Ketamine-Assisted Psychotherapy

What Is Ketamine-Assisted Psychotherapy?

Ketamine is a medication that has been used in medical settings for decades as an anesthetic.

At lower doses, it can produce temporary changes in perception, awareness, emotion, physical sensation, and your sense of time or space. This is sometimes described as a dissociative or altered state.

In KAP, the medication is prescribed by a qualified medical provider following an evaluation. Our therapeutic work also includes preparation before the medication session and integration afterward.

A complete KAP process may include:

• an initial consultation and clinical assessment with me

• a separate medical evaluation and clearance

• preparation sessions

• one or more supported medication sessions

• integration sessions following each experience

• continued individual therapy to support longer-term change

This structure helps ensure that the experience is approached thoughtfully rather than treated as an isolated medical procedure.

How Does Ketamine Work?

The complete way ketamine affects mood and psychological functioning is still being studied.

Ketamine acts in part on the brain’s glutamate system, including receptors involved in communication between brain cells. Researchers believe it may temporarily support greater flexibility in neural pathways and reduce some of the rigidity associated with depression and other persistent mental health patterns.

This does not mean ketamine automatically rewires the brain.

A more flexible state can create an opportunity. What happens within that opportunity depends on you, the therapeutic setting, preparation, integration, and the changes you practice afterward.

From a psychological perspective, some people experience:

• greater distance from repetitive or self-critical thoughts

• less attachment to familiar narratives about themselves

• increased access to emotions or memories

• a stronger sense of compassion or connection

• new perspectives on relationships and past experiences

• greater awareness of different internal parts

• a temporary reduction in defensiveness or avoidance

• an increased ability to imagine that change is possible

Not every session feels profound, and a dramatic experience is not required for the work to be useful.

The Role of Psychotherapy

Ketamine can create an opening. Psychotherapy helps you understand and use it.

During preparation, we identify what brings you to KAP, discuss expectations, explore concerns, and develop intentions for the work.

During the medication session, I remain present to support you. Depending on what arises, the session may include conversation, quiet internal attention, reassurance, grounding, emotional processing, or gentle guidance.

Afterward, integration helps us connect the experience to your everyday life.

Integration may involve:

• identifying important emotions or themes

• making sense of images, memories, or insights

• exploring how the experience relates to current patterns

• noticing parts of yourself that became more visible

• separating useful insight from temporary intensity

• identifying practical changes to carry forward

• continuing difficult work that began during the session

• building habits that support longer-term progress

An insight can feel meaningful in the moment and still fade if it is not revisited. Integration helps transform an experience into an ongoing therapeutic process.

Who Might Benefit from KAP?

KAP may be considered when traditional treatments have not provided enough relief or when you continue to feel deeply stuck despite meaningful effort.

It may be worth exploring if you are experiencing concerns such as:

• persistent or treatment-resistant depression

• anxiety that remains difficult to shift

• trauma-related symptoms

• obsessive or repetitive thought patterns

• grief or complicated loss

• emotional numbness or disconnection

• rigid self-criticism or shame

• recurring avoidance or shutdown

• difficulty accessing emotions in therapy

• limited progress despite medication and talk therapy

• existential distress or questions of meaning

• a desire for deeper therapeutic exploration

The evidence is not equally strong for every concern. A consultation does not assume that KAP is the right answer for you. It begins a process of determining whether the potential benefits, limitations, risks, and practical demands make sense for your situation.

KAP May Be Especially Relevant When You Feel Stuck

You may already have done a significant amount of work.

You may be able to describe your patterns clearly but find that understanding them has not changed how your body or emotions respond.

You may know that a fear is not entirely rational while still feeling controlled by it.

You may recognize that a protective response is no longer needed but remain unable to let it go.

You may have made progress in therapy and still feel that something important remains inaccessible.

KAP may temporarily soften the grip of familiar defenses and allow you to approach your experience with greater curiosity. That does not guarantee change, but it can create a different starting point for our work.

What the Process with Me May Look Like

1. Initial Consultation

We begin with a conversation about why you are interested in KAP.

I will ask about what you have been experiencing, previous treatment, current supports, your expectations, and what you hope may change.

This is also an opportunity for you to ask questions and for us to discuss whether KAP appears appropriate enough to continue with screening.

2. Medical Evaluation

Ketamine must be prescribed by a qualified medical professional.

A medical provider will review your health history, current medications, cardiovascular considerations, psychiatric history, substance-use history, and other factors that may affect safety or eligibility.

I do not make medical prescribing decisions.

Medical clearance does not guarantee a particular result. It determines whether ketamine may be a reasonable and medically appropriate option for you.

3. Preparation

Preparation is an essential part of KAP.

Together, we will discuss:

• how the medication may affect awareness and perception

• what a session may feel like

• fears or concerns about altered states

• expectations and common misconceptions

• your intentions for the work

• how I will support you

• practical instructions for the day

• how we will respond if difficult material arises

• plans for integration afterward

Preparation is not about predicting or controlling the experience. It helps create enough trust and understanding for you to enter the session safely and intentionally.

4. Medication Session

During the session, you take medication that has been prescribed specifically for you.

I remain present throughout the therapeutic portion of the experience. The session is structured to provide privacy, support, and enough time for the effects of the medication to develop and gradually subside.

You may experience changes in:

• your sense of time

• awareness of your body

• emotional intensity

• visual imagery

• memories or associations

• your sense of connection or distance

• the way you relate to thoughts

• your perspective on yourself or your life

You are not required to talk continuously. Some sessions involve significant internal reflection, while others become more conversational.

5. Integration

Integration generally occurs soon after the medication session.

Together, we revisit what arose, identify what feels important, and consider how the experience connects to your larger therapeutic goals.

The purpose is not to interpret every image or sensation literally.

Instead, I will help you remain curious about what the experience revealed and decide what deserves continued attention.

6. Continued Therapeutic Work

KAP is most useful when the work continues beyond the medication session.

This may involve ongoing therapy with me or collaboration with your established therapist and other healthcare providers.

The period following a session may provide increased motivation or psychological flexibility. Continued therapy helps you use that period intentionally.

What Might a Ketamine Experience Feel Like?

Every person and every session can be different.

Some people describe a sense of calm, distance from self-critical thinking, emotional openness, imagery, memories, or a broader perspective on their lives.

Others may experience confusion, anxiety, sadness, physical discomfort, or little that feels immediately meaningful.

I do not measure the value of a session by how pleasant, visual, spiritual, or dramatic it feels.

A quiet session may be useful. A challenging session may require careful processing. A session that initially feels unclear may become more meaningful during integration.

There is no correct way to experience ketamine.

Common Misconceptions About KAP

“Ketamine is a miracle cure.”

Ketamine can produce meaningful improvement for some people, but it does not work for everyone.

Benefits may be temporary, partial, or require multiple sessions and continued therapy. I do not present KAP as a guaranteed cure.

“One session will fix everything.”

Some people notice changes after one session, but I approach KAP as a process rather than a single event.

Preparation, repeated sessions when appropriate, integration, and continued therapy may all contribute to the outcome.

“It is the same as recreational ketamine use.”

No.

Clinical KAP involves a legal prescription, medical evaluation, individualized dosing, a controlled setting, professional support, and therapeutic follow-up.

Recreational or unsupervised use does not provide these safeguards and carries additional risks.

“I have to lose control.”

The medication may change your sense of control, time, body, or surroundings, but the goal is not to make you unconscious or helpless.

I remain present, and we discuss the process in detail beforehand.

“I need to have a mystical breakthrough.”

A profound experience is not required.

Meaningful change may come from a subtle emotional shift, a new perspective, greater self-compassion, or an increased willingness to approach something you have avoided.

“Anything I experience must be literally true.”

Altered states can generate powerful images, memories, ideas, or emotional conclusions.

These experiences deserve curiosity, but not every thought or image should automatically be treated as factual. During integration, I will help you explore meaning without rushing toward certainty.

“Ketamine replaces therapy.”

KAP includes psychotherapy.

The medication may create a window of openness, but preparation, therapeutic support, integration, and continued action are what help turn that window into useful change.

“Ketamine is FDA-approved for depression.”

Ketamine itself is FDA-approved as an anesthetic. Its use for psychiatric concerns is off-label.

Esketamine, a related medication sold under the name Spravato, has FDA approval for specific adult depression indications and follows a separate treatment and monitoring program.

KAP and Spravato are not necessarily the same treatment.

Is KAP Safe?

Ketamine can be used safely in appropriate clinical settings, but it is not risk-free.

Possible short-term effects may include:

• dizziness

• nausea or vomiting

• sedation

• dissociation

• temporary confusion

• anxiety or emotional discomfort

• changes in coordination

• dry mouth

• temporary increases in blood pressure or heart rate

• changes in perception or physical sensation

More serious risks are possible, particularly when ketamine is used without appropriate screening, dosing, supervision, or monitoring.

Ketamine also carries a risk of misuse. This is one reason the medication should only be used as prescribed and within a clearly structured treatment plan.

Your medical provider will give you specific instructions regarding medications, food, transportation, monitoring, and what you should or should not do following a session.

KAP Is Not Appropriate for Everyone

Certain medical, psychiatric, medication-related, pregnancy-related, or substance-use concerns may make ketamine inappropriate or require additional evaluation.

Screening may explore:

• cardiovascular health and blood pressure

• current medications and possible interactions

• history of psychosis or severe dissociation

• bipolar symptoms or unstable mania

• current substance use or history of ketamine misuse

• pregnancy or plans for pregnancy

• significant medical conditions

• ability to follow safety and transportation instructions

• availability of ongoing therapeutic support

Eligibility is determined individually by the prescribing medical provider in collaboration with the treatment team.

Being interested in KAP does not obligate you to proceed.

What About Ketamine Therapy for Teens?

KAP for adolescents requires particularly careful consideration.

The evidence base for adolescents is more limited than it is for adults. Any decision must involve age-appropriate medical screening, guardian participation, informed consent and assent, coordination with existing providers, and a clear understanding of the young person’s needs.

I do not treat KAP as a quick solution for ordinary adolescent distress.

It may be considered in specialized circumstances when symptoms are serious, other treatments have not been sufficient, and the medical and therapeutic team believes the potential benefits justify the risks and demands of treatment.

How Many Sessions Will I Need?

There is no single number that is right for everyone.

Some people experience benefits from a limited series. Others may consider additional sessions or occasional booster work. Some decide after preparation or an early session that KAP is not the right approach.

I generally emphasize a series of sessions rather than relying on one isolated experience.

The recommended course depends on:

• your goals

• your response to the medication

• the concern being addressed

• medical guidance

• the quality of integration

• your ongoing therapy

• practical considerations such as cost and time

We will review your progress throughout the process.

Why Work with Me?

I am a Licensed Clinical Social Worker with specialized education in psychedelic-assisted therapies.

I completed the nine-month Psychedelic-Assisted Therapies and Research certificate program through the California Institute of Integral Studies.

My style is active, direct, and collaborative.

During KAP, I provide more than a quiet presence. I help you prepare thoughtfully, feel supported during vulnerable moments, understand what emerges, and connect the experience to the larger work of therapy.

I also collaborate with the prescribing psychiatrist and, when appropriate, your existing therapist or other healthcare providers.

KAP Is an Opportunity—not a Promise

Ketamine-assisted psychotherapy can create a different kind of therapeutic opening.

For some people, it brings relief, perspective, emotional access, or renewed hope. For others, the effects may be limited, temporary, difficult to interpret, or not meaningful enough to justify continuing.

My goal is not to convince you that KAP is the answer.

My goal is to help determine whether it may be a responsible and useful next step for you.

Start with a Conversation

You do not need to decide whether you want ketamine treatment before reaching out.

An initial consultation gives us space to discuss why you are considering KAP, answer your questions, review the process, and determine whether moving forward with screening makes sense.

Contact me to schedule a consultation about ketamine-assisted psychotherapy.