Ketamine-Assisted Psychotherapy
Clinical psychotherapy combined with ketamine, for material that hasn't moved through conventional approaches.
What KAP actually is
Ketamine-Assisted Psychotherapy is a clinical treatment in which low doses of ketamine are used to support the work of psychotherapy. It is not the same as recreational ketamine use, ketamine infusion clinics, or psychedelic retreats. It is psychotherapy — the conversation, the relationship, the work of understanding and shifting how you experience yourself — done in a state that allows access to material that ordinary consciousness often guards against.
Ketamine itself is a well-established medication, used in medical settings since the 1970s. At the doses used in KAP, it produces a temporary shift in consciousness — sometimes described as dreamlike, sometimes as a softening of usual defenses, sometimes as a sense of being able to look at one's own experience from a slight distance. The psychotherapy work happens before, during, and after that shift. The medicine is the doorway. The therapy is what walks through it.
Why ketamine alongside psychotherapy
Some material is hard to reach. Trauma that has been buried for years, defenses that have organized around protecting against pain that no longer needs protecting from, patterns of self-criticism or shutdown that operate below conscious thought — these can be remarkably resistant to ordinary therapy. The reasoning mind can describe them, but they don't shift when described.
Ketamine appears to do something specific to that problem. It temporarily loosens the usual cognitive and emotional defenses, allowing material that has been protected to surface more easily. It also appears to enhance neuroplasticity — the brain's capacity to form new patterns — for a window of time after each session. The combination of access and plasticity creates an opening for therapeutic work that's hard to produce through talk alone.Research on KAP for treatment-resistant depression, PTSD, and certain anxiety disorders has been promising. It is not a miracle cure, and it doesn't replace the work of therapy — but for the right client, it can reach material that years of conventional treatment haven't moved.
How I work with KAP
I offer KAP in partnership with Journey Clinical, a national organization that handles the medical side of the treatment — assessing your eligibility, prescribing the ketamine, monitoring your physical health, and coordinating with your other medical providers if appropriate. Their medical team is responsible for the medication itself. I am responsible for the psychotherapy.
This division matters. Most ketamine treatment available today happens in clinics where the medication is administered with limited therapeutic support — sometimes none at all. The research on that approach is mixed: people often feel better temporarily, but the changes don't always hold without integration. KAP, by contrast, is structured around the therapy. The medicine is one part of an ongoing clinical relationship, and the work of making sense of what comes up, applying it to your life, and shifting longstanding patterns is what produces sustained change. Practically, our work together typically includes preparation sessions, ketamine sessions (which can be conducted in person or via telehealth depending on the protocol), and integration sessions afterward. The full arc usually spans several months, though shorter formats are available for specific situations.
Who KAP is for, and who it isn't
KAP is most appropriate for adults whose work has reached the limits of conventional approaches. This commonly includes treatment-resistant depression that hasn't fully responded to medication or therapy, PTSD with high activation or chronic defenses that have made trauma processing difficult, complex trauma and developmental trauma where the patterns are deeply structured, and certain anxiety patterns that have not yielded to other treatments.
It is often a fit for clients who are intellectually capable, articulate, and self-aware — who understand their patterns clearly but find that understanding has not produced change. The same defenses that make someone good at insight can also make them well-defended against the emotional and somatic material that therapy needs to reach. KAP can sometimes get past those defenses in ways that talk alone cannot. KAP is not appropriate for everyone. People with certain cardiovascular conditions, active substance abuse, psychotic disorders, or some other medical and psychiatric conditions are not candidates. The medical evaluation through Journey Clinical screens for these. It is also not the right starting point for someone new to therapy or in active crisis — KAP works best inside an established therapeutic frame, not as a first intervention.And it isn't always the right tool. Some of what brings people to consider KAP is something a different approach would handle better. Part of my role in our initial conversations is helping you figure out whether this is actually the work you need, or whether something else would serve you more effectively.
What a session is actually like
Most clients find the ketamine experience itself less dramatic than they expected. The dose used in KAP is below what would produce dissociation or hallucination in most people. The more typical experience is a softening — emotions become more accessible, defenses relax somewhat, the inner critic quiets. Some clients describe it as feeling more themselves, not less. Others describe a sense of perspective on their own life that ordinary consciousness doesn't easily offer.
During the session, you'll be in a comfortable setting, typically lying down with an eye mask and gentle music. I'll be present throughout. After the medicine takes effect, we may talk, or you may go inward — the work doesn't require constant conversation, and some of the most important material often surfaces in quiet attention. The acute effects of the medicine last roughly 45 minutes to an hour. The session itself is typically 90 minutes to two hours, including time before and after. Integration sessions afterward are where much of the actual therapeutic work happens. We make sense of what came up, connect it to the broader patterns we're working with, and find ways to bring it into your daily life. Material that surfaces in a ketamine session needs to be metabolized, not just experienced — otherwise the experience fades without producing change. The integration work is why KAP is structured as therapy rather than as standalone treatment.
On safety
Ketamine has a well-established safety profile in medical use, and the doses used in KAP are well below those used in surgical anesthesia. Journey Clinical's medical team conducts a thorough screening before treatment, including review of your medical history, current medications, and cardiovascular status. They continue to monitor throughout the course of treatment.
Common side effects during sessions can include mild nausea, increased heart rate or blood pressure, and the dissociative experience itself, which some clients find unfamiliar at first. Serious adverse events are rare but possible, which is why medical screening and ongoing oversight matter. Outside of sessions, ketamine in KAP does not produce the kind of dependency or harm associated with recreational misuse, in part because the doses are low, the frequency is structured, and the use is clinical. If you have questions about safety specifically — about your own medical situation, your current medications, or whether KAP is appropriate given your health history — the medical evaluation through Journey Clinical is where those questions get answered authoritatively. I can speak to the psychotherapy side of the work; their medical team is the right place for the medical questions.
Insurance and cost
KAP is not typically covered by insurance as a complete treatment, though portions may be reimbursable. The psychotherapy sessions I provide can be submitted to your insurance as out-of-network psychotherapy, and many plans reimburse a portion. The medical and medication components are handled by Journey Clinical and are billed separately; some clients use HSA or FSA funds for these. The full cost structure is something we'll talk through during the initial consultation so you have clear information before committing to the work.
Take the next step
KAP is a serious treatment that deserves a serious conversation before you commit to it. If what you've read here describes something you recognize — if you've reached the limits of what conventional treatment has been able to reach, and you want to know whether KAP might be a fit — the first step is a free 15-minute phone consultation. We'll talk about what you're working with, whether KAP is likely to be appropriate, and what the next steps would look like. If it isn't a fit, I'll say so.