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Ketamine-Assisted Psychotherapy

For many people, traditional talk therapy and standard psychiatric treatments don’t always bring the relief they desperately seek. Conditions like depression, post-traumatic stress, and deep-seated anxiety can feel resistant to conventional methods, leaving individuals searching for new paths forward. One innovative approach gaining recognition is Ketamine-Assisted Psychotherapy—a therapeutic process that combines the medically supervised use of ketamine with guided psychological support. By creating an expanded state of consciousness, this method allows people to explore difficult emotions, release old patterns, and access new perspectives that are often out of reach in ordinary awareness.

In this comprehensive guide, we’ll explore what this therapy entails, how it works, its benefits and risks, and why it is becoming a powerful option for those seeking lasting emotional healing. If you’d like to learn more about our work at the Oakland DBT Center, this guide is a good place to begin.

What Is Ketamine-Assisted Psychotherapy?

Ketamine-Assisted Psychotherapy (often referred to as KAP) is a structured therapeutic process that blends two essential components:

  • The administration of ketamine in a safe, controlled, and medically supervised setting.

  • The use of psychotherapy techniques before, during, and after the session to process the material that arises.

Unlike recreational use of ketamine, KAP is not about escape. Instead, it is a deliberate, guided process that allows individuals to step outside their usual thought loops and access deeper layers of consciousness. In this expanded state, clients often find it easier to revisit painful experiences, explore entrenched beliefs, and uncover new insights about themselves.

Why Ketamine? A Brief Background

Ketamine was originally developed in the 1960s as an anesthetic and has been widely used in medicine for decades due to its safety profile. Over the past two decades, researchers discovered that at lower, controlled doses, ketamine has rapid-acting antidepressant effects.

Unlike traditional antidepressants, which may take weeks to work, ketamine can bring relief within hours or days. This rapid onset is particularly important for people struggling with treatment-resistant depression, suicidal thoughts, or long-term trauma.

When paired with psychotherapy, ketamine doesn’t just provide temporary relief—it opens a window of neuroplasticity, giving the brain an enhanced capacity to form new pathways and integrate healthier patterns of thought and behavior.

The Core Phases of Ketamine-Assisted Psychotherapy

To understand how KAP works, it helps to break down the process into three essential stages: Preparation, the Expanded State Session, and Integration.

1. Preparation: Building Safety and Intention

Before ketamine is introduced, clients go through one or more preparation sessions with their therapist. These sessions focus on:

  • Reviewing medical and psychological history.

  • Setting therapeutic goals.

  • Learning what to expect from the altered state.

  • Establishing trust and emotional safety.

The preparation phase is crucial because it sets the stage for what will unfold. Clients who enter with a clear intention often find their sessions more meaningful and productive.

2. The Expanded State Session: Journeying Inward

During a ketamine session, clients typically take the medicine in a sublingual (under-the-tongue) or lozenge form, prescribed by a medical provider. The effects usually begin within 10–15 minutes, peak within 30–40 minutes, and gradually taper off after about 60–90 minutes.

The experience can vary from person to person, but common features include:

  • A sense of detachment from ordinary thought patterns.

  • Enhanced access to emotions and memories.

  • Shifts in perception of time, space, and self.

  • A feeling of connection to larger existential or spiritual dimensions.

In this state, the therapist provides a safe container, gently guiding the process when needed. Clients may wear eyeshades and listen to calming music to encourage inward focus.

3. Integration: Turning Insights Into Lasting Change

The expanded state is only the beginning. Once the immediate effects wear off, the true therapeutic work begins in integration sessions. Here, clients and therapists work together to:

  • Reflect on insights gained during the journey.

  • Identify new perspectives on old problems.

  • Explore how these insights can be applied to daily life.

  • Develop practical strategies to sustain positive change.

Integration helps transform the temporary altered state into long-term growth. Without it, the benefits may fade quickly. With it, clients can move from “altered states” to “altered traits.” Exploring structured support such as DBT skills classes can further strengthen this process by giving clients concrete tools to integrate change.

Conditions Ketamine-Assisted Psychotherapy Can Address

Research and clinical experience suggest that KAP may be beneficial for a range of mental health concerns, including:

  • Treatment-resistant depression: For people who haven’t found relief with medications or talk therapy.

  • Post-traumatic stress disorder (PTSD): Helping individuals revisit traumatic memories with greater resilience.

  • Obsessive-compulsive disorder (OCD): Supporting new patterns of thought and reducing compulsive behaviors.

  • Anxiety disorders: Easing persistent worry and fear.

  • Chronic pain: Addressing both the physical and emotional dimensions of long-standing pain.

  • End-of-life distress: Offering comfort, peace, and acceptance for those facing terminal illness.

While outcomes vary, many individuals report a sense of renewed hope, improved mood, and greater capacity for self-compassion. Families who want to better understand how to support their loved one may also benefit from specialized parents’ skills classes.

The Science Behind Ketamine’s Effects

Ketamine works differently than traditional antidepressants. Most psychiatric medications target serotonin, dopamine, or norepinephrine pathways. Ketamine, however, primarily affects the glutamate system, which plays a key role in brain plasticity and communication between neurons.

By increasing levels of brain-derived neurotrophic factor (BDNF), ketamine enhances the brain’s ability to form new connections. This “reset” effect creates a fertile ground for therapeutic work, allowing clients to break free from rigid patterns and develop healthier coping strategies.

Safety Considerations and Contraindications

While promising, KAP is not appropriate for everyone. It’s important to highlight both the benefits and limitations.

Potential side effects may include:

  • Nausea or dizziness.

  • Elevated blood pressure or heart rate.

  • Dissociation or a sense of detachment.

  • Temporary confusion or anxiety.

Contraindications include:

  • A history of psychosis or schizophrenia.

  • Uncontrolled cardiovascular conditions.

  • Certain substance use disorders.

This is why medical evaluation and clearance are essential before beginning treatment.

What to Expect in a Typical Treatment Plan

Every journey is unique, but many clients follow a general structure:

  • Preparation sessions: 1–3 meetings before the first ketamine experience.

  • KAP sessions: Each session lasts around 3 hours, with the therapist present throughout.

  • Integration sessions: Conducted 1–2 days after each KAP session to process insights.

  • Number of sessions: Some clients benefit from a handful of journeys, while others may continue for several months with periodic booster sessions.

Clear communication with both therapist and medical provider ensures the plan is tailored to each person’s needs. Young people navigating early adulthood may also benefit from supportive resources such as young adult classes, which focus on building resilience and emotional awareness.

Integration Tools for Everyday Life

To maximize the benefits of KAP, integration is key. Clients are encouraged to:

  • Journal immediately after sessions to capture fresh insights.

  • Engage in mindfulness practices such as meditation or breathwork.

  • Incorporate movement through yoga or gentle exercise.

  • Connect with supportive relationships that reinforce growth.

  • Work with creative outlets such as art, music, or writing.

Additional tools, such as programs offered through our services, can help clients build sustainable change beyond their individual therapy sessions.

How Ketamine-Assisted Psychotherapy Differs From Other Psychedelic Approaches

While ketamine is sometimes grouped with other psychedelic therapies, it has distinct features:

  • Legality and accessibility: Ketamine is FDA-approved as an anesthetic and may be prescribed off-label for mental health, making it more accessible than substances like psilocybin or MDMA.

  • Shorter duration: Sessions typically last a few hours, compared to longer psychedelic journeys.

  • Unique mechanism: Ketamine acts on glutamate pathways, whereas classic psychedelics primarily affect serotonin.

These differences make ketamine a valuable and pragmatic option in today’s therapeutic landscape.

Choosing the Right Therapist and Setting

The effectiveness of KAP depends heavily on the therapeutic relationship and environment. When seeking a provider, look for:

  • Licensed mental health professionals trained in working with altered states.

  • Collaboration with medical prescribers for safety.

  • A structured approach to preparation, journey, and integration.

  • An environment that feels safe, private, and supportive.

The combination of skillful guidance and a secure setting allows clients to fully engage in the process.

Conclusion

Ketamine-Assisted Psychotherapy represents a powerful blend of medical innovation and psychological care. By opening the mind to new possibilities and creating conditions for deep healing, it offers hope to those who have felt stuck in cycles of suffering. While not a quick fix or a one-size-fits-all solution, it provides a unique pathway for transformation when traditional approaches have fallen short.

If you or someone you love has been searching for new ways to approach emotional pain, trauma, or treatment-resistant depression, this therapy may offer a doorway to lasting change. With skilled guidance, careful preparation, and committed integration, the journey can lead not only to symptom relief but to a renewed sense of meaning, connection, and well-being. To keep learning, visit our blog for additional insights and resources.

Frequently Asked Questions

Ketamine alone may provide temporary symptom relief, but without therapeutic guidance, the insights often fade. In Ketamine-Assisted Psychotherapy, a trained therapist helps clients prepare, process, and integrate the experience, turning short-term effects into lasting emotional and behavioral change.

Many people experience rapid relief within hours or days, but lasting benefits depend on integration and ongoing therapeutic support. With proper preparation, follow-up sessions, and integration practices, clients often sustain improvements for weeks or months, with some requiring periodic booster sessions.

KAP is generally considered safe under medical supervision, but it is not appropriate for everyone. Individuals with uncontrolled cardiovascular conditions, active psychosis, or specific substance use concerns may not be eligible. A thorough medical and psychological assessment ensures treatment is both safe and effective.

Research shows KAP can support individuals struggling with treatment-resistant depression, PTSD, anxiety, OCD, chronic pain, and end-of-life distress. By enhancing neuroplasticity and increasing emotional flexibility, KAP creates opportunities to break old patterns and develop healthier coping strategies.

During a session, clients enter an expanded state of consciousness, often supported by music, eyeshades, and therapeutic guidance. Afterward, integration sessions help process insights, connect them to everyday life, and apply them in meaningful ways. This combination is what makes the therapy transformative.

GET IN TOUCH

If you are interested to learn more about Ketamine-Assisted Psychotherapy or to book a session, please contact us.
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Rajesh Jagannathan

Rajesh Jagannathan

Rajesh Jagannathan was born in India and earned a B.Tech in Computer Science from IIT, Madras. After spending a few youthful years in the Masters/Ph.D. program at the Ohio State University moved to the Bay Area for work. Since then he has stayed in the Bay Area and worked in tech for the better part of 20+ years. He has been with the center since its inception playing a key advisory role on tech related matters.

He enjoys living in the bay area with his family, exploring the outdoors in California and the world at large. While interests change over time some constants through the years have been travel, cooking, painting and board games. Lately all his spare time has been consumed by pickleball.

David Pepper

David Pepper, MD (Retired)

Dr. Pepper was born in San Francisco and attended UC Berkeley and then Medical and Graduate School in Iowa. Returning to California, he practiced and taught full spectrum Family Medicine with UCSF for 30+ years, working in Fresno, San Francisco and Contra Costa Counties. 1,000 births and 1,000 deaths one could say – with thousands of Families in between… in the ER, Hospital and Outpatient Clinics – always with a focus on Family and Community.
 
He has a long interest in Psychedelics and completed the CPTR program through CIIS in 2023. He is passionate about helping people think about how to craft their second half of life with meaning, including planning for a natural End of Life process that is not over medicalized.  He believes that a well planned End of Life allows people to live well.  More about his work can be found here.  
 
He brings his expertise in clinical assessment, and the tools that support this to working with the Team at Oakland DBT and Mindfulness Center to develop best practices for working with clients seeking expanded state treatment.  He collaborates with his wife who also works with clients in Expanded States.  He enjoys his 4 children, gardening, hiking, and community.
Rochelle

Rochelle Frank, PsyD

Rochelle Frank, PhD is a clinical psychologist in Oakland, CA with over 30 years of experience in both the public and private sectors. Dr. Frank earned her doctorate in clinical psychology at Syracuse University and completed her clinical training at Yale Psychiatric Institute. She specializes in evidence-based transdiagnostic treatment of  complex and co-occurring mood, anxiety, and trauma disorders in adults and adolescents, and related  problems in high-conflict couples and families. 

In addition to her private practice Dr.  Frank is an assistant clinical professor of psychology at the University of California, Berkeley, and also  holds faculty and supervisory appointments at The Wright Institute and the University of California San  Francisco School of Medicine.  She is co-author of The transdiagnostic road map to case formulation and  treatment planning: Practical guidance for clinical decision making (Frank & Davidson, 2014; New Harbinger),  a contributing author to S. G. Hofmann & S. C. Hayes (Eds.), Beyond the DSM (2020, New Harbinger), and  currently serves on the board of directors for the Institute for Better Health.

Dr. Frank has been involved with Oakland DBT and Mindfulness Center since 2012.  She has served as a clinical consultant and focuses on helping the Team bring a transdiagnostic process-based perspective to case formulation and treatment planning, as well as integrating methods from other third-wave cognitive behavioral therapies into the DBT model.  

In addition to enjoying time with her family, Dr.  Frank is an avid golfer, home chef, and a frequent beta-tester of her clinical skills while skiing and mountain biking.

Michael Stanger

Michael Stanger, MD

I am a board-certified psychiatrist practicing in California and Colorado across a range of settings – inpatient, outpatient, emergency and partial hospital, with current affiliations at Contra Costa Regional Medical Center and Boulder Community Health.

I have a particular interest in the therapeutic utility of ketamine to support psychotherapy. I began working with ketamine in 2016, initially in my California private practice where I administered oral and intramuscular doses. I have since continued to support therapist access and to develop understanding around the most effective use of these modality. In related work, I have mentored with the CIIS Center for Psychedelic Therapies and Research and taught sessions with the Polaris Insight Center on ketamine.

My background includes childhood immigration from South Africa to New York, working in the technology industry for several years and then traveling in an unscripted manner to arrive at the awareness that medicine, and ultimately psychiatry would be the path to be helpful to others in an applied way.

Chrysanthe

Chrysanthe Christodoulou

Operations Manager

Chrysanthe is our Operations Manager and one of our in-house Mindfulness Experts. She connects with new clients as they come into the Center, oversees day to day operations and runs special projects.  She is instrumental in supporting the Team by bringing joy, flow and ease.

Chrysanthe studied Meditation, Yoga, and Mindfulness with some of the most respected teachers of our time. She also holds a BS in Economics.  This combination of skills ensures our Center runs efficiently behind the scenes and lends wisdom to our budding Mindfulness Program.

Her local teaching career has spanned the Bay Area and beyond: overseas in Spain, Chile, Greece, and Amsterdam; and locally in San Francisco, Marin, Berkeley, Oakland, and Walnut Creek. Chrysanthe honors the magic in both movement and stillness, stirring energy and witnessing what emerges as everything settles into place. 

When Chrysanthe isn’t handling the business end of the Center or running mindfulness programming, you can find her exploring trails with her wolf pup, finding connection in community, and enjoying the sun and the sea.

Priya Jogia

Priya Jogia

Licensed Clinical Social Worker (LCSW)

​​Priya Jogia is a licensed clinical social worker (LCSW). Since 2013, she has worked in various clinical settings including: community mental health, hospital, and outpatient programs. Priya’s also spent time in Vietnam studying international social work and the relationship between culture, ethnicity, and mental health.

Priya is an active practitioner of mindfulness-based behavioral therapies including DBT and ACT, and has extensive training in CBT. As a DBT therapist, she’s seen the positive impact of using DBT skills in her own life, and is strongly committed to helping clients live meaningful lives that are aligned with their values.

Priya has an interest in perinatal mental health and working with BIPOC populations, and she strives to integrate a social and racial justice lens into her work. While being a therapist has brought a lot of meaning to Priya’s life, she tries not to take herself too seriously, and gets much joy from being a mum, being in nature, and cuddling with her dog.

Jay Indik

Jay Indik

Licensed Clinical Social Worker (LCSW)

Jay brings his compassion, creativity, and equanimity to support each person who seeks therapy.. He believes that what makes each person happy is connected to their deepest sense of what is important. Jay listens for how each client can idiosyncratically transform their suffering into a happier life. As a result of working with Jay folks’ learn to address unwanted behavior, regulate their emotions, recover from individual or cultural trauma, repair relationships, and organize their behavior consistent with their values Jay has intensive training and has practiced the following modalities for decades: DBT, Narrative Therapy, Somatic Experiencing, Sensory Modulation, Psychodynamic Treatment and Expressive Arts Therapies. Jay specializes in working with couples, parents, parent child dyads and young adults, as well as with individuals from mid-life through retirement. Jay’s experience as a theater director, parent, teacher, and executive combined with his knowledge of research validated treatments allows him to best relate and serve each individual.

Jay has two adult children (one daughter, one non-binary), a “Real Dads Love Trans kids” t-shirt, and one amazing grandchild he watches one day a week.

Ari Tavano

Ariana Tavano

Licensed Clinical Social Worker (LCSW)

Ari Tavano is a licensed clinical social worker (LCSW). She has worked in an array of clinical settings for over ten years, and utilizes the diversity of her experience to foster a therapeutic frame rooted in curiosity and empathic regard. She specializes in working with those looking to cultivate self-growth, increase interpersonal efficacy, and develop an affirming relationship with their internal worlds.

Ari extends a humanistic approach to her work by nourishing the whole self – according to one’s intersectionality and inherent wisdom. She is trained in DBT and other treatment modalities, including CBT, Existentialism, and Trauma Theory. She harmonizes the concepts of behaviorism and intuitiveness of relational healing, with opportunities to explore psychedelics and expanded-state work.

Ari invites you to build capacity for both processing and playfulness. She prioritizes humor and is often found in the ocean, on the dance floor, and imagining her next adventure. Ari has also worked as a licensed public school teacher in Hawai’i and documentary photographer in South Africa. She is committed to equity, inclusion, and the pursuit of social justice.

Alyson Barry

Alyson Barry, PhD

Licensed Clinical Psychologist

Alyson Barry is a licensed clinical psychologist (PhD). Since 2005, she’s gained experience in diverse areas of practice, including inpatient hospitals, intensive outpatient programs, community mental health, and private practice. Alyson came to DBT in 2013 through her own yoga and meditation practice, which led her to seek additional training in mindfulness-based therapies. Drawn to work with people who’ve experienced developmental trauma, she begins by addressing what’s happening in the present, helping her clients develop practical skills that fundamentally improve how they interact with themselves and the world around them. As a result of this work, this can over time, set the stage for healing the older wounds. She believes in a collaborative and consent-based treatment approach, working to ensure that clients understand and are in agreement with any diagnosis or therapeutic technique. She hopes that this transparency can help to create an environment of respect for her clients’ choice, autonomy, and knowledge of themselves. She is also a big believer in bringing humor and irreverence into therapy. In her free time, Alyson enjoys snorkeling, hanging out with her cat, and spending time with friends. Alyson is available to work via telehealth with clients in California, Colorado, and Florida.
Heather Macbeth

Heather Macbeth

Licensed Marriage & Family Therapist (MFT)

Heather co-founded the Oakland DBT & Mindfulness Center in 2012. She is a licensed MFT. She offers a relational, somatic, experiential and humanistic approach to her work and is committed to relieving psychological suffering. Her style is both compassionate and gentle as well as directive and aims to be supportive of each person’s unique needs. Her work focuses on emotion regulation, changing persistent cycles of self-blame, listening more closely to intuitive knowing and increasing self compassion. She is committed and dedicated to helping her clients have a life where they can find themselves thrive vs. just survive. Working as a therapist, clinical supervisor, skills group and workshop facilitator has brought her a lot of joy. In addition to a private practice setting she has worked in community mental health organizations with disenfranchised youth and families and in public schools as a Behavioral Specialist. Heather works with adults and teens. She is intensively trained in DBT and other treatment modalities such as; Gestalt, Psychodynamic, MBSR, ands Expressive Arts. She is certified in EAP (Equine-assisted psychotherapy) and offers equine-facilitated learning workshops in the Bay Area. Additionally, she has received her training in Ketamine Assisted Psychotherapy through the Polaris Insight Center in San Francisco and is inspired by the potential healing benefits of expanded states of consciousness work.

In her free time, and in ideal worlds, she is exploring jungles, hot springs, beaches, hanging out with animals (large and small), enjoying good food, travel and most importantly time with loved ones.

Christine Benvenuto

Christine Benvenuto

Licensed Marriage & Family Therapist (MFT)

Christine is a Licensed Marriage and Family Therapist and the co-founder and Executive Director of the Oakland DBT and Mindfulness Center. She brings over 25 years of experience in mental health to her work, with a background in working with people in all walks of life in residential, outpatient and home based settings. A systems thinker, valuing sustaining relationships, she works with individuals, couples and groups, with a strong belief that small shifts can create dynamic changes.

She blends a lifetime of interest and practice in somatics, meditation, embodiment, psychedelics and the arts with a passion for social justice, nature and thriving ecosystems. Her mentors are psychologically savvy, center co-existence, value differences and maintain a sense of humor.

Her professional training spans from depth oriented, expanded state and attachment based to behavioral styles of treatment. She co-creates a therapeutic container that feels collaborative, warm, dynamic, thoughtful and deeply resonant.

She works with individuals, couples and groups, offering ongoing weekly therapy, Ketamine-Assisted Psychotherapy and Consultation.

Along side of her professional life, Christine is grateful for her extended web of relationships as daughter, sister, wife, friend, step-mom and community connector.

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