Ketamine-assisted Psychotherapy

What is Ketamine-Assisted Psychotherapy?

Ketamine-Assisted Psychotherapy (KAP) combines ketamine prescribed and monitored by a qualified medical provider with psychotherapy. The medication can temporarily soften habitual defenses and offer a different perspective, while preparation and integration sessions help you make sense of the experience and apply what emerges to everyday life.

What is Ketamine?

Ketamine is a medication that has been used in medical settings as an anesthetic for decades. At lower doses, it can produce an altered state of consciousness and is sometimes prescribed off-label for depression and other mental health concerns. Ketamine itself is not FDA-approved to treat psychiatric disorders, although a related medication, esketamine, is approved for certain forms of depression.

How does ketamine work and how does it feel?

Ketamine primarily affects the brain’s glutamate system, including NMDA receptors, although its therapeutic effects are still being studied. People may experience relaxation, changes in body awareness, dreamlike imagery, altered perceptions of time or space, or a sense of distance from familiar thoughts and emotions. Experiences vary, and some can be challenging as well as meaningful.

How does Ketamine-assisted Psychotherapy work?

KAP generally includes preparation before taking ketamine, therapeutic support during the medication session, and integration afterward. Rather than treating the ketamine experience as the entire intervention, we use it as one part of an ongoing therapeutic process focused on your goals, patterns, relationships, and inner experience.

Is Ketamine safe?

When appropriately prescribed, screened, and monitored, ketamine can be administered safely for many people, but it is not risk-free or appropriate for everyone. Temporary effects may include increased blood pressure or heart rate, nausea, dizziness, sedation, anxiety, or dissociation. A medical provider evaluates potential risks, medications, and contraindications before treatment and monitors you throughout the process.

What does it cost?

The standard KAP protocol is six KAP sessions (3 hours / $400 each), with one integration session (1 hour / $150) after each KAP session. For new clients, there are typically at least two regular therapy sessions (1 hour / $150 each) before the first KAP session. Finally, the medicine, including appointments with the prescriber, costs around $700 for the six sessions. That’s a total of $4,300.

Some people have fewer than six KAP sessions, while others have more. We figure this out as we go. Insurance does not typically cover ketamine appointments, but the integration appointments can be submitted as standard therapy appointments.

What is the difference between Psychedelic Therapy and Psycholytic Therapy?

When I provide KAP to clients, I typically start with at least one (usually more) full dose (psychedelic) ketamine session. After that we often mix in some low dose (psycholytic) ketamine sessions. We figure this out as we go based on your experiences and what feels like it will be most helpful.

Psychedelic Therapy generally uses a higher dose of medication to encourage a more immersive, inwardly focused experience. There is typically little conversation during the medication session, with much of the therapeutic work occurring during preparation beforehand and integration afterward.

Psycholytic Therapy uses a lower dose so that the client can usually remain engaged with the therapist during the experience. The medication helps reduce defenses, deepen emotional awareness and support the psychotherapy taking place in the session.

These approaches are not rigid categories, and a KAP session may include elements of either depending on the dose, the client and the goals of treatment.