of your KAP treatment may be covered by insurance. Please call your insurer and ask about your out-of-network coverage. I cannot guarantee that any portion of your treatment will be covered.

Integration Therapy

Currently, ketamine is the only FDA-approved psychedelic medicine (KAP is an “off label” use). Accordingly, it is the only medicine that I work with directly. I do not endorse the use of illegal medicines. I understand, however, that people may have had psychedelic experiences outside of treatment with me for which they would benefit from integration. I offer ongoing integration therapy to help incorporate those experiences into the larger context of your life.

Ketamine-Assisted Psychotherapy and Integration Psychotherapy