Ketamine Assisted Psychotherapy (KAP)
Go where no other therapy has taken you
Ketamine
What is Ketamine Assisted Psychotherapy?
Kap sessions are generally 2 to 2 ½ hours in length. Clients lie on a comfortable couch or recliner with blankets, eye shades and listen to carefully curated music. Clients experience a “time out” from the ordinary mind and reality. In this space, obsessive thoughts, negative self-talk, and judgment disappear. Clients have shifts in self-perspective, increased self-compassion, and new insights into current or old problems. Throughout the session, the clinician provides psychotherapeutic support and helps clients process material that arises during sessions.
“Science is magic that works.” ~ Kurt Vonnegut
Feb 2023 Study:
Combining Ketamine and Psychotherapy for the Treatment of Posttraumatic Stress Disorder: A Systematic Review and Meta-Analysis
Session duration: Two hours
Guiding Principles:
- We provide Ketamine-Assisted Psychotherapy (KAP) and KAPspotting where ketamine is used to augment therapy.
- KAP and KAPspotting occurs within the therapeutic alliance of the client and therapist.
- Client safety comes first.
- Designed to support goals and clinical outcomes.
Here’s a quick snapshot of the three-way connection—you and your therapy team.
Client
- Schedules intake and follow-up consultations
-
Completes forms (Intake, Consent, Clinical Scales)
-
Self-administers Ketamine during session
Therapist
- Conducts Intake appointment
- Makes referral to medical provider
- Provides KAP sessions
Medical Provider
- Ketamine eligibility; Intake and follow-ups
- KAP Treatment Plan; vitals, dose, frequency
- Ketamine prescriptions and refills
The science:
Ketamine was developed by Calvin S. Stevens, a chemistry professor, in 1962. Ketamine acts as a dissociative anesthetic, procedural sedative, painkiller, and novel antidepressant. Its safety, short duration, and unique mode of action have made Ketamine an essential medication in emergency medicine worldwide. It works by blocking the brain’s N-methyl-D-aspartate (NMDA) receptors, a type of glutamate receptor, and stimulating AMPA receptors, which are believed to help form new synaptic connections and boost neural circuits that regulate stress and mood.
The study and use of Ketamine for chronic pain, drug addiction, and psychiatric disorders have grown considerably in the last few decades. The most significant finding is a discovery of Ketamine’s rapid-acting antidepressant effects (Kohtala, 2001), often within hours, with 50-80% efficacy. This is welcome news for the mental health community, which has not benefited from rapid medical advancements like other healthcare areas. For instance, while antidepressants are helpful for many, they take weeks to months for effects and have a 33% efficacy rate. In other words, antidepressants end depression for only a third of the severely depressed patients who take them. As such, in 2019, the FDA authorized Ketamine’s off-label use for treatment-resistant depression and anxiety. It is used regularly in emergency rooms to abate suicidality quickly. Off-label means it is used for something other than initially intended. Treatment-resistant means medications and psychotherapy have failed to remit a person’s depression.
What are ketamine’s benefits?
Our clients have experienced many benefits, including:
A relaxing time-out from ordinary thinking and reality
Decrease in negative or obsessive thoughts
Shifts in self-perspective, relationships, and worldview
Increase in self-compassion and self-identity
Increased creativity and cognitive flexibility
A broader outlook on challenging situations and problems
Reduction of fear and disruption of painful memories
Improved neuroplasticity and dendritic growth
Reversal of cellular damage caused by stress
Intrinsic antidepressant response
Improved ability to experience happiness and pleasure
Changes in rejection sensitivity
Changes in avoidance behaviors (e.g., not speaking up to avoid conflict, going out of your way to avoid seeing someone, not looking at mail to avoid seeing bills)
A spiritual or mystical experience—which can vary for different individuals
Any activity, behavior, or cognitive practice a person engages in after ketamine treatment, referred to as the “neuroplastic window,” will be naturally enhanced. During this time, neurons and dendrites experience more rapid and robust growth as the brain is bathed in brain-derived neurotropic factor (BDNF). The neuroplastic window can last 7 to 10 days.
How is Ketamine administered?
Ketamine can be administered via IV infusion, intramuscular injection, nasal spray, or sublingual lozenges. Sublingual lozenges are used in Ketamine Assisted Psychotherapy and KAPspotting.
A medical provider must administer IV infusion and intramuscular injection. A medical doctor must prescribe nasal spray and sublingual lozenges. We use lozenges in KAP and KAPspotting because they are fast acting, where effects are felt within minutes. The effects last 45-60 minutes.
Our partnership with a local infusion clinic is headed by a board-certified anesthesiologist with many years of ketamine experience. It is available there if he deems you are a good candidate for IV infusion.
How does Ketamine treatment feel?
Most people find the effects of ketamine to be pleasant. Effects include shifts in perception that often feel expansive, described as feeling greater openness to ideas and information. Patients often report a sense of unity with all things and a general perception of not being separate but interconnected with themselves and their surroundings.
At lower doses, clients remain conscious, feel more open, and are less fearful of discussing painful memories, thoughts, and feelings, leading to a quicker resolution. Moderate-to-high doses involve dissociation, out-of-body experiences, and a greater sense of connection to others and may include mystical or spiritual experiences. While it may feel hard to articulate what happened during the experience, patients feel like the insights gained are clear. Studies have shown that mood and neurological growth benefits continue weeks after the Ketamine experience.
The effects last 45-60 minutes.
IV infusion, intramuscular injection, nasal spray, or sublingual lozenges.
Pleasant Feeling
Sources: Journeyclinical.com, Dore J, Turnipseed B, Dwyer S, Turnipseed A, Andries J, Ascani G, Monnette C, Huidekoper A, Strauss N, Wolfson P. Ketamine Assisted Psychotherapy (KAP): Patient Demographics, Clinical Data, and Outcomes in Three Large Practices Administering Ketamine with Psychotherapy. J Psychoactive Drugs. 2019 Apr-Jun;51(2):189-198. Doi: 10.1080/02791072.2019.1587556. Epub 2019 Mar 27. PMID: 30917760.
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