Ketamine-Assisted Psychotherapy (KAP) with Jennifer Ruid, LCSW

KAP is a mental health treatment tool that combines the medication ketamine with therapy to help people process thoughts, emotions, and trauma in a different, often more flexible mental state.  This may lead to changing unhealthy thought patterns and the processing of underlying emotions.  Ketamine is most often used for depression, anxiety, trauma, and sometimes substance abuse disorders but data indicates that KAP can be effective with building resilience to stress, managing grief, OCD, treatment resistant conditions, and chronic pain.  Ketamine alone can shift mood, but the individual therapy component in KAP helps turn the shifts into lasting change.   In a private practice setting KAP is typically designed to feel much more like a calm, personalized counseling experience than a medical procedure.  The structure is intentional, predictable, and relationship centered.

Ketamine affects the brain differently than the traditional antidepressants.  It acts on the NMDA receptor and boosts neuroplasticity, which can temporarily make the brain more open to new patterns of thinking.  When people suffer from chronic depression, chronic anxiety, PTSD the neurons in their brain become stunted with fewer connections.  Ketamine helps repair this damage and create new neural connections.  This is one reason it can lead to rapid improvements in symptoms for some people.    *NMDA receptors are ionotropic glutamate receptors in the central nervous system, crucial for synaptic plasticity, memory formation, and learning.*Neuroplasticity is the brain’s lifelong ability to reorganize its structure, functions, or connections in response to learning, experience, or injury.

Before a KAP session is scheduled you must be cleared by a medical provider. The medical provider will review your medical and mental health history, provide education on the treatment of ketamine and determine if you are eligible for KAP. Your provider will write a ketamine prescription for you and your prescription will be sent to you in the mail. You will bring your prescribed medicine to your KAP session where you will self-administer the ketamine lozenges or tablets by dissolving them orally (sublingual dosage). If your current medical provider is unfamiliar with ketamine as a mental health treatment I have several local or on-line providers whom I collaborate closely with. KAP typically has three phases:Preparation: You meet with a therapist for a thorough assessment and discuss your history, psychoeducation, set personalized intentions, build grounding skills, and build trust. Dosing sessions: Ketamine is administered via a sublingual tablet or dissolving troches.  Many people experience a trance-like state from sublingual ketamine and often describe positive feelings such as euphoria, empathy, forgiveness, calmness, total relaxation and reduced mind chatter.   A therapist is present to support you.Integration: After the effects wear off, you work with the therapist to make sense of the experience and apply insights to daily life.

Some clients do a short series of therapy sessions such as 3-6 sessions.Others integrate it into longer-term therapy with the KAP or their current therapist. Sessions may be spaced weekly, bi-weekly, or monthly. Please refer to the KAP Protocol and Pricing for more details.

The initial medical screening will review your medical and mental health history to be sure ketamine is a safe and potentially effective treatment option for you. There are several conditions that may disqualify clients from KAP (see list below).  If your current medical provider is unfamiliar with ketamine as a mental health treatment I have several local or on-line providers whom I collaborate closely with.   Conditions that may rule out KAP:-pregnancy-Uncontrolled hypertension, recent heart attack, or other severe cardiovascular disease.-Severe respiratory conditions-Experiencing active psychotic symptoms-Currently in a manic phase of bipolar disorder-Liver disease-Lack of support system-You cannot commit to the treatment protocol expectations-Active substance use or history of ketamine misuse.

My in-office KAP treatment protocol consists of 1-2 preparation sessions, a minimum of 3 in-office ketamine dosing sessions and an integration session to follow each dosing session. The integration session generally takes place within 48-72 hours of the dosing session and is intended to review the memories, thoughts, and insights that arose during the dosing session. In addition, the integration sessions assist as preparation for the next ketamine dosing session.  Integration sessions may be in-person or Telehealth sessions.  This protocol is designed to improve outcomes, maximize your experience and help you get everything you can from this treatment.  Pricing Details*Medical Evaluation and Prescribing           $360 (+/-)*Ketamine Medication Costs                          $100 (+/-)*These two costs are separate costs paid to the medical provider/prescriber and the ketamine prescription If you are currently working with a mental health clinician: One 90-minute preparation session- $165Three 2.5-3-hour dosing sessions- $450/sessionThree 60-minute Telehealth or in-person integration sessions- $150/sessionTotal for 3 KAP sessions- $1,965.00 If you do not currently work with a mental health clinician:Two 60-minute preparation sessions- $150/sessionThree 2.5-3-hour dosing sessions- $450/sessionThree 60-minute Telehealth or in-person integration sessions- $150/sessionTotal for 3 KAP sessions- $2,100.00Note: I do require that you currently engage in active treatment with a mental health provider due to ketamine’s ability to uncover unresolved grief, trauma, or painful emotions. Experts believe that incorporating mental health counseling to KAP assists patients to sustain improvements and make better use of the psychological change that ketamine can facilitate. I can provide you with a referral to a local mental health provider or we can discuss the possibility on on-going outpatient psychotherapy if needed. Part or the entire preparation sessions and integration sessions may be covered by your personal insurance policy.   (see: Paying for KAP) A minimum of 3 ketamine dosing sessions is required with an arc of treatment from 3-6 sessions being most typical.  Additional KAP sessions- $400

Insurance: Currently, Ketamine Assisted Psychotherapy is not covered by insurance as it is an off-label use of the medication.  This means it is not specifically approved by the FDA for mental health treatment.  Therefore, insurance companies will not pay for it. Ketamine dosing sessions are not covered by insurance.      For preparation and integration sessions, your individual insurance policy may cover some of or all the cost as these services can be considered psychotherapy.  I can complete an Explanation of Benefits with your insurance information although it is not guaranteed as payment. It is your responsibility to be familiar with the coverage pertaining to your individual insurance benefits.   I am currently accepting most major insurance carriers for psychotherapy: Anthem Health Plans of MaineHarvard Pilgrim Health CareMaine Community Health OptionsUnited Behavioral HealthMartin’s PointAetna   HealthplansMeritainUHC/UBHUMRPayment Option Details and Policies:Discontinuing Treatment:You can discontinue treatment at any time.  Reimbursement is not available for services rendered. Payment Type:There is a preference for payment by cash or check if possible.  Credit cards and HSA cards are accepted. Payment is due at time of service. .