Ketamine-Assisted Psychotherapy
Integrating Ketamine with Depth-Oriented Psychotherapy
In my practice, KAP combines ketamine with trauma-informed psychotherapy to support deep inner work.
What Is Ketamine-Assisted Psychotherapy?
Ketamine is a legal, FDA-approved medication with a decades-long track record of safe use. It is used off-label for mental health conditions at sub-anesthetic doses and can have profound effects on mood, enhance neuroplasticity (the brain’s capacity for change), and create shifts in consciousness that soften habitual defenses.
In infusion clinic settings, ketamine is typically administered via IV as a standalone treatment. The focus is on its antidepressant properties while the psychedelic effects are treated as incidental. KAP is fundamentally different. The altered state is central to the work, not a side effect. And psychotherapy shapes the container: preparation beforehand, attuned presence during, and integration afterward.
Clients obtain ketamine through a medical provider who evaluates appropriateness and oversees the prescription; I provide the therapeutic framework.
Who Might Benefit
Early research suggests KAP may be particularly suited for those wrestling with treatment-resistant depression or anxiety, and those who have experienced trauma or PTSD. It may also be worth considering if you:
- Feel stuck in patterns of thought or behavior that have proven hard to change through traditional therapy
- Experience chronic stress or burnout
- Navigate addiction, chronic pain, or unresolved grief
- Struggle with existential or spiritual distress
KAP is not a quick fix, and it’s generally not a first step. It tends to be most appropriate for those who have genuinely engaged with other approaches and found them insufficient. For many drawn to this work, it becomes a turning point.
The KAP Process
Preparation
I typically meet with new clients for three or four preparation sessions, often more. These sessions are aimed at building familiarity and trust, and preparing clients mentally and emotionally for the ketamine dosing sessions. I describe the process and what clients might expect, so they can enter the work feeling oriented and prepared.
Ketamine Sessions
During dosing sessions, clients self-administer ketamine per their prescriber's instructions. Sessions are scheduled for three hours, with peak effects typically lasting 45-60 minutes. We usually support the inward exploration with an eye mask and carefully chosen instrumental music through headphones. I am present throughout to provide support when needed while allowing space for the inner process to unfold.
Integration
Integration is perhaps the most important part of the process. It involves making sense of what emerged and bringing it into daily life: processing what was difficult, seeing old patterns with new eyes, and finding ways to act on what's been learned.
We hold dedicated integration sessions within a few days of each dosing session. The goal is to turn experiences that could otherwise be fleeting into lasting transformation.
A Full Course of KAP
A typical course includes:
At least three preparation sessions (often four or more)
6-10 ketamine dosing sessions, typically spaced two weeks apart to allow time for integration
At least one integration session after each dosing session, ideally within 1-3 days
Some clients receive what they need from just a few sessions. Clinical experience suggests that 8-10 sessions offer a thorough exploration of what KAP has to offer. We reflect together, alongside the prescriber, on treatment effectiveness and when a natural stopping point arises. Clients can discontinue at any time.
Medical Collaboration
As a psychotherapist, I do not prescribe, distribute, store, or administer ketamine. Clients obtain their prescription through a medical provider (typically a psychiatrist or psychiatric nurse practitioner) who evaluates whether KAP is appropriate and oversees the ketamine prescription. The ketamine typically arrives from a specialized compounding pharmacy in the form of rapid-dissolve tablets, which are absorbed sublingually (held in the mouth).
I am happy to discuss medical providers I have worked with.
— Rainer Maria Rilke
Next Steps
If you’re curious whether KAP might be a good fit, we can start with a conversation.