What is the process of incorporating ketamine into therapy?

I use ketamine-assisted psychotherapy (KAP) with clients who present with PTSD, anxiety, depression, and attachment/relational issues. I provide KAP for individuals who want to explore this approach as an adjunct to the work they are doing with their current therapist, as well as with my own clients, to enhance and deepen the work in which we are already engaged.  

Ketamine-assisted psychotherapy involves an initial intake and assessment with me over 2-3 sessions, conducted in 50-minute or extended sessions. If we decide that KAP is a helpful and appropriate path for you, you will meet with one of the prescribers that I work with to do a medical evaluation and obtain a prescription for the ketamine.  We will conduct 1-2 preparation sessions to set intentions and plan for the ketamine session. A standard session will last 2-3 hours. You will need a ride to and from the ketamine session because you should not drive for several hours after taking ketamine. During the session, you will lie down and listen to a playlist specifically designed to support the ketamine experience. I will be with you the whole time to keep you comfortable and safe as well as to process any material that comes up. You will have the option to receive EMDR as you start to feel the effects of the ketamine diminish.

Once you are able to sit up, talk, and are no longer feeling the ketamine strongly, I will bring you some simple food and we will close the session. Then you will go home and we will have a follow up appointment as soon after the ketamine session as possible. I like to try to meet with people 48 hours or less after the session to use the window of heightened neuroplasticity to our advantage.

Follow-up sessions integrate your experiences on the medicine and support incorporating insights into your daily life, and may prompt additional sessions.

Why add EMDR?

EMDR is a structured, evidence-based method for reprocessing distressing memories. When combined safely with KAP, clinicians report that EMDR may take advantage of ketamine's therapeutic window to reach material that is otherwise overwhelming, potentially enhancing consolidation of corrective learning. Integration is individualized — EMDR may be offered during the same session or as part of the follow up integration process.

 Safety & contraindications

Contraindications may include uncontrolled hypertension, certain cardiovascular conditions, active psychosis, or pregnancy. Side effects can include transient dissociation, perceptual changes, nausea, dizziness, and temporary elevations in blood pressure. All clients receive pre-session medical assessment and post-session follow-up.

Outcomes & expectations

Evidence shows rapid symptom reduction for depression and promising reductions for PTSD symptoms when ketamine is paired with structured psychotherapy, however, individual responses vary and durability often depends on integration work and ongoing supports. Many clients express that it feels like a welcome reset, helps them access deeper material and makes it easier to imagine new ways of being in their lives. 

It is important to note that although many people feel benefits from this treatment, as with anything, we cannot expect it to be a cure-all and do not promise that everyone will have positive results. 

Frequently asked questions

 Q: Is KAP the same as psychedelic therapy?
A: Ketamine is a dissociative anesthetic with psychedelic-like effects at subanesthetic doses. KAP integrates these effects with psychotherapy — the model and legal/regulatory context differ from classic psychedelic protocols (e.g., psilocybin, MDMA).

Q: Will I lose control or be unconscious?
A: No — at therapeutic subanesthetic doses clients typically remain conscious but may experience altered perception and introspective states.

Q: How long before I see benefit?
A: Some clients notice mood improvements within hours to days after a session; trauma processing benefits often require several sessions and integration therapy to consolidate gains.

Q: Can EMDR always be used with ketamine?
A: Integration depends on clinical judgment, client stability, and provider training. EMDR during or after KAP is done only by clinicians trained in both trauma therapy and KAP safety protocols.

Q: Can I bill insurance for KAP?

A: I can provide a superbill to submit to your insurance. It is coded under the same billing code as psychotherapy and may be reimbursed as out-of-network coverage depending on your insurance.

Q: Will I feel sick or nauseous?

A: Some people feel nauseous and there is medicine the prescriber can provide to prevent feeling sick.