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I am a Journey Clinical KAP Provider
I offer a therapeutic modality called Ketamine-Assisted Psychotherapy (KAP), the use of ketamine as a complement to psychotherapy. I deliver KAP in my practice in partnership with an organization called Journey Clinical, which has a specialized medical team that determines eligibility for KAP, prescribes the ketamine, & supports us in monitoring outcomes. If you would like to explore the possibility of working with me on KAP, please e-mail me at [email protected] to discuss eligibility and next steps. What is Ketamine Assisted Therapy? (KAP) I offer a therapeutic modality called Ketamine-Assisted Psychotherapy (KAP) in partnership with an organization called Journey Clinical. Ketamine-Assisted Psychotherapy (KAP) is a holistic modality in which ketamine is used as a complement to psychotherapy to help eligible patients experience more frequent breakthroughs and sustained improvement in symptoms. I take on the psychotherapy portion of the experience, while Journey Clinical’s medical team supports you on all medical aspects. This includes determining eligibility, developing a custom treatment plan, prescribing the medicine and monitoring outcomes. Below is more information about KAP to help you navigate if it may be a good fit for you. What is Ketamine? Ketamine is a legal, safe and effective medicine used to treat a variety of mental health conditions, including depression, anxiety and PTSD. Ketamine has rapidly-acting antidepressant and mood-enhancing effects, which can begin to take effect within 1-2 hrs. after treatment and last for up to 2 weeks. It works by blocking the brain’s NMDA receptors as well as by stimulating AMPA receptors, which are thought to help form new synaptic connections and boost neural circuits that regulate stress and mood. Ketamine has also been shown to enhance overall neuroplasticity for lasting symptom improvement. ● Ketamine can be administered in a variety of ways, including IV infusion, intramuscular injection, via nasal spray and using sublingual lozenges. In my work with Journey Clinical they only use the sublingual lozenge form. ©Journey Clinical Inc 2023 How does Ketamine feel? The effects of ketamine, which most patients find pleasant, last for approximately 45 minutes. These effects can make you feel “far from” your body, and facilitate shifts in perception that can often feel expansive in nature. Your motor and verbal abilities will be reduced, so you’ll be lying down in a comfortable position during the experience. Once these effects subsided, we’ll spend the remainder of our appointment giving you space to process and discuss your experience. While it may feel hard to articulate what happened during the experience, patients feel like the insights gained are none-the-less clear. Studies have shown that the benefits to mood and neurological growth can last up to two weeks after the Ketamine experience. ©Journey Clinical Inc 2023 How Does Ketamine-Assisted Psychotherapy Work? 1. Initial consultation with Journey Clinical ● You schedule an initial evaluation with a clinician from the Journey Clinical medical team via zoom. They will go over your medical and psychiatric history with you, provide education on the treatment and determine if you are eligible for KAP. ● If Journey Clinical’s medical team determines that you are eligible for KAP, they will develop a personalized Ketamine prescription and outcome monitoring plan for you. ● Journey Clinical’s medical staff will write a ketamine prescription for you, and a small amount of oral ketamine will be sent to your home, enough for the first 2 KAP sessions. You will be taught to take your vitals and self-administer the ketamine lozenges by Journey Clinical’s medical team in advance of our KAP sessions. 2. Preparation sessions: ● Once you receive your ketamine lozenges, we will schedule time together for our KAP preparation, dosing and integration sessions. Preparation session(s) will be scheduled just like regular therapy sessions prior to the KAP dosing session. The goal of a preparation session(s) is to align on the process and set intentions for our KAP sessions together. 3. KAP Dosing Session: ● A typical ketamine dosing session can take place either in-person at my office, or remotely via telehealth. Up to 3 hours will be reserved for you. ● During a dosing session, you will self-administer your ketamine lozenge either in my office or in your home. You will be in a comfortable, reclining position wearing an eye mask and listening to calming music. Although a KAP dosing session may be largely an internal experience, I will be present with you the entire time to hold space and provide support as needed. 4. Integration Sessions: ● After our KAP dosing session, we will meet for multiple integration therapy sessions to review the memories, thoughts & insights that arose during your dosing session, and to prepare for the next dosing session. 5. Follow-up consultations with Journey Clinical: ● After our first KAP session, Journey Clinical’s medical team schedules regular follow ups with you to monitor outcomes and prescribe ketamine lozenge refills, as appropriate. The frequency of follow ups depends on your unique treatment plan, at a minimum of once per quarter. ● After our first KAP session, Journey Clinical’s medical team schedules regular follow ups with you to monitor outcomes and prescribe ketamine lozenge refills, as appropriate. The frequency of follow ups depends on your unique treatment plan, at a minimum of once per quarter. What is the Cost of Treatment?Please contact me for further information regarding my fees for Ketamine-Assisted Psychotherapy. ○ Journey Clinical Medical Costs: Visit their website for further details at https://www.journeyclinical.com/patients Where can I find out further information about Ketamine Assisted Psychotherapy? Here are some great resources including podcasts and articles to learn more about ketamine assisted psychotherapy and treatment: ● What is ketamine-assisted psychotherapy? https://www.psychologytoday.com/us/blog/new-beginning/202208/introduction-ketamine-assisted-psychotherapy ● Science behind ketamine and the brain https://www.youtube.com/watch?v=nW21-AYY_fs&ab_channel=YaleMedicine ● The impact KAP has had in real people's lives https://www.youtube.com/watch?v=4XSa4ZHCh98&ab_channel=JourneyClinical ● Podcast all about Ketamine https://open.spotify.com/episode/4aOSjydc0wEXCvHkYon3fL ● Dr. Andrew Huberman’s 90 minute podcast into how ketamine therapy works https://www.youtube.com/watch?v=Rxmv7rT9leo&ab_channel=AndrewHuberman ● Interview with Lauren Taus on how psychedelics are changing therapy https://www.youtube.com/watch?v=9E-Mf_XJ2U0&ab_channel=Blu ●Meta-analyses of Ketamine treatment studies https://pubmed.ncbi.nlm.nih.gov/33065824/ https://www.nature.com/articles/s41380-022-01757-7 Unfortunately we have a serious opioid epidemic and crisis that seems to be growing with the spread of high powered opioids including fentanyl. I recently learned about a resource in WA state that provides free Narcan (Naloxone) for personal use. This can be a life saving treatment and is such a great resource to have on hand if ever needed. I just ordered it online and the whole process took less than 5 minutes and will be shipped directly to me. Here is the resource if you or anyone you know needs it or wants to have it in their first aid kit in case of emergency:
http://phra.org/mail-order-naloxone As a mental health therapist, I've worked with a lot of children with divorced parents and blended families.
Here are some of my favorite books for helping children understand and adjust to parents separating and divorcing, and adapting to a blended family: Dinosaurs Divorce https://smile.amazon.com/Dinosaurs-Divorce-Dino-Life-Guides/dp/0316109967/ Two Homes https://smile.amazon.com/Two-Homes-Claire-Masurel/dp/0763619841/ The Family Book by Todd Parr https://smile.amazon.com/dp/0316070408/ Two Homes https://smile.amazon.com/Two-Homes-Claire-Masurel/dp/0763619841/ The Mommy Book by Todd Parr https://smile.amazon.com/dp/0316337749/ The Daddy Book by Todd Parr https://smile.amazon.com/Daddy-Book-Todd-Parr-ebook/dp/B007GB6UFA/  For those of you that live in Western Washington like I do, you also know how dark, cold, and dreary it can be this time of year. The sun goes down earlier and earlier and at times it can feel like we hardly see the sun at all. I hear from a lot of people how easy it would be to want to sleep all day, or go to bed as soon as it gets dark (as early as 5pm here sometimes!). Not having much daylight can definitely affect how we feel and can contribute to fatigue, trouble sleeping, and depressed mood. For some people, their symptoms are bad enough to be classified as Seasonal Affective Disorder, which is a seasonal type of depression lasting through the winter months. Even if you don’t have Seasonal Affective Disorder, the lack of daylight can be depressing and uncomfortable. Here are a few of my tips to help beat the winter blues: 1. Look into light therapy. Light therapy boxes are essentially small boxes emitting super bright light that use with your peripheral vision (not looking at directly). Ideally, boxes should omit at least 10,000 lux of light and can be helpful when used in the morning and sometimes the evening. Some people use one while eating breakfast or drinking their coffee, and others may bring theirs to work to have on their desk for a pick-me-up on tiring day. For more information on how to use a lightbox, check with your doctor. You can also read more from the Mayo Clinic at https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder There are numerous options for light therapy boxes, but here are a few samples to get you started on your search: Light therapy boxes https://www.amazon.com/dp/B07MG4JL45/ https://www.amazon.com/Verilux-HappyLight-Lucent-Bright-Therapy/ https://www.amazon.com/Therapy-UV-Free-Brightness-Adjustable-Standing/ 2. Get as much daylight as you can. With busy work schedules and working hours often coincide with daylight hours, sometimes the morning hours can be your best bet to get a little sun. Even taking a walk or sitting in your car during a work break can give you a little daylight exposure. 3. Talk with your doctor about Vitamin D. Make sure your body is getting enough vitamins and minerals it needs, including Vitamin D. Since we get so much of our Vitamin D from sun exposure, people living in northern latitudes have increased risk for Vitamin D deficiency. Vitamin D deficiency can affect our immune system, bone health, and mental health including depression. 4. Exercise. Yes, I know you’ve heard this before and it can be hard to exercise when it’s so cold and dark outside. But even if you only feel up to doing a little bit, a 15 minute walk or going to the gym 1x/week can make a big difference in our energy and mood. If you don’t have access to a gym, many people use large buildings for a walk, such as shopping malls. Check out your local mall and see if they offer a mall walking group, or just walk around yourself. If you live near Olympia, we have a local group here at https://www.shoppingcapitalmall.com/live360-event/Capital-Mall-Walker-Program 5. Don’t isolate. I know it can be easy to spend hours on your warm couch and binge watch your favorite shows on Netflix. But staying inside our homes all the time isn’t always what is best for us. Schedule some activities ahead of time with supportive family or friends and put it on your calendar, so you’re more likely to stick with your plans. This time of year can also be a good time to learn about other classes and interests, such as volunteering or taking classes at your local Parks and Recreation. For Olympia Parks and Recreation, check out http://olympiawa.gov/city-services/parks. For Lacey Parks and Rec, check out https://www.ci.lacey.wa.us/city-government/city-departments/parks-and-recreation 6. Don’t be afraid to ask for help. If you or a loved one are feeling depressed, you are not alone. Please don’t hesitate to ask for help. You can talk with your doctor, or ask for referrals to therapy from your insurance company or look online at https://www.psychologytoday.com/us  I was playing tennis recently and had one of those rough days where I really wasn’t playing well and I started feeling very discouraged and frustrated. I felt like quitting right then and there and going home. But I had already committed to playing and had to keep going, even though I was playing terribly and felt like quitting. And no, I didn’t magically start playing better, or even feel better after I finished. But I had made it through, even though it sucked.
Life can feel like this sometimes, where we are stuck in a rut, or feel like we are barely hanging on. We may feel like we want to quit or we want to stop going through the motions when times are hard. Life can be very challenging and it may feel like we are barely trudging through the mud of life. You are not alone in this and many people feel this way at different points in their life. The good news is that there is help. Having a counselor to listen unconditionally and provide support can help you trudge through when times are hard. It’s okay to ask for help, we all need it sometimes. Hang in there, you’re not alone. Thanks for reading, -Rondale  I was playing tennis the other day and had inspiration for another blog post. Yes, another post related to tennis (one of my favorite activities and in my opinion a great sport for increasing mental toughness and resiliency)! I was playing tennis against a player that hits the tennis ball in a much different style than me. I was trying to figure out the best way to play against her and I started to match her playing style instead of playing my way. This went horribly. I started losing points right and left that I should have won and I became very frustrated. After losing for a while, I took a break and told myself to breathe and think. Why was I changing to match someone else? Why was I scared to play my way? I was limiting myself and my abilities because of fear of making mistakes. I realized that I needed to play the game my way, with my own style. Once I started to be myself and play tennis the way that felt genuine and right to me, I started doing so much better. I eventually won that game. I definitely would not have made a comeback if I hadn’t changed strategies. The moral of this story is that it’s important to be ourselves. I know we’ve all heard this before, but I think it’s a good reminder. When we try to go through life morphing and adapting into someone else’s way we are not being our true selves. When we are not being ourselves we are not optimizing our strengths. I encourage you to look at the strengths you already have, I guarantee you already have many! Go through life as you and not someone else. Be your best self. Thanks for reading! Rondale  “Always do what you are afraid to do”. This quote by Ralph Waldo Emerson is one of my favorite quotes of all time. One of the reasons why I like this quote is because it reminds me that I can still chose to do things in spite of my fear. Anxiety can feel debilitating at times and like it’s limiting our life. I commonly work with people that want to work on their goals and make changes in their life. Unfortunately for those struggling with anxiety it can often feel like their anxiety is getting in their way. One of the things I recommend is to break things down into much smaller steps and tackle each small step one at a time. This can help things feel less overwhelming. Counseling can be very helpful for this. People can learn skills to manage their anxiety and the anxiety can definitely get better. However, sometimes there is still some remaining anxiety and fear, especially when it comes to making big decisions in our lives, such as changing jobs or going back to college. But as Ralph Waldo Emerson states, “Always do what you are afraid to do”. This quote reminds me that I can still take steps towards positive change in my life even if I am afraid. We can still make progress and take steps in spite of our anxiety and fears. As I commonly tell my clients, it’s okay to have strong emotions, we are human, we are not robots. It’s what we do with those emotions that matters. If we feel very strongly about making a positive change in our life, we can still do it in spite of our fear. Thanks for reading! Rondale So many times I still see and hear about the stigma with mental health issues. How many times must we hear that “it’s not real” or that people with mental illness could “just get over it” or that they “should just move on with their lives”. How many times do we need to hear this? I’m tired of misperceptions and the stigma associated with mental illness and receiving mental health treatment. It’s time to clarify some things. Would we tell someone with diabetes that they don’t really need their insulin? Would we tell someone with cancer that they don’t really need treatment? Would we tell someone that wears glasses that they don’t really need their glasses if they just tried harder to see? Of course not! So why do we do this with mental health issues like anxiety and depression? It’s okay to need help and get treatment, just like it’s okay to need eyeglasses if you can’t see or medication if you are sick. Let’s get real with some facts. 1 in 5 adults in America experience a mental illness. That’s 20 percent! If you are struggling with a mental illness, you are not alone! If you have a friend or family member struggling with a mental illness, they are not alone. Let’s stop the stigma one person at a time. I’ll start: I go to a doctor when I’m sick. I take medication when I need to. I wear eyeglasses because I need them. I’ve received mental health treatment from a counselor. It’s okay to need medical help and it’s okay to need help with our mental health. Let's break down the stigma together. Thanks for reading! -Rondale  https://www.nami.org/NAMI/media/NAMI-Media/Infographics/GeneralMHFacts.pdf One of the things that I like to do in my spare time is listen to podcasts that inspire me and encourage my own personal growth and development. Recently I listened to this podcast and I liked it so much I wanted to share it. The podcast is The Happy Secret to Better Work by Shawn Anchor, a psychologist who studies and researches positive psychology, which is essentially the study of good things -- people’s happiness, strengths, love, optimism, resiliency and more (aka the positive things in life).
I love this podcast because 1) it’s hilarious and 2) it has some excellent points. Shawn talks about how much our perspective influences how we respond to our life circumstances. I see the importance of this so much in my own life and in my work as a counselor. How we chose to think about things can be so influential. Our society constantly bombards us with negative news and stories of doom and gloom. This can lead us to focus even more on the negative and miss out on seeing the good things in our lives, in others, and in our society. What if we decided to try to notice more of the positive? What if we decided to focus more on our strengths rather than our weaknesses? I believe that every person and child that comes into my office has strengths that we can use and build on in counseling. I think it’s very easy and natural to focus more on the negative, especially when we are struggling and having a hard time. I totally understand that! It isn’t easy for me either. But even in the midst of hard times our perspective on it can make a huge difference. I encourage you to listen to this podcast and see what you think. Thanks for reading! -Rondale Anxiety can be experienced in many different ways and there are several different types of anxiety disorders, but a lot of the symptoms of anxiety overlap. In this blog post I will talk about some of the common symptoms of anxiety and a few free online resources that may be helpful. Here are some of the symptoms of anxiety I commonly see in my office: Difficulty falling and/or staying asleep Irritability Difficulty concentrating Stomach and digestive issues Difficulty controlling worrying Avoiding people, places, or things that trigger the anxiety Nightmares/bad dreams Racing thoughts Muscle tension Headaches Chest tightness In children, sometimes anxiety can look a little different. Children will often complain of physical complaints, such as stomach aches. They may go to the nurse at school frequently or ask to go home or call home more often than other kids their age. They may want to stay home from school more often than typical or have trouble sleeping in their own room. The good news is there is treatment for anxiety. If you are interested in learning more about anxiety and strategies you can use to help cope with anxiety, AnxietyBC is an excellent website and a great resource. There is a ton of information on the website about anxiety and resources to help with it. AnxietyBC created a free self-help app called MindShift which includes information about anxiety, strategies to deal with it, and relaxation exercises. Another one of my favorite apps to help anxiety is InsightTimer which is a free relaxation and meditation app. If you are concerned that you or your child has anxiety, I highly recommend talking with a counselor. Counseling can be very useful in helping you learn skills and strategies to deal with the anxiety. Thanks for reading! -Rondale |
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November 2023
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