Ketamine is currently the only psychedelic assisted psychotherapy medicine that is available for use by therapists and clients in a regular private practice setting in California and most other states. While other psychedelics such as psilocybin and MDMA are proving highly effective in clinical trials, they are not yet available for LMFTs and their clients in most places, although this will likely change quite soon.
KAP Process, Timeline, Cost
- We determine through consultation and often some initial therapy sessions that KAP is an appropriate treatment modality for the distress you are experiencing.
- I refer you to a physician for an initial appointment and intake (the MD will charge between $195-300) to determine from a medical perspective if KAP is likely to be of benefit, and if so, the MD prescribes you the Ketamine that will be compounded by Koshland Pharmacy and sent directly to you. You will be the person to administer it to yourself. The type of Ketamine I work with is sublingual/oral, as opposed to Intramuscular or “IM” (a shot), and your prescription will be either chewable troches or rapid dissolve tablets, at the dosage recommended by the prescribing physician.
- We will do at least one if not more preparation therapy sessions to specifically hone in on your intent and desired healing for the KAP session. This session is a usual 50-60 minute session length, and is in addition to other sessions we may have had together. Cost of preparation and integration sessions are the same as regular therapy sessions, $250 for LMFT and $170 for AMFT.
- The KAP session itself is typically 3-4 hours long, depending on dosage. This includes time in the beginning for establishing the “set and setting” for the journey, then the Ketamine experience itself, typically with eye shades and music on a comfortable couch or floor mat/cushions with me right there by your side supporting your experience, and then a period of time coming out of your expanded state and reorienting to the environment and ordinary consciousness. You will need someone to drive you home from your KAP session, as driving in contraindicated for the rest of the day. KAP session cost is $700, with sliding scale options available.
- Two or more integration sessions (at regular therapy session rate) to digest the material and experience of the KAP session and merge its impact into everyday life. Integration is often considered the most important part of the process overall, as it allows the learning and healing to actually play out in everyday experiences, feelings, and relationships.
- Often it is recommended to do multiple KAP sessions in frequent succession, such as one KAP session per week for 6 weeks (with at least 1-2 preparation and integration sessions in between), but this is not required.
- We know KAP can be very cost prohibitive and inaccessible, and we continue to advocate with MediCal and insurance companies toward insurance coverage for KAP services. At this time we are not able to offer KAP services to clients who have MediCal, although we do integrate highly effective trauma healing modalities like Brainspotting and EMDR for our MediCal clients. We also will soon have lower end sliding scale options available via our partner nonprofit Lichen Health, $130 for prep/integration and $300 for KAP session, and, hopefully with future grant funding, pro bono options as well.
Much writing and research exists about the benefits of KAP, particularly in the treatment of depression, anxiety, PTSD, and trauma. Here are several useful links and places to learn more about the research and practice of KAP:
Ketamine: Catalyst for Paradigm Change in Mental Health, by Scott Shannon, MD
Psychedelics Today: Veronika Gold- Methods of Ketamine Assisted Psychotherapy https://psychedelicstoday.com/2019/05/07/veronika-gold-methods-of-ketamine-assisted-psychotherapy/
PsychEd Episode 34: Ketamine for Treatment-Resistant Depression with Dr. Sandhya Prashad https://podcasts.apple.com/sg/podcast/psyched-episode-34-ketamine-for-treatment-resistant/id1215646896?i=1000515122266
Ram Dass, Here and Now, Episode 166: How Different It Is… Some have found this podcast helpful when thinking about altered states of consciousness. You can skip to 17 minutes in if you want to just listen to Ram Dass’s talk.