Ketamine Assisted Psychotherapy (KAP)

the frontier of new treatment options

I 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. I take on the psychotherapy portion of the experience, while a medical team supports you on all medical aspects. This includes determining eligibility, developing a custom treatment plan, prescribing the medicine and monitoring outcomes.

KAP treatment can be in-person or remote

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 has 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. In my work with Journey Clinical we only use the sublingual lozenge form.

What issues are treated with Ketamine?

They include, but not limited to:

Depression
Anxiety Disorders (generalized anxiety, social anxiety, OCD)
Bipolar Disorder
Substance Abuse Disorders
PTSD/trauma
Eating Disorders
Adjustment Disorders
Other conditions such as Burnout

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.

What is Ketamine-Assisted Psychotherapy?

We work as a team: myself as the psychologist, you the client, and the medical team with Journey Clinical.
You will be referred for an evaluation with Journey Clinical, and based on your unique needs, a treatment plan is put into place.
Sessions comprise of “dosing sessions,” and “integration sessions.” These sessions allow you to experience ketamine and then process what the journey was like for you. It is a unique experience, and no two people will have the same. During the integration sessions, we discuss how to incorporate this experience with your therapeutic goals.
6-8 sessions are usually recommended. A treatment plan is set forth by the medical team after a thorough evaluation.

Why do I offer this treatment?

There are several factors that led me to offering this treatment to my clients. Firstly, I come from an indigenous background and have learned through my studies that re-introducing spiritual practices into native communities can combat the ill effects of colonization, to include depression and substance use disorders. Furthermore, the use of peyote within a ceremonial context has shown to have positive outcomes for Native American Church (NAC) participants. Peyote is used legally in the U.S. as a sacrament in NAC ceremonies and have personally seen the positive effects of traditional practices, to include sweat lodge and medicine ceremonies.

It may seem that psychotherapy and native spiritual practices are not inherently connected. Well, they usually are not. What I have seen personally, under the right conditions, is that the use of medicines can have a profound positive effect on a person’s mental health. In traditional communities, shamans or other leaders are the experts who lead participants down this road of uncovering, enlightenment, healing and discovering. These journeys are heightened and possible by the use of psychedelics (or other methods, such as heat in a sweat ceremony) in order for people to experience a mind-altering state of consciousness.

In the U.S., the use of mind-altering medicines or drugs are usually not sanctioned, and in fact, are often deemed illegal. Michael Pollen, in the Netflix docuseries, “How To Change Your Mind,” discuss the history of psychedelics in the U.S. While ketamine is not a true psychedelic, like psilocybin (mushrooms) or peyote/mescaline, it has properties that can be psychedelic in nature at certain dosages.

So, how do we get to ketamine? A little history…

Ketamine was first synthesized in 1962 and was used during the Vietnam era as an anesthetic in the field, as it was generally safe where people did not need constant monitoring like other anesthesia. In 1970, the FDA approved ketamine as a dissociative anesthetic and procedural sedative. In the 1980’s ketamine was known as a party drug, but was also used medically by veterinarians since it is well tolerated and very safe. In 1985, the World Health Organization (WHO) deemed ketamine to be an “essential medicine.” However, in 1999, the Drug Enforcement Agency (DEA) labeled ketamine as a Schedule III drug and began to prosecute usage.

In 2000 researchers out of Yale studied and published their impressive results of ketamine on patients with treatment-resistant depression and was subsequently replicated by many other researchers since then. Research protocols skyrocketed and a psychiatric revolution was ushered in.

In 2015, the Ketamine Research Institute was founded, and in 2016, the American Society of Ketamine Physicians. Standards of treatment were set-forth and published by the American Psychiatric Association, in the Journal of American Medical Association (JAMA) in 2017 for ketamine-infusion treatment.

And finally in 2019, the FDA approved ketamine and was no longer used off-label for the treatment of depression.

Why is Ketamine Getting this Attention for Mental Health treatment?

It is a quicker (within 2-4 hrs. of dosing) anti-depressant and mood-enhancing medicine.
Has shown positive results for “treatment-resistant,” depression— where other treatments have failed, ketamine can be effective. (50-80% response rate)
Duration of one dosing can be felt for 2/3 days- 2 weeks, and subsequent doses have a cumulative anti-depressive effect.
There are mild and transient side effects (i.e., nausea).
Shows positive effects on suicidality.
Ketamine is relatively safe and versatile in usage (as a anesthetic, sedation, and in psychiatry).
Increased “neuroplasticity” — the brain’s ability to learn and change by increasing the neural connections.
This enhances the psychotherapy treatment, because this “window of neuroplasticity,” allows for an increased ability to make changes by:
- working towards your goals, new habits, etc., with a skilled therapist
- feeling a relief of the difficult symptoms feel in their everyday life.
- A new perspective can be experienced in your ketamine sessions, and can therefore, help to move you towards change.