Integrative Psychiatry for Adults

Our approach to psychiatry is based on the belief that well-being is multifaceted, and effective support must include the whole person. Our providers are trained to explore and evaluate the patient’s lifestyle, social context, and environmental conditions, and in addition to any appropriate medication may also suggest evidence-based supplements, psychotherapy, and/or yoga or fitness activities.

All psychiatric care begins with an in-depth, one-hour evaluation. Our providers are gifted listeners and our consultation rooms designed for comfort and safety. Providers ask thorough questions with a compassionate presence, and take great care in understanding each patient’s situation.

When medications are prescribed, follow-ups are scheduled to check-in and verify results, and make adjustments as needed.

Psychotherapy

Our psychotherapists have diverse backgrounds and orientations, but we share some common understandings:

  • Each individual has an internal healing intelligence, which we honor and support.
  • The therapeutic relationship is sacred – our duty to our clients is also a privilege.
  • Pain is inevitable. Suffering may be optional.

We address a wide range of issues, including:

  • Anxiety and Stress Management
  • Depression
  • Traumatic Experience
  • Loss and Tragedy
  • Life Transitions
  • Family Conflict
  • Self-Esteem
  • Parenting and Career Challenges
  • Existential Issues

Our approach to psychotherapy includes several possible components:

Therapeutic Relationship
Above all, we work to provide an environment that is a safe, accepting, and honest experience for the client.

Somatic Intelligence
The body holds immense wisdom and healing power. We can train our clients to listen patiently to their felt physical experience, and leverage that wisdom and power.

Social Environment
We can support clients in healing, building and maintaining supportive relationships with family, friends, and partners.

Physiology
By supporting patients in developing healthy behaviors in the areas of diet, exercise, and sleep, we can support them in nourishing a healthy psychology.

Experiential Transformation
We look for moments in which the present moment contains the possibility for transformation.

Internal Dynamics
We can assist clients in developing an awareness of and freedom from disempowering beliefs, and undoing biases in the realm of cognition and perception.

Early Conditioning
In helping our clients identify and address early emotional injuries, we may help them find new freedom from outdated ways of being.

Psychoeducation
In addition to providing therapeutic guidance, we assist our patients in understanding the how and why of the process so that they can become more skillful with future challenges.

Ketamine-Assisted Psychotherapy

Psychiatric use of ketamine has become relatively widespread in recent years. Ketamine has been studied and promoted by the National Institute of Mental Health (NIMH). Often, it has been used after other treatment approaches have been unsuccessful.

At Roots Behavioral Health, our approach is unique in several important ways:

  • We believe the therapeutic relationship is an essential component of the process. Our therapists are specifically trained in KAP as well as auxiliary modalities, and bring a wealth of experience and compassion to their craft.
  • We are highly focused on preparation and integration. We see the healing process as extending well beyond the ketamine experience itself, and support our patients in continuing their therapeutic journey in their daily lives.
  • Our treatment team is deeply collaborative. Our therapists and medical providers consult regularly to improve our treatments and outcomes.

Ketamine is a schedule III medication that has long been safely used as an anesthetic, and is now in use at smaller doses as an effective treatment for depression, PTSD, addiction, and other psychiatric diagnoses as well as for existential and spiritual crises.

At the biological level, the current understanding of ketamine’s mode of action is as an NMDA (N-methyl-D aspartate) antagonist working through the glutamate neurotransmitter system. This is a unique pathway, distinct from other psychiatric medications such as SSRIs, SNRIs, mood stabilizers, etc.

In more subjective terms, ketamine produces a state of consciousness that is often described as dissociative, which means that one’s baseline sense of reality and self are changed in unique ways. These changes can provide a healthy disruption of repetitive or dysfunctional thoughts and behaviors, allowing new insights and understandings to emerge.

Ketamine-Assisted Psychotherapy begins with preparation. First, we offer an in-depth psychiatric evaluation to assess whether this approach is appropriate to the patient’s needs. We continue with a second appointment to give a detailed overview of the intentions, format, costs, and the possible risks of treatment. Next, patients meet with their KAP psychotherapist for a preparation session to establish goals and context for the treatment. KAP dosing sessions are then scheduled, which are two hours long, and include both a check-in with the medical provider and two full hours of time with the psychotherapist. Many patients are prescribed 6 – 8 sessions over 3 – 8 weeks, with follow-ups as-needed. Individual treatment protocols are always tailored to the needs of each patient.

During dosing sessions, we typically provide ketamine via an intramuscular (IM) injection, typically in the deltoid (shoulder muscle). Alterations in consciousness begin within 5 minutes or less, typically peak in 20 – 40 minutes, and return to baseline usually occurs within 2 hours. Dosing sessions may include significant periods of introspective silence as well as deep processing with the KAP psychotherapist. Our patients are never left alone during their sessions, and work with the same therapist throughout the treatment protocol to nourish safety, connection, and depth of transformation.

Pregnant women and nursing mothers are not eligible for treatment because of potential effects on the fetus or nursing child. The effects of ketamine on pregnancy have not been studied and it is therefore advisable to avoid this treatment during pregnancy.

Ketamine is not recommended for individuals with schizophrenia or those currently experiencing a manic episode.

Those with untreated high blood pressure are not eligible for treatment as ketamine causes a temporary rise in blood pressure. Additionally, a history of heart disease or hyperthyroidism may make you ineligible for treatment. Ketamine has an extensive safety record and has been used at much higher doses for surgical anesthesia without respiratory depression (compromised breathing).

During KAP we ask that patients remain reclined during the entire session, as balance and coordination are often compromised during the experience.

Other effects may include blurred vision, slurred speech, mental confusion, anxiety, nausea, elevation of pulse, double vision, and loss of appetite. When present, these effects typically fade within 2-4 hours.

Ketamine is a controlled substance and is subject to Schedule III rules under the Controlled Substance Act of 1970. Ketamine belongs to the same group of chemicals known as arylcyclohexylamines and is classified as a hallucinogen.

Repeated, high dose, chronic use of ketamine has caused urinary tract symptoms and even permanent bladder dysfunction. There is no evidence for addiction or dependence if ketamine is taken as medically prescribed. Therefore, ketamine should never be used except under the direct supervision of a licensed physician.

Costs will vary significantly according to your insurance and prescribed treatment protocol. Assuming a total of 8 KAP sessions, the total cost of treatment may vary from $3,850 to $5,250. For a tailored estimate of your costs, please complete the New Patient contact form  and include your insurance information.