What is Ketamine Assisted Psychotherapy?
Ketamine assisted psychotherapy, or KAP, is a specific treatment model that involves the use of ketamine alongside talk therapy. Because of its psychedelic and sedative effects, ketamine can help you find a unique sense of separation from yourself and your thought processes. Overcoming mental health challenges can be incredibly difficult because you feel so swept up in your negative thoughts, so the dissociation that happens with ketamine may allow you to take a step back and find clarity.
The psychedelic effects of ketamine on their own may not be enough to overcome depression, though. The true value of the medicine happens when it’s combined with therapy. After you experience the clarity and awareness the drug provides, you and your therapist will discuss your life concerns, thinking habits, or other worries. You’ll find ways to incorporate the insights you discovered into your daily life, and you’ll use the experience to take active steps toward improving your mental health.
What Is Ketamine?
Many of you know ketamine as a club drug, but it has several medicinal purposes. 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, nasal spray, and using sublingual lozenges. In my work with Ketamine, we only use the lozenge form.
Is Ketamine a Psychedelic?
Ketamine shouldn’t cause psychedelic effects in low doses. In moderate amounts, though, it does have psychedelic properties. This experience may help people view personal or vulnerable situations from a new perspective, and it can promote a sense of meaning and purpose.
The psychedelic experience of ketamine can be valuable in a therapeutic setting, but it may be overwhelming or harmful if taken without oversight or taken in too high of a dose. When you’re experiencing depression or other mental health concerns, you’re in an emotionally vulnerable state. The effects of ketamine or other psychedelic drugs could lead to other uncomfortable mental health symptoms when you don’t have a professional to help facilitate the process. This is why self-medicating is so dangerous and why it’s critical that you work with a psychotherapist and prescribing physician if you’re interested in this treatment.
How do you prepare for a KAP session?
Before you undergo KAP, your treatment team will make sure it’s an appropriate method for you. Your team will ask about your psychological and physical health history, and you’ll discuss your goals for the treatment. You can also discuss any questions or concerns you have about the therapy.
You and your therapist will have 1-3 sessions to prepare you for the treatment session in which you will set an Intention for the session. This is essentially getting your mind set for what it is that you are seeking to change or move towards or understand. You and your therapist will decide whether these sessions will be in person with your therapist or at home with a support person nearby.
What does ketamine feel like?
The effects of ketamine, which most clients find pleasant, last approximately 45 minutes. The effects of ketamine can make you feel “far away” from your body and the experience can be expansive in nature. Because the medicine has psychedelic and sedative effects, you will experience a unique sense of separation from your body and your thoughts which will allow your Inner Healing Mechanism to guide you towards healing.
During a ketamine session you will notice reduced verbal and motor abilities so you will be lying down with eye shades and headphones on with a relaxing soundtrack to support you in your experience. After the medicine wears off you will slowly come back to presence in the room and in your body. This is the time when the brain is most open to creating new ways of thinking and behaving which are supported by integrating the experience with your therapist.
It is normal to be nervous before trying ketamine. You and your therapist will spend as much time as needed to prepare you for the experience and decide, with the medical prescriber, what is the appropriate dose for you. Your therapist will be with you every step of the way to guide and support you in the process.
The actual KAP session may last between 75 minutes. You’ll begin by taking a dose of ketamine, and you’ll likely notice the effects after about 15-20 minutes. The effects will gradually increase for the next 30 minutes, and then they’ll slowly diminish. Your therapist will offer support during this time if you experience any anxiety, confusion, or discomfort.
After the session, you and your therapist will discuss your experience. Sometimes, therapists prefer to talk about the experience in the moment, but it can be difficult to articulate your thoughts and feelings. When speaking with your therapist, you can explore how you felt, what you thought about, and how you can apply these insights to your life. This is what is referred to as the Integration phase of treatment in which the brain is most open to creating new thoughts and habits. You will be supported to talk about your experience in the session with your therapist and support system, journal about your experience and be in nature to reflect on the experience. This is how the medicine is best supported to create new neural pathways in the brain to support emotional shifts and behavior change.
Candidates for KAP
The most common mental health condition treated with KAP is depression. Because the drug works differently from other antidepressants, it may be an option for people who haven’t been successful with traditional psychotropic medications or conventional therapy.
KAP can be an effective treatment for other conditions, too. It has been used to treat anxiety, PTSD, addiction, and chronic pain. Many people see an immediate improvement in their mental health symptoms in the hours or days following the KAP session, but it usually takes a few sessions for long-term effects to settle in.
There are certain medical or psychological concerns that may disqualify a patient from receiving KAP. These include hallucinations, mania, cardiovascular disease, hyperthyroidism, and some other conditions.
How many sessions will I need?
Most therapists recommend having at least three (but most effectively, six) KAP sessions. While the first one can be powerful and beneficial, it often takes recurring sessions to tap into the true potential of the medicine. Research shows that ketamine has a cumulative effect, so multiple sessions will ensure that you continue to feel the benefits long after you’ve ended the treatment. The number of sessions are based on the goals of treatment.
Cost of KAP sessions
We will work with you to come up with a treatment plan that is affordable for you.
We offer free consultation with your therapist to see if KAP is right for you. We can support you with Superbills to get reimbursement from your insurance company.
Preparation and Integration sessions $200
Ketamine Assisted Psychotherapy sessions $200/hour