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$235 Per 50-minute session
30 minute sessions offered with limited availability; please inquire within.
$250 for Existing Clients
$300 for New Clients
If you need to cancel or reschedule an appointment, please provide 24 hours notice. This allows me the time and ability to offer that hour to someone else. If you cancel or reschedule with less than 24 hours notice, or do not show for your appointment, you will be charged the full fee for that missed session.
I do not accept insurance. However, I can provide monthly statements that you may submit to your insurance company with the possibility of receiving full or partial reimbursement, depending on your plan. I reserve a few spaces for clients needing a sliding scale who have financial hardship.
The full session fee is due at the time of session.
I accept cash, Venmo, Apple Pay, Zelle, all major credit cards, and checks.
Standard sessions are 50 minutes long, but double sessions can be scheduled upon request. While individual needs may differ, I typically recommend once a week sessions to start. Based on your progress and needs we can then reduce the frequency of sessions to bi-weekly or monthly.
Welcome! I know the idea of Ketamine-Assisted Psychotherapy (KAP) may be exciting, confusing, and overwhelming, but I’m glad you’re here to learn more. Please feel free to reach out with any other questions or concerns, I love educating people on the subject, and providing an additional tool for healing and progress. This is meant to serve as an introductory guide. Should you choose to pursue KAP, we will have at-length discussions including consent forms.
Ketamine is a synthetic pharmaceutical compound, classified as a dissociative anesthetic. It is one of the most widely used drugs in modern medicine, and is on the World Health Organization’s List of Essential Medicines. It was developed in 1963, FDA approved in 1970, and adopted by many hospitals and medical offices because of its rapid onset, proven safety, and short duration of action.
Ketamine is most commonly used in surgical settings, including pediatric surgery, due to its excellent safety profile, particularly around breathing/airway management. It has also been utilized successfully in managing acute and chronic pain conditions due to its analgesic properties.
In the last two decades, ketamine has been increasingly clinically applied at subanesthetic doses as an off-label treatment for various chronic treatment-resistant mental health conditions, such as depression, alcoholism, substance dependencies, post-traumatic stress disorder, obsessive compulsive disorder. other psychiatric diagnoses as well as for existential, psychological and spiritual crises and growth.
As mentioned, ketamine is classified as a dissociative anesthetic, where “dissociation” means a sense of disconnection between mind and body, and from one’s ordinary reality and usual sense of self. The present understanding of ketamine’s mode of action is as an NMDA antagonist working through the glutamate neurotransmitter system. This is a different pathway than that of other psychiatric drugs such as the SSRIs, SNRIs, lamotrigine, antipsychotics, and benzodiazepines.
Ketamine also affords a reprieve from habitual patterns of thought that underlie mood and behavior, thereby creating an opportunity for learning new, healthier patterns of thought, opening up the opportunity to rewire habituated neural pathways in the brain.
We will use a sublingual form of administration, lozenges or tablets placed under the tongue or in your cheek as they dissolve. You will meet with a physician who will conduct a physical and medical review and prescribe the medication for you to pick up at the compounding pharmacy.
Another option is working with Wondermed and their physician to collaborate and be your prescribing practitioner. I do not administer the medicine. You will bring in the medicine that you received from your prescribing provider. The physician you chose will distribute the medicine to you either through a compounding pharmacy or through the mail if you use Wondermed’s physician. You will bring the medicine to your session and I will provide the container and integration. At no point during the treatment does anyone but the patient handle or administer the medicine.
Together, we will determine the appropriate dosing to begin treatment. We will meet for 1-3 preparation sessions (or more if necessary) and follow each medicine session with 1-3 integration sessions, or as determined by our collaborative treatment goals. A medicine session is a full 3 sessions back to back.
Though research has demonstrated an antidepressant response to low doses that are minimally psychoactive or sub-psychedelic, this effect tends to be cumulative, requiring repeated administrations over short periods of time. Some practitioners view the psychedelic and dissociative experiences that occur at higher doses to provide a more robust and longer-lasting outcome. While experiences vary greatly, it is generally thought that lower doses provide empathogen-like (heart opening) responses, while higher doses create dissociative, psychedelic, out-of-body, ego-dissolving peak experiences.
The choice of dose and frequency also depends on multiple factors, including client preference, therapeutic goals, prior exposure to ketamine and other psychedelics, body height and weight, and sensitivity. Those without prior experiences are advised to begin with lower doses to reduce anxiety and build familiarity with ketamine’s effects, while those who are experienced with altered states of consciousness may begin with higher initial doses.
The ketamine experience is characterized by the relaxation of ordinary concerns and usual mindset, all while maintaining conscious awareness. This tends to lead to a disruption of negative feelings and preoccupations
Sensory effects of ketamine may include distorted visualization of colors, feeling suspended in space or floating, experiencing out-of-body sensations, vivid dreaming, and changes in visual, tactile, and auditory processing. Synesthesia (a mingling of the senses) may occur. Familiar music may not be recognizable. An ordinary sense of time may morph into time dilation.
These effects typically start 1 to 10 minutes after ketamine dosing. The peak effects typically last 20 to 30 minutes, and then slowly diminish for the next hour. Metabolizing the medicine is not one size fits all, so this is just a scale for reference of averages. Some alterations in sensory perception, speech, and motor ability may continue for approximately 5 hours.
Two to three hours after ketamine administration, clients can return home with another driver. Driving an automobile or engaging in hazardous activities should not be undertaken on the day of the administration, and not until all effects have stopped.
Before participating, you will be carefully interviewed to determine if you are a good candidate for ketamine treatment. This will include discussing your medical and psychiatric history, review of your medical and psychiatric records if necessary, and administration of brief psychological tests. You are required to be under the care of a primary care physician to evaluate your overall health, and in particular your respiratory and cardiovascular status. It is preferred that you are under the care of a mental health provider who refers you to our service and will continue your care after your ketamine treatment. If you are not currently under the care of an external mental health provider, I may request that you begin doing so before KAP treatment.
Pregnant women and nursing mothers are not eligible because of undetermined potential effects on the fetus or nursing child.
Information on ketamine’s interaction with other medicines is only partially available; any possible interactions will be assessed to help determine your eligibility for ketamine treatment.
Once the initial medical and psychological evaluations have been completed and we have agreed to move forward with KAP, we will schedule your intake session during which we will collaborate in your goals for treatment and set intentions for your experience. This will be followed by 1-3 prep sessions during which we will explore your strengths and challenges and begin to identify common themes that run through your life and growth processes. I may also offer breathing exercises and other mindfulness meditation guidance in this session to address any anxiety you might have going into the experience. During the intake session we will also review our ketamine-assisted therapy protocol in order to provide an informed consent for treatment.
These preparation sessions are also intended to build a sense of connection between the two of us as I believe that the safety and trust of the therapeutic relationship is crucial to the efficacy of this medicine. We may also explore ritual and ceremony that you may like to invoke for your medical experience as well as the use of music. People often find music helpful, as it grounds them and gives them something tangible to hold onto, and can potentially enhance or direct the experience. We will provide playlists designed to optimize your benefit from the journey.
The first dose will give us a measure of your responsiveness to ketamine, and enable us to witness the effectiveness of the lozenges and adjust the dose if needed. Some people experience empathogenic effects in this dose range, and engaging in therapeutic exploration can be quite fruitful. Others find speaking too difficult and prefer an internal focus, even at this lower dose. Your preferences for engagement will be respected.
Throughout the ketamine session, I will be present for support and to guide you through any recommended relaxation exercises, play soothing music, or read your personalized invocation if desired. During these sessions, you will be offered an eye mask to facilitate and enhance the experience, and to help you maintain an internal focus. Although some patients are talkative, many find it beneficial to just stay with that internal focus, as forming words can be challenging while in the ketamine experience. You are welcome to share whatever you like, but there is no pressure to narrate your journey. Once the effect of the medicine subsides, you will have the opportunity to share.
I will reconnect with you (and potentially engage in psychotherapy) as you return from the most active phase of your journey, and are ready and willing to communicate with the outside world. The moments following an altered state can be exquisitely poignant and powerful in their ability to evoke and reshape how we attach to others, and I honor these moments and the sacred space they can hold. You will be welcomed to share about your experience and discuss any insights or alternative perspectives that you discovered. However, some choose to contemplate their experience quietly and discuss it at a later integration session. Whatever decision you make in these moments will be respected.
Ketamine has an extensive record of safety and has been used at much higher doses for surgical anesthesia, without respiratory depression. As with any other medication, there are also some potential risks and side effects to be informed of and considered.
The most common physical side effect is a short-term elevation in blood pressure, pulse, or heart rate, which may be a risk to those with heart disease, and can be misinterpreted as a symptom of anxiety. Other possibilities for side effects include dizziness/lightheadedness, sedation, impaired balance and coordination, slurred speech, mental confusion, excitability, diminished ability to see things that are actually present, diminished ability to hear or to feel objects accurately including one’s own body, headache, anxiety, nausea, vomiting, and diminished awareness of physical functions such as respiration. These effects are transient and resolve as the active phase of the medication ends (generally within 4 hours).
Repeated, high dose, chronic use of ketamine has caused urinary tract symptoms and even permanent bladder dysfunction or cystitis in individuals abusing the drug. These adverse effects are much less likely in medically supervised ketamine treatment populations, but might include more frequent, painful, or difficult urination. Please inform your providers immediately if you notice any of these side effects.
In terms of psychological risk, ketamine has been shown to worsen certain psychotic symptoms in people who suffer from schizophrenia or other serious mental disorders. It may also worsen underlying psychological problems in people with severe personality disorders and dissociative disorders.