Our Services
Ketamine Assisted
Ketamine Assisted Psychotherapy at Rouse
Ketamine-Assisted Psychotherapy (KAP) is a holistic modality in which ketamine is used as a complement to psychotherapy to help eligible clients experience more frequent breakthroughs and sustained improvement in symptoms. Rouse offers the psychotherapy portion of the experience, while ISHA’s medical team supports you on all medical aspects. This includes determining eligibility, developing a custom treatment plan, prescribing the medicine and monitoring outcomes.
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. Clients go through an assessment process with a licensed psychotherapist and medical prescriber to evaluate whether this treatment is appropriate and safe for them.
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 and 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 various ways, including IV infusion, intramuscular injection, nasal spray, and sublingual lozenges. At Rouse, we only use the sublingual lozenge form.
How does ketamine feel?
The effects of ketamine, which most clients 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, the remainder of the appointment is spent giving you space to process and discuss your experience. While it may feel hard to articulate what happened during the experience, clients 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, and multiple sessions in concert with a therapist can have effects that last much longer.
How Do I Sign Up?
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You schedule an initial intake with a therapist at Rouse either in-person or virtual over Zoom. They will gather information to input into the Journey system and work to learn more about you to create a plan for how many prep sessions and integration sessions will occur during the course of KAP. Current clients may only need one prep session, while new clients can expect at least three, in order to build a safe container for the work and ensure that you have all the skills you need to get the most out of KAP.
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● You schedule an initial evaluation with a clinician from the ISHA Health medical team via zoom, or your own psychiatrist. 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 personalized 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 the KAP sessions.
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Once you receive your prescription, we will schedule time together for our KAP preparation, dosing, and integration sessions. Preparation sessions will be scheduled like regular therapy sessions before the KAP dosing session. The goal of the preparation sessions is to align on the process and set intentions for KAP sessions together.
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● A typical ketamine dosing session is 3 hours long and can take place either in-person at Rouse’s office in San Francisco, or remotely via telehealth.
● Dosing sessions are made up of 3 phases: intention setting and clinical check-in, taking the medicine, and closing. In the medicine phase, you will self-administer your ketamine lozenge. 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, your therapist is with you the entire time to hold space and provide support as needed.
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After a KAP dosing session, you will meet with your therapist 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.
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After our first KAP session, you will schedule your regular follow ups with your medication prescriber 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.
How much does it cost?
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.
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■ 50-minute intake, prep, and integration sessions are $300/session
■ 3-hour medicine sessions are $900/session
■ 3-hour couples medicine sessions are $1050/session
Some sliding scale slots available.
Contact admin@rousetherapy.com to join waitlist for group KAP sessions.
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First-time patients:
● Initial medical consultation with ISHA Health: $350 Spring Sale! (Normally $450)
● Cost of medication: Typically $50-150 for one months supply
Ongoing treatment:
● Follow-up medical consultation with your prescriber ~$350 (at least 1X per quarter)
● Cost of medication: $50-150 (enough for one months supply)
References & Resources
1. Paradigms of Ketamine Treatment by Raquel Bennett, Psy.D. for MAPS ©Journey Clinical Inc 2023, https://maps.org/news/bulletin/paradigms-of-ketamine-treatment-spring-2019
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, https://www.tandfonline.com/doi/full/10.1080/02791072.2019.1587556
3. Ketamine for Depression and Mood Disorders by Erica Zelfand, ND for Townsend Letter, https://www.townsendletter.com/article/438-ketamine-for-depression-and-mood-disorders/
4. Ketamine-Facilitated Psychotherapy for Trauma, Anxiety, and Depression by goop, https://goop.com/wellness/health/ketamine-facilitated-psychotherapy/
5. Ketamine Assisted Psychotherapy with Jonathan Sabbagh of Journey Clinical - Psychology Talk Podcast, https://youtu.be/llK3NYRCeVM?si=6hPKMUhWmRqxU0mv