Ketamine-Assisted Psychotherapy (KAP)
The use of ketamine for improved mental health and personal growth is a rapidly expanding field. When combined with therapy, ketamine can help build new neural pathways, improving cognition, self-acceptance and emotion regulation. KAP sessions follow a safe, structured protocol. The psychiatric providers at Drishti work closely with experienced therapists to provide KAP when it is medically and psychiatrically safe to do so.
What is ketamine-assisted psychotherapy?
Ketamine-assisted psychotherapy (KAP) is therapy that takes place while you are under the influence of ketamine, with your therapist present in the room with you throughout the experience. Ketamine works differently than traditional antidepressants: it blocks NMDA glutamate receptors, which triggers a surge of glutamate that activates AMPA receptors. This cascade turns on signaling pathways in the brain and increases BDNF (brain-derived neurotrophic factor), which promotes synaptogenesis — the rapid formation of new synaptic connections. This is thought to be part of why ketamine's effects can show up within hours to days rather than the weeks typical of standard antidepressants, and why people are often able to form new neural pathways, and process things in new ways, faster than they might in talk therapy alone.
What role does Drishti's Holistic Wellness play in ketamine-assisted psychotherapy (KAP)?
At Drishti, our role is primarily on the medication management side. We prescribe ketamine lozenges or rapidly dissolving tablets and work with each person individually to find the right dose. On occasion, one of our psychiatric prescribers will also facilitate the psychotherapy portion of KAP, but most of the time, you'll work with one of the therapists in our collaborative network — we have wonderful relationships with a number of therapists and can help match you with the right fit. Some people find us because their own therapist refers them to us for the prescribing piece; others come to us first and we help connect them with a therapist.
What is the process of getting a ketamine prescription and doing KAP?
Getting started with KAP begins with the same thorough initial evaluation we use for all of our medication management clients — a full review of your psychiatric, medical, and social history. In the last 15 to 20 minutes of that evaluation, we'll talk specifically about the ketamine prescription and your plan moving forward. During your KAP sessions, you'll work directly with your therapist, and your therapist will communicate back to your prescriber at Drishti about how things went. KAP sessions are 2 hours, so they are longer than regular therapy sessions.
We initially prescribe for two KAP sessions, then have you come back for a 20-30-minute follow-up to check in and see how things are going. At that time, we can make any adjustments to your dose. From there, we'll prescribe in blocks of four to six KAP sessions at a time, checking in with you after each block is complete.
Your ketamine prescription will need to be compounded at a special pharmacy. We work with multiple pharmacies and you will have the option to pick up your prescription in Newton, MA or get your prescription shipped. If you choose to ship your prescription, an adult will need to be available to sign for the delivery.
NOTE: Not all clients are medically and psychiatrically cleared for ketamine use, and it’s our job at Drishti Holistic Wellness to make sure that if you do use ketamine, you do so safely.
How many KAP sessions will I need?
This varies quite a bit from person to person. Some people do just one session while others may do a series of six or more. How many sessions you need is a decision made collaboratively between you, your therapist, and your psychiatric prescriber at Drishti — we always take your preferences and needs into account. KAP sessions are generally spaced out by at least a week and each session is 2 hours.
How is KAP different from a ketamine or Spravato clinic?
In ketamine-assisted psychotherapy, your therapist is with you in the room while you're under the influence of ketamine, helping you set intentions and goals and process what comes up in real time. At Drishti, we typically recommend KAP for people who feel stuck in therapy or who want to do focused, deep work on a specific issue — it's not generally something we recommend as an ongoing treatment. If someone has treatment-resistant depression and is likely to benefit from more regular ketamine use, we'll refer them to a dedicated ketamine or Spravato clinic instead. We work closely with Lumin and Stella, both of which have locations in Brookline as well as elsewhere throughout Massachusetts.
Do you accept insurance?
For initial evaluations and follow up appointments, we accept Blue Cross Blue Shield (BCBS) and Aetna. If you have a different insurance plan, we would bill you upfront for the cost of treatment. The initial evaluation is $350 and follow-up visits are $175. You're welcome to use an HSA to cover these costs. If you have a PPO plan, you may also be able to submit a receipt from your visit to your insurance provider for partial reimbursement.
Ketamine-assisted psychotherapy sessions themselves aren't always covered by insurance. Sessions at Drishti Holistic Wellness are $450. Many of the therapists in our collaborative network accept insurance, have sliding scales or packages available.
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