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Traditional antidepressants work on the monoamine neurotransmitters, mostly serotonin, norepinephrine, and dopamine. Ketamine works in a completely different way and helps reset the GABA and glutamate system of neurotransmitters. These receptors are closely linked to mood, anxiety, learning, and memory. This is why some patients may have failed over a dozen different oral antidepressant medications, but still have a great response to ketamine infusions.

KAP stands for ketamine-assisted psychotherapy and refers to a patient receiving both ketamine medicine and concurrent therapy treatment as a catalyst for psychological healing and growth. This allows you to change thought and behavior patterns, gain perspective, process difficult experiences and emotions, and feel better overall. The KAP experience is one of relaxation – feeling relaxed in your body and mind. In the KAP session, your mindset and defense systems soften, which allows you to explore new ways of thinking and feeling and gives you the ability to explore, process, and discuss difficult topics. You will also have the opportunity to experience the reduction of anxiety and depression within your session as these feelings are replaced with those of calm and relaxation, and sometimes love.

There are many different styles of KAPas different practitioners offer the therapy component at different times (before ketamine treatment, during, immediately after, and in the days following). In our offices we provide the therapy component before by way of preparation sessions where we guide and support you in learning how to get the most out of your medicine sessions, during by way of KAP sessions, and immediately after via time following your medicine experience to integrate the session content as we have seen that this provides the most substantial and lasting change.

One of the many benefits of KAP is that your therapist will not only help you within your session – to feel safe, to explore what you want to explore – but will also help you to understand and integrate the insights, thoughts, and feelings that arise from your session into your day-to-day life, which will ensure the benefits of your ketamine session will live on after your session ends and impact your daily life for the better. KAP can lead to significant growth, change, and shifts in mood and overall well being. You may have done therapy before, but you’ve never done therapy quite like this!

Ketamine can be administered in several different routes of administration including oral, intranasal (IN), intramuscular (IM), and intravenous (IV).

For oral ketamine you typically place a lozenge under your tongue and hold your saliva in your mouth for 10 or 15 minutes before spitting it out. This method is often used by therapists who collaborate with a treating prescriber, but said prescriber does not work with them in their office and they may not have a working relationship other than connecting you to said provider for your ketamine prescription. Often when you receive ketamine treatment via the oral route you are not being monitored during your ketamine experience by your medical professional. Prescribers who utilize this route of administration are often either new practitioners or providers without the medical knowledge to perform infusions. Some drawbacks are the very bitter taste, the fact that you cannot talk for 10-15 minutes due to a mouthful of saliva, and the fact that each experience will differ depending on how much medicine is actually absorbed. This approach provides some mild ketamine effects and can help with mild cases of depression or for a client who may feel stuck in their current therapy process.

Intranasal (IN) involves you spraying ketamine into your nose. This will differ each experience depending on how much medication is actually absorbed in your nasal mucosa. The effects come on more rapidly, meaning you will feel the medicine come on fast, and then they just as quickly end. Spravato is an FDA approved form of IN ketamine, but is not the racemic ketamine you will receive otherwise. The benefit to Spravato is that it may be covered by your insurance. Drawbacks include that there is typically no therapy offered with Spravato, or IN Ketamine in general, and for Spravato you will need to be monitored in the office following your treatment for no less than two hours so the appointment time commitment is hefty.

Intramuscular (IM) involves your provider injecting you with Ketamine from a needle in the back of your upper arm. This method provides a rapid effect, but it is more sustained than IN. The biggest drawback to the intramuscular route is that once it’s in, it’s in -there is no pausing or adjusting the dose and your experience will last anywhere from 40 minutes to an hour, so you are committed to riding the ketamine journey to it’s end.

At Rooted Revival we utilize the intravenous (IV) route of administering ketamine so you will receive ketamine infusions when you choose to work with us. This method of administration not only allows for you to receive 100% of the medication dose, but provides a slow, soft onset of the medicine and allows us the ability to stop, pause, or adjust the dose at any time, thus putting you in full control of your experience at all times. Because we can adjust the dose we can ensure you receive a strong, robust effect from the medicine – one where you achieve your treatment goals, but the dose remains at a level that is not anxiety-producing, scary, or“too much,” while on the flip side isn’t so mild you don’t get much out of it.

As mentioned previously, because we offer therapy during your infusion (as well as immediately following) we adjust your dose each session to reach the perfect amount that will allow you to feel ketamine’s psychedelic effects while still being able to talk to your therapist. This technique was developed and perfected by Dr. Sullivan of Initia Nova and Rena Beyer of Fostering Greatness and Rooted Revival starting back in 2017 and has proven to be profoundly beneficial for our clients. IV ketamine infusions provide the most robust antidepressant and anti-suicidal properties, pair great with therapy, and the effects wear off quicker than oral and IM (within about 5-10 minutes), with less side effects!

There are numerous things that set our office apart from other offices offering IV ketamine, and other routes of administration, and these differences are important to note when choosing your provider!

At Rooted Revival we partner with the doctors of Initia Nova to provide this treatment and therefore your therapist will have a working relationship with your doctor - they will actively and daily collaborate on your care. Furthermore, our doctors are on-site at all times and they will meet with you prior to every session and at the end of every session, collaborating with you and your therapist on your care. They are actively involved in your treatment at all times and they are invested in your progress. And, because they are always on-site, they are able to intervene at any time if needed either medically or to assess your dose in real time.

And, unlike other offices, your therapists are on-site, working with you during your session and immediately following it, and are available for integration as well. Your therapist is a part of your treatment team ensuring you are reaching your goals and your medicine dosage is correct for the work you are attempting to accomplish, actively discussing this with your doctor and collaborating with you and your doctor at every session!

At Rooted Revival we believe in offering therapy during your infusion - giving you the ability to actively process and explore what is coming up during your session with your therapist should you want to and choose to - which is typically not offered elsewhere. In other offices, if KAP is being offered during your time with the medicine, what you are usually being offered is a quiet time to introspect, sometimes with music playing, while a therapist is present holding space for you and only after your ketamine experience do you then get to process the session with your therapist. This is by no means “bad,” but you should have the option to choose when to talk and process and when to be introspective, which sometimes both happen within one session with us and it often varies from session to session - but it is always at your discretion and following what the ketamine journey is bringing up for you.

On the other hand, sometimes when offices are offering “KAP” what they are actually offering is a referral to a therapist outside their office who will integrate the ketamine session with you, but isn’t actually offering KAP during your medicine session at all. As you know by now, at Rooted Revival we offer both KAP sessions and integration sessions & we also offer to collaborate with your current therapist should you already be connected to one, to help them provide integration for you. It is unlikely you will find the kind of care we provide elsewhere and we are proud to be offering such a comprehensive treatment!

This is a nuanced answer because it can be different for everyone. For this reason it is best to work with an experienced doctor and therapist who can ensure your experience feels safe and allows you the ability to get the most out of your ketamine experience. Since we use an IV administration of ketamine in our office, you will experience the onset of the ketamine as a slow, soft onset. You can think of the medicine experience much like a bell curve where the medicine gently enters your system and you begin to feel some of the effects within 5-10 minutes, it reaches a peak after about 30 minutes, and then slowly leaves your system. Within 15-20 minutes of the ketamine IV finishing you will feel much like yourself again.

Some people report seeing shapes or colors. Some people report time feeling like it is moving slower or faster. Some people feel floaty. Most people report feeling more willing, able, and safe to discuss and process their thoughts and feelings.

It is normal to feel anxious before your first session, not knowing what to expect. Ketamine guides you into feeling relaxed. Your worries tend to float away or you may experience the feeling of caring about them less. Ketamine makes it much easier to discuss important or difficult topics, which is why combining therapy with ketamine is so useful. Many of our patients have reported being able to discuss traumatic events for the first time, or described KAP as being like 50 regular therapy sessions wrapped into one.

At the medicine’s ‘peak’ you may feel“weird” or “strange.” We embrace these feelings and in fact target our dosing to get you to that point – the point where you are experiencing the ketamine’s psychedelic properties, but are not in a fully psychedelic space.

The best part about doing KAP with IV infusions is the control and flexibility, we can always pause, slow down, or speed up an infusion if need be, which would either lessen, stop, or increase the ketamine’s experienced effects. Each session will be a little different as we adjust the dose and you explore further in your own mind. We will be there to guide you every step of the way!

At Rooted Revival, and Initia Nova, we recommend 3 preparation sessions - the first one being your psychological intake session - and 8 KAP sessions. Prior to beginning these 11 sessions, you will have an intake session with your doctor from Initia Nova.

Therefore, your treatment may look something like this:
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Week 1: Medical intake with your doctor from Initia Nova & Psychological intake with your therapist from Rooted Revival (“preparation session 1”)

Week 2: Preparation session 2

Week 3: Preparation session 3

Week 4: KAP sessions #1 & #2 (either on M/W in the NJ office or T/Th in the DE office)

Week 5: KAP sessions #3 & #4 (either on M/W in the NJ office or T/Th in the DE office)

Week 6: KAP sessions #5 & #6 (either on M/W in the NJ office or T/Th in the DE office)

Week 7: KAP session #7

Week 8: No sessions

Week 9: KAP session #8

This schedule of sessions is a template and can be adjusted based on your urgency to start treatment, your schedule, our schedule, and your treatment needs as we move through the treatment itself. One thing we do not change is having twice weekly KAP sessions for your first 6 sessions.

While most providers will recommend 6 KAP sessions to start (and then moving on to maintenance), some offering preparation sessions and some not, we recommend the 8 sessions to not only ensure you meet your treatment goals sufficiently before moving on to maintenance ketamine session, but to also ensure you have a gentle experience moving from having twice weekly sessions to having a break between sessions. Oftentimes at session 6 you are just starting to feel better and you are just starting to make lasting change in your day-to-day life that then having a break from sessions for four weeks(or more) would be detrimental to your progress.

And, we recommend the preparation sessions to ensure you know what to expect from your treatment, all of your questions are answered, you are educated on how to make the most out of your treatment during your sessions and in between them, and you are fully resourced for how to manage the change that will pretty rapidly occur for you, which is exciting and what you’re looking for, but can be overwhelming or anxiety provoking if you don’t have the resources prior to manage this.

Getting started is quite easy! First, you would begin with a consultation call with one of our collaborating doctors from Initia Nova to discuss the medical aspects of this treatment. Then, you may opt to have another consultation call with us at Rooted Revival to discuss the therapeutic aspects of this treatment.