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Ketamine-Assisted Psychotherapy (KAP) & Integration in Oakland

Individual Ketamine-Assisted Therapy & Integration for California Residents via Telehealth

What is Ketamine Integration?

While many clinics offer ketamine therapy as a medical treatment, I provide Ketamine-Assisted Psychotherapy (KAP) and integration. This approach combines the medicine with dedicated therapeutic support to help you make meaning of your experience and create lasting life change. Based in Oakland, I offer these services to clients throughout California via telehealth.

You've done the work. You're still not there.

You're not someone who gave up or never tried. You've been in therapy. You've read the books, maybe done the retreats, adjusted the medications, changed your diet, your relationships, your city. You understand yourself pretty well, intellectually at least.

And yet something hasn't shifted. The patterns come back. The same feelings return in new situations. Life keeps moving but something in you feels like it's waiting.

You might be at an inflection point, after an illness, a diagnosis, a relationship ending, or simply a quiet moment where you looked up and thought: this isn't quite it.

You're not in crisis. You're at a threshold.

Ketamine therapy isn't only for people who've tried everything.

Some people come to this work because nothing else has worked. Others come because they never wanted to go the traditional route in the first place, whether that's medication, a diagnosis, or a system that never quite fit them. Both are welcome here.

What ketamine offers is a different kind of opening. It doesn't ask you to think your way through. It creates a temporary shift in the way your nervous system holds its old conclusions, and that's where the work happens.

“I’ve had anxiety for as long as I can remember, and there were so many nights with little sleep where I was worrying about small things. Ketamine therapy helped me see I was living for everyone else. I’ve been able to walk away from groups of people that didn’t fit and start choosing a life and relationships that actually feel like mine.”
— F., Client

What changes isn't just your mood. It's the way you relate to yourself. Clients come out with new friendships, different jobs, relationships that finally feel real, bodies they've stopped fighting. Not because ketamine did that, but because something loosened enough for them to do it themselves.

This work is for you if:

You're highly capable and still struggling, and you're tired of those two things coexisting.

Your life is complex, maybe you're navigating queerness, neurodivergence, chronic illness, or a transition that doesn't have a roadmap.

You want more than symptom relief. You want to actually know yourself and feel at home in your life.

You're ready to go somewhere new, not just feel better about where you are.

I’m Olivia. I’ve spent the last six years in Oakland facilitating this work for people who have realized they need something fundamentally different than traditional talk therapy. If you’ve found your way here, it’s likely because you’re looking for a path that doesn't feel like the ones you've walked before. Let’s talk.

“Something important remained from my ketamine experience: For the first time I realized how powerfully depression is ingrained within my brain. I physically felt it — the black dog — acting inside my old neural wirings.
It was something concrete, physical, like ruts where traumas line up to bring me bad thoughts. That’s why it’s so easy to stay there, trapped by pain, and why it takes so much effort to escape. I understood that chronic depression might not respond to language and thoughts, that only a rewiring of the brain’s neural pathways might dislodge it.”
— Vanessa Barbara, New York Times

What we actually do together

Most of this work happens in three phases, though they bleed into each other.

Before your session, we get clear on what you're bringing. What you're hoping to loosen, understand, or move through. We talk about what feels stuck and why the usual approaches haven't reached it. This isn't intake paperwork. It's the beginning of the work.

During the session, I'm with you. Ketamine can surface strong emotions, unexpected memories, or a completely different way of seeing something you've been carrying for years. Having a therapist present, not just a prescriber, means those moments have somewhere to go.

After is where most of the change actually happens. Integration is the process of taking what opened up and letting it reshape how you move through your days. We use conversation, sometimes art-making or somatic practices, to help what you experienced become something you can actually live differently.

I work with your body as much as your mind. Not because it's a technique, but because a lot of what keeps people stuck lives below the level of thought, in the nervous system, in old protective patterns that made sense once and haven't updated. That's where somatic work comes in.

I'll also coordinate with your prescriber, or connect you with the one I work with, so your care isn't fragmented.

How to Integrate Your Ketamine Journey Without Feeling Lost in the Afterglow

You’ve done the brave work of the session. You’ve touched the expansive, the wordless, and perhaps the confusing. But now, the lights are back on, the music has stopped, and the "ordinary" world feels a little too loud. You know you felt a shift, but then the old habits start knocking, and you end up wondering if you’ll just go back to exactly how you were before.

This is not a failure of the medicine. It is a gap in integration.

True healing isn't just about the "trip"—it’s about the landing. What you’re experiencing isn't a lack of progress; it's your nervous system trying to find its footing after a profound opening.

The Journey Inward Method

We don’t rush to "fix" or analyze. Instead, we use somatic awareness and relational pacing to weave your insights into your daily life. We focus on building your capacity to stay with the new sensations before we ever try to change your behavior. This is about identifying the human truths uncovered in your journey and creating an emotional foundation for lasting change.

Outcomes: Building Your Capacity

  • Somatic Anchoring: Tools to find your "center" when the insights feel too big or disorienting.

  • Relational Boundaries: Language to protect your "vulnerable state" and communicate your needs to loved ones.

  • Pattern Recognition: A framework to see your old "nervous system patterns" as they arise, without the weight of shame.

  • Integration: Specific practices to bridge the gap between "non-ordinary states" and your everyday reality.

You don't have to carry the weight of your transformation alone. If you're ready to explore how these experiences can become a permanent part of your healing journey, I’m here to walk with you. Let’s talk for 20 minutes.

Common Questions and Answers about Ketamine Assisted Therapy

These details cover what to expect before, during, and after your experience.

  • I offer a type of therapy known as Ketamine-Assisted Psychotherapy (KAP), also called Ketamine Therapy, which incorporates Ketamine into therapy sessions. Ketamine is an FDA-approved medication; however, when used to treat mental health conditions, it is considered an off-label treatment. This means it is used for conditions not yet formally approved by the FDA. Ketamine is believed to encourage biochemical, anatomical, and functional shifts in the brain that may help increase adaptability, open new pathways for change, and ease rigid thought patterns.

    Planning for sessions takes into account your needs, goals, and the intensity of your symptoms, as well as the insights and changes that emerge between sessions. Together, we’ll discuss how many KAP sessions feel appropriate as part of a collaborative plan. While 3–6 sessions are often recommended before evaluating effectiveness, you can always pause or stop treatment at any time, and your decision will be respected. Throughout our work together, I draw on my training and experience with Ketamine-Assisted Psychotherapy and collaborate with your prescribing physician, who will complete a detailed assessment to encourage physiological and psychological safety.

  • At-home ketamine therapy is a specialized form of telehealth where ketamine-assisted psychotherapy is conducted in the safety and comfort of your own environment. This model is designed for those who have a quiet, private space and have been clinically cleared for a self-administered, sublingual protocol.

    The process begins with a comprehensive screening and preparation phase. This includes both a clinical intake with me and a medical evaluation with a specialized prescriber to ensure that at-home treatment is a safe and appropriate fit for your physical and mental health. Only after this thorough preparation will you receive a prescription for compounded ketamine lozenges (troches) or Rapid Dissolve Tablets (rdts) from a pharmacy.

    On the day of your session, we meet via a secure video platform. I remain present with you onscreen for the entire duration of the medicine's effects, providing a grounded therapeutic presence. My role is to offer guidance and somatic anchoring as your experience unfolds, ensuring you feel held and supported throughout the journey. Each session is followed by dedicated integration therapy to help you translate the insights from your experience into tangible shifts in your daily life.

  • Ketamine is a dissociative anesthetic that was first developed in the 1960s and has a long history of safe use in medical settings. In the context of mental health, it is used off-label to support neuroplasticity and rapid relief from symptoms of depression, anxiety, and trauma.

    Unlike traditional antidepressants that primarily target serotonin, ketamine works on the neurotransmitter glutamate. By increasing the expression of brain-derived neurotrophic factor (BDNF), it helps the brain build new neural connections in the prefrontal cortex—essentially helping the brain "rewire" old, stuck patterns. While the medicine itself provides the opening, the therapeutic work we do together ensures those shifts become lasting changes in your daily life.

  • Ketamine Assisted Therapy with me involves self-administration of pre-prescribed Ketamine in the form of a quickly dissolving sublingual tablet. After being dissolved beneath the tongue, you "swish" the tablet around your mouth for fifteen minutes. Orally administered Ketamine has a rapid onset (15–20 minutes), a 45-minute peak, and a gradual return to ordinary consciousness. Our three-hour sessions start with a check-in and discussion of your goals for the meeting, after which you self-administer the Ketamine as prescribed by your doctor, and we discuss what arises during your treatment. Some people speak more or less than others, but you are welcome to engage in verbal exploration whenever you feel compelled.

    You will also need an onsite support person available throughout the session (but not in the room with you). Afterward, you may want to re-ground with your supportive person in your environment. Please visit here for more information about the role of your supportive loved one. Please visit here for more information about the role of your supportive loved one.

    After the session, you will be encouraged to explore metaphors, feelings, sensations, ideas, and symbols that arose during or after the session. I'll also encourage you to engage with what emerged during the experience during your day-to-day life.

  • Yes, Ketamine is a legal controlled substance. While it was originally FDA-approved as an anesthetic, it is now widely and legally used off-label by medical professionals to treat depression, anxiety, and PTSD. While many other psychedelic substances are currently in the process of being decriminalized or researched, Ketamine-Assisted Psychotherapy (KAP) is a fully legal and regulated therapeutic option today.

    To begin this work, you must be evaluated by a medical practitioner. I frequently refer clients to a trusted collaborating physician specializing in ketamine, though I am also happy to coordinate care with your existing doctor if they are trained in this modality. Your prescribing doctor will determine your eligibility and initial dosage. Based on your specific needs and risk factors, they may recommend that your initial sessions take place under direct medical observation to ensure your safety while a therapeutic dose is established. As you become more familiar with the medicine’s effects on your body and mind, we will continue to coordinate with your doctor to adjust your dosage—whether that means increasing it for a deeper experience or decreasing it due to sensitivity or evolving needs in the therapeutic process.

    For at-home sessions, your prescription is typically filled by a specialized compounding pharmacy and mailed directly to you in sublingual doses. Because Ketamine is a controlled substance, safe storage is a non-negotiable requirement. Your prescriber will discuss this with you in depth, but you must have a plan to keep your medication inaccessible to others. This typically involves a specialized medication safe or a robust locking compartment. If you feel unable to guarantee the secure storage of your medication at home, we can discuss in-person treatment alternatives to ensure your safety and the safety of those around you.

  • While I can’t tell you what Ketamine will feel like for you, the generally lower doses of Ketamine used in Ketamine Therapy allows you to engage in a light trance-like state. You may feel an enhanced sense of connection to the collective, a softening to receiving the experience, a decrease in mental defenses, a sense of openness, and a lessening of anxiety/increased feelings of well-being. It’s important to remember that there is some variability in how Ketamine feels for different people, so the sensations described may differ from your experience(s).

    Lower dose administration generally aids in developing deeper communication. Engaging with a low dose of Ketamine during therapy can inspire time away from your typical patterns of thought, relief from mental “loops,” a decrease in feelings of negativity, encourage meditative states, and facilitate a sense of openness to a more expansive understanding of yourself.

  • Can you tell me about Ketamine and dissociation?

    Ketamine’s classification as a dissociative drug can feel a bit confusing. While at moderate to high doses, it may cause mental alteration that involves disconnecting from one’s perception of the environment, feelings, thoughts, memories, or sense of identity when used at higher doses. At such amounts, one may have an ‘out-of-body experience.’ However, lower doses may involve a sense of calm and relaxation that supports disconnection from day-to-day anxieties without disconnection from the therapy process. The alteration level depends on how the body responds to metabolizing the drug as well as the dosage and route of administration (i.e., orally, injected, or through IV).

    In my practice, we work with low to moderate doses administered sublingually. This route of administration and dosing encourages a slower onset of the medicine's effects and allows continued connection to the present, communication, and exploration but in an expanded mental state.

    Understanding Dissociation and Ketamine:

    • Moderate to High Doses: Mental alteration and potential 'out-of-body experience.'

    • Low Doses: Calmness, relaxation, and reduced anxiety with capacity to engage in therapy.

    • Administration Methods: Orally, injected, sublingual or through IV, affecting the onset and intensity of dissociation. Olivia Clear’s precribing MD uses Sublingual.

    • Sublingual Administration: Encourages slower onset and maintained connection to present, allowing effective therapeutic exploration.

  • Low to moderate doses of Ketamine administered sublingually provide a balanced approach, promoting therapeutic benefits without overwhelming dissociative effects. This method supports a gradual and gentle entry into the expanded mental state, enhancing the therapeutic process and maintaining engagement with the present moment.

  • In at-home ketamine therapy, the prescribing doctor may offer ketamine as a troche or lozenge. Both are sublingual (under-the-tongue) delivery methods that let the medicine absorb through the mucous membranes in your mouth.

    Both forms provide similar absorption and effectiveness, but your doctor may recommend one over the other based on your needs and preferences.

    For at-home ketamine treatment through secure telehealth, these sublingual options are non-invasive and allow for personalized dosing.

  • Therapy before, during, and after ketamine sessions provides a supportive space for your work with ketamine to unfold safely and meaningfully.

    Ketamine can enhance the brain’s flexibility, making it easier to engage with emotions as sources of insight, connect bodily sensations with feelings, and relate to your experiences in ways that feel manageable and supportive. This increased neural connectivity may also allow access to memories or patterns that are usually difficult to approach, giving you a chance to understand them with less anxiety.

    The combination of ketamine and therapy often feels particularly supportive because symptoms of depression or anxiety can lift quickly. With some relief from these symptoms, therapy can focus on exploring new perspectives and developing approaches that foster lasting change.

    Recovery with ketamine-assisted therapy is often gradual, and you may notice a period of disorientation or adjustment, sometimes called the “therapeutic bends.” During this time, old coping patterns may resurface, and it can feel uncertain how to integrate a growing sense of wellness. Depression, anxiety, and trauma can occupy so much mental and emotional space that adjusting to new ways of being can feel unfamiliar.

    Integration is where the deeper transformation happens. Ketamine integration therapy helps translate the experiences, insights, images, memories, or bodily sensations that arise during sessions into meaningful changes in daily life. Because ketamine supports neuroplasticity—the brain’s ability to form new connections—this period is ideal for reinforcing new ways of thinking, feeling, and relating.

    While ketamine may provide rapid relief, integration is what allows those benefits to last and deepen. It’s where insights become embodied wisdom.

  • I'm an out-of-network provider, meaning you pay me directly for sessions. After each appointment I can send you a superbill, which is an itemized receipt with everything your insurance company needs to process a claim.

    Whether you get reimbursed depends on your plan. Some clients with out-of-network mental health benefits have received significant reimbursement, sometimes covering 50-100% of session costs. Preparation and integration sessions are often covered even when the ketamine sessions themselves aren't, so it's worth asking specifically about those.

    To find out what you're eligible for, call your insurance provider and ask about out-of-network mental health benefits. You can also look up your explanation of benefits on their website.

    If you're not sure where to start with that conversation, I'm happy to help you figure out what to ask.

  • As a therapist, I am not a prescriber nor am I trained in pharmacology, so this information is provided for harm reduction purposes. Your prescribing doctor or pharmacy can provide well-informed sources of information on this topic.

    This information is from an Informed Consent document written by a medical doctor: “Ketamine is classified as a Hallucinogen and categorized as an Arylcyclohexylamine. It is a schedule III controlled substance. There is potential abuse with Hallucinogens, but physical dependence involves tolerance and withdrawal symptoms, which researchers have not identified in Ketamine users. However, those who use Ketamine regularly have reported “cravings,” and the positive impacts on mood, cognition, and perception may inspire a desire for more frequent use.”

    Please note that your medication is carefully and thoughtfully prescribed. Your Ketamine use in each session is logged and reported to the prescribing doctor.

    During your assessment, please inform your medical doctor of any history of addiction and discuss the potential risks and benefits of working with Ketamine. You may also consider exploring a range of treatment options including but not limited to: antidepressants or SSRIS, psychotherapy, Electroconvulsive Therapy (ECT), or Transcranial Magnetic Stimulation (TMS.)

  • Ketamine therapy, while promising for certain conditions, may not be suitable for everyone. Individuals frequently excluded from consideration include those with a history of psychosis, active substance abuse, uncontrolled hypertension, recent heart attack or stroke, specific medical conditions like severe liver or kidney dysfunction, or pregnancy/ breastfeeding, specific medication interactions, allergies, or sensitivity to ketamine, and those with unrealistic expectations or a lack of commitment to the therapy process.

    A thorough assessment by a qualified healthcare doctor is imperative to determine the suitability of ketamine therapy based on individual medical history, current health status, and potential risk factors. During your medical evaluation, you will be asked to share a detailed history of any previous or ongoing health issues, mental health diagnoses, use of other substances and a list of your current medications to assess if KAP may be a suitable treatment for you at this time.

  • You may have heard ketamine referred to as a horse tranquilizer, and while that’s technically true, it leaves out a lot of important context. Ketamine is used on animals, including horses, as a safe anesthetic in veterinary medicine — which why you might hear that ketamine is a horse tranquilizer. But that’s only one small part of its story.

    In humans, ketamine has been FDA-approved for decades and is now used off label in mental health settings at much lower doses to help treat depression, anxiety, and trauma. While we find ketamine useful for animals, we alsofind for some people it has the ability to support shifts in mood, perception, and even neuroplasticity in the brain.

  • As Ketamine therapy gains popularity, many people are curious about medication compatibility. The prescribing doctor is a knowledgeable resource to speak with about the safety of your medications in combination with Ketamine. Antidepressants or SSRIs may be safe to combine with Ketamine. However, it is currently believed that some medications, for example benzodiazepines, lamotrigine, and memantine, may affect Ketamine's efficacy. Taking these medications may not mean you cannot explore Ketamine Therapy but it’s important that you share your full medication and supplement list with your prescribing doctor, who can provide support surrounding adjusting or changing your medications to facilitate a more safe or effective Ketamine therapy process.