Ketamine Assisted Psychotherapy (KAP)

Ketamine Assisted Psychotherapy (KAP)

Journey Psychological Services is excited to offer a therapeutic modality called Ketamine Assisted Psychotherapy (KAP) in partnership with an organization called Journey Clinical.

Ketamine Assisted Psychotherapy (KAP) is a holistic modality in which ketamine is used as a complement to psychotherapy to help eligible patients experience more frequent breakthroughs and sustained improvement in symptoms. Dr. Kelly takes on the psychotherapy portion of the experience, while Journey Clinical’s medical team supports you on all medical aspects. This includes determining eligibility, developing a custom treatment plan, prescribing the medicine and monitoring outcomes.

You may also work with your own Ketamine prescriber; however, they must be a licensed medical professional and a release of information will be required to allow for treatment collaboration with Dr. Kelly and JPS.

Dr. Kelly and Journey Psychological Services do not provide access to any substances and do not condone or support the use of illicit substances.

Below is more information about KAP to help you navigate if it may be a good fit for you.

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. By working with the mind in an open, flexible state we are able to explore old patterns from a new perspective and set change in motion.
  • Ketamine can be administered in a variety of ways, including IV infusion, intramuscular injection, via nasal spray and using sublingual lozenges. In my work with Journey Clinical we only use the sublingual lozenge form. You will keep the lozenge in your mouth for 10-20 minutes and then discard the remaining amount per your provider’s instructions.

How Does Ketamine Feel?

  • The effects of ketamine, which most patients 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 lying down in a comfortable position during the experience. Once these effects subsided, we’ll spend the remainder of our appointment giving you space to process and discuss your experience. While it may feel hard to articulate what happened during the experience, patients feel like the insights gained are none-the-less clear. Studies have shown that the benefits to mood and neurological growth can last up to two weeks after the Ketamine experience.
  • While ketamine use in therapeutic settings is often described as relaxing and pleasant, some patients may experience the unfamiliarity of the ketamine state as disconcerting – perhaps in the heaviness/floating sensation, feeling of being outside of one’s body, physical discomfort (such as nausea or vertigo, particularly if there is a lot of physical movement before the acute effects have worn off), the presentation of distressing psychological material, and so on.
    • Your preparation sessions will cover ways to mitigate difficult experiences and, during your dosing session, Dr. Kelly is there, in part, to offer reassurance and support in the event of any kind of distress that may arise.
    • These unpleasant events are uncommon; however, in your preparation and integration sessions, we will discuss reframing a “bad trip” and explore the lessons that can be learned from a challenging experience.

What is Integration?

  • Integration is the act of reflecting back on the dosing experience while the mind is open and neuroplasticity is elevated. Essentially, you are taking all of the insights, visualizations, ideas, and feelings that occurred during the ketamine treatment and looking at it collectively with a KAP trained psychotherapist to derive a lesson out of the session. It can also help you see past events from a new perspective that give them new meaning. Integration is an opportunity to reveal what’s needed to change negative thought patterns, behaviors and habits. Integration is an essential part of the KAP process and helps to facilitate lasting change.

How Does Ketamine-Assisted Psychotherapy Work?

1. Intake appointment with Dr. Kelly:

  • Intake appointments are 60 minutes long
  • In your intake session, we will explore your presenting problems and any symptoms you are experiencing, discuss goals, review your mental health history, and discuss the appropriateness of KAP for you
  • Intake appointments are required for new patients, for current patients interested in KAP, please skip to step 2

2. Initial consultation with Journey Clinical

  • Dr. Kelly will refer you to Journey Clinical and you will schedule an initial evaluation with a clinician from the Journey Clinical 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 Journey Clinical’s medical team determines that you are eligible for KAP, they will develop a personalized Ketamine prescription and outcome monitoring plan for you.
  • Journey Clinical’s medical staff 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 KAP sessions. You will be taught to take your vitals and self-administer the ketamine lozenges by Journey Clinical’s medical team in advance of our KAP sessions.
  • Once you receive your ketamine lozenges, we will schedule time together for our KAP preparation, dosing and integration sessions.

3. Preparation sessions:

  • Preparation session(s) will be scheduled just like regular therapy sessions (55 minutes) 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.
  • The amount of KAP preparation needed will vary from person to person; however, for your first dosing session, at least one KAP preparation session is required.
  • Our preparation sessions will allow you to ask questions and mentally ready yourself for the KAP dosing session. We will discuss set and setting and review the procedure of the dosing session.

4. KAP Dosing Session:

  • A dosing session is the process of taking your medically prescribed Ketamine in the presence of a KAP trained psychotherapist.
  • A typical ketamine dosing session lasts between 2-3 hours and takes place in your own home, remotely via telehealth.
  • During a dosing session, you will self-administer your ketamine lozenge in your home. You will be in a comfortable, reclining position wearing an eye mask and listening to calming music. Although a KAP dosing session may be largely an internal experience, Dr. Kelly will be present with you the entire time to hold space and provide support as needed.
  • KAP Dosing Sessions are typically held on Wednesday afternoons from 2pm-5pm ET.
  • A chaperone will need to be present (in the home, not in the session). We will discuss the role of the chaperone during our preparation sessions.

5. Integration Sessions:

  • After our KAP dosing session, we will meet for multiple integration therapy sessions to review the memories, thoughts, and insights that arose during your dosing session, and to prepare for the next dosing session.
  • Integration sessions will be like regular therapy sessions (55 minutes), with a focus on processing your ketamine experience
  • Your first integration session is typically held within 24 hours of your first dosing session – if your first dosing session occurs on a Wednesday, we will arrange to hold our first integration session on Thursday.

6. Follow-up consultations with Journey Clinical:

  • After our first KAP session, Journey Clinical’s 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.

What is my investment?

Journey Clinical Medical Costs (charged by and paid to Journey Clinical)

  • Medical Intake: $250 (One time fee, reimbursable through out-of-network benefits – OON)
  • Follow-up Sessions: $150/Session (minimum of 1/quarter, reimbursable through OON)
  • Cost of Ketamine Lozenges: approx. $75 for approximately 4-6 lozenges (not eligible for reimbursement by insurance)
  • Fees above are set by Journey Clinical and are subject to change. Please check here for up to date fee information.

Ketamine Assisted Psychotherapy Costs: (charged by and paid to Journey Psychological Services)

Payment Plans and Packages Available for Services Below –

  • Intake appointment $250 (1 session, 60 minutes, reimbursable through OON)
  • Preparation Sessions: $250 (1-3 sessions required before dosing, based on individual need – minimum of one session required; 55 minutes each; reimbursable through OON)
  • 1st Dosing Session: $750 (up to 3 hours; not eligible for reimbursement by insurance)
  • Additional Dosing Sessions: $550 (up to 2.25 hours; not eligible for reimbursement by insurance)
  • Integration Sessions: $250 (2+ sessions, based on individual need – minimum of one session required after each dosing session; reimbursable through OON

Do I need any special equipment to participate in remote KAP?

  • A blood pressure cuff is required – if you don’t have one, you can purchase one for under $25.00 at Amazon, other online retailers, or your local pharmacy
  • A private, comfortable space with a bed or couch
  • In your preparation sessions you will discuss the use of the following optional arrangements for your setting:
    • Eye mask (recommended)
    • Cup/container to spit remaining medicine (recommended)
    • Music (recommended playlist provided)
    • Pen and notebook
    • Meaningful objects
    • Art supplies
    • Pleasant scent (essential oils, candles, incense, etc.)
    • Refreshing beverage
    • Snack for end of session

How Do I Get Started?

What is the cancellation policy for KAP services?

  • All KAP services require at least 24 hours notice to cancel. Since KAP dosing sessions are allotted up to 3 hours of time, timely notice regarding the need to reschedule/cancel is essential. The full rate of service will be charged for late cancellations and/or no shows. We appreciate your advanced notice of schedule changes to avoid these fees.

Helpful Resources:

Paradigms of Ketamine Treatment by Raquel Bennett, Psy.D. for MAPS

The Ketamine Cure by David Dodge for The New York Times

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


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