Getting Started with Ketamine-Assisted Psychotherapy (KAP): A Beginner-Friendly Roadmap
You’ve done the research: Ketamine-Assisted Psychotherapy (KAP) can harness your neuroplasticity to disrupt the unhelpful patterns associated with anxiety, depression, and PTSD. Woo hoo! But now what? The process of embarking on a KAP journey is somewhat different from traditional talk therapy. No worries there; I’m here to give you a step-by-step guide of what to expect with visual guides and a handy calendar. You deserve to have all the data you need to feel informed and excited about your journey.
This post will share what KAP looks like specifically with Dr. Shannon York and In Alignment Wellness. That includes working in partnership with Journey Clinical for medical clearance and the ketamine prescription. The most typical protocol includes eight dosing sessions occurring once every other week for four months total. Medication is self-administered in the form of a lozenge in the comfort of your own home with all meetings occurring virtually via secure telehealth video. If your KAP adventure includes a different prescriber, route of administration, or therapist, your process may differ from what is described here. With that being said, let’s jump in!
Step 1: Getting Started and Setting Goals
The KAP journey begins with connection and gaining clarity about our intended focus. Our initial meetings will center around getting to know each other and exploring your goals. This is your time to share what’s on your mind! What has worked in the past? Where have you felt stuck? What are you hoping will change from this work? We’ll compare what you’re seeking with what KAP has to offer and see if it feels like a good fit for you.
New clients: You’ll start with a free 15-minute consultation to discuss KAP, your goals, and my clinical approach. If it sounds like working together would be beneficial to you, we’ll schedule a 75-minute intake session to dive deeper into your history and therapy goals. Getting the most out of the medicinal journey requires mutual trust. For that reason, I like to have at least four sessions of getting to know one another before beginning the dosing process. We’ll let the trust building process take as long as it takes for us to feel ready! No rush; we’re on your timeline.
Existing clients: If we’ve already been working together, we’ll spend 2-4 sessions exploring how KAP can enhance your current therapy. We’ll discuss what elements of our work together will be the same and what will be different when adding ketamine dosing sessions, then focus on next steps to pursuing the KAP experience.
Throughout the process, we will review the science behind ketamine’s supportive role in moving toward your mental health goals when used in an intentional therapy protocol. We’ll think through your network of family and friends to identify who may be the best fit to be present with you during your dosing sessions. Your support person will help you with any logistical concerns during your journey, like refilling your water bottle, wrangling pets, or getting you a blanket. I’ll share more information on what to expect throughout each stage of the journey with lots of room for questions along the way.
Step 2: Medical Screening with Journey Clinical
Safety and suitability are crucial when it comes to KAP. That’s why the next step involves a medical screening with the expert team at Journey Clinical. During this hour-long online meeting, they’ll:
Review your medical and mental health history
Explain how ketamine works and what to expect from your KAP experience
Screen for any potential risks to ensure ketamine is safe for you
If KAP is determined to be a good fit with your therapy goals and medical history, Journey Clinical will create a personalized dosing plan. They’ll send a small supply of oral ketamine lozenges to your home, along with detailed instructions to ensure safe and effective use during your sessions. The initial prescription provides medication for two dosing sessions. You will meet with your Journey Clinical medical provider again after the second dosing session so you can adjust your dose if needed (more on that below!).
Step 3: Preparation Session
Preparation is key to a meaningful experience with KAP. Before your first dosing session, we’ll meet to:
Set the stage by discussing what to expect during dosing and beyond
Discuss ways to help you create a calm, distraction-free environment during dosing
Review the role of the support person during dosing (usually a friend, family member, or partner present with you)
Address any questions or concerns
Establish your intentions for the dosing session ahead
I’ll also encourage you to begin a journaling practice. Writing down your thoughts, goals, and reflections before the session can deepen your experience and provide clarity about what you hope to achieve.
Step 4: Your First Dosing Session
Your first dosing session is a three-hour experience designed to be safe and transformative. It’s broken down into three parts:
Preparation (1 Hour): We will practice some grounding exercises, review your intentions, and ensure everything is in place before beginning the dosing. We’ll collaborate with your support person about your preferred way to interact during the session (e.g. being in the same room for the whole journey versus having them check on you at 15-minute intervals, offering supportive touch or not, what verbal interaction may be welcome or unwelcome). Prior to beginning, we will take your vitals with your home blood pressure monitor and ensure they are within the designated range per Journey Clinical’s recommendation.
Dosing (1 Hour): You’ll take the ketamine lozenge and embark on your journey. This administration involves placing a dissolving lozenge in the mouth, swishing for ~12min, then spitting out the medicine. Most people find that the peak effects of the medicine last about 45-60 minutes.
Post-Journey Review (1 Hour): After the journey, we’ll let you slowly come back to the space around you. If desired, you can share what you noticed during the dosing experience, including thoughts, feelings, images, sounds, and physical sensations. You are always in control of what you wish to share. We may start processing what you experienced, identify key themes, and connect these insights to your therapy goals. Before ending the dosing session, we’ll review expectations of what you might experience for the remainder of the day and how to best care for yourself in order to make the most of your journey.
Step 5: Integration Session
Within 24-48 hours of your dosing session, we’ll meet for an integration session. The first 48 hours after dosing are when the neuroplastic window is most powerful! This step is where the therapeutic work deepens:
Reflecting on your experience and its personal meaning
Practicing new ways of thinking and behaving
Creating a plan to apply your insights in the weeks ahead
Integration is what differentiates ketamine administration from ketamine-assisted psychotherapy. Intentional focus on your insights, goals, and plan for implementing changes ensures that the benefits of the session extend into your daily life, fostering lasting growth.
Step 6: Reflective Journaling
About a week after your session, journaling becomes an essential tool for solidifying your insights. This practice allows you to:
Review the lessons, insights, and experiences from your dosing session
Reset intentions to practice new helpful thoughts or behaviors
Process lingering emotions or thoughts
Track your progress and growth
I am happy to recommend journals with KAP-specific prompts and/or provide you with guided prompts to help make this process easy and meaningful.
Step 7: Prep Journaling Before Your Next Dose
Journaling isn’t just for reflection—it’s also a way to prepare, shift your mindset, and refocus. Before your next session, take time to review your progress and refresh your intentions. This preparation can deepen your connection to the process and enhance your experience.
Step 8: Second Dosing Session
Your second dosing session follows the same structure as the first: preparation, dosing, and post-session review. Based on your experience in the first session, we may make some changes to setting up your soothing environment, connecting with your support person, dosage, and/or your plan for self-care following dosing. Experiences can differ for folks regarding their adjustment to the dosing process. After the second dosing session, you may have found your groove or you may still be tinkering with ways to further improve your experience.
Step 9: Integration Session 2
After your second dose, we’ll meet again for a second integration session. Building on your first experience, this session helps to further anchor the changes you’re making and ensure they align with your goals. Some folks decide they have reached their goals after this session and choose to stop here. Others decide to continue with the eight-dose protocol. It is always up to you! We’ll talk through pros and cons of continuing on with the recommended dosing schedule to achieve your therapy goals.
Step 10: Follow-Up with Journey Clinical
Shortly after your second dose, you’ll have a follow-up with Journey Clinical’s medical team. This 30-minute meeting includes:
A review of your progress
Adjustments to your dosage if needed
A plan for your next steps in treatment
The medical professional will ask about any side effects, how the dose intensity feels (Too intense? Not intense enough?), and your impressions of the impact so far. With that information, they may recommend changes to your protocol or to maintain the course with the original recommendations.
Step 11: Maintenance Journaling Round 2
As your treatment progresses, journaling remains a cornerstone of KAP. Continuing to write allows you to:
Stay connected to your growth
Reflect on the changes you’re experiencing
Identify areas where you’d like to focus moving forward
Step 12 and Beyond
After your second dosing session, our work continues in the same formula:
Preparation journaling before dosing
Dosing session
Integration session
Maintenance journaling between dosing sessions
The most common protocol includes eight dosing sessions. You are always in control of stopping or continuing based on your needs. By the fourth dosing session, you may notice deeper themes emerging, along with a growing sense of connection to your inner self. We’ll reflect on the full trajectory of your experience after we complete the final integration session.
Reviewing Your Progress
At the conclusion of your dosing sessions, we’ll take time to review everything you’ve learned and achieved. This reflective process helps you:
Recognize how far you’ve come!
Identify changes in your thoughts, behaviors, and emotions
Plan your next steps, whether that’s continuing therapy (with or without additional dosing), exploring other treatments, or taking a pause to reflect
Ready to Start Your Ketamine-Assisted Psychotherapy Journey?
If you’re ready to take the first step, let’s connect! Schedule your free 15-minute consultation today and discover how Ketamine-Assisted Psychotherapy can make a difference in your life. We can work together to create the change you’ve been seeking and help you feel like yourself again.
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