“Change begins when we become conscious of what has been unconsciously shaping us.”
Ketamine Assisted Psychotherapy (KAP) 101
Ketamine can temporarily increase neuroplasticity, creating a window when the brain may be more receptive to new patterns of thought, emotion and behavior.
Ketamine-Assisted Psychotherapy (KAP) combines ketamine with psychotherapy to support deeper therapeutic work leading to symptom improvement and lasting change. As a KAP provider, I provide the psychotherapy while a prescribing physician manages the medical care, including eligibility, treatment planning, prescribing, and monitoring.
What is 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. I only use the sublingual lozenge form in my work.
How Does Ketamine Feel?
The effects of ketamine, which most clients 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 in a comfortable position during the experience. Once these effects subside, we’ll spend the remainder of our appointment giving you space to process and discuss your experience. Studies have shown that the benefits to mood and neurological growth can last up to two weeks after the Ketamine experience.
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 Sessions
My typical hourly rate.
Typical Medical Costs
KAP Intake:
Consultation: $250
Non-covered services (including medication): $112
KAP Follow-Up:
Consultation: $150
Non-covered services (including medication): $208
Medication Management (regular psychiatry appointment):
$250 flat fee
How Do I Sign Up?
If you would like to explore the possibility of working with me on KAP, please e-mail me at amy@amyschulze.com to discuss eligibility and next steps.
What is Journey Clinical?
I am currently using Journey Clinical for KAP support. Journey Clinical is a platform for licensed psychotherapists to incorporate science-based psychedelic therapies in their practice safely and effectively, starting with Ketamine-Assisted Psychotherapy (KAP). Journey Clinical’s in-house medical team takes on patient eligibility, prescriptions and outcome monitoring, while I take on the therapy. Their collaborative care model is designed to deliver personalized treatment plans to meet your individual needs and improve long-term outcomes.
How Does Ketamine-Assisted Psychotherapy Work?
Initial Consultation
You schedule an initial evaluation with a clinician from a designated 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 the medical team determines that you are eligible for KAP, they will develop a personalized Ketamine prescription and outcome monitoring plan for you.
The medical team will write a ketamine prescription for you, and a small amount of oral ketamine will be sent to your home, enough for the first 2-4 KAP sessions. You will be taught to take your vitals and self-administer the ketamine lozenges by your medical team in advance of our KAP sessions.
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.
KAP Dosing Session:
A typical ketamine dosing session lasts around 2 hours and can take place either in-person at my office, or remotely via telehealth.
During a dosing session, you will self-administer your ketamine lozenge either in my office or in your home and utilize tapping to engage the bilateral process of EMDR. 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. When finished, we will explore the insights gained on your journey.
Integration Sessions:
After our KAP dosing session, we may decide to meet for additional therapy sessions to review the memories, thoughts and insights that arose during your dosing session. If appropriate, we will begin to prepare for the next dosing session.
Follow-up consultations with your medical team
After our first KAP session, your 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.
Helpful Resources
Paradigms of Ketamine Treatment by Raquel Bennett, Psy.D. for MAPS
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
Ketamine for Depression and Mood Disorders by Erica Zelfand, ND for Townsend Letter
Ketamine-Facilitated Psychotherapy for Trauma, Anxiety, and Depression by goop
Ketamine Assisted Psychotherapy with Jonathan Sabbagh of Journey Clinical - Psychology Talk Podcast