Ketamine-Assisted Psychotherapy
At Elevated Wellness, we utilize ketamine as a transformative tool that supports the process of psychotherapy
Sometimes we understand our patterns but still cannot seem to change them.
We know that we feel anxious, disconnected, depressed, angry, traumatized, guarded, or overwhelmed. We may have even spent years talking about these concerns and learning tools to manage them. And yet, something deeper continues to feel out of reach.
Ketamine-Assisted Psychotherapy, commonly called KAP, combines psychotherapy with the carefully supervised use of ketamine. This innovative treatment is gaining recognition for its effectiveness in addressing various mental health conditions. The medicine may help temporarily soften familiar patterns of thinking and self-protection, creating space for new perspectives, emotional processing, and a different relationship with yourself.
At Elevated Wellness, ketamine is not offered as a quick fix or a stand-alone solution. It is one part of a thoughtful therapeutic process that includes preparation, a supported medicine session, and integration afterward. We believe this evidence-based model provides the best opportunity to create healing and change.
What Is Ketamine-Assisted Psychotherapy?
Ketamine-Assisted Psychotherapy combines two elements:
Ketamine, a prescription medication that can produce changes in perception, awareness, and emotional openness.
Psychotherapy, which provides the relationship, preparation, safety, and ongoing work needed to understand and apply what emerges.
During a ketamine experience, people sometimes find that their usual thoughts, defenses, or ways of making sense of themselves become less rigid. This can allow them to encounter emotions, memories, internal conflicts, or possibilities from a different perspective.
Psychotherapy helps you approach those new perspectives with care—and helps you decide what to carry back into your everyday life.
What is Ketamine?
Ketamine is a medication that has been safely used in medical settings for decades and is FDA-approved as an anesthetic.
In mental health care, licensed medical providers may prescribe ketamine “off-label.” Off-label prescribing means that a medication is being used for a purpose other than the specific use for which it was originally approved, which often happens when evidence emerges showing the medicine’s benefits in a different context. This is a common and legal medical practice when a qualified prescriber determines that the potential benefits are appropriate for a particular patient.
Elevated Wellness partners with Journey Clinical for the medical portion of treatment. Journey Clinical’s medical team evaluates each prospective patient, determines medical eligibility, prescribes the medication when appropriate, and remains available for medical follow-up.
If you are medically eligible, your Elevated Wellness therapist provides your care from there.
Meet Your Elevated Wellness KAP Team
Nicole Rettino, MSW, LCSW, LCADC, CCS
Nikki is a licensed clinical social worker, licensed clinical alcohol and drug counselor, and certified clinical supervisor. She is the founder and lead clinician at Elevated Wellness.
She brings over 20 years of experience helping people navigate trauma, substance use, emotional distress, and relationship challenges.
Nikki’s approach helps you reconnect with yourself, build resiliency, and find relief, with maybe a few unexpected laughs along the way.
She completed specialized training in Ketamine-Assisted Psychotherapy through Fluence and has extensive experience providing KAP to clients working through anxiety, trauma, relationship challenges, and other longstanding emotional patterns.
Paul Cohen, MSW, LSW, JD
Paul is a licensed social worker who completed specialized training in Ketamine-Assisted Psychotherapy through the SoundMind Institute in Philadelphia in 2024.
He has worked with a wide range of KAP clients since then, helping people navigate grief, trauma, anxiety, depression, emotional blockages, spiritual crises, and relationship challenges.
Paul’s approach integrates mindfulness, somatic awareness, and relational psychotherapy to help people slow down, listen inwardly, and work with what emerges.
Before becoming a therapist, he practiced as an attorney—an experience that informs his work with people who are accustomed to relying on insight, achievement, and intellect but want to connect more deeply with themselves and others.
How might KAP help you?
Many of us become caught in deeply established emotional and behavioral patterns.
We may repeatedly criticize ourselves, anticipate danger, disconnect from our bodies, avoid difficult emotions, or return to the same painful dynamics in our relationships. These patterns often developed for understandable reasons. Even when they are no longer helping us, they can be difficult to change through insight alone.
During a ketamine experience, some people report:
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- Greater distance from repetitive or self-critical thoughts
- Deep relaxation
- Increased access to emotions
- A softened sense of fear or defensiveness
- New perspectives on longstanding experiences
- A stronger sense of connection, compassion, or possibility
- Greater awareness of the body and internal experience
- Insights that previously felt intellectually understandable but not emotionally accessible
- An experience that feels spiritually significant
Every experience is different. Some sessions feel meaningful or emotionally powerful. Others are quiet, subtle, confusing, or primarily physical. A dramatic experience is not required for KAP to be useful.
The goal is not to chase a particular feeling or “breakthrough.” The goal is to approach whatever arises with curiosity, support, and respect.
The Elevated Wellness Approach
Our approach to KAP is grounded in psychotherapy.
We believe that the quality of the therapeutic relationship, the preparation before the session, and the integration afterward are at least as important as the medicine experience itself.
Your therapist will not attempt to force a particular experience or tell you what your experience means. Instead, we create a supportive environment in which you can turn inward while knowing that someone trained and trusted is present with you.
Throughout the process, we emphasize:
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- Emotional and physical safety
- Informed consent
- Collaboration with the medical team
- Respect for your pace and boundaries
- Trauma-informed care
- Mindfulness and body awareness
- Curiosity rather than interpretation
- Translating insight into meaningful change
KAP is something we do with you, not something that is done to you.
In comparison to medical-model clinics where you might be left alone during the medicine session, or Internet-based models where the only support is virtual, a KAP session at Elevated Wellness may look like this:
Getting Started – The 5 Steps of KAP at Elevated Wellness
1. An initial consultation
We begin with a conversation about what is bringing you to KAP.
You will have an opportunity to describe what you have been experiencing, what you have already tried, and what you hope might change. We will discuss the KAP process, answer your questions, and consider whether this approach appears consistent with your therapeutic needs.
A consultation does not commit you to treatment.
2. Medical Evaluation
If you and your Elevated Wellness therapist decide to continue, you will be referred to Journey Clinical for a medical and psychiatric evaluation.
Journey Clinical’s prescribing team will review your health history, current medications, mental health history, possible contraindications, and the potential risks and benefits of ketamine. The decision to prescribe ketamine belongs solely to the medical provider.
When appropriate, the medical team may request additional information or clearance from another health care provider.
If you are medically eligible, Journey Clinical will prescribe your medication and provide instructions for its use. You’ll then work with your Elevated Wellness therapist.
3. Preparation
Before your first dosing session, you and your therapist will meet for preparation sessions.
Preparation may include:
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- Clarifying your hopes and intentions
- Discussing fears or expectations
- Learning what you may experience during the session
- Identifying ways to communicate your needs
- Practicing grounding and regulation skills
- Exploring your relationship with control, uncertainty, and vulnerability
- Creating a plan for transportation and aftercare
- Reviewing consent, boundaries, and practical instructions
An intention is different from an expectation. It may provide a gentle direction for the work, but we do not attempt to control what the experience becomes.
4. The Dosing Session
During the dosing session, you will self-administer the medication prescribed to you by Journey Clinical according to the medical team’s instructions.
You may be invited to recline, wear an eye mask, listen to music, and allow your attention to turn inward. Your therapist will remain present to provide grounding, reassurance, and therapeutic support.
Some people want to speak during the experience. Others want quiet. Some want reassurance or help reconnecting with their body. Others prefer minimal interaction.
There is no single correct way to experience a KAP session.
You will remain at the office until the acute effects have sufficiently subsided and your therapist determines that the session can safely conclude. You will need to arrange transportation and must follow all post-session instructions provided by the medical team.
5. Integration
Integration is the therapeutic work of making sense of the experience and bringing it into your life.
A ketamine session may offer an insight, image, emotional release, bodily experience, or new point of view. But an experience does not automatically become lasting change.
During integration, we may explore:
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- What felt important or emotionally alive
- Images, memories, sensations, or themes that emerged
- Parts of the experience that felt confusing or uncomfortable
- Connections to your history and present life
- Changes you want to make
- New ways of relating to yourself or others
- Practices that can help you continue the work
Integration is a process of listening carefully, making intentional changes, and allowing meaning to develop over time.
What might a KAP session feel like?
Ketamine affects each person differently, and individual experiences can vary from session to session.
Possible experiences include:
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- Deep relaxation
- A sense of lightness or heaviness
- Changes in the perception of time
- Feeling more distant from the body
- Visual imagery, colors, or dreamlike experiences
- A sense of observing thoughts rather than being caught inside them
- Emotional openness
- Feelings of connection, peace, grief, fear, love, or uncertainty
- Temporary difficulty speaking or organizing thoughts
- Nausea, dizziness, or physical discomfort
You may experience something that feels profound. You may also have a session that feels subtle or difficult to understand. Your therapist will be present throughout the dosing session to support you through whatever arises.
What can KAP be used to address?
KAP may be considered as part of treatment for adults experiencing concerns such as:
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- Depression or persistent low mood
- Anxiety
- Trauma-related symptoms
- Post-traumatic stress
- Emotional disconnection
- Shame and chronic self-criticism
- Longstanding patterns that have been difficult to shift
- Difficult life transitions
- Grief and loss
- Feeling stuck despite previous therapeutic work
The evidence supporting different applications of ketamine continues to develop. KAP is not a guaranteed treatment or cure, and eligibility is determined individually.
Your therapist and the Journey Clinical medical team will help you consider the potential benefits, limitations, and risks in relation to your particular needs.
Is KAP Right for Everyone?
No. Ketamine-Assisted Psychotherapy is not appropriate for every person or every stage of treatment.
Medical or psychiatric factors that may affect eligibility can include:
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- Certain cardiovascular conditions
- Uncontrolled high blood pressure
- Certain respiratory, eye, liver, or bladder conditions
- Pregnancy
- Ketamine allergy or sensitivity
- A history of a primary psychotic disorder
- Acute mania
- Severe psychiatric instability
- Active or uncontrolled substance use
- A history of problematic ketamine use
- Certain medication interactions
This is not a complete list. Medical eligibility can only be determined by the Journey Clinical prescribing team after evaluating your individual history.
Even when someone is medically eligible, your Elevated Wellness therapist may recommend additional stabilization, preparation, or conventional psychotherapy before beginning KAP.
Your safety always takes priority over moving quickly.
How is this different from a ketamine clinic?
Ketamine can be administered through several different medical models.
Some clinics primarily offer intravenous ketamine infusions, with limited psychotherapy before, during, or after the medication. Other services prescribe ketamine for people to take at home with relatively little direct therapeutic support.
Elevated Wellness offers a psychotherapy-centered model.
The ketamine experience takes place within an ongoing therapeutic relationship and is surrounded by preparation and integration. Your therapist helps you understand what you are seeking, remains present during the dosing session, and supports you in translating the experience into your relationships, choices, and daily life.
We are not simply trying to create a temporary change in how you feel. We are interested in how the experience can support the work you are already doing to create lasting change in your life.
Other FAQs:
Is Ketamine-Assisted Psychotherapy legal?
Ketamine is an FDA-approved prescription medication that may be legally prescribed. In our collaborative-care model, ketamine is prescribed only after a licensed Journey Clinical medical provider evaluates you and determines that it is medically appropriate.
Who prescribes the ketamine?
The medical team at Journey Clinical evaluates eligibility and, when appropriate, prescribes the medication. Elevated Wellness does not prescribe or dispense ketamine.
What form of ketamine is used?
Journey Clinical typically prescribes a sublingual ketamine lozenge. Your medical provider will determine the medication, dosage, and instructions appropriate for you.
Will my therapist be present?
Yes. Your Elevated Wellness therapist will remain available for any support you may need throughout your dosing session.
Will I lose control?
Ketamine can temporarily change your perception, sense of time, and experience of your body. Many people remain aware that they are in the room and participating in a therapeutic session, although communication and movement may feel different. Your therapist will remain present throughout the session to ensure your safety, comfort, and support.
Preparation includes discussing concerns about control and developing ways for you to ask for support.
Do I have to talk during the ketamine session?
No. Some people speak throughout portions of the session, while others remain mostly quiet. Your therapist will follow your needs rather than requiring you to process verbally while the medicine is active.
How many sessions will I need?
There is no universal number. Your treatment plan will depend on your goals, response to the medicine, medical guidance, and the clinical judgment you and your therapist develop together.
After each session, we will consider what was helpful and whether another dosing session is appropriate.
Do I need to be in therapy?
Yes. KAP at Elevated Wellness is provided within a psychotherapy relationship. Preparation and integration are essential parts of our approach.
If you already work with another therapist, we can discuss whether coordination between providers would be helpful and appropriate.
Can I drive myself home after?
No. You will need to arrange safe transportation after a dosing session and follow the medical team’s instructions about driving, work, alcohol, medications, and other activities.
Is KAP covered by insurance?
Elevated Wellness is an out-of-network psychotherapy practice and can provide documentation that you may submit for possible reimbursement, depending on your insurance benefits.
Journey Clinical’s medical services are billed separately. Some medical expenses may be eligible for insurance coverage or reimbursement. Journey Clinical can provide current information about its fees and coverage policies.
What if I have a difficult experience or “bad trip”?
Not every ketamine experience is peaceful or comfortable. Fear, grief, physical discomfort, difficult memories, or uncertainty can arise.
Your therapist will help you prepare for these possibilities, remain present during the session, and support you in processing what occurred afterward. A challenging experience is not necessarily a harmful or unsuccessful experience. In fact, challenging experiences often provide important insights that can help us make change, especially if there is careful support and integration of the experience.
Let’s begin with a conversation…
You do not need to know whether ketamine is right for you before reaching out.
The first step is simply a conversation about where you are, what you have tried, and what you are hoping might become possible.
We will answer your questions honestly, discuss the potential benefits and limitations of KAP, and help you determine an appropriate next step. Fill out the form below, or give us a call, and we’ll get back to you soon.