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What is Ketamine Assisted Psychotherapy?
Ketamine-assisted psychotherapy (KAP) is an innovative therapeutic approach that combines the use of the medication ketamine with traditional psychotherapy techniques in a safe and supportive setting. Ketamine is a dissociative anesthetic that has been used for decades in medical settings for adults and children for pain relief and anesthesia. The World Health Organization (WHO) has listed Ketamine as an Essential Medicine since 1985 and it has been approved for use by the FDA since 1970. It is known to be the most widely used anesthetic in the world. In the last decade, research has shown that Ketamine has major therapeutic benefits for treatment resistant depression and other mental health conditions such as post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and substance dependency.
At Del Ray Psych, KAP is conducted with the participation of a medical provider who prescribes a low to moderate dose of ketamine in the form of a lozenge. This dose induces a relaxed state with some mild to moderate dissociative effects. A trained therapist facilitates the experience in a supportive and therapeutic environment that is accompanied with soft music and an eye mask to keep the surrounding environment as relaxed as possible. The client is typically conscious and able to interact with the therapist throughout the session. During the ketamine session, the patient is guided through a therapeutic process, which may include various psychotherapeutic techniques such as talk therapy, mindfulness exercises, or trauma-focused therapy. The combination of ketamine and psychotherapy provide the optimal environment to address a clients defenses, rewire neural pathways, and access deep feelings that may otherwise be blocked or difficult to access.
Ketamine enhances the healing in the brain by modulating certain brain chemicals, particularly glutamate, which plays a role in mood regulation and cognition. Research has shown that ketamine induces fast-acting antidepressant effects. Ketamine induces not only functional changes in the brain but also structural changes as evidenced by producing new neuronal connections and neuroplasticity. This allows the brain to “rewire” and can have a rapid and profound effect on a person's perceptions, thoughts, emotions, and behaviors. By combining ketamine administration with psychotherapy, we are able to make both treatments more effective. While ketamine helps with neuroplasticity, psychotherapy helps with addressing underlying emotional or mental blocks that can be an obstacle to deeper healing. KAP allows emotional blocks and defenses to soften allowing a person to address uncomfortable feelings and memories, potentially shortening the amount of time needed in therapy.
Questions?
Do you have questions about Ketamine-Assisted Psychotherapy (KAP) and would like to see if it is right for you? Contact us using the form below and we will get back to you within 48 hours.
Who can benefit from KAP?
Ketamine Assisted Psychotherapy can be a highly effective treatment for clients struggling with various forms of treatment resistant depression, anxiety, obsessive-compulsive disorder (OCD), Post-Traumatic Stress Disorder(PTSD), and substance use disorders.
Many people who do not have a clinical diagnosis can also benefit from KAP. The transformative psychedelic journey and powerful biochemical effects (especially new neuronal connections) can support personal healing and growth. These new neuronal connections may assist in resolving issues such as feelings of stress, extreme burnout, identity challenges, life transitions, or stagnation in one’s life.
Our Treatment Processes
Together with a medical professional and highly-trained psychotherapist, KAP opens up pathways to significant and rapid change. Once the therapist and client have determined suitability for KAP and conducted an intake session, the client will be referred to a collaborating medical provider for an intake. The medical professional will prescribe the medicine upon determining eligibility. Some contraindications for the use of ketamine are ongoing active substance abuse, pregnancy, nursing, psychosis, hyperthyroidism, acute mania, recent traumatic brain injury, and/or cardiovascular problems. The KAP session described below takes approximately 2.5-3 hours. Following the KAP session, there will be an integration session that will involve discussion and integration of the experience and how it pertains to the client’s current life issues.
(Right to Left) Sonia Palmieri, MSN, ANP-BC; Eleni Boosalis, PsyD; Lauren Fisher, PsyD
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The first step is to meet with a licensed medical provider who prescribes sublingual ketamine lozenges. In this intake you will discuss your medical history and assess your physical eligibility for this treatment. Once cleared, your provider will then explain the process, answer any questions, and address any concerns you may have regarding ketamine treatment.
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Before the ketamine session, you will have one or more preparatory therapy sessions. These sessions aim to determine psychological eligibility, establish a therapeutic relationship, discuss treatment goals, and prepare you for the ketamine experience. Our therapist may educate you about the effects and potential risks of ketamine and address any concerns or questions you may have.
50-60 min Mental Health Intake/Prep Session with one of our trained providers: $200
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During the KAP sessions, you'll be administered a controlled dose of ketamine, under the supervision of both a healthcare provider and licensed therapist. The dose will be carefully calibrated based on your individual needs. While under the influence of ketamine, you'll engage in psychotherapy techniques with the guidance of the therapist. This may involve exploring and processing emotions, memories, and/or traumatic experiences. The altered state induced by ketamine can facilitate deeper introspection and potentially help you gain new insights and perspectives.
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After each ketamine session, there will be an integration session. This involves discussing and integrating the insights and experiences gained during the session into your daily life. The therapist will help explore themes, insights, and somatic experiences that arose during the session. The therapist will also work with you to process any positive or negative feelings that may have come up during the KAP session as well as ways to remain connected to the ongoing growth that can continue beyond the KAP experience. The therapist may offer after care instructions, including journaling, listening to the playlist used during KAP, and issues to follow up with the client’s future therapy sessions.
Interested in taking the next step for 1-on-1 Kap?
1-on-1 KAP Sessions
Our 1-on-1 KAP sessions take place in our KAP room located in Del Ray Psych and Wellness. The session is approximately 2.5-3 hours in length.
Pricing:
One (1) mental health intake with a Del Ray Psych Clinician (50-60 mins) - $200
(BCBS Insurance can be used for this session)
One (1) medical intake with a ketamine prescriber (if needed, we can provide you with a recommendation) - $400 (must include prescription for ketamine)
Lozenge KAP session with licensed therapist* (2.5-3 hrs) - $650 (includes eye mask, journal, snack, drink)
Individual KAP Session Format:
During a KAP session, you will discuss intention setting, partake in a meditation and breathing exercise, guided journey (60-75 minutes), post-journey integration. Sage clearing of the space, snacks and drinks are also included in this session.
*In order to partake in a KAP session, you MUST complete a medical and mental health intake to be cleared. Medical and mental health intakes are only needed once regardless of how many individual and group sessions will be booked.
Ketamine Assisted Psychotherapy FAQs & Resources
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Ketamine is a FDA approved anesthetic agent originally developed in 1962. It has been used primarily as an induction agent for general anesthesia in surgery for children, adults, and animals. Ketamine has a remarkable safety track record, hence its use in the pediatric population. Recently, it has been discovered that ketamine can be highly effective in treating depression, PTSD, Fibromyalgia, and other conditions.
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Ketamine is only available by prescription from a medical provider, a physician or nurse practitioner. Reach out to get a list of preferred providers.
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The short answer is, yes. Our practice procedures require you to be cleared by a medical professional.
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Ketamine is not recommended for clients who have cardiovascular conditions such as uncontrolled hypertension. Clients with active mania or a history of psychotic illnesses (e.g., schizophrenia) should not take ketamine, as there could be severe risks. Ketamine is also not indicated for clients who are actively abusing substances or have abused ketamine in the past.
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Routes of administration of ketamine include intravenous, intramuscular, intranasal, and sublingual/bucal. At Del Ray Psych & Wellness, we currently use sublingual/bucal which is compounded ketamine lozenges (self-administered sublingually/bucally and held under tongue for several minutes).
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The experience of a ketamine journey can vary from person to person, and it depends on factors such as the dosage, setting, and individual characteristics. However, there are some common elements that are often reported:
Dissociation: Ketamine is known as a dissociative anesthetic, which means it can induce a sense of detachment from one's body or surroundings. During a ketamine journey, you may experience a shift in your perception of reality, feeling disconnected from your body or a sense of floating or out-of-body experiences.
Altered Sensations: Ketamine can distort your sensory perception, leading to changes in how you perceive sounds, colors, and textures. Some people report enhanced or distorted sensations, while others may experience a blurring or merging of sensory inputs.
Emotional Effects: Ketamine can elicit a range of emotions, which can vary from euphoria and relaxation to introspection and introspective experiences. Some individuals may experience a deep sense of peace and contentment, while others may confront difficult emotions or memories.
Time and Space Distortion: Ketamine can alter your perception of time and space. It may feel as if time is slowing down or speeding up, and your sense of spatial awareness may be distorted.
Insights and Transcendent Experiences: Ketamine journeys can be accompanied by profound insights, self-reflection, and a sense of transcendence. Some individuals report gaining new perspectives on their lives, increased self-awareness, or a feeling of connectedness with something larger than themselves.
Visual Imagery: Ketamine can also induce vivid and immersive visual imagery, often described as dream-like or hallucinatory. These visual experiences can be abstract, colorful, or symbolic.
It's important to note that the effects of ketamine can vary depending on the dose and the context in which it is administered. In therapeutic settings, the experience is typically guided by a trained professional who can help create a safe and supportive environment to navigate the journey.
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Ketamine journeys, particularly when used in a therapeutic context, have been associated with several short-term and long-term benefits. It's important to note that the research in this area is still ongoing, and the effects can vary between individuals. Here are some potential benefits:
Short-Term Benefits:
Rapid Mood Improvement: Ketamine has shown promise in rapidly reducing symptoms of depression, anxiety, and other mood disorders. Many individuals report experiencing an immediate improvement in their mood and a temporary relief from emotional distress.
Enhanced Emotional Insight: Ketamine can facilitate introspection and self-reflection, allowing individuals to gain new insights into their emotions, thoughts, and behaviors. This increased awareness can support personal growth and promote a deeper understanding of oneself.
Increased Relaxation and Stress Reduction: Ketamine's anesthetic properties can induce a state of deep relaxation and calmness. This can provide temporary relief from stress, tension, and physical discomfort.
Long-Term Benefits:
Sustained Mood Improvement: While the immediate mood-enhancing effects of ketamine may be temporary, there is evidence to suggest that ketamine-assisted therapy can lead to sustained improvements in mood and a reduction in depressive symptoms over time, even after the ketamine sessions have ended.
Improved Treatment-Resistant Conditions: Ketamine has shown promise in treating individuals with treatment-resistant depression, post-traumatic stress disorder (PTSD), and other challenging mental health conditions. It may offer an alternative treatment option for those who have not responded to traditional therapies.
Enhanced Resilience and Coping Skills: Through the insights gained during ketamine journeys and the therapeutic support provided, individuals may develop enhanced resilience, self-compassion, and new coping mechanisms. These skills can help individuals better navigate life's challenges and maintain their mental well-being in the long term.
It's important to note that ketamine journeys should always be conducted under the supervision of trained professionals in a controlled and therapeutic setting. Furthermore, individual responses and outcomes can vary, and ketamine should not be seen as a universal or standalone solution for mental health conditions.
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A sitter is a person who is a trained mental health professional that provides support and assistance to someone undergoing a psychedelic experience. The sitter's primary role is to create a safe and supportive environment for the individual, ensuring their physical and emotional well-being throughout the session. Sitters also help process the individual’s experience, transcribe the experience in a journal, and guide through the experience. They may also have expertise in mindfulness, meditation, and other contemplative practices that can help the individual navigate the psychedelic experience. Having a sitter present during a psychedelic therapy session can help minimize the risk of adverse reactions and ensure that the individual receives the maximum benefit from the treatment.
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