Now At-Home & Virtually Guided

Ketamine Therapy: A Week By Week Guide

If you’re considering ketamine therapy for the first time, you may be wondering “How does this all work?” or “What is the experience like?”

There are some differences and nuances between other program’s models, such as intravenous infusions/intramuscular injections (IV/IM), or sprays. Mindbloom's treatment model uses ketamine tablets for oral administration.

Below is a look at a week-by-week overview of the typical ketamine therapy protocol here at Mindbloom, with a specific focus on Mindbloom’s virtual introductory program (or first course of treatment): the Basics.

Ketamine Therapy: Week By Week

Week 0: Fit, Guide & Clinician Introductions, and Medical Evaluation

You’ve completed the pre-candidate survey which has identified that you may possibly be a good candidate for treatment, you have made the decision to move forward in our process to find out if ketamine treatment may be a good fit for you, and your deposit is paid. We’re excited for you!

Your next step is to schedule and attend clinical consultation: the first meeting with your licensed Mindbloom clinician. You can think of this meeting as a psychiatric evaluation, with a specific focus on identifying if this treatment is right for you, and if so what are the important things you need to know before proceeding. Be prepared to discuss how you’re feeling, what your goals are, and an in-depth medical and psychiatric history.

At the end, if the clinician identifies that you are a good fit for ketamine treatment, the first dose will be ordered, and your “Bloombox” —important items related to your experience including a blood pressure cuff, eye mask, and journal— is sent out for delivery.

Once you are approved for treatment, and you have booked your first virtual visit (the first time you take the medicine), you are introduced to your “Guide.” Your Guide will help you prepare, process, and integrate your experience throughout the entire program. The guide does not function in a clinical role. They are not licensed therapists. However, they are trained in a coaching model and the integration of psychedelic medicines and well suited to guide you through your Mindbloom journey with ketamine. 

Initially, they are there to ensure you receive your Bloombox, have prepared your space for the journey, support you in setting intentions, have your Peer Monitor (a loved one or close friend) available, and are feeling comfortable starting your sessions.

Week 1: First session and integration guidance

It’s time for your first session! 

You have your first dose of medication, your essential supplies are by your side, and your Peer Monitor is standing by. You will jump on video and be joined by your Guide to ensure everything is set up to support a valuable and safe experience.

After re-visiting your intentions and taking time to connect with yourself, you and your Guide discuss safety protocols, take blood pressure readings, confirm dosages, and intentions, and make space to address any questions or concerns.

With your Guide available and your Peer Monitor present, you take the medicine and embark on your first session. You may experience a range of emotions, insights, or sensations: From dissociation, to cathartic emotional release, reliving past memories, or novel (new) feelings or sensations. Everyone’s experience with the medicine differs, and how you’ll feel during the experience varies. 

After taking some time to process the experience and doing some integrative journaling, you reunite with your Guide and your clinician on video. You’ll discuss how the experience was, what arose for you, and how you felt about the medicine and your dosage. Based on this, your clinician will adjust the dosage if necessary, and submit the remaining prescription for your next 3 sessions.

Taking some time to reflect and process your session, and to take initial action for integration, will help the rest of the program unfold as smoothly as possible.

Your Guide continues to help you unpack and make sense of the experience in the first week, and will set up some integration activities for the next week. They’ll work with you to get the next session scheduled about 1-2 weeks from the first session date.

Week 2: Second session and initial results / insights

During the week leading up to your second session, you will continue to integrate, and may have a few questions for, or conversations with, your Guide. You’re free to use their expertise and insight to help you make sense of and reflect on the experiences you are having. 

Changes in mood or outlook may occur. You may experience mood elevations, a sense of calm, new relationships or associations with triggers and an openness to new experiences throughout the following days.

It is generally recommended, particularly for the first program, to space the sessions one week apart. This allows space for one treatment to settle and for you to reflect, the benefits to compound, and allows the biological and neurochemical changes to take place, all while hopefully making progress forward with each step along the way.

In Week 2, you return for your second session. You discuss and prepare with your Guide just as you did in the first round, sharing any insights or experiences that have transpired over the past few days. With the medical checks in place and your Peer Monitor present, you head into your second ketamine therapy session.

Once again, you are reunited with your Guide after your experience to reflect on your journaling, share about your experiences, and begin to make sense of anything that has come up for you. Your Guide can help to further unpack the experience, suggest some next steps and integration activities, and hold space for any challenging emotions or memories that arose throughout the experience.

Now at the halfway point of the first treatment program, you have a digital Medical Team Check-In, so that our clinical team can chart your progress, track your experiences, and make any necessary adjustments or interventions that are required.

The next few days are time spent being gentle with yourself, in reflection, and acting on any lessons or experiences that surfaced.

Week 3: Choosing a guided or self-guided treatment path

In the time leading up to the third session, you may notice positive shifts in mood. You may also receive comments from others about changes they are noticing in you. You might notice new opportunities or ways of thinking about certain areas in your life.

The more you dedicate yourself to the integration time in between sessions, the deeper the lessons settle in, and the more durable the experience and the benefits become in the long-term.

With more experience and a deeper relationship with the medicine, the third session gives you the opportunity to continue with your guide for video supported treatment preparation and debriefing or self-guided (using the medicine on your own at home, with Peer Monitor present), at the discretion of your clinician. The ability to steward your own healing process can provide a sense of autonomy, confidence, and be an important shift in your healing process.

If you choose self-guided sessions, the structure remains the same. Your Peer Monitor is present throughout each dosing session. You can curate your own soundscape for the experience, as you’re familiar with set and setting preparation recommendations, or use the ones that are provided for you. You will leverage your learnings around preparing your mindset by revisiting your intentions, trusting and letting go, and journaling post treatment in support of integration.

You continue to remain in contact with your Guide, who is there to answer questions, offer advice, or simply listen if there is something that needs to be expressed. The option to add on more dedicated integration coaching sessions is also available, promoting ample space to deeply explore the themes emerging and ensure they contribute to lasting change.

Week 4: Final session and check-ins

Following the weekly treatment schedule, you have a few days for reflection and integration before embarking on the fourth and final session of your introductory program. As always, you can refer to the personalized and curated preparation and integration materials provided in your account, or work closer with your Guide to navigate anything still uncertain.

The fourth treatment session marks the end of the introductory program and first course of treatment., and some clients have seen considerable change by this point. This is typically marked by noted elevations in mood and outlook, powerful insights that have helped resolve past challenges or future worries, or a new relationship with yourself and how you see your role in the world —or in your own life.

There is a final medical check-in from the clinical team to monitor progress, and ensure that your care is at the level you need and want. The final step is to schedule a check-in with your Guide to wrap-up the first program.

Week 5: Next steps

This is the final check-in with your Guide for the introductory program. You’ll discuss how you’re feeling, make a plan for ongoing integration, and take a look at what next steps are available.

It’s important that each program has a ‘closing.’ It’s a time to reflect on where you were when you started, and where you are today. You’ll consider what work remains to be done and how to continue to integrate the experiences. Ultimately, you’ll look towards the future and determine what the right next step is for you.

There are 3 paths clients often take at this point:

  1. Parting Ways: Some clients have done the work they needed to do, and choose to return to their lives and the world with the knowledge they’ve gained.
  2. Taking Time to Integrate: Some of our clients complete an initial course of treatment and feel better at that point. Some may opt to take a few weeks to integrate the themes/lessons/experiences that unfolded. We may then see them a month or two later as the growth has solidified and they hope to find deeper healing or they have identified that their mood has shifted back a bit and it may be time for a treatment booster to bring them back to their new elevated baseline mood.
  3. Starting a New Program: Some clients feel like they have built substantial momentum, and are starting to delve into important territory. They want to continue treatment, and move onto another curated 4-session treatment program to continue exploring these themes and making progress to their mental health goals. The process begins again with a check-in with the clinician who works with the client to develop an individualized plan for continuing care.

FAQ about Mindbloom’s Psychedelic Therapy Programs

IF you had any further questions after reading the above, here are some questions that are frequently asked about our introductory program: The Basics.

What does each program look like?

Mindbloom’s programs are structured as a pack of 4 treatment sessions. Each treatment session takes about 2-2.5 hours, depending on the involvement of a Guide or not. Each program—think of this as a digital guide or workbook—has a particular theme, with all preparation and integration content supporting the exploration of this theme. 

How many sessions are there?

Mindbloom programs have 4 sessions. Some IV/IM ketamine clinics may sell single-session options, or larger packs of 5-6. This will vary based on the provider.

What do I need to do?

Although considered a rapid-acting antidepressant (RAAD), Ketamine treatment and therapy isn’t a “magic pill,” Doing the preparation work before following instructions and guidance by your clinician,, and continuing the integration work after sessions is important.

Being willing to make changes, begin new habits, and have important conversations, all deeply assist the effects of the medicine itself.

What’s the time commitment?

The sessions themselves are 2-2.5 hours long, generally spaced 1 week apart during the first course of treatment. A full program will take about 4-6 weeks to complete, and depending on time spent reflecting and integrating, will be about 2-6 hours of work each week.

Can I stretch the program out longer?

To maximize the biological effectiveness of ketamine treatments, it’s helpful to keep each dosing session 1-2 weeks apart, however, this is a conversation that should be had with your clinician as everyone's treatment is individualized based on their needs.

It is possible to increase the length of time between each individual dosing session, though particularly for the first introductory programs, this is not recommended. There are biological and neurochemical benefits to ketamine as a medicine, which work best when compounded.

Why are there 4 sessions?

Each individual dosing session provides both biological and psychological benefits. By stacking a series of sessions closer together in a shorter amount of time, you can maximize the potential effects of the treatment. Mindbloom has developed our protocol to include an initial course of four treatments to build up a solid foundation of the medicine in your system and help you hopefully achieve a new baseline.

Disclaimer

Sources

This article is for informational purposes only and is not intended to be a substitute for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. If you are in a life-threatening situation, call the National Suicide Prevention Line at +1 (800) 273-8255, call 911, or go to the nearest emergency room.

Important FDA Safety Information

Ketamine is not FDA-approved for the treatment of depression or anxiety. Learn more about off-label uses here.

Side effects of ketamine treatment may include: altered sense of time, anxiety, blurred vision, diminished ability to see/hear/feel, dry mouth, elevated blood pressure or heart rate, elevated intraocular or intracranial pressure, excitability, loss of appetite, mental confusion, nausea/vomiting, nystagmus (rapid eye movements), restlessness, slurred speech, synesthesia (a mingling of the senses).

Do not proceed with ketamine treatment if any of the following apply to you:

  • Allergic to ketamine
  • Symptoms of psychosis or mania
  • Uncontrolled high blood pressure
  • CHF or other serious heart problem
  • Severe breathing problem
  • History of elevated intraocular or intracranial pressure
  • History of hyperthyroidism
  • Other serious medical illness
  • Pregnant, nursing, or trying to become pregnant

Ketamine has been reported to produce issues including, but not limited to, those listed below. However, lasting adverse side-effects are rare when medical protocols are carefully followed.

While ketamine has not been shown to be physically addictive, it has been shown to cause moderate psychological dependency in some recreational users.

  • In rare cases, frequent, heavy users have reported increased frequency of urination, urinary incontinence, pain urinating, passing blood in the urine, or reduced bladder size
  • Ketamine may worsen problems in people with schizophrenia, severe personality disorders, or other serious mental disorders.
  • Users with a personal or family history of psychosis should be cautious using any psychoactive substance, including ketamine, and discuss potential risks with your MindBloom clinician before proceeding with treatment.
  • The dissociative effects of ketamine may increase patient vulnerability and the risk of accidents.

To promote positive outcomes and ensure safety, follow these ketamine treatment guidelines:

  • Do not operate a vehicle (e.g., car, motorcycle, bicycle) or heavy machinery following treatment until you’ve had a full night of sleep
  • Refrain from taking benzodiazepines or stimulants for 24 hours prior to treatment
  • Continue to take antihypertensive medication as prescribed
  • Avoid hangovers or alcohol intake
  • Refrain from consuming solid foods within 3 hours prior to treatment and liquids within 1 hour prior to treatment
  • Ketamine treatment should never be conducted without a monitor present to ensure your safety
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Ketamine Therapy: A Week By Week Guide