Ketamine-Assisted Psychotherapy: What to Expect Before, During and After

Maybe you’ve done years of therapy. You understand your patterns. You could probably teach a class on them. And still, your body doesn’t seem to have gotten the memo.

That gap between knowing and feeling is where ketamine-assisted psychotherapy (KAP) can help some people. Here’s what it is, how it works in my practice, and what to consider before you try it.

What Is Ketamine-Assisted Psychotherapy?

KAP pairs a prescribed dose of ketamine with psychotherapy before, during and after the medicine experience. Ketamine is FDA-approved as an anesthetic. Licensed medical providers also prescribe it “off-label” for mental health concerns, a common and legal practice.

The medicine is only part of the work. The therapy around it, the preparation and the integration, is where much of the change gets made.

How Ketamine May Help

Researchers are still learning exactly how ketamine works. One leading idea is that it affects glutamate, a brain chemical involved in learning, and may briefly make it easier for the brain to form new connections. This is called neuroplasticity.

In plain terms: for a window of time, old patterns may hold a little less tightly. Therapy helps you use that window well.

Ketamine has been studied most for depression, especially depression that hasn’t responded to other treatments. Research on PTSD and anxiety is growing. Results vary from person to person, and ketamine isn’t right for everyone.

What the Process Looks Like

1. Consultation. We talk about what you’re hoping for and whether KAP makes sense for you.
2. Medical screening. A licensed prescriber evaluates you and decides whether ketamine is safe for you, and at what dose.
3. Intention setting. Before your first medicine session, we prepare: what you want to explore, what support you need and what to expect.
4. Medicine session. Ketamine is taken as lozenges that dissolve under the tongue, following your prescriber’s instructions. Your prescriber usually has us start with a half dose and adjusts from there. I’m with you for the session. If you dose at a clinic, I provide your preparation and integration.
5. Integration. Afterward, we make sense of what came up and turn it into something you can use in daily life. Many of my clients say this is the most helpful part.

Some people prefer a lower dose while we talk during a therapy session, sometimes called psycholytic work. Others prefer a deeper experience followed by integration. Your prescriber and I work with you as a team to find what fits.

Why the Therapy Part Matters

In an altered state, feelings and memories that usually feel too big can sometimes be met with more distance and less fear. People often describe seeing an old pattern from the outside for the first time.

But insight alone rarely changes much. Integration is where we connect it to your body, your relationships and your choices. Journaling, rest and gentle body awareness between sessions help it settle in.

Is KAP Safe?

Ketamine is generally well tolerated under medical supervision, but it isn’t risk-free. Common short-term effects include dissociation, nausea, dizziness and a temporary rise in blood pressure. It isn’t appropriate for everyone, including people with certain heart conditions or certain mental health histories. Your prescriber makes that call.

KAP is not a crisis service. If you’re in crisis, call or text 988.

Can I Do KAP From Home?

For clients in California, sessions can happen virtually from your home when your prescriber approves it. Every client needs a trusted adult with them during the medicine session. This is a prescriber protocol and also best practice for remote sessions, and we plan the safety details together ahead of time.

What Does It Cost?

My sessions are $267 per hour, and a medicine session runs three hours, or $801. Prescriber visits and medication are billed separately by the prescriber.

I don’t take insurance, but I can provide a superbill for preparation and integration sessions, which you may be able to submit for out-of-network reimbursement. Check with your plan.

Is KAP Right for You?

KAP may be worth exploring if you’ve done meaningful therapy and still feel stuck, if medication hasn’t been enough for depression or anxiety, or if you want to work with what your body holds, not just what your mind understands.

I offer KAP to adults 18 and older. It isn’t a quick fix or a replacement for ongoing care. For the right person, with the right support, it can open a door.

Curious whether it’s a fit? Learn more about KAP with me or book a consultation.