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Ketamine Assisted Psychotherapy

 

If you’re at a point where you feel so exasperated with your depression or PTSD / trauma-based symptoms that you often think, “Other people might be able to get better, but I don’t think I’m one of them” — you came to the right place.

 

Perhaps you’ve been on numerous antidepressant medications and never felt genuinely “better” on any of them over a sustained period, or at least better enough to justify the side effects some folks experience. Or, maybe you’ve been leery of trying traditional medications for those very reasons. Either way, ketamine assisted psychotherapy (KAP) could be the out-of-the-box option you’ve been looking for.

Whether you have existing knowledge about ketamine treatment, or this is your first time exploring it, this page will provide an introduction to ketamine, KAP, and what the process is like to engage in this treatment with me in my Murfreesboro office.

 

What is Ketamine?

Ketamine is a medication that has been FDA-approved since the 1970s for use as an anesthetic during surgery.  Like many other medications, it has also been used as a recreational drug (illegally), known most popularly in the 1990’s club scene as “special K.” A research study in 2000 first discovered that ketamine has an antidepressant effect, and in the 20+ years since, many additional studies have been done to expand upon that finding and identify how ketamine can be administered safely as a treatment for mental health issues, especially depression and trauma / PTSD.

Though the FDA has not yet approved it specifically for this use (given the many layers of red tape required before this can happen), treatment of mental health issues is now widely recognized by many psychiatric and other mental healthcare providers as an effective “off label” use for ketamine. (Refer to this Harvard Medical School article for information on the current hypothesis on how ketamine works in the brain.)

Ketamine belongs to a group of chemical compounds known chemically as Arylcyclohexylamines and classified as Hallucinogens (psychedelics). While the therapeutic dose for mental health treatment is significantly lower than the dose used for anesthesia, many people do experience a hallucinogenic effect.

 

Why do Ketamine Assisted Psychotherapy?

Research in the overlapping fields of psychiatry and psychology has often concluded that the combination of medication and psychotherapy is the most effective treatment for a variety of mental health challenges. 

Some psychiatric providers administer ketamine in a clinical setting without therapeutic support, and this is effective for some folks. Likewise, some people improve with therapy alone. But especially with treatment-resistant depression, recent data shows that combining the effectiveness of ketamine with evidence-based psychotherapy can increase both the impact and longevity of positive change.

 

As psychiatrist Dr. Lynne McInnes explains,

“People with treatment-resistant depression may have stopped benefiting from therapy because their capacity to learn is impaired by stress-induced neuronal atrophy.  A group at Yale University has published preliminary data suggesting that cognitive behavioral therapy can act synergistically with ketamine to prolong the antidepressant effects of ketamine infusions.

Anecdotally, many of us know that ketamine enhances the psychotherapeutic process by accelerating the transference, enhancing openness, and fostering empathy between the patient and provider. It also tends to reduce inhibitions, making it easier to talk about difficult subjects.”

 

What does Ketamine Assisted Psychotherapy look like?

After an initial intake session with me, you’ll complete 3 KAP sessions over the span of 8 weeks, with an additional therapy session for integration in between each of the KAP sessions. 

A KAP session is about 2 hours in total. During these sessions, we’ll begin with talking and intention-setting to get you in the most supportive state of mind for the session, and you’ll then receive an intramuscular injection (a shot) of ketamine administered by my colleague, Dr. Scott Giles (DO). I will be in the room with you the whole time, in a space that I have very intentionally designed to feel safe, supportive, and calming.

As the medication becomes active, you’ll shift into an altered state of consciousness in which you’re likely to experience new insights, connections, and cognitive shifts that are often difficult to access during normal waking consciousness. Additionally, clients with a spiritual worldview often report having experiences they describe as transcendent or mystical. During the session, we will explore topics related to your specific needs and goals, while I also allow space for you to be immersed in your experience. Afterwards, you will need someone to drive you home and should plan to avoid any potentially hazardous activities or anything that requires your full attention for several hours after the session.

Integration therapy sessions in between the KAP sessions are also important to the process, as they can further enhance the overall effects and outcome of the treatment, increasing retention of the positive impact of the treatment long after your last KAP session.

Some clients may elect to do a “booster” KAP session at some point in the future after completing the initial KAP process if they found it to be highly effective. Others find that it feels sufficient to return to more traditional psychotherapy sessions after completing KAP.

 

Does it really work?

As with any medication or therapy, people respond in different ways, and there are no guarantees of a specific outcome. However,  in addition to a lot of promising research, I made the commitment to get the required education and training to offer KAP after seeing how effective it was for some of my colleagues’ clients.

Since I began offering KAP, I have been incredibly encouraged by the outcomes. I’ve seen clients go from chronic suicidal ideation (that never substantially improved with traditional medication) to wanting to live, and actually enjoying life. I’ve seen folks be able to achieve shifts in their thinking that they were never able to access with the combination of therapy and traditional medication, and those shifts have been retained long after KAP was completed. Clients who felt “stuck” in therapy before were able to make progress in ways they never thought would be possible for them.


How much does it cost?

The initial intake session and follow-up integration sessions (50 minutes each) are $150 each. Each KAP session, including the infusion, is $600. For an average of 3 KAP sessions, intake, and 3 integration sessions, expect the treatment to cost about $3000-4000, depending on whether you schedule more than one integration session between each KAP session. Payment is required at the time of service, or you may pay for the full round of KAP up front.

*Ketamine Assisted Psychotherapy is not covered by insurance. It is best to contact your insurance carrier to find out accurate information.  

 

How can I get started? 

If you would like to begin the process of exploring KAP with me, contact me to schedule either a brief phone consultation to ask more questions, or a full intake session to begin the process.

At your intake session, we’ll start getting to know each other and establishing your goals for KAP, as well as ensuring that you are an eligible candidate. (I do not recommend KAP for folks who are experiencing current psychosis symptoms, severe OCD, severe kidney or heart problems, or are under the age of 20.)