Ketamine Integration Therapy

You may have found that traditional therapy, while productive, is not leading to the healing or symptoms reduction you desire. Ketamine can be a great short-term adjunctive intervention that can lead to significant therapeutic. I offer a therapeutic modality called Ketamine-Assisted Psychotherapy (KAP) in partnership with an organization called Journey Clinical. Ketamine-Assisted Psychotherapy (KAP) is a holistic modality in which ketamine is used as a complement to psychotherapy to help eligible patients experience more frequent breakthroughs and sustained improvement in symptoms.

I take on the psychotherapy portion of the experience, while Journey Clinical’s medical team supports you on all medical aspects. This includes determining eligibility, developing a custom treatment plan, prescribing the medicine and monitoring outcomes. Below is more information about KAP to help you navigate if it may be a good fit for you.

What is Ketamine? Ketamine 101

Ketamine is a legal, safe and effective medicine used to treat a variety of mental health conditions, including depression, anxiety and PTSD. Ketamine has rapidly-acting antidepressant and mood-enhancing effects, which can begin to take effect within 1-2 hrs. after treatment and last for up to 2 weeks. It works by blocking the brain’s NMDA receptors as well as by stimulating AMPA receptors, which are thought to help form new synaptic connections and boost neural circuits that regulate stress and mood. Ketamine has also been shown to enhance overall neuroplasticity for lasting symptom improvement. Like dreams, Ketamine can open doors to dissociated emotions, and self-states that are dormant or unprocessed. Non-linear experiences, visuals, and symbols that defy normative experiences may arise. Because Ketamine reduces amygdala reactivity, you may feel detached and able to examine what emerges in your mind in comfortable fashion and with more clarity leading to insight and psychological integration and balance.
In my work with Journey Clinical we only use the sublingual lozenge.

How Does Ketamine Feel?

The effects of ketamine, which most patients find pleasant, last for approximately 45 minutes. These effects can make you feel “far from” your body, and facilitate shifts in perception that can often feel expansive in nature. Your motor and verbal abilities will be reduced, so you’ll be lying down in a comfortable position during the experience. Once these effects subsided, we’ll spend the remainder of our appointment giving you space to process and discuss your experience. While it may feel hard to articulate what happened during the experience, patients feel like the insights gained are none-the-less clear. Studies have shown that the benefits to mood and neurological growth can last up to two weeks after the Ketamine experience

How Does Ketamine-Assisted Psychotherapy Work?

1. Initial consultation with Journey Clinical
   You schedule an initial evaluation with a clinician from the Journey Clinical medical team via zoom. They will go over your medical and psychiatric history with you, provide education on the treatment and determine if you are eligible for KAP.
   
   If Journey Clinical’s medical team determines that you are eligible for KAP, they will develop a personalized Ketamine prescription and outcome monitoring plan for you.
   
   Journey Clinical’s medical staff will write a ketamine prescription for you, and a small amount of oral ketamine will be sent to your home, enough for the first 2 KAP sessions. You will be taught to take your vitals and self-administer the ketamine lozenges by Journey Clinical’s medical team in advance of our KAP sessions.
2. Preparation sessions:
   Once you receive your ketamine lozenges, we will schedule time together for our KAP preparation, dosing and integration sessions.
   
   Preparation session(s) will be scheduled just like regular therapy sessions prior to the KAP dosing session. The goal of a preparation session(s) is to align on the process and set intentions for our KAP sessions together. We will discuss your hopes, fears, and dread about the session. Although Ketamine can be a powerful catalyst it is not a cure, magic bullet, or the appropriate treatment for everyone. The treatment additionally, requires planning and intentionality. Prior to the Ketamine dosing session, we will set up an intention or goal. This may be about your anxiety and depression connected to a particular area of life such a relationship, career issues, or self-worth. You may have a broad intention such as letting go of toxic relationships or wanting to be more effective socially. Journaling and discussing the intention will help with the unfolding process and lay the groundwork for insight.
3. KAP Dosing Session:

A typical ketamine dosing session lasts between 1-2.5 hours and can take place either in-person at my office, or remotely via telehealth.

During a dosing session, you will self-administer your ketamine lozenge either in my office or in your home. You will be in a comfortable, reclining position wearing an eye mask and listening to calming music. Although a KAP dosing session may be largely an internal experience, I will be present with you the entire time to hold space and provide support as needed.

4. Integration Sessions: After our KAP dosing session, we will meet for multiple integration therapy sessions to review the memories, thoughts & insights that arose during your dosing session, and to prepare for the next dosing session. During the ketamine session I will the hold the space and provide you with the support necessary. This may be just watchful witnessing or emotional support if concerned or observations to make your experience more meaningful. After coming out of the therapeutic ketamine trance, we will work together to piece together imagery, narrative and relational themes that may have arisen. Some people will find that layers of meaning unfold days or even weeks after a dosing session. It may feel like a puzzle is unraveling. Follow up sessions to make sense of this new material and insights and how to integrate are extremely key components so material gained is internalized.

How much does it cost?

Ketamine-Assisted Psychotherapy is an affordable, accessible modality. Although the medical intake and follow ups are not covered by insurance, they are eligible for out-of-network reimbursement.

Ketamine-Assisted Psychotherapy

• Session rates for 2.5 hour Ketamine dosing session if a flat $600.
• Medical Intake: $250 (One time fee, reimbursable through out-of-network) with journey psychiatrist.
• Follow-up Sessions: $150/Session (minimum of 1/quarter, reimbursable through out-of-network)
• Cost of Ketamine Lozenges: $75 for approximately 4-6 lozenges (not covered by insurance)

How Do I Sign Up?

If you would like to explore the possibility of working with me on KAP, please e-mail me at drbrustein@gmail.com to discuss eligibility and next steps.

What is Journey Clinical?

Journey Clinical is a platform for licensed psychotherapists to incorporate science-based psychedelic therapies in their practice safely and effectively, starting with Ketamine-Assisted Psychotherapy (KAP). Journey Clinical’s in-house medical team takes on patient eligibility, prescriptions and outcome monitoring, while I take on the therapy. Their collaborative care model is designed to deliver personalized treatment plans to meet your individual needs and improve long-term outcomes.