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 mood-enhancing effects, which can begin to take effect within 1-2 hrs. after treatment. 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.
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 subside, 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 happens during the experience, patients feel like the insights gained are clear.
Ketamine and Relationships
Research has shown that partners that undergo ketamine treatments together will also experience more benefits as the medicine increases neuroplasticity, which is the brain’s capacity to create new connections. This benefit allows coupled patients to adopt new, healthier habits surrounding communication and relating to one another. Depending on the individual, the medicine can also provide antidepressant and anti-anxiety benefits for weeks or even months post-treatment, making it easier for some couples to create a stronger connection.
Ketamine-assisted therapy for couples believe that partners become more willing to hold difficult conversations because they have access to more empathy. In a typical setting, a difficult conversation can cause an explosive response of hurt or cause a partner to withdraw. With ketamine-assisted couples therapy, you may reconnect to the feelings of falling in love with increased compassion for your relationship.
When given a low dose of ketamine, both partners will enter a relaxed state, allowing the couple to feel more comfortable, vulnerable, and open to sharing and receiving feedback on their emotions with one another. Couples feel more comfortable sharing because the relaxing effects of the ketamine treatment help suppress the reactionary response. Instead, patients are better equipped to share their emotional state, listen to their partner’s emotions, and form healthier habits with communication.
What is Journey Clinical?
Journey Clinical is a platform for licensed psychotherapists to incorporate science-based psychedelic therapies in their practice safely and effectively, starting with Ketamine Assisted Psychotherapy (KAP). Journey Clinical’s in-house medical team takes on patient eligibility, prescriptions, and outcome monitoring, while I take on the therapy. Their collaborative care model is designed to deliver personalized treatment plans to meet your individual needs and improve long-term outcomes.
How Does Ketamine-Assisted Psychotherapy Work?
- Initial consultation with Journey Clinical: You schedules an initial evaluation with a clinician from the Journey Clinical medical team via zoom. They will go over your medical and psychiatric history with you, provide education on the treatment and determine if you are eligible for KAP. * If Journey Clinical’s medical team determines that you are eligible for KAP, they will develop a personalized Ketamine prescription and outcome monitoring plan for you. Journey Clinical’s medical staff will write a ketamine prescription for you, and a small amount of oral ketamine will be sent to your home, enough for the first 2 KAP sessions. You will be taught to take your vitals and self-administer the ketamine lozenges by Journey Clinical’s medical team in advance of our KAP sessions.
- Preparation sessions: Once you receive your ketamine lozenges, we will schedule time together for our 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 our KAP sessions together.
- KAP Dosing Session: A typical ketamine dosing session lasts between 1-2 hours and can be done remotely via telehealth or in person in our office. During a dosing session, you will self-administer 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, I will be present with you the entire time to hold space and provide support as needed.
- Integration Sessions: After our KAP dosing session, we will meet for multiple integration therapy sessions to review the memories, thoughts & insights that arose during your dosing session, and to prepare for the next dosing session.
- Follow-up consultations with Journey Clinical: After our first KAP session, Journey Clinical’s medical team schedules regular follow ups with you to monitor outcomes and prescribe ketamine lozenge refills, as appropriate. The frequency of follow ups depends on your unique treatment plan, at a minimum of once per quarter.
- Follow-up Consultations with Journey Clinical: After our first KAP session, Journey Clinical’s medical team schedules regular follow ups with you to monitor outcomes and prescribe ketamine lozenge refills, as appropriate. The frequency of follow ups depends on your unique treatment plan, at a minimum of once per quarter.
What is the Cost of Treatment?
Ketamine-Assisted Psychotherapy is an affordable, accessible modality. Although the medical intake and follow ups are not covered by insurance, they are eligible for out-of-network reimbursement.
Ketamine-Assisted Psychotherapy rate: is $160 per 50-minute session, sliding scale can be applied (expect a preparation session, dosing sessions (90 minutes – prorated with the 50-minute rate), and integration sessions after each dose).
Journey Clinical Medical Costs:
- Medical Intake and initial dosing: $355 (One-time fee, reimbursable through out-of-network)
- Follow-up Sessions: $150/Session (minimum of 1/quarter, reimbursable through out-of-network)
- Cost of Ketamine Lozenges: $85 for approximately 4-6 treatment doses (not covered by insurance).
Resources:
1. Paradigms of Ketamine Treatment by Raquel Bennett, Psy.D. for MAPS
2. Ketamine Assisted Psychotherapy (KAP): Patient Demographics, Clinical Data and Outcomes in Three Large Practices Administering Ketamine with Psychotherapy – research study by Jennifer Dore et al, 2018
3. Ketamine for Depression and Mood Disorders by Erica Zelfand, ND for Townsend Letter
4. Ketamine-Facilitated Psychotherapy for Trauma, Anxiety, and Depression by goop
5. Ketamine Assisted Psychotherapy with Jonathan Sabbagh of Journey Clinical – Psychology Talk Podcast