What Is Ketamine-Assisted Psychotherapy (KAP)?
Ketamine-Assisted Psychotherapy (KAP) is an innovative, evidence-based approach to mental health treatment that combines the use of ketamine with psychotherapy in a structured, therapeutic setting. Rather than using ketamine as a stand-alone medical intervention, KAP integrates the medicine with intentional psychological support before, during, and after the experience.
Ketamine acts as a catalyst. It increases neuroplasticity- the brain’s ability to change, form new neural connections, and reorganize itself. It can temporarily lower psychological defenses and increase access to unconscious or subconscious material that may be difficult to reach through traditional talk therapy alone. For many people, this creates a powerful window of opportunity to process trauma, shift long-standing patterns, and access new insight.
Ketamine also downregulates the amygdala- the brain’s fear center. This can allow individuals to revisit painful memories or emotional material without becoming overwhelmed, flooded, or shut down. Clients often report being able to approach difficult experiences with more curiosity and compassion rather than fear.
It’s important to distinguish Ketamine-Assisted Psychotherapy from ketamine infusions offered in medical clinics. Infusion-based treatment is grounded in a psychopharmacological model, where ketamine is administered as a medication-only intervention, similar to TMS or a vitamin infusion. While ketamine infusions can provide symptom relief, particularly for depression, research and clinical experience show that benefits often diminish when ketamine is not paired with psychotherapy.
KAP, by contrast, integrates the neurobiological effects of ketamine with therapeutic processing and integration. At Expand Your Self Wellness in Baltimore, Maryland, we believe ketamine is most effective when used as a catalyst within a relational, trauma-informed therapeutic container. For that reason, we do not offer ketamine infusions alone. We provide comprehensive Ketamine-Assisted Psychotherapy designed to create lasting change.
How Ketamine Works in the Brain
Ketamine works through several powerful neurobiological mechanisms.
One of the most significant is its ability to increase Brain-Derived Neurotrophic Factor (BDNF) and stimulate a surge in glutamate, the brain’s primary excitatory neurotransmitter. This process promotes synaptogenesis- the formation of new neural connections and enhances neuroplasticity.
In simpler terms: ketamine creates a temporary state in which the brain becomes more malleable.
Rigid thought patterns, entrenched beliefs, and stuck emotional states can become more flexible. Clients often describe feeling as though they are able to “step outside” habitual narratives and see themselves or their lives from a broader, more compassionate perspective.
Ketamine also reduces activity in the Default Mode Network (DMN), a network of brain regions associated with self-referential thinking and maintenance of our sense of identity or ego. While the DMN is essential for functioning, it can become overactive in depression, anxiety, trauma, and obsessive patterns.
When the DMN quiets, clients may experience:
- Reduced rumination
- Greater cognitive flexibility
- A sense of spaciousness or perspective
- Increased emotional access
- A softening of rigid identity structures
This temporary shift allows for new insights, emotional release, and meaningful therapeutic breakthroughs.
Importantly, ketamine does not “do the work” on its own. The neuroplastic window it opens is most effective when paired with intentional psychotherapy and integration.
What Happens in a KAP Session?
Ketamine-Assisted Psychotherapy involves three essential phases: preparation, dosing, and integration.
Preparation
Preparation is foundational. This phase includes a comprehensive medical and psychological assessment to determine safety and appropriateness for treatment. Not everyone is a candidate for ketamine therapy, and careful screening ensures both safety and efficacy.
Beyond assessment, preparation focuses on building therapeutic rapport and safety. The relationship between client and therapist is central to the process.
The KAP therapist collaborates on:
- Clarifying goals and intentions
- Discussing dosage options
- Establishing touch agreements (if applicable)
- Choosing music
- Determining level of therapist interaction and therapeutic modalities that might be incorporated.
- Exploring fears or expectations
This phase emphasizes “set and setting”- the mindset entering the experience and the external therapeutic environment. Research consistently shows that intention and environment significantly influence outcomes in psychedelic-assisted therapy.
The Dosing Session
The dosing session typically lasts 2–3 hours and takes place in person in a carefully designed therapeutic setting.
At Expand Your Self Wellness, we offer both sublingual lozenges and intramuscular (IM) ketamine. IM administration offers significantly higher bioavailability compared to lozenges and allows for a more consistent and predictable therapeutic experience.
During the session:
- Clients are typically lying down on a comfortable couch or floor mat.
- Eyeshades are often used to support inward focus.
- Curated music may be played to support emotional movement.
- The therapist remains present and attuned throughout.
Depending on the client’s needs, the session may be:
- Quiet and inward
- Interactive
- Incorporating modalities such as EMDR, Internal Family Systems (IFS), somatic therapy, psychodynamic exploration, among others
At our Baltimore practice, clients also have access to a recovery lounge after their session to rest and gently reorient before returning home.
Integration
Integration is where lasting change takes root.
The optimal integration window typically falls within 72 hours to one week after a ketamine dosing session, when neuroplasticity remains elevated.
Integration sessions focus on:
- Processing insights
- Translating symbolic or ineffable experiences into practical meaning
- Identifying behavioral or mindset shifts
- Reinforcing new neural pathways
- Developing concrete next steps aligned with goals
Integration bridges the mystical and the practical. It transforms insight into embodied change.
Without integration, insights can fade. With integration, they become the foundation for sustainable transformation.
What Can Ketamine-Assisted Psychotherapy Help With?
I often describe KAP as a treatment for people who feel stuck.
Stuck in:
- Repetitive negative thinking
- Trauma responses
- Emotional avoidance
- Relational patterns
- Addictive cycles
- Identity rigidity
Research and clinical experience show strong efficacy for:
- Treatment-Resistant Depression (TRD)
- Post-Traumatic Stress Disorder (PTSD)
- Complex Trauma
- Anxiety Disorders
- Obsessive-Compulsive Disorder (OCD)
- Substance Use Disorders (in recovery settings)
Emerging research suggests ketamine can be particularly helpful for individuals in recovery from addiction by increasing cognitive flexibility and reducing shame-based identity narratives.
At Expand Your Self Wellness, we have worked with many clients in recovery from substance use as well as other addictive behaviors who experience KAP as a powerful adjunct to their ongoing recovery work.
Beyond diagnosable conditions, many clients seek KAP during life transitions- midlife awakening, identity shifts, relational ruptures, grief, or spiritual disconnection. Ketamine can create space for reorientation and renewed purpose.
Is Ketamine-Assisted Psychotherapy Safe?
When provided by trained medical and mental health professionals in a supervised setting, Ketamine-Assisted Psychotherapy is considered extremely safe.
Ketamine has been used in medical settings for decades as an anesthetic. In therapeutic contexts, doses are significantly lower than those used for surgery.
Safety measures include:
- Thorough screening
- Ongoing medical oversight
- Clear contraindications
- Trauma-informed care
Like any medical intervention, KAP is not appropriate for everyone. A comprehensive evaluation ensures responsible treatment.
How Is Expand Your Self Wellness Different?
Expand Your Self Wellness is Baltimore’s only dedicated Ketamine-Assisted Psychotherapy practice offering a comprehensive IM ketamine program.
Our team has trained and grown together for over four years. Each practitioner has extensive experience in trauma-informed, psychedelic-informed psychotherapy.
What sets us apart:
Specialized Focus
We are not a general therapy practice that occasionally offers ketamine. KAP is central to our work.
Intramuscular (IM) Ketamine
We proudly offer the only dedicated IM program in the Baltimore area. IM administration allows for significantly higher absorption compared to lozenges, creating a more reliable and immersive therapeutic window.
Trauma-Informed and Inclusive Care
Safety, respect, and collaboration are foundational. We welcome clients of all races, ethnicities, religious backgrounds, political identities, and legal statuses.
Individualized Treatment
We do not use a cookie-cutter protocol. Treatment is collaborative and adaptive. Clients provide ongoing feedback, shaping the therapeutic process throughout.
The PATH Approach
Our work is rooted in our signature PATH framework- Psychedelic Awareness for Transformational Healing. PATH integrates mind, body, and spirit, supporting clients in accessing expanded states of awareness while grounding insight into embodied change.
In essence, our work is holistic. We meet the whole person.
Getting Started with Ketamine Therapy in Baltimore
If you are exploring Ketamine-Assisted Psychotherapy in Baltimore or Maryland, we encourage you to reach out for a consultation or fill out our screen form. (link form?)
KAP is not about escaping your life- it is about expanding your relationship to it.
When used thoughtfully, with preparation and integration, ketamine can catalyze meaningful and lasting transformation.
If you feel stuck, curious, or ready for change, we are here to support you.
