Ketamine Assisted Therapy in Seattle, across Washington & Oregon - coming August 2026

Ketamine infusions are typically administered in a medical clinic through an IV, primarily for rapid relief of depression. They may include minimal or no therapy. Ketamine Assisted Psychotherapy (KAP) is different in two important ways: first, ketamine is usually administered as a sublingual lozenge (dissolved under the tongue) rather than IV; second, a trained therapist is present throughout the experience and provides structured preparation before and integration therapy after every medicine session.

The therapeutic container is what makes KAP distinct. Research suggests that set (mindset and intention), setting (the environment), and the therapeutic relationship all significantly influence outcomes. KAP is designed to maximize all three. The goal is not just relief — it is lasting, integrated transformation.

Yes. Ketamine is a Schedule III controlled substance in the United States, meaning it is legal when prescribed by a licensed physician or nurse practitioner. The FDA approved ketamine for anesthetic use in 1970, and its use in mental health treatment is an accepted off-label practice. Esketamine (Spravato), a ketamine derivative, received FDA approval specifically for treatment-resistant depression in 2019.

In Washington and Oregon, licensed therapists can legally facilitate the psychotherapy component of KAP in collaboration with a licensed prescriber. Our practice works within this collaborative model: your therapist holds the therapeutic relationship and sessions; a separately licensed prescriber handles the medical evaluation, prescription, and monitoring.

There is no one-size-fits-all answer, and any practice that gives you a confident number before knowing your history should be approached with caution. That said, a typical KAP course for trauma or depression involves 2–4 preparation sessions, followed by 3–6 medicine sessions (often spaced one to two weeks apart), and then ongoing integration therapy that may continue for months afterward.

Some clients experience profound and lasting shifts after a single medicine session when combined with consistent integration work. Others benefit from a more extended course. Factors that influence this include the complexity and chronicity of your trauma history, your current nervous system regulation, the modalities we pair with KAP, and how actively you engage with integration between sessions. We discuss this collaboratively throughout your treatment.

Ketamine produces a dissociative, non-ordinary state of consciousness. At therapeutic doses, most people experience a sense of floating, gentle detachment from the body, visual imagery (with eyes closed), and altered perception of time and space. Many describe it as deeply peaceful; others encounter profound emotional material, vivid inner landscapes, or a sense of unity and interconnection.

The experience is non-predictable — two sessions may feel entirely different from one another. This is not something to fear; it is precisely why we invest in preparation. You won't lose consciousness, and you won't do or say anything outside your control. Your therapist is present and attuned throughout. The session typically lasts 90–120 minutes from administration to return to full baseline awareness, after which you rest before being accompanied home by a trusted person.

Often, yes — and your history with both trauma and altered states is important information that shapes how we approach preparation. A difficult past psychedelic experience does not disqualify you from KAP; in many cases, having some prior context for non-ordinary states can actually be helpful. What matters is that we understand what made previous experiences difficult and build our preparation around that.

Complex trauma history is not a contraindication to KAP — it is often precisely the context in which KAP is most indicated. We take extensive time in preparation to establish internal resources, safety protocols, and a clear therapeutic relationship before any medicine session. If at any point — before or during — you or we determine the timing isn't right, we pause. Your readiness and sense of safety are not negotiable.

You don't have to choose just one, and in practice, we often move fluidly between modalities depending on what a given session calls for. Brainspotting is particularly well-suited for work done in the days immediately following a medicine session, when the nervous system is most receptive to processing subcortical material. EMDR is often woven in for clients who have specific traumatic memories to reprocess, using the expanded neuroplasticity window to lower activation enough for bilateral processing to work effectively. IFS runs as a kind of ongoing map — helping you understand and relate to the parts of yourself that show up throughout the KAP process, including any parts that are ambivalent or afraid of the work.

We assess your needs, preferences, and history during the preparation phase and collaborate with you on which approaches to emphasize. You are an active participant in designing your treatment, not a passive recipient of a protocol.

The psychotherapy component of KAP — preparation and integration sessions with your therapist — may be covered by insurance in the same way as other therapy services, depending on your plan. We are currently in-network with [list your insurance panels here] and can provide superbills for out-of-network reimbursement for other plans.

The ketamine itself — the medicine and the prescriber's medical evaluation — is typically not covered by standard insurance and is paid out-of-pocket directly to the prescribing medical practice. Costs vary by prescriber and region, but we are happy to help you understand the full picture of anticipated costs during a free consultation so there are no surprises.

Yes. I am licensed to provide telehealth therapy in both Washington and Oregon. Preparation sessions, all integration therapy, and ongoing trauma-focused work (Brainspotting, EMDR, IFS) can be conducted via our secure video platform. This makes KAP accessible to clients throughout the Pacific Northwest who are willing to travel to Seattle for the medicine session itself — which must take place in person.

If you are in Oregon and need support identifying a local prescribing partner for the medical component, I will help facilitate that referral. My goal is to make KAP as accessible as possible while maintaining the quality of care and safety protocols the work requires.

Ketamine does have some potential for dependency with frequent, recreational use at high doses — this is well-documented. However, in the structured context of KAP — low therapeutic doses, administered infrequently (typically no more than once per week during an active course), under medical supervision — the risk of dependency is considered low. Our prescribing partners carefully screen for substance use history and monitor usage throughout treatment.

Other risks include temporary increases in blood pressure and heart rate during sessions, transient dissociation that resolves quickly, and rare instances of bladder problems with long-term, high-frequency use (which is not the profile of therapeutic KAP). Emotionally, some sessions can bring up difficult material. This is not a risk to be avoided — it is often where the deepest healing happens — but it is why a skilled therapist holding the container before, during, and after is essential rather than optional.

The 48–72 hours following a medicine session are some of the most important in your treatment — this is when the neuroplasticity window is widest and the most integration can happen. We provide every client with a personalized integration protocol, but general guidance includes: protect your sleep (ketamine enhances the overnight memory consolidation process); journal, draw, or otherwise externalize what arose during the session; move your body gently; limit alcohol, stimulants, and substances; and be compassionate with any mood fluctuations.

We schedule an integration session within 48 hours of each medicine experience whenever possible. If difficult emotions, unusual thoughts, or physical symptoms arise that feel alarming, we are available by phone. You are not left alone in the aftermath — the integration support is part of the work, and we take it as seriously as the medicine session itself.