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Writer's pictureSara Adams, LCSW-R

Getting Started with Ketamine-Assisted Psychotherapy (KAP)

Updated: Jul 21

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. Sustainable Wellness takes on the psychotherapy portion of the experience, while Journey Clinical’s medical team supports you on all medical aspects of the process. This includes determining eligibility, developing a custom treatment plan, prescribing the medicine and monitoring outcomes. Below is more information about KAP to help you explore whether 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 post-traumatic stress disorder (PTSD). Ketamine has rapid-acting antidepressant and mood-enhancing effects, which can begin to take effect within 1-2 hours after treatment and last for up to two weeks. Ketamine works by blocking the brain’s NMDA receptors and 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 improvement of symptoms.


Ketamine can be administered in a variety of ways, including IV infusion, intramuscular injection, nasal spray and sublingual lozenges. Our team at Sustainable Wellness only uses the sublingual lozenge form at this time.


What is Journey Clinical?

Journey Clinical is a platform for licensed psychotherapists to incorporate science-based psychedelic therapies in their practice safely and effectively. Journey Clinical’s in-house medical team takes on patient eligibility, prescriptions and outcome monitoring, allowing KAP-trained clinicians the opportunity to provide the psychotherapy components of KAP treatment. Journey Clinical’s collaborative care model is designed to deliver personalized treatment plans to meet your individual needs and improve long-term outcomes.


What does Ketamine feel like?

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. Patients lie down in a comfortable position during the dosing experience, as verbal abilities are reduced.


Once the effects of ketamine subside, your KAP-trained therapist spends the remainder of the appointment giving you space to process and discuss your experience. While it may feel hard to articulate the experience, patients often find clarity in their gained insights. Studies have shown that the benefits to mood and neurological growth can last up to two weeks after the ketamine dosing experience.


What to expect from the KAP process.

1. Initial consultation with Journey Clinical
  • Your first step is to schedule an initial evaluation with a clinician from the Journey Clinical medical team. These consultation appointments are conducted via Zoom. A member of Journey Clinical’s medical team will review your medical and psychiatric history, provide education on the treatment, and determine your eligibility for KAP.

  • If the medical team determines that you are eligible for KAP, they will develop a personalized ketamine prescription and outcome monitoring plan for you.

  • A medical staff member will write a ketamine prescription for you, which will then be sent to your home or local pharmacy for pick up. Your first prescription will include enough medicine two KAP dosing sessions.

  • You will receive instructions by the medical team on how to take your vitals and self-administer the ketamine lozenges during your KAP dosing sessions.


2. Preparation sessions
  • Once you receive your ketamine lozenges, you will schedule time to meet with your therapist for KAP preparation, dosing and integration sessions. Preparation session(s) will be scheduled just like regular therapy sessions prior to the KAP dosing session. The goal of a preparation session(s) is to align on the process and set intentions for your KAP experience.


3. KAP dosing sessions
  • A typical ketamine dosing session lasts for about three hours and can take place either in-person at our office, or remotely via telehealth. You will be in charge of self-administering your ketamine lozenge.

  • 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, your therapist will be present with you the entire time to hold space and provide support as needed.


4. Integration sessions
  • After your KAP dosing session, you and your therapist will meet for multiple integration therapy sessions to review the memories, thoughts and insights that arose during your dosing session. You will also prepare for the next dosing session.

  • Your first integration session will be scheduled within 72 hours, preferably the next day, to maximize the ketamine’s impact on your therapy process. 


5. Follow-up consultations with Journey Clinical
  • After your first KAP session, Journey Clinical’s medical team schedules regular follow up medical consultations with you to monitor outcomes and prescribe ketamine lozenge refills, as appropriate. The frequency of these follow up appointments depends on your unique treatment plan, though they’re scheduled once quarterly at minimum.


What is the cost of treatment?

As you learned above, first-time patients require an initial medical consultation with Journey Clinical, and follow-up consultations are required at least once quarterly. Your first ketamine prescription will include enough medicine for at least 2 dosing sessions with your therapist. Your follow-up prescriptions often include enough medicine for 4-6 KAP dosing sessions. You can find the latest information about Journey Clinical’s medical consultation and prescription fees here. Although the medical intake and follow-up appointments through Journey Clinical are not covered by insurance, they are eligible for out-of-network reimbursement.


Fees surrounding the psychotherapy portion of your KAP treatment will depend on your treatment needs and goals, as well as the modalities used by your individual psychotherapist. Our most current psychotherapy KAP fees at Sustainable Wellness are listed on our Rates page here. While our dosing sessions are not covered by insurance, your preparation and integration sessions may be eligible for in- or out-of-network reimbursement, depending on your insurance provider and plan.


Contact us at 585-206-2631 or hello@sustainablewellnessny.com to inquire about our KAP services, or submit a message through our Contact Form and someone will follow up with you within 48 buisness hours.


 
Helpful resources.

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

Ketamine for Depression and Mood Disorders by Erica Zelfand, ND for Townsend Letter

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