Ketamine-Assisted Psychotherapy (KAP)
What is KAP?
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. Cypress Integrative Wellness partners with Journey Clinical to be able to provide KAP to patients. Cypress’ psychotherapists take on the psychotherapy portion of the experience, while Journey Clinical’s medical team supports you on all medical aspects. This includes determining eligibility, developing a custom treatment plan, prescribing the medicine and monitoring outcomes.
KAP is a unique therapeutic method used to address a variety of mental health conditions, including depression, post-traumatic stress, chronic pain, addiction, eating disorders, and anxiety. Ketamine enhances and deepens the therapeutic process, and the use of psychotherapy and other integrative forms of treatment amplify and prolong the curative effects of ketamine. This can often lead to greater and quicker improvements in mental health.
Cypress Integrative Wellness offers KAP as part of our comprehensive and holistic approach to wellness. Below is more information about KAP to help you navigate if 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, such as depression, anxiety and PTSD. Ketamine has rapidly-acting antidepressant and mood-enhancing effects, which can begin to take effect within 1-2 hours after treatment and last for up to 2 weeks. 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 our work with Journey Clinical we only use the sublingual lozenge form.
Ketamine itself was first synthesized in the 1960s and has been used as an anesthetic since the 1970s. However, its potential for treating depression and other mental health conditions was discovered later. The study of ketamine as a treatment for mental health conditions, which began in the 1990s.
Timeline:
1960s: Ketamine was first synthesized and developed as an anesthetic.
1970s: Ketamine became widely used in medical settings as a safe anesthetic.
1990s: Researchers began studying ketamine's potential for treating depression, particularly in treatment-resistant cases.
2000s-2010s: Clinical trials and studies started to show promising results for ketamine as a fast-acting antidepressant. The use of ketamine in mental health settings began to grow.
2010s-Present: The combination of ketamine with psychotherapy (KAP) started to gain more attention. Research on KAP has expanded, focusing on its efficacy for various conditions like PTSD, anxiety, and chronic pain.
KAP is still relatively new compared to other therapeutic modalities, but it has been under increasingly rigorous study for over a decade, with a growing body of evidence supporting its effectiveness.
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 subsided, 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 happened during the experience, patients feel like the insights gained are none-the-less clear. Studies have shown that the benefits to mood and neurological growth can last up to two weeks after the Ketamine experience.
What to expect with KAP?
Below you will find the phases of KAP and understand how this treatment works.
1. Initial consultation with medical provider
You schedule an initial evaluation with a the Cypress’ Medical Liaison via Telehealth. 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 the medical provider determines that you are eligible for KAP, they will develop a personalized Ketamine prescription and outcome monitoring plan for you.
The medical provider will write a ketamine prescription for you, and a small amount of oral ketamine will be sent to your pharmacy, enough for the first 2 KAP sessions. You will be taught to take your vitals and self-administer the ketamine lozenges by the medical provider in advance of our KAP sessions.
2. Preparation sessions:
Once you receive your ketamine lozenges, you will schedule time with your therapist for your 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 KAP treatment.
3. KAP Dosing Session:
A typical ketamine dosing session lasts approximately 2-3 hours and can take place either in-person at the Cypress office or remotely via telehealth.
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, 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 will meet with your therapist for multiple integration therapy sessions to review the memories, thoughts and insights that arose during your dosing session, and to prepare for the next dosing session.
5. Follow-up consultations with medical provider:
After your first KAP session, you may schedule a follow up appointment with the medical provider 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.
While KAP is highly individualized and based on your unique circumstances and needs, the start of a typical KAP program at Cypress includes:
1 Psychological Assessment with Cypress Integrative Health
1 Medical Intake with Cypress’ Medical Liaison (required)
2-3 Preparatory Sessions
4-8 Ketamine Assisted Therapy Sessions
6-12 Integration Sessions (1-2 after each Ketamine session)
We recommend a commitment to 4-8 ketamine sessions, as this medicine tends to have a cumulative effect and is most beneficial after multiple treatments. Typically, patients feel significant relief of mental health symptoms following a full course of KAP.
Some patients will come back for booster sessions to maintain progress after their KAP treatment, which is typically one dosing and integration session per month or as needed.
Who benefits from KAP?
Ketamine-Assisted Psychotherapy (KAP) can benefit a wide range of individuals, particularly those who have not responded well to traditional treatments. Here’s a breakdown of who might benefit:
People with Depression: KAP has shown promising results for individuals who have not found relief through conventional antidepressants or other forms of therapy.
Individuals with Anxiety Disorders: Those suffering from severe or chronic anxiety, including generalized anxiety disorder (GAD), social anxiety, or PTSD, may find KAP helpful in reducing symptoms and improving overall mental well-being.
Patients with Trauma or PTSD: KAP can be particularly beneficial for those with histories of trauma or post-traumatic stress disorder, helping to alleviate the emotional and psychological weight of traumatic memories.
People Struggling with Suicidal Ideation: Ketamine’s rapid-acting effects can be life-saving for individuals experiencing acute suicidal thoughts, offering a crucial intervention when immediate relief is necessary.
Individuals with Chronic Pain or Health Conditions: Those dealing with chronic pain or health conditions, particularly when linked with mood disorders, may experience both pain relief and mood stabilization through KAP.
Those Facing End-of-Life Distress: KAP can offer profound emotional support and relief from existential anxiety for individuals facing terminal illnesses, helping them find peace during the end-of-life process.
People Battling Substance Use Disorders: KAP can assist in breaking the cycle of addiction by helping individuals gain new perspectives on their behaviors and fostering the emotional shifts necessary for recovery.
Individuals with Eating Disorders: KAP has been shown to decrease cognitive rigidity and support behavioral change, thereby helping those struggling to decrease eating disorder behaviors.
Individuals Seeking Personal Growth and Self-Exploration: Even for those without a specific diagnosis, KAP can be a tool for deep personal insight, emotional healing, and spiritual exploration.
KAP is not suitable for everyone, and it’s essential that individuals undergo thorough screening by qualified professionals to determine if it’s the right fit for their needs.
Who is not a good fit for KAP?
Not everyone is a good fit for Ketamine-assisted psychotherapy. A few common medical and psychiatric contraindications include:
Uncontrolled hypertension / high blood pressure
Uncontrolled glaucoma/ pressure in the eye
Acute mania or mixed state
Unstable medical condition
Severe breathing problems
History of primary psychotic disorder
Ketamine allergy or sensitivity
Active Ketamine use disorder
If you are not sure whether you are a good fit for KAP, you may book a medical intake session with the Journey Clinical team, where you will be assessed for both ketamine-assisted psychotherapy and traditional medication management.
Why therapy is essential for maximizing the benefits of KAP?
1. Integration of Experiences
Processing Insights: Ketamine can induce profound psychological experiences, including altered states of consciousness, deep emotional insights, and shifts in perception. Therapy provides a structured space to process these experiences, helping individuals make sense of what they encountered during their ketamine sessions.
Application to Daily Life: The therapeutic process helps translate the insights gained during the ketamine experience into meaningful changes in thoughts, behaviors, and emotions. Without therapy, the powerful insights might remain abstract or disconnected from everyday life.
2. Emotional Safety and Support
Guidance Through Vulnerability: Ketamine can bring up intense emotions or unresolved psychological issues. A therapist provides a safe, supportive environment to navigate these emotions, ensuring that the experience remains therapeutic rather than overwhelming.
Preventing Adverse Reactions: While ketamine is generally safe, its psychoactive effects can sometimes lead to challenging experiences. A therapist is trained to recognize and address any distressing reactions, providing immediate support and strategies to manage them.
3. Personalized Treatment
Tailored Approach: Therapy allows for the integration of ketamine's effects into a personalized treatment plan that addresses the individual's specific mental health needs, whether they are related to depression, anxiety, PTSD, or other conditions.
Ongoing Assessment: Through therapy, the effectiveness of KAP can be continually assessed, and adjustments can be made to the treatment plan. This ensures that the individual receives the most benefit from their sessions.
4. Long-Term Healing
Building Resilience: Therapy helps individuals build coping mechanisms and resilience that extend beyond the immediate effects of ketamine. This supports long-term mental health and well-being, preventing relapse or the need for ongoing ketamine treatments.
Sustaining Positive Changes: The therapeutic relationship helps sustain the positive changes initiated by ketamine. Regular sessions encourage continued growth, self-awareness, and the maintenance of mental health improvements over time.
5. Enhancing Therapeutic Outcomes
Synergistic Effects: The combination of ketamine's neurochemical effects and the insights gained through therapy creates a synergistic effect, where the benefits of each modality enhance the other. This integrated approach is often more effective than either treatment alone.
Holistic Healing: KAP within a therapeutic framework addresses not just the symptoms of mental health conditions but also the underlying causes, promoting holistic healing and personal growth.
In summary, therapy is vital in KAP because it ensures that the profound experiences and neurochemical changes induced by ketamine are harnessed in a safe, supportive, and meaningful way, leading to lasting psychological and emotional benefits.
Why Choose Cypress for KAP?
At Cypress Integrative Wellness, we understand that the true power of Ketamine Assisted Psychotherapy (KAP) lies not just in the ketamine itself, but in how it’s integrated into your overall healing journey. Ketamine induces a unique period of heightened neuroplasticity—a “neuroplastic window” where the brain becomes more adaptable and open to forming new neural connections. This window is a critical time for fostering lasting change, but without proper therapeutic support, its benefits can be limited.
Why Integration Matters
During the neuroplastic window, your brain is primed for transformation, making it an ideal time to introduce new, healthier thought patterns and behaviors. At Cypress Integrative Wellness, our licensed therapists are specially trained to help you harness this powerful phase. Unlike typical IV ketamine clinics, which often focus solely on administering the medication, we provide a comprehensive therapeutic approach that maximizes the potential of KAP.
Our Specialized Support
Our therapists offer personalized, compassionate support to help you process and integrate the profound experiences and insights gained during your ketamine sessions. This integration work is essential for:
Reinforcing Positive Changes: We help you solidify new, healthier neural pathways that ketamine creates, ensuring that these changes are long-lasting.
Consolidating Insights: Our therapy sessions guide you in translating the emotional and psychological breakthroughs from your ketamine experience into actionable, life-enhancing changes.
Preventing Regression: By actively working through the experiences during the neuroplastic window, we help you avoid reverting to old, unhelpful patterns of thinking or behavior.
Supporting Emotional Healing: We provide a safe, supportive environment for processing any intense emotions or unresolved issues that may arise, ensuring they contribute to your healing rather than becoming overwhelming.
At Cypress Integrative Wellness, we believe in treating the whole person—mind, body, and spirit. By integrating therapeutic support with ketamine treatment, we help you achieve lasting, meaningful change, setting you on a path to long-term well-being. Our approach is designed to fully harness the neuroplastic window, ensuring that your journey through KAP is both transformative and enduring.
Discover the difference that expert integration can make with Cypress Integrative Wellness.
What is the cost of KAP?
As of 2024, Aetna is the only insurance provider covering KAP. However, you may be able to seek coverage for psychotherapy services; this includes all sessions outside of your dosing session. The medical intake and follow-up appointments may be covered by your insurance depending on the plan you have. If you are not cleared medically for KAP, your medical intake fee will be refunded.
Cypress Integrative Wellness Psychotherapy Costs*:
Initial Psychological Assessment: $300
The typical hourly rate for psychotherapy is $250/hr (this applies to preparation, dosing, and integration sessions. Please note that if you are using your insurance, you may only bill for one hour of the dosing session and the remaining time will be billed out-of-pocket. Typically the first dosing session is 3 hours, but dosing sessions thereafter tend to be 2 hours.
Medical Costs:
First-time patients
Initial medical consultation: $350 (If you are not cleared medically for KAP, this fee will be refunded to you).
Cost of medication: $120 (enough for one month)
Ongoing treatment
Follow-up medical consultation with $150 (as needed)
Cost of medication: $120 (enough for one month)
A typical course of KAP treatment and fees is outlined below:
Psychological Assessment with Cypress Integrative Health: $300
Medical Intake: $350
3 Preparation Sessions: $750 ($250 each)
1 KAP Session: $500-750 ($250 per hour)
1 Integration Session: $250
Cost of medication: $120 (enough for one month)
Repeat the last two steps for each new dosing session, typically 6 sessions and as needed.
*Please note that Cypress will offer a discount off of KAP services for each subsequent dosing session to help alleviate the overall cost.
Begin the journey.
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