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Ketamine-Assisted Psychotherapy
Ketamine-Assisted Psychotherapy (KAP) offers a unique and promising approach to addressing mental health challenges like depression, anxiety, and trauma. As a sex therapist, I specialize in supporting clients whose struggles with these issues are intricately tied to sexual self-confidence, sexual function, sexual orientation, and gender identity. By incorporating ketamine into psychotherapy, KAP can unlock new insights and avenues for healing, particularly for those whose symptoms have not responded sufficiently to other treatments.
How KAP Works
KAP involves the use of ketamine in conjunction with psychotherapy. Ketamine is a medication approved by the FDA for anesthesia but is used “off-label” in much smaller doses to help treat psychiatric conditions. Research shows that ketamine has the potential to reduce symptoms of depression and anxiety by stimulating neuroplasticity—the brain’s ability to form new connections. This can make therapy more effective by helping you process and explore previously difficult or inaccessible emotional material.
During KAP, you will take ketamine as a sublingual tablet (under the tongue) prescribed by a medical provider. The therapeutic experience involves a carefully guided process, which includes three key phases: preparation, dosing, and integration.
The KAP Process
Preparation Sessions
Before starting KAP, I will initiate a referral to Journey Clinical, a trusted partner that specializes in medical evaluations for ketamine treatment. Journey Clinical will reach out to schedule your virtual appointment with a physician or nurse practitioner. They will assess whether ketamine is appropriate for you based on your medical history and current mental health status.
In our preparation sessions, we’ll discuss your mental health background, set clear intentions for your KAP experience, and thoroughly review the potential risks and benefits of ketamine use. We will also focus on “set and setting,” ensuring that both your mindset and the physical environment are optimized for your session. This includes discussing preferences for comfort, such as eye shades, blankets, music, scents, and lighting, so you feel supported throughout the journey.
Dosing Sessions
The dosing session is where you take the prescribed ketamine, and this is primarily an inward journey, meaning the focus will be on your internal experience. The session takes place in person at my comfortable office in downtown Stamford, lasting up to three hours. I’ll be present throughout, offering emotional and physical support only if needed, but mostly allowing you space to process. The effects of ketamine create a sense of dissociation, helping to break habitual thought patterns and potentially leading to profound shifts in awareness.
The primary goal is for you to experience the ketamine journey on your own terms. Toward the end of the session, we’ll briefly discuss any emotions, memories, sensations, images, or themes that emerged, which will form the foundation for our integration work.
Integration Sessions
In the days following your dosing session, we will meet for integration therapy. Integration is a critical aspect of KAP because it helps you make sense of the experiences and insights gained during your ketamine journey. During these sessions, we’ll utilize the enhanced neuroplasticity provided by ketamine to explore the new themes that have emerged and how they relate to your broader therapy goals. This is where lasting change is most often facilitated, as you gain new perspectives on issues related to depression, anxiety, and trauma, as well as deeper aspects of your sexual self-esteem and identity.
Risks and Benefits of KAP
Ketamine has been used safely for decades as an anesthetic, but its use in psychotherapy is newer and considered experimental. While KAP offers a potential breakthrough for treatment-resistant conditions, it is not a cure-all. The dissociative effects of ketamine may help create new pathways in the brain, and research has shown a high response rate for those with treatment-resistant depression. However, ketamine is not appropriate for individuals with a history of psychosis or certain medications. The risks, benefits, and off-label nature of KAP will be thoroughly reviewed with you during the medical evaluation and informed consent process.
Additional Resources
To help you make an informed decision, please review the FAQs below. Journey Clinical also offers robust resources on their website:
FAQs
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If KAP is the primary therapy modality, dosing sessions are held every other week for a total of six to eight dosing sessions. At least two preparation sessions are held prior to the first dosing session and at least one integration session is held between each dosing session. This course of treatment would take approximately four to five months of weekly sessions.
If KAP is supplemental to more traditional psychotherapy, there can be fewer dosing sessions with longer intervals in between. You and I will work together to determine the optimal length of time between dosing sessions based on the recurrence of your symptoms. As a rough estimate, dosing sessions may be held once about every four to six weeks under this model.
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The Journey Clinical medical provider who completes your evaluation will prescribe ketamine in the form of a rapid disintegrating tablet. It is placed under the tongue and swished for about twelve minutes. The remainder of the medication is then spit out and not swallowed. The details of this process will be thoroughly reviewed during the preparation sessions.
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The initial medical evaluation and treatment plan with the Journey Clinical team costs $338. If you are not medically cleared during the evaluation, the full fee is reimbursed to you. The fee includes the medical consultation, two doses of medicine, and four-day shipping.
Follow up medical consultations cost $298. This includes the fee for the appointment, six doses of medication and four-day shipping.
Preparation, dosing, and integration sessions are billed at my hourly rate of $275. Preparation and integration sessions are one hour. Your first dosing session is scheduled for three hours. Based on the time needed for the first dosing session, subsequent dosing sessions may be scheduled for three, two and a half, or two hours. Dosing sessions are not eligible for out of network reimbursement.
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Journey Clinical is in network with Aetna in NY and CA, Anthem Blue Cross of CA, and Blue Cross Blue Shield of MA. Journey Clinical does not currently accept any other insurance plans, including Medicaid (i.e. Husky).
Stay tuned - the Journey team is hard at work to become in network with other insurance plans and in other states.
These in-network options are only for the medical evaluation and follow ups with Journey Clinical. As is the case with all of the therapy I provide, preparation, integration, and dosing sessions are out of network.
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It is your responsibility to understand any out of network benefit that you may have through your health insurance provider. I recommend that you determine the following information: what procedure codes are covered, deductible amount, any limit to number of sessions, any maximum annual limit, and if percentage reimbursement is determined by actual fee paid or a standard and reasonable rate. Request that reimbursement funds be sent to you directly.
Journey clinical will provide you with a superbill with the following procedure codes:
Intake medical evalutation: 90792
Follow-up medical consultation: 99214
I will provide you with a superbill the first of each month for sessions held during the previous month. I will use the following procedure codes:
Initial intake / first preparation session: 90791
Preparation and integration sessions: 90834
My fee for dosing sessions is not eligible for out of network reimbursement.