Psynergy Centre Health & Wellness is proud to be the first and only clinic in Medicine Hat, Alberta specialized in offering assisted therapy utilizing sublingual and intramuscular Ketamine treatments under the direction of Dr. Krista Leicht and in collaboration with Dr. Michael Weigel at The Hill Center Medical Clinic, Mettra Pharmacy and Southview Pharmacy prescribing pharmacists.

Ketamine Assisted Psychotherapy (KAP) is a unique transformational approach of altering consciousness to facilitate mental health and psychotherapy. KAP is a new treatment option for individuals suffering from treatment resistant depression, chronic pain, major depressive disorder, bipolar II, severe anxiety disorder, post traumatic stress disorder, suicidal ideation, eating disorders and substance abuse issues. The medicine acts as a catalyst or lubricant to facilitate the process of new learning and perspective shifts making actionable steps to change in one’s life easier. Our KAP program is implemented in a measure based method; meaning pre and post screens related to symtomology,  global distress scores,  and self reported functioning obervations are provided to measure self reported changes and improvements as it relates to progress and benefits of treatment.

 

Our Team

Psynergy’s multidisciplinary KAP team consists of a Psychiatric Medical Director leading our physician administrators, advanced care paramedics, trained registered psychiatric nurse, psychologists, guides and psychotherapists.  Utilizing the National Institute of Mental Health protocol and guidelines for Ketamine use, we work collaboratively to provide you a safe and transformative experience. All providers are actively involved in your healing journey. Upon psychiatric medical director approval and prescription, a licensed medical physician is the administrator, a licensed mental health professional works as the collaborator to the client in supporting this change through preparation and integration. New clients are required to have a referral and require a thorough psychiatric, medical, and mental health assessment with our team with a “three green lights” policy approval to proceed with treatments.

Ketamine is a synthetic pharmaceutical compound, classified as a dissociative anesthetic, due to its tendency to produce a disconnection from our usual way of feeling and experiencing the world. Ketamine is a glutamate (NMDA) receptor antagonist that has been shown to have rapid antidepressant properties with documented improvements within 2 hours with duration up to a week but, with assisted psychotherapy can extend the benefits and at times resolved the factor contributing to the mental health suffering. When used in sub-anesthetic doses to treat mental health and pain conditions, it can allow the body to turn off overactive pain receptors and develop new synaptic and neurogenic experiences associated with relief. It is also used in emergency rooms and surgical suites with all ages across the lifespan, around the world  and has an excellent safety profile. Unlike anesthesia that is meant to make one unconscious, KAP treatment is meant to keep patients awake with lower doses which are shown to be more effective for this treatment method by keeping clients in a deep state of relaxation and non-ordinary state of consciousness.

 

Why Ketamine Assisted Psychotherapy?

Ketamine Assisted Psychotherapy is a unique approach to traditional psychotherapy. Ketamine can produce a disconnection from our usual way of feeling or thinking often referred to as the Default Mode. Given at lower doses often with facilitated psychotherapy session, it produces shifts in consciousness that may lower your defences and allow you to dig deeper into your psyche, traumas and healing processes. It can allow for shifts in consciousness such as expanded states of awareness, novel ways of viewing life concerns, and freedom from worries and anxieties of our ordinary mind states. Psychotherapy following treatments offers real time reflection on this experience to enhance growth and change while reducing pain and distress. Traditional therapy focused on support, integrating insights, and identifying and reinforcing change are all part of the treatment process. Ketamine may in some instances and for some people, facilitate psychedelic like experiences such as non-ordinary states of consciousness, somatic releasing and intrapersonal  growth/connection. This psychedelic like experience is not one that should be expected in KAP sessions but should be prepared for and with intention can be transformational.

The standard pairing of Assisted Psychotherapy with Ketamine is Cognitive Behavior Therapy (CBT). However, other specialty treatments may be utilized as well when deemed appropriate such as Somatic Experiencing, Internal Family Systems, Emotion Focused Therapy, Dialectical Behavior Therapy, Mindfulness, Eye Movement and Desensitization and Reprocessing, Acceptance and Commitment Based Therapy  and other complementary modalities such as body work, breath work, acupuncture, massage, expressive arts and cultural practices etc as provided by your specialty trained therapist or referral to such providers. Preparation and Integration, either individually or in groups, of the ketamine process are crucial to the positive experience, outcomes and prolonging of the benefits of Ketamine vs Ketamine treatments alone.  It is widely shown through research that paring medication with psychotherapy is the most beneficial way to treat mental health disorders, such as depression and PTSD. KAP is no different. It is important to us that you have the most beneficial treatment and opportunity to heal. Our KAP program emphasizes the potential for change and healing through self empowerment, and such change is best facilitated within a structured, supportive therapeutic environment with a collaborative team including your support person(s) who are aware of your issues, hopes, struggles and desires.  It’s important you know and understand why we are doing what we are doing with each of the interventions throughout the protocol. The aim is to support you to make contact with, attend to and work through emotional experiences. In particular,  we want to help you to 1- transform maladaptive emotions states, 2- draw from the wisdom of adaptive emotion states, and 3- develop skills and confidence with navigating emotional states in general. These advanced skills will also make symptoms less necessary to cope with stress and distress, and in a way that is organic.

The collaborative team serves as guides through your inward process, and assists you in moving along this journey, as well as processing the experiences that impact on your daily life after your experience. Since ketamine can create conditions of psychological openness, we believe that having a safe authentic connection and trust with your therapeutic team in a calm supportive environment enables the deepest possible work to occur. All content that arises is meaningful. The medicine gives you what you need, not necessarily what you want.  Preparatory and integration sessions with the psychotherapist/psychiatrist, before and after your KAP sessions, are meant to build this connection and safe support to reduce distress and harm and include your support person(s). However, as a non-specific amplifier, we cannot always guarantee an easy journey, so it is important to reflect on the value of challenging experiences as well.

Side effects of treatment may include headache, nausea, dizziness, blurred vision, drowsiness, dissociation/derealization, bruising from injection site, elevated mood, anxiety/agitation, changes in blood pressure, heart rate or breathing. These effects are transient and majority are gone by 2-3 hours post medicine. You cannot operate a vehicle after so you will need a support person to pick you up post medicine journey. There is also the possibility that one may not respond to ketamine treatments-as that cannot be guaranteed.

An uncommon side effect of chronic ketamine abuse/misuse is painful cystitis. Please notify medical professionals immediately if you notice bladder pain. Ketamine also creates transient increases in blood pressure. You will not be a candidate if your blood pressure is above 150 and unmanaged. Should your blood pressure become stabilized and below 150 you may be considered.

Other exclusionary criteria that does not allow for consideration:

• Active substance abuse (Alcohol, cannabis, non-prescribed medications, etc.)
  • Negative urine toxicology screening prior to the initiation of treatment and during IV ketamine treatment course may be warranted
• History of psychosis or active psychosis
• History of increased intracranial pressure
• Pregnancy (current)
• Uncontrolled hypertension (above 150)
• Acute or unstable cardiovascular disease, thyroid or glaucoma, intracranial aneurysm, cirrhosis
• Use of MAOI’s
• Previous negative response to ketamine, allergy to ketamine

Cost

A one time fee of $500 for lifetime prescription management goes directly to the Medical Director’s office at Neuromed Clinic at the time of booking initial appointment. This fee is NOT covered by health benefits. Subsequent direct appointments with the psychiatric Medical Director and medical practitioners are billed through Alberta Health Care. Should you not be approved for Ketamine treatments, this $500 fee will be returned to you.

Psychological therapy in the form of preparation and integration are specialized private services not covered by Alberta Health Care. Therefore, the psychotherapy fees range from $190-$225 per hour depending on practitioners specialization, credentialing, and experience. Group integration fees are billed at a rate of $65 per hour. Of note, Blue Cross Blue Shield has indicated coverage depending on certain policy plans. It is suspected other insurance providers will follow suit. You will need to inquire about your benefits policy.

2-3 individual preparation sessions  (includes psychological screen) and 6 integration sessions are required to facilitate best outcomes. Therefore, the required accompanied therapy can range from $1,630-2,025 depending on the appropriate therapeutic format (group or individual or combo) for your individual specific treatment.

Ketamine medication can cost up to $150 for your monthly supply. The sublingual pharmacists will work with your benefits provider to advocate for coverage. Intramuscular treatment administration is billed to Alberta Health Care per 6 sessions.

Total cost for this highly specialized private service can range from $2130-2,675.

 

Next Steps

1-Print the KAP Patient Referral form below,  have your Psychiatrist complete it and fax to 888-453-8200. If you do not have a psychiatrist, your General Practitioner may also refer.  It is imperative that your referring Psychiatrist and/or General Practitioner understand our Medical Director provides the specialized care of ketamine only. Your usual medical providers/prescribers are responsible for ongoing medication management. If you do not have a Psychiatrist nor a General Practitioner, please phone our office for further direction 403-527-5911 to book with our medical provider.

2-Once the referral is received, You will be booked to attend to a psychological assessment to consent to and understand the steps of process and expectations of the program. If you are considered an appropriate psychological candidate you will then proceed to step 2.

3-The referral then gets forwarded to Psynergy Centre’s Medical Director for Psychiatric Assessment of appropriateness of ketamine. A virtual appointment will be booked with you. One time, lifetime administration fee is due.

If DENIED-process stops and reason for denial is sent to Referring Physician/Client , administration fee deposit is returned.

4- The appropriate administrator will contact you to do a medical assessment and if medically approved, you may be required to obtain additional medical such as bloodwork and urine analysis, prior to first appointment.

If APPROVED-A prescription to the appropriate administrator for either sublingual or intramuscular treatment will be made. At that time, your medicine prescription protocol will be made and first 6 treatment dates with respective preparation/integration will be set.

You will proceed when psychologically ready.  Psynergy Centre’s Ketamine Assisted Psychotherapy Program requires that you work with our therapists to ensure you are working with specialty qualified practitioners trained in this modality. Clients must commit to attending all individual and/or group psychotherapy sessions specific to Ketamine preparation and integration at Psynergy Centre. Clients may have their own community therapist that they may choose to continue to work with in other areas outside of the scope of Ketamine Assisted Psychotherapy. Failure to complete steps or participate in assisted therapy are grounds for dismissal from the program. Again, these therapy sessions are not covered by AHC. They are private specialized psychological services-benefits may cover based on insurance provider and policy. Please contact your benefits provider prior to booking. Any previous screenings with Psynergy team will go towards prep sessions at no additional charge.

5- Upon completion of the 6-12 week program, the patient is discharged from the treatment program when deemed necessary by the administrator and Medical Director.

KAP Referral