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Ketamine-Assisted Psychotherapy

Ketamine is a dissociative anesthetic which shares some similar subjective effects as 'classic' psychedelic drugs and has been used for quite some time through IV administration to treat depression. Recently, ketamine has been used with other routes of administration and in conjunction with psychotherapy in Ketamine-Assisted Psychotherapy (KAP). I partner with Journey Clinical to provide clients with access to a physician who is able to prescribe ketamine lozenges for in-office and at-home use. KAP services are best suited for individuals who are experiencing more severe symptoms or those who wish to deepen their therapeutic work and self-exploration.

What does ketamine feel like?

It is difficult to describe what any single person's ketamine experience will be like, though many people report a feeling of disconnection with their body and/or ordinary mental processes. Individuals' responses to these experiences may vary, but they are often reported to as "mystical", "blissful", or "peaceful". During these experiences, individuals may also recall emotions or memories that have been long-neglected or been held unconsciously. Individuals often develop insight about themselves and the problems they are experiencing which allow for greater capacity to change their behavioral and emotional patterns.

3 - Stage Model

Psychedelic-assisted therapies are typically provided in a three stage model including preparation, facilitation, and integration. When doing KAP work with clients largely from an existential-humanistic framework which I developed as part of my doctoral program. The model is accessible below this section for those interested in pursuing KAP.

Preparation: After a screening and consult with myself and an initial assessment with one of Journey Clinical's physicians, this stage involves developing trust, exploring presenting issues, solidifying goals and intentions for the session, and reviewing typical drug effects, both physiological and psychological. During this stage, we will also collaborate to develop a treatment plan. This stage may be incorporated into the psychological component of screening and assessment for some patients. Clients typically receive between 1-4 preparation sessions before their lozenge session.

Facilitation & At-Home Use: This stage involves ketamine administration alongside psychological support  to help you remain grounded in the experience and assist in processing psychological material which arises during the session. Clients are provided with eyeshades and specially selected music playlists to deepen their experience and intermittently interact with me using more typical therapy approaches and mindfulness exercises. Clients are required to have a total of 4, three-hour facilitated sessions before being approved for at-home use. These 4 sessions may be administered in close conjunction with one another over a short period (2 weeks) to maximize the beneficial physiological effects of ketamine or spaced out over a longer period to meet other needs (psychological, scheduling, financial).

After completion of 4 facilitated sessions, clients may be approved for at-home use of their lozenges. Clients who are working with lozenges at home are required to take their vitals before/after the experience and keep a journal of their experiences, documenting their intentions, effects, and experiences, which are then brought into integration sessions.

Those participating in KAP in-office MUST have a friend or family member transport you home from the session. Those participating in either facilitated or self-guided use at home MUST have a 'chaperone' (i.e. trusted, safe, sober adult) home to relay some information to me and who is accessible in the case of an emergency.

Integration: The 'final' stage of KAP is integration, a process by which you are supported in meaning-making regarding your experiences and working to solidify gains made through your experiences. This period also includes support for developing integration practices which may include things such as journaling, meditation, yoga, or other behavioral changes you choose to make as a result of your experiences.

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