Ketamine Assisted Therapy (KAP)
Deep trauma work, with the defenses turned down.
Some things are hard to reach. Not because you're not trying, but because the parts of you that protect you are very good at their jobs. For some clients, ketamine can turn the volume down on those defenses, opening the door to insight and processing that's otherwise hard to access. Pair that opening with real therapy, before, during, and after, and you have ketamine-assisted psychotherapy.
At Room to Breathe, KAP happens inside a therapy intensive, not as a standalone drug experience. The medicine opens the door. The therapy is what walks through it.
How the Therapist and Prescriber roles work
I've partnered with Journey Clinical, a specialized medical practice, so that the medical and therapeutic sides of KAP each belong to the people trained for them.
Journey Clinical handles everything medical: the evaluation to determine whether ketamine is appropriate and safe for you, the prescription, the medication itself, and the dosing plan. You become a patient of their practice for the medical piece, and you pay them directly for the evaluation and medication.
I handle the therapy: preparation beforehand, support during the medicine session, and the integration work afterward, where the change actually takes hold. I'm a Licensed Professional Counselor trained in EMDR, Certified in Brainspotting, and experienced in Parts Work, and all of that comes with me into KAP sessions.
The medication comes in lozenge form, and you self-administer it during our session.
What a medicine session is like
Three hours in my office, start to finish. The medicine sets that timeline, not me; it can't be shortened, and it doesn't happen twice in a day.
We start by settling in and naming what you're bringing. Then you take your lozenge and hold it for about fifteen minutes. The effects build from there, sit deepest for roughly forty-five minutes to an hour, then ease back down. We leave time at the end to touch what came up before you head home.
You'll be reclined and comfortable, with an eye mask and music if that helps you, and without if it doesn't.
Usually more than one
A single medicine session isn't the treatment. It's the first one or two of a course.
Journey Clinical typically prescribes enough for one or two sessions to begin with, so they can see how you respond. A full course tends to run six to eight, sometimes more. The sessions build on each other; each one opens a little further, and the integration between them is where that opening gets consolidated.
How close together your sessions can safely happen is a medical question, so it belongs to your prescriber. Worth asking them early if you're thinking about traveling in for several days.
None of this means committing to eight sessions today. It means we plan your course together, with your prescriber, so you know roughly what you're stepping into and what it costs. It also means you're never left holding medicine with nowhere to take it.
Two dosing options
Which one fits is decided together with your Journey Clinical prescriber, you, and me.
Psycholytic dosing is a lower dose that softens defenses while you stay present and connected. We can talk and do therapy during the experience itself, which works especially well with EMDR and Brainspotting. The work happens between us.
Deeper dosing is a fuller inward journey. The experience does more of its work internally, and my job is to hold the space and stay available while it does. The therapy happens in the preparation before and the integration after.
Neither is better. They're different doors into the same work.
What tends to come up
Time stretches. Senses blend. Feelings and memories surface without being summoned, and some of what arrives is beautiful, some strange, some genuinely hard. Difficult material showing up isn't a sign that something has gone wrong; it's often exactly why we're here.
I'm with you the whole time.
Getting home
Ketamine keeps working after our session ends, and one of the things it works on is your sense of how you're doing. You may feel clearer than you actually are. That isn't a failure of attention or willpower, it's just what the medicine does, and it's the reason this particular decision isn't left to you in the moment.
So someone you know and trust brings you here and takes you home. Not a rideshare, not a cab, not someone you met that morning. They're welcome to leave and come back; they just need to be reachable the whole time and able to return when I say you're ready. You'll give me a backup name as well, for the days that don't go to plan.
You won't drive again until the next morning, after a full night's sleep.
If you're traveling in, bring someone with you. A partner, a friend, a family member who's up for a few days away. If that genuinely isn't possible, tell me at the consultation. The driver isn't the part we negotiate, but how you get one here is something we can usually solve together, and it's better solved before you book anything than after.
Integration
Scheduled the next day or soon after, and included in every package. This is where an interesting experience becomes a durable change, and it's the part people are most tempted to skip once they're already feeling better. It's also the part that makes the rest of it hold.
Common questions
Is this legal?
Yes. Ketamine is FDA approved as an anesthetic, and licensed prescribers can prescribe it off label for mental health, which is legal and increasingly common. The research is promising rather than settled, and Journey Clinical will go through all of that with you. The medical piece stays entirely with the prescriber; the therapy stays with me.
Who is KAP for?
People doing deep trauma work who are medically appropriate for ketamine and emotionally ready for an intensive. Journey Clinical makes the medical determination; you and I make the readiness determination together. It's an option, never a default, and never a requirement.
How many sessions?
Usually more than one, and that's worth knowing at the start rather than partway through.
Journey Clinical typically prescribes enough for one or two sessions to begin with, so they can see how you respond. A full course tends to run six to eight, sometimes more. The sessions build on each other; each one opens a little further, and the integration between them is where that opening gets consolidated.
How close together your sessions can safely happen is a medical question, so it belongs to your prescriber. Worth asking them early if you're thinking about traveling in for several days.
None of this means committing to eight sessions today. It means we plan your course together, with your prescriber, so you know roughly what you're stepping into and what it costs. It also means you're never left holding medicine with nowhere to take it.
Is it in person?
Yes. Ketamine-assisted work is in person only, at my office in Henrico, VA, minutes from Richmond.
Clients can travel from around Virginia and beyond, and the format is built for it. A medicine session takes about three hours and has a day to itself; if you're doing more than one, they're spaced out with integration in between. Your prescriber will tell you how much room those sessions need, which is the thing to sort out before you book travel.
What does it cost?
You’ll receive 2 bills from 2 separate practices. The intensive pricing on my Services page covers the therapy: preparation, the medicine session, and integration. I don't accept insurance and I don't provide superbills, so this portion is paid directly and can't be submitted for reimbursement. HSA and FSA cards work.
Journey Clinical bills you separately for their side. Some clients get partial reimbursement for Journey's consultations through out-of-network benefits. That's between you, them, and your plan, so ask both before you count on it.
You'll receive a Good Faith Estimate from me covering my portion before we begin.
The first step is a free 15-minute consultation, no ketamine decision required. We'll figure out together whether an intensive fits, and which kind.
Finally, come up for air.