Ketamine Assisted Psychotherapy (KAP)
What’s different about ketamine?
Ketamine is an alternative medicine for depression and anxiety. It does not carry the same side effect profile as more traditional antidepressants - serotonin selective reuptake inhibitors, or SSRIs. For people who’ve had difficulties with SSRIs, ketamine may be a better option. It works faster than traditional antidepressants, and the neuroplasticity effects are strong, meaning the results are deeper than surface-level symptom relief. It is well known to produce new connections in the brain, taking advantage of the neuroplasticity effect. Ketamine, when combined quality therapy such as Internal Family Systems therapy (IFS) or EMDR, can help get to and heal the root cause of the psychological pain rather than just providing symptom relief.
Why low dose (psycholytic) ketamine? (What we use in our practice)
You may have heard of ketamine in the context of psychedelics. At higher doses, it can work as a psychedelic. However, our dosing is different from psychedelic dosing and carries substantial and different benefits. The doses we prescribe are psycholytic. This means that it produces an immediate state of calm and ease, and a sense of mental spaciousness. Ketamine is in the “dissociative” class of medication, which this means that people can experience their difficult emotions with a sense of psychological space and without a sense of being overwhelmed. Since you are more open and calm with a psycholytic dose, and we still get the benefits of neuroplasticity (a more malleable brain), we can have an overall deeper, faster, and more transformative therapeutic experience.
How does ketamine work in the brain?
Ketamine’s effects in the brain are complex and research is continuing all the time. Some of the most well-known mechanisms involve the neurotransmitters Glutamate and GABA. There are many different kinds of neurotransmitters (chemical messengers) in the human brain, but Glutamate and GABA are the most common ones because they are the top excitatory (promoting neurons firing) and inhibitory (blocking neurons firing) neurotransmitters, respectively. Ketamine is an antagonist (meaning, it blocks) a neurotransmitter receptor called NMDA, which is found on both GABA and Glutamate neurons. It’s thought to block the GABA receptors more effectively, meaning that GABA doesn’t inhibit neurons firing as often if ketamine is taken. This leads to an overall increase in neural activity in the prefrontal cortex. Ketamine is also known to interact with another neurotransmitter receptor - AMPA, which may be responsible for a sequence of molecular events that include proteins that promote neuroplasticity through new connections (proteins like Brain-Derived Neurotropic Factor, or BDNF as well as others like mTor, eEF2, and GSK-3). Brain science is very complex, but what we do know, and what is important for us to know as we work together in the KAP process, is that it promotes new neural connections and that is likely a contributing factor in ketamine’s antidepressant and anti-anxiety effects.
How we work together at Be Balanced Counseling
In order to be considered as a candidate for KAP, we require that each client be evaluated by our psychiatric nurse practitioner, Elizabeth Shrader DNP, to receive medical clearance. Once cleared then Amy, the psychotherapist, will meet with the client to review the client’s intentions for the ketamine experience as well as prepare the client by reviewing the Set and Setting for the KAP experience. Elizabeth and Amy will work collaboratively as your prescriber and therapist to ensure safety and effectiveness of your experience.
KAP Session Fee lead by Amy Burnside: $200 for 60 minutes; $300 for 90 minutes
KAP Psychiatric Intake Evaluation by Elizabeth Shrader: $300 for 60 minutes
KAP preparation session: $175 for 60 minutes
Additional Integration sessions beyond the KAP session, as needed: $175 for 50-60 minutes
Ketamine oral troches: Cost varies based on client’s standard pharmacy insurance benefits. Most insurances cover the medication.
Articles and Videos
Ketamine & Depression: How it Works - Yale Medicine Explains (youtube.com)