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

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

☐ COMFORTABLE CLOTHING

☐ MEANINGFUL/SENTIMENTAL ITEM

    • Verify client has not eaten for 3-4 hours prior, no water 1 hour before, and any medication interactions followed

  • Review Dosing Prep content and question document

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

    • Client must have laptop and phone on Do Not Disturb

      • You may want to have client listen to music on another device and not on laptop so if you were to speak to them it would not frighten them due to volume issues

    • Needed for emergency contact and establish HIPAA compliant texting/call for communication during session

    • (ORAL KETAMINE) Responsible for timer & alerting when to spit

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

    • Remain close by to assist if needed

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

    • Assist with post journey snack / drink prep

    • Remain with client until medication effects have subsided

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

    • You will want to be able to hear the client during their dosing journey in case need arises and they call to you for comfort, emergency, or booster

    • Ketamine can sometimes create a feeling of having to urinate so encourage client to use bathroom immediately before taking ketamine tablets

  • (Follow instructions given by medical provider as the blood pressure and heart rate must be under threshold per medical instructions to proceed )

    • Therapist cannot assist with taking blood rate/heart rate due to medical out-of-scope guidelines. Therapist records stats

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

    • Length of session, client follows medical provider instructions for ketamine intake, how to indicate when booster is needed, set expectations, Reminder to Trust, Let Go, Be Open

    • Review client’s intention for dosing session

    • An intention can be: A desired outcome for the journey, a desire to receive insights or healing in specific areas of life, aspiring to observe or cultivate particular traits within the client

    • Create an intention that is positive, present oriented, and provides direction (i.e. Show me…, Help me…

    • Remember that the intention is not a rigid instruction, but will help frame their experience, but then they should let go of the expectation and allow journey to show them what they need not necessarily what they want

      To learn more about how you can help your client create an effective intention, click HERE.

    • Mindset and setting will help increase client’s ability to let go and be open to the process. Pre dosing meditation or breath work can assist with preparation.

Prepare Setting

    • Therapist cannot assist in physically dispensing of the tablets due to medical out of scope guidelines. Watch Chaperone or client open designated package

    • Client sits in upright position to prevent swallowing

    • Place tablet(s) under tongue. Hold saliva in mouth and do not swallow.

    • Client may leave one earphone off of ear to hear therapist meditations, guidance, and countdown of timer

    • See medical provider for minutes. Timing may vary as discussed with medical provider to be longer or shorter

    • Encourage client to swish saliva in mouth periodically to increase absorption.

    • Provide positive feedback of holding and swishing. Give countdown periodically

    • Meditations that are related to client’s intention could be utilized

    • It is recommended to allow time for client to sit with own thoughts so allow time for peace without meditation or speaking

    • Client 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)

    • As discussed with medical provider, client could choose to split dose & take each tablet separately

    • Client 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)

    • Client can recline and secure eyemask and headphones

    • Remind client of intention and to …Trust, Let go, Be open.

    • Do not interfere with client’s journey but remain in proximity for safety or guidance

    • Remain attentive to when client signals they would like booster tablet and repeat dosing protocol

Dosing Session - KAP Protocol (Oral Ketamine)

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

    • 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

    • Client may leave one earphone off of ear to hear therapist meditations, guidance, and countdown of timer

  • Medicine should begin to take effect in 3-5 minutes

    • As discussed with medical provider, client should only use the number of sprays indicated in instructions

    • Client can recline and secure eyemask and headphones

    • Remind client of intention and to …Trust, Let go, Be open.

    • Do not interfere with client’s journey but remain in proximity for safety or guidance

    • Remain attentive to when client signals they would like booster tablet and repeat dosing protocol

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

    • Client takes blood pressure and heart rate and writes down results

    • If client has sustained increased blood pressure over threshold as indicated by medical provider call 9-1-1 and medical provide

    • Client will be unsteady on their feet so provide support for safety

    • Therapist or Chaperone can take notes on any insights client may want to share.

    • Allow client to share when ready. Some clients may want to process on their own and integrate in the next session.

    • Encourage client to not make any major decisions for the rest of the day due to being in an altered state

  • Encourage them to visit the Self Care Guide for guidance.

End of Dosing Session

Integration Session (same day optional)

Encourage your client to explore the insights and experiences of their ketamine session with personal reflection. Journaling will help unlock the full potential of your ketamine therapy journey after the session has finished.

Go to the Integration Prompts or begin Integration Process