Yes, when administered in a controlled, clinical setting by trained professionals, ketamine is considered safe. It has a long history of medical use and is FDA-approved for anesthesia. Its use in mental health is carefully monitored and tailored to each client’s needs.

Ketamine can produce altered states of consciousness, but most clients remain aware and able to engage with their therapist. The experience is often described as introspective, calming, or emotionally insightful. Hallucinations are rare and typically mild when ketamine is used at therapeutic doses.

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 subside, 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 happens during the experience, patients feel like the insights gained are clear.

Please review the following qualifications that must be met in order for someone to be eligible for KAP:

• Is 18+ years old

• Lives in a state where Journey Clinical operates

• Has a therapeutic alliance with one of our member-psychotherapists

• Meets an eligible diagnosis such as depression, trauma, or anxiety

• Cannot have unstable medical conditions or unstable substance use disorders
  

However, eligibility is officially determined during the Intake consultation with a member of the Journey Clinical Medical Team when your medical history is fully reviewed.Item description

Ketamine can be administered in various ways, including through an IV, nasal spray, or intramuscular injection. At Positive Balance Counseling, we only use the sublingual rapidly dissolving tablet (RDT) form. The ketamine tablets are held under the tongue and dissolve almost immediately.

Unlike some other routes which must take place in a clinical setting, sublingual lozenges are safe to administer in an office or home environment. Item description

The following is an overview of the KAP process, including the different types of appointments patients will have.

1. Initial Medical Intake Evaluation (with your Journey Clinical Medical Team Member):

• You'll start by meeting with a member of the Journey Clinical medical team for a 1-hour appointment via a Zoom (video) call to determine KAP eligibility.

• To schedule this appointment, simply log in to your Patient Portal.

• If eligible, you'll be prescribed enough ketamine for the first two dosing sessions of your 6-8 dose course of treatment. You will come back for a short follow-up check-in appointment within 30 days of your initial medical appointment to make any adjustments to your dosing and to complete your treatment. Read more about that here.

2. Preparation Session (with your Journey Clinical Member Therapist):

• During this therapy session, you'll set goals and intentions for KAP. You may have 1-3 preparation sessions, which will take place in the week(s) leading up to your first dosing session. 

• Preparation sessions typically last 50 minutes or 1 hour and can occur in-person or via video call.

3. KAP Dosing Session (with your Journey Clinical Member Therapist):

• You'll meet with your therapist either in their office (if doing in-person KAP) or via video call (if doing remote KAP). You’ll check your vital signs and if they're within safe parameters, you may self-administer the sublingual ketamine lozenges.

• You'll be in a comfortable position in a quiet space. Many patients will use an eye cover and listen to peaceful music. 

• Dosing sessions last 2-3 hours, though the effects of ketamine will last approximately 45 minutes.

• At the end of the session, you will check your vitals again and report them to your therapist.

• You'll have two dosing sessions before your follow-up medical appointment. 

4. Integration Session (with your Journey Clinical Member Therapist):

• During this therapy session, you’ll work with your therapist to discuss your ketamine experience and any shifts in perspective, deepening your therapy work. This is sometimes done immediately after a KAP session, but is typically scheduled in the week following your dosing session.

• At least one integration session must occur between all dosing sessions. 

• Integration sessions typically last 50 minutes or 1 hour and can occur in-person or via video call.

5. Follow-up Medical Appointment (with your Journey Clinical Medical Team Member):

• Within 30 days of your initial intake appointment, you’ll meet with your Journey Clinical prescriber again for a 30-minute appointment via a Zoom (video) call. The prescriber will ask about your experience and can make any adjustments to your treatment plan.

• If eligible, you'll be prescribed enough ketamine for up to 6 additional dosing sessions. 

• See additional details about the follow-up appointment here. 

• To review or reschedule your follow-up appointment, simply log in to your Patient Portal. 

6. Additional KAP Dosing Sessions and Integration Sessions (with your Journey Clinical Member Therapist):

• After your follow-up medical appointment, you'll have 4-6 additional dosing sessions and integration sessions.

Medical Intake Appointment (with Journey Clinical Medical Team): Please ensure that you have stable internet connection and a computer or phone that has a camera on for the call. Please be prepared with a list of all current medications and dosages that you're taking, including vitamins and supplements.
Sensitive information will be discussed during the consultation and important education will be provided, so please ensure you're in a private environment, without any distractions. We do not condone driving during any appointment calls, and ask that you avoid public places. If there are interruptions or distractions, your appointment may be canceled due to the importance of obtaining full, accurate information from you and providing thorough education for your safety.
Please only schedule an intake if you plan to partake in KAP within 1 month of the appointment. Prescriptions do expire, and controlled substances should not be held for long periods of time. We're happy to meet with you soon!

Preparation and Dosing Sessions (with Positive Balance Counseling):

You will receive individualized instructions during your intake session with a Journey Clinical Prescriber if you qualify for KAP. You will hold a preparation session with your therapist to talk about the importance of setting intentions before your session.
A few practical setting elements to prepare ahead of time for your dosing session include:
- A cup to spit the medicine
- A refreshing beverage and healthy snack for the end of the session
- A private and quiet space with minimal external stimuli
- A comfortable place to lie down
- A notebook and pen
- An easily-accessible bathroom
- A face towel
- A bag or bucket in case of nausea Remember to bring your ketamine and a blood pressure cuff with you to each dosing session. Please ensure you have pre-arranged safe transportation home and avoid operating any machinery, vehicles, or bicycles after your KAP session for the remainder of the day. After 24 hours, all acute effects of ketamine should be resolved.
It's also recommended to print out the follow up email from your consultation with your Journey Prescriber so you have the medication instructions and vital parameters readily available on the day of your KAP session.

Integration Sessions (With Positive Balance Counseling Therapist): After each dosing session, you will schedule a talk therapy session with your therapist to debrief the experience and utilize the benefits of ketamine to work toward your treatment goals. If you used a notebook during or after your dosing session, you can bring your notebook to integration sessions. 

• Patients can expect to do a minimum of 6-8 dosing sessions. Within 30 days of your initial intake appointment, your Journey Clinical Medical Provider will conduct a medical follow-up to assess your response to treatment, ensure appropriate dosing, and address any concerns. Completing the full 6-8 session course allows sufficient time to engage in the therapeutic process and experience the full benefits of treatment.

How frequently will I have my dosing sessions?

• A typical Ketamine-Assisted Psychotherapy (KAP) protocol involves dosing sessions every two weeks, with integration therapy sessions in between to process insights and reinforce therapeutic progress. However, dosing frequency is individualized and could be up to 2 KAP sessions per week depending on severity of symptoms. This will be determined collaboratively with your Journey Clinical Medical Provider and psychotherapist based on your clinical response, treatment goals, and overall mental health needs.

What is the science behind doing 6-8 dosing sessions?

• The 6-8 session model is supported by clinical research demonstrating that serial ketamine treatments provide more sustained symptom relief than single-dose interventions. Studies indicate that repeated dosing protocols lead to greater reductions in symptoms of depression, anxiety, and PTSD compared to a single administration. For example, research comparing single, repeated (6-session), and maintenance dosing schedules has shown that a structured series of sessions results in longer-lasting improvements in mood and overall well-being.

What are typical treatment outcomes?

• Clinical data from Journey Clinical indicate that 87% of KAP patients experience improvement in depression and anxiety symptoms following completion of 6-8 dosing sessions. To optimize therapeutic outcomes, completing the full treatment course at a consistent interval is strongly recommended.

Do patients ever continue KAP beyond 6-8 dosing sessions?

• Yes. After completing an initial 6-8 session treatment course, some patients transition to maintenance KAP, with dosing intervals typically ranging based on symptom stability. Maintenance KAP is highly personalized, and your Journey Clinical Medical Provider and therapist will collaborate with you to determine the best approach for your long-term care.

What else should I know about KAP dosing session frequency?

• The frequency of ketamine dosing sessions is tailored to each individual and depends on factors such as:

  • Symptom severity and clinical history

  • Availability of your therapist for both dosing and integration sessions

  • Medical guidance from your Journey Clinical Medical Provider

• Your treatment plan will be designed to support both immediate symptom relief and long-term mental health benefits, ensuring a personalized and evidence-based approach to care 

PREMERA BLUE CROSS BLUE SHIELD

COMMUNITY HEALTH PLAN OF WASHINGTON

ENTHEA

MOLINA

WELLPOINTE (AMERIGROUP)

COORDINATED CARE

Insurance will cover the preparation sessions & the integration sessions. The dosing session which is two to three hours is cash pay.

MEDICATION COST IS DETERMINED BY JOURNEY CLINICAL. PLEASE FEEL FREE TO ASK QUESTIONS DURING THE CONSULTATIO ABOUT YOUR KETAMINE MEDICATION.