Ketamine Assisted Psychotherapy (KAP)
At Be Balanced Counseling, we provide low dose KAP in the office. This type of therapy allows us to use low levels of the medicine, ketamine, to assist in the healing process. This is a coordinated effort between the client, Amy Burnside, the therapist, an Elizabeth Shrader, the nurse practitioner. In this approach the client and therapist are doing therapy together, while using the low dose medicine as a tool. The most common therapy that Amy uses in this treatment is called IFS therapy (Internal Family Systems, created by Dick Schwartz. Amy has advanced training in this modality and has achieved one of the highest levels, which is certification.
Additionally, if you prefer to participate in a higher dose ketamine session at a ketamine clinic, (IV, Intramuscular, or Intranasal), Amy Burnside can assist you with preparation and integration sessions which are done before the first session and 24-72 hours after your higher dose session. These sessions are done at Be Balanced Counseling via in person or tele-health option. Proper preparation (set (mindset) and setting) and integration are vital components to getting the most out of your ketamine experience. Amy will help you to create your intention for your sessions and help you process or integrate the learnings that happening during your ketamine session.
Why consider ketamine?
Ketamine is an alternative medicine for depression and anxiety. It does not carry the same side effect profile as more traditional antidepressants - serotonin selective reuptake inhibitors, or SSRIs. For people who’ve had difficulties with SSRIs, ketamine may be a better option. It works faster than traditional antidepressants, and the neuroplasticity (brain flexibility) effects are strong, meaning the results are deeper than surface-level symptom relief. It is well known to produce new connections in the brain, taking advantage of the neuroplasticity effect. Additionally, the use of ketamine, in combination with quality therapy, such as Internal Family Systems therapy (IFS) or EMDR, can help clients uncover and heal the root cause of symptoms, behavioral patterns, emotional reactivity, addictive behaviors, relationship challenges, self-esteem issues, and loss of sense of self with more ease and more quickly.
Why low dose (psycholytic) ketamine? (What we use in our practice)
You may have heard of ketamine in the context of psychedelics. At higher doses, it can work as a psychedelic. However, our dosing is different from psychedelic dosing and carries substantial and different benefits. The doses we prescribe are psycholytic. This means that it produces an immediate state of calm and ease, and a sense of mental spaciousness. Ketamine is in the “dissociative” class of medication, which means that people can experience their difficult emotions with a sense of psychological space and without a sense of being overwhelmed. Since the client is more open and calm, it can be easier for them to open up and get to the internal spaces that need the attending and healing.
How does ketamine work in the brain?
Ketamine’s effects in the brain are complex and research is continuing all the time. Some of the most well-known mechanisms involve the neurotransmitters Glutamate and GABA. There are many different kinds of neurotransmitters (chemical messengers) in the human brain, but Glutamate and GABA are the most common ones because they are the top excitatory (promoting neurons firing) and inhibitory (blocking neurons firing) neurotransmitters, respectively. Ketamine is an antagonist (meaning, it blocks) a neurotransmitter receptor called NMDA, which is found on both GABA and Glutamate neurons. It’s thought to block the GABA receptors more effectively, meaning that GABA doesn’t inhibit neurons firing as often if ketamine is taken. This leads to an overall increase in neural activity in the prefrontal cortex. Ketamine is also known to interact with another neurotransmitter receptor - AMPA, which may be responsible for a sequence of molecular events that include proteins that promote neuroplasticity through new connections (proteins like Brain-Derived Neurotropic Factor, or BDNF as well as others like mTor, eEF2, and GSK-3). We are not scientists or medical providers at Be Balanced Counseling. For additional information regarding the science please discuss with a medical provider trained in the therapeutic benefits of ketamine, as always, we encourgage you to be an informed consumer and do your own research as well.
Source: Joyous - The Science Behind Our Treatment
How we work together at Be Balanced Counseling
In order to be considered as a candidate for KAP, we require that each client be evaluated by our partner psychiatric nurse practitioner, Dr. Elizabeth Shrader DNP. During your evaluation, Dr. Shrader will evaluate if you are a good candidate and medically cleared to participate in KAP sessions at Be Balanced Counseling. This includes reviewing your health history and medication and supplements. Once cleared then Amy Burnside, LCSW our KAP trained psychotherapist, will meet with the client to review the client’s intentions for the ketamine experience as well as prepare the client by reviewing the Set and Setting for the KAP experience. Elizabeth and Amy will work collaboratively as your prescriber and therapist to ensure safety and effectiveness of your experience.
KAP Session Fee lead by Amy Burnside, LCSW: $200 for 60 minutes; $300 for 90 minutes
KAP Psychiatric Intake Evaluation by Dr. Elizabeth Shrader, DNP - prices and insurance vary
KAP preparation session with Amy Burnside, LCSW: $175 for 60 minutes
Additional Integration sessions beyond the KAP session, as needed: $175 for 50-60 minutes. This will vary whether you are doing psycholytic dose where we use the medicine while doing the therapy vs. doing integration session AFTER your higher dose medicine sessions with a medical provider.
Ketamine oral troches (medicine used in the psycholytic sessions): Cost varies based on client’s standard pharmacy insurance benefits. Most insurances cover the medication.
Articles and Videos
Ketamine & Depression: How it Works - Yale Medicine Explains (youtube.com)