Reflections

Plans + Pricing

About

Why Innerwell

Refer a Patient to Innerwell

Work With Us

Contact

Ketamine Therapy in California

Ketamine Therapy in Colorado

Ketamine Therapy in Connecticut

Ketamine Therapy in Florida

Ketamine Therapy in New Jersey

Ketamine Therapy in New York

Ketamine Therapy in Oregon

Ketamine Therapy in Washington State

Ketamine for Depression

Ketamine for Anxiety

Ketamine for PTSD

Ketamine for Postpartum Depression

Innerwell Privacy Policy

Terms & Conditions

Innerwell Telehealth and Informed Consent

Page Not found. It's okay, we all get a little lost from time to time.

KBS, Inc. and its affiliates (“Innerwell”) provide a platform that connects medical professionals with individuals. Innerwell does not control or direct the activity of the medical professionals providing care through the platform. Innerwell does not provide medical advice and nothing on the platform should be considered medical advice.

Save over 10% on medicine plans (discount applied automatically) - HSA/FSA Accepted

Let’s start with something easy. Can you tell us a little about your professional background and areas of focus?

I'm a licensed clinical social worker and practicing psychotherapist for over five years. The foundation of my training is in psychodynamic treatment. I mostly focus on the unconscious, internal conflicts, attachment, and trauma. 

How would you describe your approach to therapy?

I am relational in my approach. I believe that understanding and healing occurs in the context of our relationships, and therapy at its core is the building and deepening of a relationship. 

I think they would say that I care, listen well, and am committed to their well-being. 

How did you become interested in working with psychedelics including ketamine?

I caught wind of the clinical trials and research findings while in graduate school, specifically the remarkable results of MDMA-assisted therapy for individuals with treatment resistant PTSD. It just made sense to me that lowering defenses and greater access to varying states of consciousness have the potential to expedite the healing process and alleviate suffering. I've been engaged in the conversation surrounding psychedelics and mental health ever since. 

What excites you most about the future of psychedelics?

I'm most excited to see how the use of psychoanalytic theory and practice in psychedelic therapy will continue to evolve. I've been reading old case studies of analysts describing their work with patients using psychedelics as a therapeutic support, and they are fascinating. 

Enough about work! Let’s try some rapid fire questions;

First, Where do you live? - Western MA and Brooklyn, NY

What's a perfect afternoon? - Basking in the sun with my partner, little one, and dearest friends on either a hammock, a blanket in the park, or my porch. I'd like there to be snacks. 

Favorite food? Pizza/Pasta - fully ripened mango

Describe yourself in two words. - curious, direct

Lindsay is a Licensed Clinical Social Worker with 6 years of experience providing psychodynamic treatment to individuals with challenges and curiosities related to self and identity, relationships, and how one's past shapes the present. She seeks to provide a warm and attentive space that encourages an exploration of the range and complexity of experience and feeling in order to deepen an understanding of self. Lindsay has post graduate training in relational psychoanalytic, psychedelic-assisted and somatic trauma therapies.

Clinician Spotlight: Lindsay Kazi, LCSW

Clinician Spotlight: 
Lindsay Kazi, LCSW

I’m a Board Certified Psychiatric-Mental Health Nurse Practitioner who graduated from University of San Diego.  I have over a decade of experience in working with a wide range of psychiatric conditions, across all age ranges, while working in long term and short term inpatient settings as well as in the psychiatric emergency department.  I’m originally from the east coast and have worked with clients in New York and New Jersey along with California. , My areas of focus include depression, anxiety disorders, and PTSD. 

My approach is patient-centered and holistic, considering the whole person, including their physical, emotional, and social well-being. I believe in taking the time to listen to concerns and working collaboratively with clients to meet their needs and goals, to achieve optimal mental health and wellness.  Everyone is incredibly unique, so I think treatment and therapeutic relationships should be able to adapt to each individual. 

My patients have told me that they appreciate my empathy and allowing them to be vulnerable without judgement. 

I have heard from some friends and previous clients that have experienced positive, life influencing benefits.  I am all for anything that is relatively safe and can provide more options for self improvement.  

I’m excited to see people more hopeful about other possible ideas and options to be able to help themselves become better individuals.  I appreciate the openness the future is moving towards. 

First, Where do you live? - I live in sunny San Diego

What's a perfect afternoon? - Rock climbing somewhere awe inspiring and then cooling off by paddle boarding on a lake, into the beautiful sunset.

Favorite food? Pizza/Pasta - Mediterranean food

Describe yourself in two words. - Grateful adventurer

Kevin is Board Certified Psychiatric-Mental Health Nurse Practitioner who graduated from the University of San Diego. He has over a decade of experience in treating a wide range of psychiatric conditions across all age ranges while working in the mental and behavioral health field. His approach to care is patient-centered and holistic, which means he considers the whole person, including their physical, emotional, and social well-being. He believes in taking the time to listen to his clients concerns and work collaboratively with them to meet their unique needs and goals to achieve optimal mental health and wellness.

Clinician Spotlight: Kevin Santos, NP

Clinician Spotlight: 
Kevin Santos, NP

By now, you have probably heard quite a lot about ketamine—the new, but not-so-new, medication that is gaining traction and worldwide recognition as a game-changing solution to the mental-health crisis that our world is currently facing. 

In fact, one in every 8 people globally—an estimated 970 million—suffers from some degree of mental illness—and this number is only rising, per data from the World Health Organization (WHO). Considered an “essential medicine” by that very same organization, ketamine just may be the key to unlocking the treatment that can help millions of people living with a myriad of mental health disorders. 

In its essence, ketamine is a dissociative anaesthetic that provides short-acting relief for pain. It has been around since the 1950s and was discovered by Parke-Davis and Company in their Detroit laboratory. They were on the hunt for the ideal anaesthetic and gave ketamine the developmental code name CI-581. The earliest clinical research on ketamine was performed on animals before it was then used on prisoners of war as an alternative to phencyclidine (PCP) for anaesthetic purposes. It was not until the 1970s, during the Vietnam War, when ketamine’s use was extended for the purpose of surgical anaesthesia. 

Ketamine has a wide range of utilization and can be used operatively at both high and low doses. At low doses, it has been shown to be instrumental in treating mental health and pain disorders, explains Mike Cooper, M.D., Psychiatrist and Medical Director at Innerwell. We all have NMDA receptors throughout our brain that play an integral role in both memory and learning. What ketamine does, Dr. Cooper explains, is antagonize these receptors and blocks a neurotransmitter that binds to these receptors, called glutamate. “Ketamine essentially blocks the binding of glutamate to those receptors, which in turn increases activation of a different kind of receptor called AMPA,” he says. “By increasing activation of AMPA you increase the release of BDNF, or brain derived neurotrophic factor, which is a protein in the brain that increases neuroplasticity.”

What is neuroplasticity? Put simply, neuroplasticity is the ability of our nervous system to shift in response to various stimuli, therefore creating new neuronal connections in the brain, explains Dr. Cooper. 

Ketamine is administered through a variety of routes, namely oral, intravenously (IV,) intramuscularly (IM) or intranasally (IN). Here’s a look at how each one works and in which use case one may be preferred over another.  

This is perhaps the least expensive and most straight-forward way to administer ketamine, especially when it comes to treating depressed patients, per research published in The Journal of Clinical Psychiatry. The only downside of dosing ketamine orally is that only about 25 percent of the drug actually reaches systemic circulation. This means that doses may have to be higher to achieve the same results that would be needed if the drug was administered via other methods, such as intravenously. 

In the operating room, ketamine is typically administered intravenously, since there is simply more literature and decades of research supporting this method. It is also how the very first human trial of ketamine infusion was administered. This is often how ketamine infusion clinics prefer to administer their ketamine, according to Dr. Cooper. Research has shown this route to be quite effective, especially when given slowly in a very low dose of 0.5 mg/kg over the course of 40 minutes (http://ketamineinstitute.com/wp-content/uploads/2016/09/Antidepressant-Effects-of-Ketamine-in-Depressed-Patients-Berman-2000.pdf).

Mental health clinics that offer ketamine-assisted psychotherapy sometimes administer ketamine intramuscularly or injected into the muscle, almost in the same way that a vaccine is administered. 

Additional data is accumulating on the intranasal route, which is quite non-invasive and simply involves spraying the medication into the nostrils. In terms of bioavailability, or how well a drug is absorbed in the body, research has shown that intra-nasally is roughly 45 percent, compared to intravenously, which is 100 percent and intramuscularly, which is about 95 percent, according to Dr. Cooper. “These are rough estimates, but they give a general sense of how a practitioner would calculate what dose to give a patient relative to an IV dose,” he says. “So, for instance, if you wanted to give an equivalent dose orally as compared to 90 milligram dose intravenously, you would give 300 mg orally, assuming approximately 30 percent bio available.”

Yes—ketamine is actually one of the safest anesthetics available today, especially in regards to how it preserves the airway reflexes. “You can put someone to sleep with ketamine, but they can still breathe on their own without needing to be connected up to any kind of supplemental oxygen or any kind of airway procedure like an intubation to provide mechanical breathing,” explains Dr. Cooper. This is unique when compared to other anesthetics that put you to sleep. During this process, these anesthetics often suppress a patient’s breathing, which requires them to be intubated in an operating room and provided mechanical ventilation to keep them breathing. With ketamine, on the other hand, the patient continues to breathe even though they're asleep and not feeling pain.

Ketamine is also a very short-acting medication, lasting up to about an hour after its onset. The only real potential downside of ketamine is that it has been shown to increase blood pressure slightly for some patients. Even so, this rise in blood pressure is not to an alarming or concerning degree, notes Dr. Cooper. “While it can increase heart rate a little bit, it is a very physiologically safe medication.”

Ketamine for mental health: the new frontier

While, traditionally, ketamine has been used mainly as an anaesthetic, in the last couple of decades, it has been used increasingly in psychiatry after it was found to be helpful in treating depression in a very rapid manner when given intravenously. Practitioners have been using it off-label to treat depression for a long time, however, a certain form of ketamine, called esketamine, under the name Spravato, was FDA approved in 2019 for the clinical treatment of depression.

Recent reviews published in both Pharmacological Reviews and the Australian and New Zealand Journal of Psychiatry have shown ketamine to be impressively effective in the treatment of major depressive disorder as well as in the treatment of post-traumatic stress disorder.

While other depression medications such as sertraline (Zoloft®), paroxetine (Paxil®), fluoxetine (Prozac®) and citalopram (Celexa®), may take many months to work fully, ketamine has been shown to work as rapidly as after one dose, within 24 hours of the first dose, in fact, notes Dr. Cooper. 

This is perhaps the number one question most patients considering ketamine may have—and it is understandable as to why. This depends on the dose range, according to Dr. Cooper. “At the extreme end of the dose range, ketamine is going to act as a general anesthetic and can put someone to sleep to the point where they're not going to remember the experience and not feel pain,” he says. This is more of how it was traditionally used when it was first discovered. “As you look at the lower doses, say, if you go on the opposite end of the spectrum, where you take a low dose of ketamine, it can be a very relaxed feeling,” he says. The effects of this low dose could be compared to a glass of wine, for example, in terms of that relaxation feeling. 

“Most patients describe the feeling of ketamine as very relaxed and open where they feel comfortable talking and communicating about difficult things in their life,” says Dr. Cooper. “In this low-dose administration, it can be thought of as a psycholytic agent where it lowers ego defenses  to allow patients to talk about aspects of their personality, their life and their memories in a little bit more of an easier way than they can without ketamine.”

In the moderate dose range, ketamine tends to be more like a psychedelic where patients may close their eyes and see beautiful colors, geometric patterns and other shapes, especially when they’re listening to music. They may also notice a distinct shift in their perspective. “They might feel that their sense of self is growing larger, or that they feel more connected to their surroundings or to the people around them, as well as a heightened sense of oneness and connectedness to the world,” explains Dr. Cooper. 

As the dose increases from there, ketamine generates sort of almost an out-of-body experience, where a patient may feel like they're outside looking inward in a very peaceful way. “They feel very much a part of the universe and they can even have these visual experiences of watching the universe being constructed and planets coming into existence and quite metaphysical, extraordinary experiences like that,” says Dr. Cooper. 

The length of time during which ketamine lasts is about an hour long when used for its psychological effects, with only very mild residual effects of the medicine lasting longer than that 60-minute duration period. The official half-life of the medicine, or how long it takes for the medicine in your body to be completely eliminated by 50 percent is an estimated 2.5 hours in adults, per FDA data. 

How a ketamine treatment works depends mainly on the model of treatment. If it is an intravenous ketamine clinic, a patient would go to their doctor’s office, often a psychiatrist. Next, they would be connected to an IV and would receive an infusion of ketamine over the course of an hour or two. There may also be a nurse in position to check in with the patient at frequent intervals. “This type of model doesn't usually involve psychotherapy; it is usually the patient in a clinic room getting an infusion of ketamine, almost like chemotherapy,” explains Dr. Cooper. 

Another model is called ketamine assisted psychotherapy, where the patient undergoes psychotherapy at the same time as they are having a ketamine experience. Often, this type of model kicks off with a preparation session beforehand where the practitioner seeks to learn and understand more of what the patient is seeking assistance and help with. “Part of the initial intake involves setting an intention for the journey, talking about what it is going to be like for them and helping select the music to play to guide them on their way,” says Dr. Cooper. 

This type of ketamine therapy could be provided after they get an intramuscular injection of ketamine, an IV infusion of ketamine, or after they take an oral or sublingual dose of ketamine, according to Dr. Cooper. “The most common route of administration for a patient receiving treatment in the form of psychotherapy is intramuscular injection after which you would lie on the couch in their office and talk about things that come to your mind,” he says. “Often, the psychiatrist will encourage the patient to look inward at their life, put eye shades on, and listen to a music playlist to help guide them on this introspective journey and reflect on their life during the ketamine experience.”

Another type of ketamine-assisted psychotherapy involves the practitioner treating the patient virtually over Zoom. This can allow for a more comfortable experience and may encourage the patient to go more in-depth about their thoughts and past experiences. If a patient chooses to go this route, they would be prescribed ketamine orally in the form of a lozenge or tablet. They would also have a support person or family member present who would be there to help them through potentially difficult aspects of their journey.

During the treatment, the practitioner conducts a medical evaluation that involves assessing the patient's psychiatric history, medical history, and any past experiences with non-ordinary states of consciousness, as well as educating the patient about what the ketamine experience can feel like to them. 

The  first ketamine experience often starts with a very low dose of the drug, which simulates the feeling of drinking a glass of wine—the patient is relaxed and can get comfortable with the medication. “Some patients choose to remain at a lower dose because they find it very therapeutic and can do a lot of good psychological work at this dose,” says Dr. Cooper. “For patients who feel ready to have a bit more of an intense experience, the doctor can carefully titrate the dose over time so the patient can  learn to work with the stronger effects along the way.”

Who would be an ideal candidate for ketamine therapy?

Ketamine is very versatile and there is a great deal of emerging evidence that is showing it to be useful for treating a variety of conditions, especially depression. “Ketamine can be quite beneficial for someone who has depression and has not responded to traditional antidepressant medications like Prozac and Lexapro, or for a patient who's in psychotherapy and has made some progress towards treating their depression and anxiety, but they want to augment their treatment or have a bit more rapid improvement in their symptoms,” explains Dr. Cooper. “Patients who are naturally very introspective and philosophical in general, who would appreciate the kind of inward journey and perspective that they can gain through ketamine, would also be very good candidates for this type of treatment.”

It’s important to recognize that ketamine treatment, while quite extensive and science-backed in its therapeutic abilities, is not for everyone—and determining whether or not it’s right for you is a deeply personal decision that shouldn’t be taken lightly.

If you do decide to try ketamine, it’s also important to recognize that there is no substitute for working with a licensed expert who has been certified and trained in this specialty. Not only can they help prepare you for what to expert and guide you along the journey, but they can also help you better process your experiences and traumas.

If you’re interested in harnessing the power of psychedelics to move beyond what’s been holding you back, sign up and take our patient screener to take the first step towards healing.

Learn about the history of ketamine, the science behind its amazing neuroplasticity-inducing effects, and how it is being harnessed for mental health to help patients heal.

Ketamine 101

What is ketamine? 

How is ketamine administered? 

Is ketamine safe?

What does ketamine feel like? 

How long does ketamine last? 

How does a ketamine treatment work?

Deciding if ketamine is right for you

I received my Masters in Clinical Psychology from Antioch University, Los Angeles, California. I chose the Marriage and Family Therapist track, becoming licensed in 1998 and have practiced in a variety of outpatient settings for over 20 years. In 2019 I moved to Maine and became licensed here, and also certified as an out-of-state provider of telehealth services to Florida residents. 

For many years I worked on a mobile psychiatric emergency team as a clinician, seeing people in crisis related to mental health challenges, substance abuse, and chronic stress. I saw hundreds of people struggling to cope with high levels of social and environmental stress. After 10 years in this line of work, my own health was impacted. I became drawn to new science on trauma informed healthcare  In 2018, I became a certified facilitator of Polyvagal informed Mindfulness and Resilience building techniques, and changed my career focus to help people build resilience and cope better with stress.

For the past 5 years, my focus has been on empowering individuals, couples, and families with tools and skills to overcome various mental health challenges including co-occurring substance use disorders, supporting them to build and maintain healthy relationships, overcome obstacles, and lead happier, healthier lives.

My approach is client-centered, holistic, empowering, and collaborative. I believe mental health challenges often require a multidisciplinary approach and I am well-versed in collaborating with other healthcare professionals  I quickly engage my clients as partners in change. I believe tools and skill building are key to this process. I draw from a variety of trauma informed Mindfulness and Resilience building techniques to educate and support my clients in building resilience and cope better the stress in their lives.

This might sound funny, but what they do say about me is that I "hit the nail right on the head". I take this to mean that I quickly attune to their state of being and arrive at an understanding of their needs. My clients would also say that I'm respectful, validating, and support them as individuals on a journey to self-discovery.

I had one psychedelic experience in my twenties that influenced me in choosing a path toward understanding human potential through higher consciousness, and being of service to others. But it really wasn't until the past 5 years that I became drawn to the field of neuroscience focused on trauma recovery. I came across study after study researching the use of psychedelics, finding that healing at the cellular level was possible. The research on Ketamine and neuroplasticity was very promising in this light, especially considering the FDA had approved the off-label use of Ketamine for conditions that I treat such as post-traumatic stress syndromes and chronic depression. The use of Ketamine as a psychedelic seemed to me a natural progression in my general philosophy and definitely compliments the kind of work I do as a therapist.

I am so excited about the potential of psychedelics to change our collective attitudes towards healing the whole person and discover that past adverse experiences don't have to limit our future potential. I see a future in which these medicines are used responsibly to enhance creativity, boost productivity, and facilitate personal growth and transformation. For me, the future of psychedelic medicines offers hope for a better world in which we all have the opportunity to reach our full potential and contribute to creating a more compassionate, connected, and thriving society.

First, Where do you live? - Westbrook, Maine

What's a perfect afternoon? - A perfect afternoon for me is a little excursion kayaking in calm water at a place like Bear Pond, taking in the beauty of the mountain and woodland views while floating wherever the current takes me.

Favorite food? Pizza/Pasta - Poke and sushi

Describe yourself in two words. - Nature-loving and curious

Susan is a licensed Marriage and Family Therapist with a Masters in Clinical Psychology from Antioch University Los Angeles. She has over 20 years of professional experience working with individuals and couples from diverse lived experiences. Her clients benefit from her expertise in developing embodied self-awareness through mindfulness based approaches that emphasize self-compassion, which Susan believes is key to releasing old patterns of tension and trauma at the root of many mental health issues. Susan has a genuine commitment to creating a safe therapeutic atmosphere where her clients feel respected and deeply supported as they engage in their unique process of healing through Ketamine assisted psychotherapy.

Clinician Spotlight: Susan Benjaminsen, LMFT

Clinician Spotlight: 
Susan Benjaminsen, LMFT

I’m a psychiatric mental health nurse practitioner (PMHNP) and family nurse practitioner (FNP) with over 30 years of experience working in both practice and as faculty in the California State University system. I hold graduate degrees in nursing from UCLA and Case Western Reserve University. Since 2014, I have worked as a nurse practitioner in psychiatric settings including acute care psychiatric health facilities, crisis stabilization units and outpatient settings with patients who are suffering from moderate to severe mental illness. It’s rewarding to see patients’ mental health improve with medication and treatment regimens. I believe mental health illness deserves the same attention and care as any disease and feel privileged to practice within this specialty.

I am committed to a patient centered care approach which means providing care that is respectful and responsible to individual preferences, needs and values. The patient is at the center of clinical decision making, and I see my role as providing the knowledge and expertise to guide and support the process.

Patients say that I listen carefully to their experience, that I review treatment options with them and thoroughly explain each step of the way.

Mental health illness can be life threatening and not all traditional treatments work effectively for all individuals. Ketamine represents a drug classification with a different neurochemical pathway from other medications for depression. It’s exciting to be part of a practice on the cutting edge of approaches to mental health illness.  

Seeing the research on psychedelic medicine applied in clinical settings.

First, Where do you live? - Berkeley, California

What's a perfect afternoon? - Cycling into San Francisco with my family

Favorite food? Pizza/Pasta - Smoked herring

Describe yourself in two words. - Authentic and Non-judgmental

Diane is a Psychiatric Mental Health Nurse Practitioner and Family Nurse Practitioner with a Doctor of Nursing Practice degree who has combined both practicing and teaching nursing throughout her career. She began working in a variety of psychiatric settings 9 years ago after seeing a need for mental health providers. Diane emphasizes a holistic approach to healing that includes medications, connections with a community, physical activity, and nutrition. A proponent for healthy life balance, she is an enthusiastic speed skater, cyclist, and runner.

Clinician Spotlight: Diane Katsma, NP

Clinician Spotlight: 
Diane Katsma, NP

I’ve had a lifelong interest in psychology, physics, art, and eastern philosophy. I studied fine art in high school with the goal of majoring in art therapy in college. Life happened, and I found myself as an accountant and bookkeeper for a decade. I decided that I would prefer to be pursuing my passion.  I started college for psychology and mental health, and began working as a technician shortly thereafter. After switching degree tracks to nursing, I continued in inpatient psychiatry, then completed a masters degree in Psychiatric Mental Health Nursing. Directly after, I became certified in Psychedelic Assisted Therapy. Since then, I have spent the majority of my time in integrative and ketamine assisted treatments. My areas of focus are depression, anxiety, and PTSD, with additional interests in ADHD and autism spectrum disorders.

My number one approach to therapy is building a good relationship and earning trust. I strive to show my clients that they are accepted, heard, and understood. 

My patients say that I am easygoing, caring, and relatable. 

I found out that psychedelics were being studied for therapeutic purposes when I saw an article about the MAPS MDMA studies in 2015. Having some knowledge of various psychedelics and their history, I realized the immense potential for healing and impact on the mental health field. I wanted to learn more, and be a close part of managing these cutting-edge treatments as the field emerged. I had already been on the verge of switching to nursing to become a provider, and this was the catalyst for my final decision. As I was completing my degree, ketamine was becoming more available as a treatment option. I dove in, and have never looked back.

What has been your most meaningful experience in working with psychedelics?

The most meaningful part of working with psychedelics has been seeing the change in clients mind, body, and spirit. This can happen all at once, and sometimes at mind-boggling speed.  Being witness to these treatments has helped me to grow not just as a clinician, but as a fellow human being. 

The most exciting part is the potential for healing! Research on various substances and future medications is ongoing, as is the research on how they interact in specific sites of the brain. Much is being discovered, and the future of psychedelics is very bright. 

First, Where do you live? - Central Florida

What's a perfect afternoon? - Indoors: Laughing at silly videos with family.  Outdoors: Strolling during a breezy day with temperatures between 65-70 degrees.

Favorite food? Pizza/Pasta - Chocolate muffins

Describe yourself in two words. - Kind-hearted revolutionist

Margaret is a Licensed Mental Health Counselor from New York. She has been practicing therapy for over 12 years and specializes in the treatment of all forms of trauma. Margaret is a strong believer that all people have the capacity for healing and that therapy is a pathway to achieve this. She values the collaborative approach of working with clients to achieve their goals. In her free time, she loves to spend time with her family and friends, and to be outside in nature.

Clinician Spotlight: Margaret Morrow, LMHC

Clinician Spotlight: 
Nicole McCloskey, NP

As the world adjusts to post-pandemic life, regulation are changing that affect how patients will be able to access at-home ketamine treatment. Understanding the upcoming changes will allow you to make an informed decision about the healing journey you’re on.

Starting May 11th, 2023, the Covid-19 related Public Health Emergency (PHE) will officially come to an end. The PHE allowed companies like Innerwell to treat patients with controlled substances through virtual at-home appointments, and increased access to quality care for millions across the country. The Drug Enforcement Agency has proposed a new set of rules related to how controlled substances can be prescribed to patients after May 11th.

Under the new rules, you will still be able to begin an at-home ketamine treatment program, but you can only be prescribed a 30-day supply of ketamine. Beyond 30 days, you will need to have an in-person visit with an Innerwell prescriber, or you will need an in-person referral from a licensed psychiatrist or primary care physician with a DEA registration in your state of residence. After you meet this requirement, you may resume seeing your current prescriber at Innerwell virtually.

In most circumstances Innerwell patients will be able to complete our 8-treatment Foundation Plan without requiring an in-person visit, but patients who are interested in our 24-treatment Extended Plan will need to have one in-person visit or a referral in order to be prescribed the medicine included in their care plan.

If you’re interested in getting started now, click here to take our patient screener.

If you choose to begin treatment after May 11th, and your care plan requires an in-person visit, you will have multiple options available to you. 

You can visit us in one of our soon to be open in-person offices.  We'll have more detailed information on these locations in the coming weeks.

Alternately, you can choose to provide a referral from your own doctor who has evaluated you in-person.

We’ve seen the power that ketamine has to transform lives, and we believe that reducing barriers to this treatment will reduce suffering and save lives. 

We’re working alongside other stakeholders, including healthcare organizations like the American Psychiatric Association, the American Medical Association, and the American Hospital Association, to address these access limitations.

As the regulatory environment evolves, we’ll keep you updated with how these changes may affect your care, and how you can make sure your voice is heard as we fight to increase access to critical mental health services that millions rely on. Join our mailing list below to make sure you’ve got the latest updates.

This article discusses changing regulations related to the upcoming May 11th, 2023 expiration of the Covid-19 Public Health Emergency.

At-Home Ketamine Regulatory Update (Covid-19 PHE Expiration)

The Future of At-Home Ketamine Treatment

I started my career in cancer care. I worked many years in a surgical role and enjoyed being able to physically see a problem and instantly remove it. The astonishing gap in mental health care, however, did not sit well with me. So I took action and helped start a mental health care team who responds to psychiatric emergencies. My experience with this team was a natural segue into working with many different types of mental health and wellness, including incredibly common ailments like anxiety and depression. I also have extensive experience in pain management and substance use disorders that made me well versed in different therapies including psychedelic healing properties. 

My approach to therapy is patient-led. I lend my experience and knowledge, but also focus heavily on understanding and comfort. I believe unlocking new connections and perspectives is the key to healing and personal growth. Guiding that process helps patients reach their full potential.

My patients would describe me as empathetic and honest. I take the time to gently listen and understand each client’s perspective and where a person feels they may be on their journey. At the same time, I speak openly and honestly. I am easygoing, nonjudgmental, and compassionate. My goal is to leave each client feeling validated and a little more empowered.

I already had great experience in using psychedelic therapy with good success, but when a family member became overcome by depression, it became a matter much closer to my heart. Walking this loved one step by step through the process of ketamine treatment, and having the joy of seeing successful results, made me dedicated to increasing access and availability of psychedelic treatments so that others could feel the same lifted weight my family so fortunately did.

I believe that psychedelics are the future of medicine. When you see firsthand the absolutely incredible effects these therapies produce, at a much higher efficacy and lower risk than current standard treatments, it’s hard not to get excited.

First, Where do you live? - I enjoy living in the quiet craziness of New York City. 

What's a perfect afternoon? - I enjoy jogging along the East River, pilates, family and friend time, waking up late and lounging with a coffee . If all that could happen in an afternoon, then yes it would be perfect.

Favorite food? Pizza/Pasta - As an Italian this is hard to answer, but my grandmother would disown me if I didn’t say her ravioli of course. 

Describe yourself in two words. - Passionate healer

Chrissy is a licensed physician assistant from Tufts University School of Medicine. She started her journey as a provider helping cancer patients where she quickly recognized a need for deeper healing. She since has years of experience uplifting clients through traditional and innovative techniques. After supporting a family member step by step through successful ketamine treatment, Chrissy has dedicated her talents to expanding access to what she considers life-changing therapeutic treatment. She is currently based out of Manhattan, New York where you can catch her Citibiking through Central Park any day of the week.

Clinician Spotlight: Christina Cariello, PA

Clinician Spotlight: 
Christina Cariello, PA

Innewell clients that are on plans that include Psychotherapist-Led Ketamine Experiences begin with two supervised ketamine experiences. These experiences are under the guided care of a licensed therapist who’s been trained in helping you harness the power of psychedelics for introspection and self-exploration. Your therapist is with you from start to finish during your ketamine experience.

You may be wondering what it’s like to work with a therapist while you’re undergoing a psychedelic experience. In this article, we’re going to break down what to expect and provide tips for interacting with your therapist during your virtual ketamine sessions.

Will I feel like talking during my ketamine experience?

Ketamine is classified as a dissociative anesthetic. When you take ketamine, you will most likely feel calm, quiet, and relaxed. Some people compare taking ketamine to going into a very deep meditation. The experience offers a beautiful opportunity to reflect on your life from a more distanced and less emotionally reactive space. During supervised experiences, your therapist will be on-camera and present with you, and their role is to maintain a safe and supportive environment throughout your experience, enabling deep introspection without fear of judgment. Likewise, their job is not to “watch you” during your session*, but rather to keep a pulse on the energy and shifts that take place as your experience unfolds.

Do I need to talk to my therapist during Ketamine Assisted Therapy?

If there is a story, memory, or thought that comes up during your session, your therapist will be happily ready to listen and help you process it. You may exchange dialogue similar to a typical therapy session while you are in your altered state. 

However, it’s important to recognize that you are not required or expected to talk and engage with your therapist throughout your experience. If you feel like putting on your eyemask and simply listening to the music, that is completely fine. In some cases, clients will not speak at all during a ketamine-assisted therapy session, only opening up once the effects have worn off and their session is complete. In this case, your therapist will honor the quiet space while still being attentive..

The dynamics of communication during ketamine experiences are fluid, and will likely change from session to session. At one particular dose, you might have a highly verbal session, and at another dose, you may prefer more silence.

In summary, there is no “right way” to interact with your therapist during the journey. They are there to support you in whatever way you need. 

What happens after my supervised experiences?

After your first two supervised sessions, you should start to feel comfortable with how ketamine makes you feel. Likewise, your therapist and psychiatric clinician will be working together with you to ensure you’re safe and at the optimal dose throughout the duration of your program.

Subsequent ketamine experiences are self-guided and followed by an Integration Session with your therapist. Integration sessions allow you to work with your therapist during the optimal time window when your brain is benefitting from the neuroplasticity that ketamine induces.

You will always have access to your therapist and psychiatric clinician throughout your entire journey at Innerwell. We want you to feel comfortable communicating anything that comes up for you, whether it’s an insight, question, or concern.

*You’ll have a sitter at home to make sure you’re safe. Plus, all Innerwell sessions start with a series of safety checks to make sure you’re ready to go.

A must-read for anyone considering the Individualized Psychedelic Assisted Therapy plan, this article discusses what it's like to have a therapist with you while you're undergoing a psychedelic experience.

How do I interact with my therapist during my ketamine experience?

At-home ketamine therapy is quickly becoming an increasingly popular alternative to the traditional in-person experience of going to a ketamine clinic. Not only is it often more affordable and convenient, it's also more comfortable and provides more personalized care than a clinic can provide.

When considering the cost of in-person ketamine treatment at a clinic, many people are surprised by how expensive it can be – often costing twice as much or more than at-home treatment. With at-home therapy, patients are able to save hundreds or even thousands of dollars from their overall bill.

The comfort level of being able to undergo a treatment in your own home cannot be understated either. All too often, clinics can be intimidating environments due to unfamiliarity with medical staff and surroundings. At home, patients are able to relax in an environment that is familiar and comfortable for them – making it easier for them to open up emotionally and experience the full therapeutic benefits of the ketamine experience without feeling uncomfortable in any way. This is especially beneficial for those who suffer from social anxiety or those who may feel intimidated by visiting a clinical setting. 

Personalized Programs & Self-Care Resources

One of the other key advantages of at-home ketamine treatments is that they offer greater flexibility and personalized care than what you might receive at a clinic. For example at Innerwell, we have multiple plan options as well as the ability to supplement your care plan with specialized add-on therapy services from licensed psychotherapists who have been trained in ketamine-assisted psychotherapy. These options allow us to tailor our plans around each individual’s unique needs and requirements. 

In addition, the Innerwell program offers support tools like guided meditations by Zen master Henry Shukman, journaling exercises, curated music playlists for accompanying your session and charts that illustrate how your mood and symptoms improve over time as compared to your previous experiences with ketamine treatments. Resources like these are rarely a part of the in-person ketamine experience delivered by most clinics.

Lastly, when you choose an at-home treatment option such as Innerwell’s model you don't have to worry about transportation from the clinic after your session ends like you would if you went there in person, since you won’t be able to drive for a few hours after a ketamine experience. 

In addition, having the flexibility to self-administer ketamine at home makes the process easy and manageable for many people who may have difficulty taking time off work or facing logistical challenges that come with going to an in-person facility. Keep in mind that you’ll still need to coordinate with your Sitter to make sure they’re able to be with you in person for the duration of each of your ketamine sessions.

Who is in-person ketamine treatment best for?

Despite the drawbacks, in-person ketamine treatment at a clinic can be the right choice for you depending on your circumstances. In-person ketamine treatment is best for those who would feel more comfortable with a clinician overseeing each of their sessions. For those who are especially nervous or worried about treatment, having a medical professional available may provide them with added confidence and comfort. In addition, in-person ketamine treatments offer intravenous or intramuscular administration methods which may be preferred for some people, depending on their medical history or circumstances. 

There are numerous benefits associated with choosing an at-home ketamine therapy program over traditional in-person visits, which include saving money while still receiving quality care, convenience due to flexible scheduling, comfort due to being in familiar surroundings, and personalization through tailored care plans. These benefits make choosing an at-home option over traditional clinics an attractive choice for many. If you're weighing the decision between at-home and in-person care, it’s always a good idea to seek the advice of a psychiatric professional who can help you make an informed decision about what's right for you.

FAQs about at-home ketamine therapy with Innnerwell

1. What are the benefits of at-home ketamine therapy?

At-home ketamine therapy is highly convenient and cost-effective, as it allows patients to receive quality care without having to travel to a clinic. It also provides a very safe and comfortable setting that allows patients the time they need to process their experience in the privacy of their own home. Benefits may include improved mood, decreased anxiety, and improved sleep quality. 

2. What are the benefits of going to a ketamine clinic?

Going to a ketamine clinic offers certain advantages that can't be achieved at home. For example, clinics provide direct supervision by medical professionals who can closely monitor symptoms and side effects while administering the ketamine treatments. Some patients may have a stressful home environment, so undergoing treatment at a clinic may be more relaxing for them. 

Ketamine works by blocking nerve signals within the brain that are associated with depression and anxiety, giving patients an increased ability to manage their symptoms and feel better over time. It rapidly increases communication between neurons in the brain which stimulates neural pathways for fast relief from depressive symptoms like sadness, fatigue, and low motivation.

4. How is at-home ketamine therapy administered?

At-home ketamine therapy is generally administered orally via rapid dissolve tablets that are held in the mouth with periodic swishing for approximately ten minutes to facilitate absorption.. This form of administration is fast-acting, convenient, and easy to regulate dosing levels depending on each patient’s individual needs. 

5. How many ketamine therapy sessions are needed?

We don't believe in one-size-fits all care so our plans are personalized to each patient's unique needs based on factors such as severity of symptoms and overall health condition of the patient. Patients begin treatment with either our 8-dose or 24-dose programs, and undergo a proprietary dose-finding process to reach the optimal dose and frequency of treatment. Most patients undergo either weekly or twice weekly ketamine sessions for the duration of their plan.

Ketamine therapy is right for you if you are experiencing moderate to severe depression that has not responded positively to other forms of treatment such as psychotherapy or medication management alone. Patients who have responded to ketamine generally find long-lasting relief from their symptoms with many reporting complete remission of depression after only several treatments! If you think you may benefit from ketamine therapy, you can take our patient screener or reach out to Innerwell at care@helloinnerwell.com or call us at (909) 679-3482.

Learn about the benefits of at-home ketamine therapy, which is quickly becoming an increasingly popular alternative to the traditional in-person experience of going to a ketamine clinic. Make an informed decision about what's best for you.