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Last month, we had our SF Bay Area panel, “Ketamine-Assisted Psychotherapy: Enhancing Client Outcomes through Collaborative Care.” The evening was filled with insightful discussions on the transformative power of KAP treatment and how collaborative care can enhance patient outcomes.
A huge thank you to our expert panelists for sharing such deep reflections on the KAP movement:
- Dr. Kwasi Adusei, DNP, PMHNP-BC (Schedule a meeting here)
- Jodie NewDelman, PsyD
- Melissa Whippo, LCSW
- Gwen Pelfini, LMHC, LPCC, NCC, PATP
For those who missed the event, we compiled some of the biggest insights below:
On Journey Clinical’s Collaborative Care Model
In our patient-centered collaborative care model, our highly-trained, in-house medical team takes on all medical responsibilities of KAP (patient eligibility, prescriptions, and outcome monitoring) while our member psychotherapists take on the psychotherapy. This approach allows patients to remain in therapy with existing clinicians, receive personalized treatment plans, and experience the highest quality of comprehensive care possible. As Journey Clinical’s Senior Prescriber, Kwasi discussed the benefits of collaborative care from the medical team’s perspective:
Kwasi continued: “The medical team is responsible for assessing clients to make sure that they’re safe to continue with KAP so our member therapists can feel comfortable working with them. When I think about collaborative care, I know that I can focus within my own practice and don’t have to think about all the other pieces.”
Jodie also spoke about the importance of collaborative care in the context of the current healthcare system:
She added: “I’m passionate about addressing some of the in-depth issues that are endemic to the way that we deliver healthcare right now, so I like to work with organizations that embody that, and do this work in a scalable way.”
KAP and the Therapeutic Alliance
At Journey Clinical, we believe that the ongoing, positive, and trusted relationship between the patient and their psychotherapist is the key to delivering Psychedelic-Assisted psychotherapy (PAP) safely and effectively. As a Journey Clinical member psychotherapist, we asked Gwen to share the importance of the therapeutic alliance when doing Ketamine-Assisted Psychotherapy:
Gwen continued: “In my experience with clients who I’ve worked with for years, I’m noticing the trend of inquiries coming my way from people already undergoing their own therapy with a therapist they want to stay with. They feel very strongly supported in their therapeutic alliance, but want to work with ketamine with me. Branching out that collaborative care model to envelop other psychotherapists and support each other in filling in the gaps and leveraging our strengths has been a blessing, and Journey Clinical has been so supportive.”
Kwasi also discussed the impact of KAP on the therapeutic alliance: “I’ve had clients tell me that their relationship with their therapist is improving. The number one predictor of positive outcomes is the quality of the therapeutic alliance. Whether or not a patient’s anxiety or depression is being reduced, the relationship that’s formed between her and her therapist through vulnerability in a safe space – what is that going to do for the rest of their work together in a year, or 5 years? That’s a really beautiful outcome that is never going to be captured by the medical data.”
On KAP for Perinatal Care
Melissa is the founder of Deva Collective, a non-profit that is pioneering psychedelic research for women’s health. She spent a decade in service of women’s health at the UCSF School of Medicine and now works mostly with the postpartum population. When asked about the benefits of KAP for perinatal care, she spoke about her experiences of supporting her patients with KAP:
Melissa added: “When I did ketamine training in 2018, I was coming from UCSF and had a massive caseload of patients with perinatal mood and anxiety disorders. There was nothing in the literature that looked at the interaction between ketamine and breast milk, so we did a small study that demonstrated that if a breastfeeding patient wanted to safely have a ketamine experience through the intramuscular route of administration, breast milk was completely clean of medicine after 12 hours. That’s something that the family unit and care team can plan around.”
On Journey Clinical’s Community
Community is at the heart of Journey Clinical. As the largest network of Psychedelic-Assisted Psychotherapy providers in the US, we lean into our passionate, robust community to support each other along their KAP journeys. We asked Gwen to share her experience of doing this work within a supportive community:
Gwen continued: “Giving therapists support in launching something or identifying a need, and giving a nice nudge to fill the need – that’s how the ambassador program started. I see people who have also stepped up in the community and I can support them. Not one person has to do it all - the fabric of community being collaboratively woven together and Journey Clinical providing all the outlets to do so, it’s been such a clinician focused approach that I really believe in in so many ways because we’re feeling celebrated and empowered. The work that we provide our clients is going to be that much more supported and celebrated.”
Some of our other panelists shared Gwen’s same values of working within a community:
- From Jodie: “I’ve personally benefited just from the exposure to everyone’s expertise. You can’t squeeze that into all of your training. But here, you have a community that’s offering their expertise freely and it just feels like a gift in a lot of ways.”
- From Melissa: “It’s really important to come together in community to do this work because we can keep each other accountable and support one another.”
KAP with Somatic Therapy
Within Journey Clincial’s model, members can use KAP as an adjunct to their therapeutic specialties, such as IFS, EMDR, Somatic, and more. We asked Melissa about her experience incorporating KAP into her somatic approach:
Melissa added: “A lot of people say that you have to feel it to heal it. We can intellectualize and understand a lot of things on a cognitive level, but our brain isn’t separate from our body. I invite everyone that I work with to be in a practice that supports being in contact with the physical body, because there’s so much information that we carry within our bodies everyday.
I’m working with a patient who is an elder and psychedelically-naive. She has an idea of wanting to work with ketamine, but a lot of anxiety around it. She came in this morning saying ‘I don’t know why. I’m feeling really nervous.’ Instead of trying to explain it away, I invited her to do some breath work and guided practice. It was an invitation to be curious and compassionate with what she was noticing in her being, and she said afterwards that it was a beautiful first session.
I’m also a yoga instructor, so if my patients are interested, we might include some actual physical practices that enhance the work with ketamine. These body-based connective practices can be really supportive for the integration of these big, ineffable experiences.”
On KAP Patient Outcomes
When discussing the transformative effects on KAP patient outcomes that our panelists have witnessed, Kwasi spoke about how the enhanced neuroplasticity has led patients to live more aligned with their values – even when they don’t expect it:
Kwasi continued: “During follow-ups with Journey Clinical, we measure the impact of the patient’s mental health on their day-to-day function. I’ve seen multiple clients cry when they see the objective results of their measures dropping because they felt failed by the mental health system and never knew that it was possible for them.
When people find that their professions are removing them from opportunities to show up for their families, communities, and be in nature in the way that they want, that dissonance is going to cause a lot of distress. One of the outcomes that I think is really beautiful is when people have an opportunity to start aligning with their values because they’re not so depressed anymore. They can get up, let the sun hit their face, and start communicating a little better with their loved ones.
We call psychedelics non-specific amplifiers. We allow people to lean into whatever might come up for them. They might go into therapy thinking, ‘I’m here to work on my childhood,’ but instead what shows up for them is realizing ‘I haven’t been so compassionate as a parent.’ When that comes through and they have the opportunity to really work with that, integrate it with their therapist and align themselves with their values, that is the most beautiful outcome.”