SD sunset lg.JPG

Therapeutic Ketamine

have you tried everything?

Do you feel like you’ve tried everything to overcome your depression, anxiety, or trauma-related symptoms without relief or too many intolerable side effects? Are you feeling stuck? If yes, we’re pleased to introduce Resilience Behavioral Health Solutions and to provide ketamine-assisted psychotherapy (KAP). KAP differs from the primary ketamine treatments being offered; instead of administering ketamine intravenously (IV) in a sterile medicalized setting, at Resilience we offer an alternative, individualized approach…and no IVs. This is provided in a warm comfortable safe space with carefully selected music and when needed gentle guidance. At Resilience, a board-certified psychiatric provider (who maintains an advanced cardiovascular life support (ACLS) certification) is with you throughout the treatment. This ensures you are medically monitored and therapeutically supported during your experience.

What is KAP like?

Resilience BHS utilizes approaches very similar to the those that are being and have been used in clinical trials of MDMA and psilocybin (e.g. Johns Hopkins studies) but with intramuscular (an injection into a muscle) ketamine; there are no IVs, no tubing, nothing tethered to the physical body. KAP has been used internationally since the 1970s and has gained momentum in the U.S. by psychiatric providers and mental health clinicians over the last 10-15 years due in large part to research of psilocybin and MDMA for clinical use. Resilience BHS incorporates techniques (e.g. attention to music, setting/environment, eye covers, integration, etc.) used in psychedelic-assisted psychotherapy.

Post-ketamine administration clients frequently report a calm, trance-like state, others report a more expansive, non-physical experience. KAP requires subanesthetic ketamine dosages based on published research and individual clients’ unique chemistry. Research continues with this “old” medication; to date, researchers suggest ketamine offers symptom relief in treatment-resistant depression and trauma-related conditions (e.g. PTSD) such as anxiety, hopelessness, disordered eating, and poor sleep.

Please take a look at our FAQ below for more information and schedule a consultation to learn if KAP is right for you.

KAP space for individual sessions

KAP space for individual sessions

FAQ

can you tell me a little more about Ketamine?

If you are unfamiliar with ketamine here is a brief history of how and why it is being used for Ketamine-Assisted Psychotherapy. Ketamine was invented in the 1960s and has traditionally been used in higher doses as an anesthetic (for surgery) with children and adults. It has also been used during war times on the battlefield as an effective analgesic (pain medication). In recent years, ketamine has been administered as an “off-label” treatment, per the FDA, for psychiatric conditions that have been resistant to currently available modalities such as medications and/or psychotherapy. For many, ketamine has been found to provide rapid, sometimes immediate relief of major depressive symptoms, including suicidal ideation; however, the degree and length of symptom relief is variable from patient to patient with some requiring few doses and others needing maintenance administration to experience ongoing symptom relief and remission. As with other mental modalities KAP is not a magic bullet, the client’s ongoing personal work (e.g. lifestyle changes & ongoing integration therapy) are integral in the effectiveness of KAP and the duration of experienced improvements.

IS KAP Contraindicated for some people?

Ketamine is considered safe for most adult patients (and with pediatrics as an anesthestic). It is not safe, in this setting, for persons with history of uncontrolled high blood pressure, myocardial infarction (MI), stroke, or aneurism because it can raise blood pressure. It is also not generally used with clients who are currently experiencing mania (e.g. bipolar I disorder) or thought disorders (i.e. schizophrenia) as more research is needed.
 

How do you administer the medication?

At Resilience BHS, we offer KAP using intramuscular (IM) administration of ketamine. This allows us to customize your treatment and dosage based on your symptoms and your chemistry (how you metabolize and respond to the medication).
 

What if I have a psychiatric provider or therapist already?

During your KAP treatment, if your medications require adjustment we will collaborate with your current provider and prescribe the medications if needed (with the exception of scheduled medications such as benzodiazepines or psychostimulants). After the initial 1 or 2-week KAP treatment sessions you will resume working with your current psychiatric provider; you may find that occasional maintenance KAP treatments are helpful for continued symptom remission in which case we would collaborate with your current or established psychiatric provider.

We strongly encourage all of our clients to continue therapy whether you are engaged in counseling prior to KAP or not; integration (therapy) throughout and post-KAP is a critical part of this treatment modality. Additionally, ketamine continues to promote neuronal (brain cell) synaptic branching or neuroplasticity post-treatment and therapy is strongly encouraged to maximize these new synaptic connections. Remember there is no magic bullet, the combination of medication, including ketamine, with continued self-exploration increases the likelihood of long-term symptom reduction and relief.


Is Ketamine assisted psychotherapy (KAP) covered by insurance?

KAP is not currently covered by insurance as it is considered an “off-label” (per the FDA) use contrary to a growing body of research and data supporting its efficacy. At Resilience BHS, whenever possible, we will provide a super bill and you may be able to receive some reimbursement from your insurance company.


What is the cost of KAP?

Based on current research data treatment resistant depression responds best to several ketamine doses over a 2-3 week timeframe; some clients have benefited from maintenance treatments every 1-3 months, others experience symptom remission and do not require maintenance treatments. The cost for an initial evaluation is $250; recommendation for KAP will depend on your medical and psychiatric history.

 

can I drive after taking or receiving ketamine?

Though you will be able to leave the clinic between 2-2.5 hours after your scheduled KAP start time; you will not be permitted to drive post-KAP sessions. Transportation to and from the clinic on days you are undergoing KAP will need to be arranged in advance. You will be able to safely and legally drive the day following your KAP sessions and resume your normal activities.


How does ketamine work?

Ketamine is believed to have a unique mechanism of action (MOA). Unlike the majority of psychotropic medications available in the United States, ketamine has been found to target glutamate receptors, more specifically, N-methyl-D-aspartate (NMDA) receptors. Glutamate is an excitatory neurotransmitter associated with numerous neurological functions including memory and learning; glutamate also moderates anxiety and adrenaline release as well as aspects of sleep. Ketamine antagonizes or blocks glutamate receptor transmission. Ketamine is also being used in specialized medical settings for chronic and/or severe pain conditions as it also targets pain brain cell receptors. Research for how, what (e.g. other conditions), and why ketamine helps with these conditions is the focus of ongoing research.

KAP fees for adult clients

  • Psychiatric evaluation and medical record review for medical clearance (required): $250

    1. 3 in-office KAP sessions over 1-2 weeks (every other day) fees without insurance is $1315. Patients are reassessed to determine if additional KAP sessions [beyond the initial 3] may be beneficial.

    2. 6 in-office KAP sessions over 2-3 weeks fees without insurance are $2630.

    3. Maintenance KAP: 1 in-office session for clients previously treated with ketamine and/or KAP for mental health conditions without insurance is $375.

    4. 50-minute integration sessions $150 per session or 5 session package $650 ($100 savings)

    5. For optimal and long term benefits, we recommend weekly therapy for 8-12 weeks post-KAP with a knowledgeable integration therapist.

    6. We provide a discount for first responders (e.g. police, firefighters, EMS), healthcare providers, and veterans for KAP services.

    7. You may use your HSA debit/credit card for KAP.

questions?

Feel free to reach out with general questions through the contact page or by telephone.