KAP Dosing Session Protocol

Procedure and structure for the ketamine dosing session

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1. Items Checklist

2. Prepare Setting

3. Dosing Session

4. End of Dosing Session

5. Integration

KAP Items Checklist

Review all items are prepped before proceeding with dosing session as advised by medical provider

Essentials

☐ Blood pressure cuff

☐ Eye mask

☐ Noise-canceling headphones

☐ Ketamine Tablets

☐ Spit cup

☐ Bucket or Trashcan

☐ Pillow

☐ Journal & Pen

☐ Time (iphone, Alexa, etc.)

☐ Facial Tissue

Optional

☐ Weighted blanket

☐ Do Not Disturb sign

☐ Anti-nausea medication

☐ Grounding object

☐ Water or Flavored sports drink

☐ Post journey snack

☐ MEANINGFUL/SENTIMENTAL ITEM

☐ ESSENTIAL OILS

☐ COMFORTABLE CLOTHING

    • Refrain from eating for 3-4 hours prior to dosing, no water 1 hour before, and follow medicine interaction guidelines

    • Pillow & blanket, dim lighting, secure pets

    • Gather Checklist items

    • Place Do Not Disturb sign on door

    • Ensure music playlist is selected in advance and will not have commercial interruptions

    • It is important to prevent any disruptions during your dosing session

    • This is needed for the exchange of information during your dosing session

    • Responsible for timer & alerting when to spit

    • Take Blood pressure and heart rate before and after journey and write down stats

    • Assist with your needs and provide support as requested

    • For self dosing session Chaperone will text therapist stats, timings, concerns

    • Assist with post journey snack / drink prep

    • Remains with you until medication effects have subsided

    • Discuss consent to touch with your chaperone if feeling distress

    • It is important to have a conversation about what kind of comforting touch is appropriate during the dosing session as each person has a comfort level. (i.e. hand on shoulder, foot, top of head, hold hand, etc)

    • You will want them to hear you during the dosing journey in case the need arises and you call for comfort, emergency, or time to take the booster

    • Ketamine can sometimes create a feeling of having to urinate so it is suggested you use bathroom immediately before taking ketamine tablets

  • (Your blood pressure must be under 160/90 and heart rate under 100)

    • If stats are over the maximum rate, engage in grounding activities (i.e. breathwork, meditation, etc.) to lower stats. If after several attempts your stats are not under threshold, do not proceed with dosing session and refer to medical provider and therapist to discuss options and reschedule KAP session

    • Write down the stats

    • This is the time to ask any questions you and your chaperone may have about the protocol, concerns, and expectations.

    • Create an intention that is positive and present oriented

    • Remember that the intention is not a rigid instruction but will help you frame your experience

    • Cultivating the best mindset and preparing a comforting setting will help increase your ability to let go and be open to the process which will provide a more successful outcome. Engaging in meditation or breath work in advance of dosing can assist with the preparation.

Prepare Setting

    • Do not swallow, hold saliva in mouth

    • Sit in an upright position to prevent swallowing

    • Swish saliva periodically to ensure the medication will dissolve and increase absorption

    • As discussed with medical provider, you may take the number of tablets they prescribed for one journey

  • Timing to hold ketamine in mouth will be indicated on instructions from medical provider

    • Chaperone should provide reminders to swish saliva in mouth periodically

    • It helps to provide positive feedback during holding and swishing

    • Give verbal countdown periodically

    • You may choose to leave one earphone off of ear to hear the therapist/chaperone read a meditation, provide guidance, and share countdown of the timer

    • Start timer (13 min)

    • Your therapist and chaperone are in charge of the timer and will inform you of when it is time to spit out the medication

    • Meditations are located here

    • It is recommended to allow time for the client to sit with their own thoughts as well so allow time for peace without meditation or speaking during the swishing

    • You could rinse mouth after spitting by swishing and then spitting again with a liquid such as sports drink to help reduce lingering taste (if needed)

    • Ketamine can numb the mouth so assist with the holding the spit cup

    • You may recline, secure eye mask, and headphones.

    • Reflect on your intention and then remember to …Trust, Let go, Be open.

      • The length of the journey will vary with every experience and each individual is unique. No need to rush or label your experience as good or bad, right or wrong. Allow the journey to show you what you need.

    • Chaperone is advised to not interfere with your journey but should remain in proximity for safety or guidance

    • As discussed with medical provider, you may split dose into 2 separate tablets.

    • Chaperone should provide reminders to swish saliva in mouth periodically

    • It helps to provide positive feedback during holding and swishing

    • Give verbal countdown periodically

  • Timing to hold ketamine in mouth will be indicated on instructions from medical provider

    • You may recline, secure eye mask, and headphones.

    • Reflect on your intention and then remember to …Trust, Let go, Be open.

      • The length of the journey will vary with every experience and each individual is unique. No need to rush or label your experience as good or bad, right or wrong. Allow the journey to show you what you need.

    • Chaperone is advised to not interfere with your journey but should remain in proximity for safety or guidance

    • When you feel the effects of the ketamine reducing, you may choose to take a booster to deepen and extend your journey

    • Chaperone will remain attentive to when you signal you would like to take booster tablet

    • [Engage in booster protocol]

      • Take booster, hold saliva, swish, write down time taking booster, set timer for 12 minutes, alert client to spit when timer ends

  • Timing to hold ketamine in mouth will be indicated on instructions from medical provider

  • For medical emergencies call 9-1-1 or go to the nearest hospital, contact your medical provider, and inform your therapist of adverse reactions

Dosing Session
KAP Protocol (Oral Tablet)

Follow the instructions from medical provider. The steps below are an example of how a session may occur.

Dosing Session
KAP Protocol (IM or Nasal Ketamine)

Always follow instructions from medical provider. The following steps are an example of how a dosing session may occur.

Follow the instructions from medical provider. The steps below are an example of how a session may occur.

    • Therapist cannot assist in giving injection or handling nasal spray

    • Client will follow instructions as to how many sprays for each nostril during session hour

  • The use of noise cancelling headphones can help deepen the inner exploration and heighten experience or if silence is preferred wearing noise cancelling headphones can eliminate distractions

    • Write down time injection or nasal sprays began and number of sprays taken

  • When you feel the effects of the ketamine reducing, you may choose to take a booster to deepen and extend your journey.

    Write down time and number of sprays. Do not go over maximum allowed per medical instructions

  • For medical emergencies call 9-1-1 or go to the nearest hospital, contact your medical provider, and inform your therapist of adverse reactions

    • Client should not be rushed and can be allowed to stay with their own internal processing

    • You are your chaperon will take your blood pressure and heart rate and write down results

    • If you have sustained increased blood pressure and heart rate over threshold call 9-1-1 or go to the nearest hospital, contact your medical provider, and inform your therapist of adverse reactions

  • You will be unsteady on your feet so ensure you feel stable enough or receive assistance from chaperone for safety purposes

    • You are encouraged to write, draw, sketch and express any thoughts, bodily sensations, or insights experienced during your journey. Your therapist or chaperone can also take notes if you prefer.

    • You may review your journal entries during your next integration session with your therapist

  • It is recommended you eat healthy foods to complete your journey with proper nutrition

  • It is recommended you create the change you want to see in yourself by engaging in self care to take advantage of the brain’s most increased window of neuroplasticity (ability to create new patterns). You may explore the self care guide.

End of Dosing Session

Integration (Same day optional)

After your session, explore the insights and experiences of your ketamine session with personal reflection. Journaling will help unlock the full potential of your ketamine therapy journey as you share your innermost thoughts, insights, and experience without judgment.

Click here to find a list of helpful journal prompts to explore.