Eye Movement Desensitization and Reprocessing (EMDR) is an eight-phase psychotherapy approach that helps people recover from trauma without having to talk at length about the traumatic experience(s). EMDR can relieve depressive and anxiety symptoms and help reframe negative beliefs, resolve unprocessed trauma and adverse experiences, improve energy and mood, and create a more positive understanding of the self and others. EMDR therapy can be used alone or with other approaches to create and promote a safe environment for clients to achieve their goals.

Brainspotting works by identifying, processing, and releasing core sources of emotional and body pain, trauma, dissociation, and various other challenging symptoms.

Brainspotting simultaneously diagnoses and treats. It is enhanced with Biolateral sound and is a valuable tool in addressing a wide range of emotional and physical challenges.

Ketamine-Assisted Psychotherapy (KAP) 101

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 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.

● Ketamine can be administered in a variety of ways, including IV infusion, intramuscular injection, via nasal spray and using sublingual lozenges. In my work with Journey Clinical, we only use the sublingual lozenge form.

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 ersonalized 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.

3. KAP Dosing Session:

● A typical ketamine dosing session lasts between 1-2 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.

5. Follow-up consultations with Journey Clinical:

● After our first KAP session, Journey Clinical’s medical team schedules regular follow ups with you to monitor outcomes and prescribe ketamine lozenge refills, as appropriate. The frequency of follow ups depends on your unique treatment plan, at a minimum of once per quarter.

Follow-up Consultations with Journey Clinical :

● After our first KAP session, Journey Clinical’s medical team schedules regular follow ups with you to monitor outcomes and prescribe ketamine lozenge refills, as appropriate. The frequency of follow ups depends on your unique treatment plan, at a minimum of once per quarter.

What is the Cost of Treatment?

● 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

■ My typical hourly rate is $175/hr

○ Journey Clinical Medical Costs

■ First-time patients

● Initial medical consultation with Journey Clinical: $250

● Cost of medication: $88 (enough for 2 sessions)

■ Ongoing treatment

● Follow-up medical consultation with Journey Clinical $150 (at least 1X per quarter)

● Cost of medication: $148 (enough for up to 6 sessions)

How Do I Sign Up?

● If you would like to explore the possibility of working with me on KAP, please e-mail me at tarabenincasa@lotusintegrativecounseling.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.

Helpful Resources:

1. Paradigms of Ketamine Treatment by Raquel Bennett, Psy.D. for MAPS

2. Ketamine Assisted Psychotherapy (KAP): Patient Demographics, Clinical Data and Outcomes in Three Large Practices Administering Ketamine with Psychotherapy - research study by Jennifer Dore et al, 2018

3. Ketamine for Depression and Mood Disorders by Erica Zelfand, ND for Townsend Letter

4. Ketamine-Facilitated Psychotherapy for Trauma, Anxiety, and Depression by goop

5. Ketamine Assisted Psychotherapy with Jonathan Sabbagh of Journey Clinical - Psychology Talk Podcast

Cognitive behavioral therapy (CBT) is a type of psychotherapy that can help people manage mental and emotional health issues by changing how they think and behave. CBT is a combination of cognitive therapy and behavioral therapy that focuses on current problems and finding solutions. It's different from other psychotherapies because it doesn't deal primarily with the past.