Augmented Psychotherapy is composed of various modules. Together with you, we create a treatment plan at the beginning of the therapy based on these modules. The treatment costs are based on your treatment plan. The costs are based on the German GoÄ (Gebührenordnung für Ärzte).
The costs for the treatment can be partially or completely reimbursed, depending on the decision of the health insurance. This should always be checked with your health insurance company. You should also check tax deductibility.
I am not from Berlin, can I still take part in therapy?Nikolaj Gründer2023-08-07T02:11:12+02:00
Yes, Augmented Psychotherapy is also possible if you are not from Berlin or the surrounding area. However, on the days on which you receive ketamine, you will need to take an overnight stay into account. In the immediate area of our practice there are several options for overnight accommodations in hotels. If you travel alone, it is possible for a therapist to accompany you to a hotel which is closeby (after ketamine sessions). If you choose accommodation which is further away, you will have to make sure that someone can pick you up in our clinic to accompany you to your accomodation. The psychotherapy session for integration (after each ketamine session) and the aftercare following the intensive treatment weeks with ketamine can also be done online, if necessary.
We have negotiated special terms with the following hotels. We are happy to assist you in arranging your stay. If you require our assistance, please let us know:
A smaller part of Augmented Psychotherapy can be done from home via video call. For the ketamine sessions it is necessary that you come to Berlin and plan an overnight stay. In most cases, this means 5 overnight stays in Berlin.
We will be happy to assist you organize your arrival and departure. We have arranged special rates with surrounding hotels where we will be happy to make the reservations for you. We can also assist you in booking and organizing trains, flights as well as cabs and transfers. Please call or email us and we will discuss your individual needs.
Will my health insurance pay for my treatment?Nikolaj Gründer2021-05-20T18:30:48+02:00
For people with private insurance, reimbursement is often possible. This also depends on your insurance policy. It is also possible that only a part of the therapy will be covered. For people with public health insurance, the insurance usually decides on the basis of treatment indication, your individual course of disease, previous treatments, and the severity of your illness. When various attempts at therapy have already failed to fulfill the desired outcome, reimbursement is often possible. In any case, we recommend contacting your health insurance to check whether (partial) reimbursement is possible.
You should also check whether you can claim your treatment costs as tax exempt.
Can I continue a course of psychotherapy with you?Nikolaj Gründer2021-05-21T10:43:13+02:00
Augmented Psychotherapy is an intensive, outpatient, short-term therapy over the course of about 9 weeks. Based on therapeutic need, it comprises 25-35 therapy hours. Of these, about 10 treatment hours consist of therapeutically supported sessions with ketamine administration. The next day, you will receive a psychotherapy session for integration. After the core phase of therapy, additional psychotherapy sessions for integration may be offered. If you have further psychotherapy needs after that, we can together consider what type of additional therapy may be helpful for you. We do not offer long-term outpatient treatment in our clinic.
Case reports have described the development of an addiction in people who are also dependent on other substances. In Augmented Psychotherapy, ketamine is used only in low doses and only a few times. Developing a dependence at that rate is highly unlikely. Additionally, altered states of consciousness can be used therapeutically to treat substance abuse disorders (Johnson et al. 2014).
If it turns out that I am not able to receive ketamine, can I still take part in therapy?Nikolaj Gründer2021-05-20T18:14:27+02:00
Ketamine administration is only one method of evoking altered states of consciousness. If this is not possible for medical reasons, we offer methods without the use of medication, such as stroboscopic light or special breathing techniques. Intensive changes in consciousness are also possible with non-pharmacological methods and can be therapeutically useful.
I would like to stop taking my antidepressants, can Augmented Psychotherapy be helpful with that?Nikolaj Gründer2021-05-21T10:43:05+02:00
Together we will create an individual treatment plan, which can also include the possibility of tapering and stopping medications. In our concept of Augmented Psychotherapy, there is a post-treatment session after six months. This is the typical period in which depressive symptoms can return after one stops taking antidepressants (recurrence of depression). We will gladly work with you to use Augmented Psychotherapy with ketamine as a way to protect against such recurrence after stopping antidepressants.
You can also come to use if you are in a stable phase without depressive symptoms, or with only mild symptoms, and want to stop taking antidepressants because of their side effects. We will work with you on a plan for quitting, in which Augmented Psychotherapy can help protect you from regressing back into a depressive episode (relapse prevention).
I’m currently in outpatient psychotherapy, can I simultaneously take part in treatment?Nikolaj Gründer2021-05-21T10:42:56+02:00
A combination with your outpatient psychotherapy can be done. For therapeutic reasons, we strongly recommend discussing the procedures of Augmented Psychotherapy with your psychotherapist. Because Augmented Psychotherapy is conceptualized as an intensive short-term therapy, we recommend pausing your outpatient psychotherapy for the duration of the treatment and resuming it afterwards. We are happy to work with you on an individual treatment plan and we can get in touch with your therapist if you would like us to do so.
What are the side effects that can occur when taking ketamine?Nikolaj Gründer2021-05-20T18:14:04+02:00
The altered states of consciousness which occur during ketamine administration are considered desirable and will be molded and processed with you in Augmented Psychotherapy. In other applications of ketamine, these perceptual changes are viewed purely as side effects. We understand altered states of consciousness as important instruments of therapy. During these altered states, distinct changes in perception, feelings, and thoughts can occur. Under some circumstances, these changes in consciousness can be very intense. This is why we embed them in a psychotherapy specifically developed for working with them.
Further physical side effects include moderate increases in blood pressure, as well as increases in heart rate. Nausea, vomiting, and blurry vision may also occur. Allergic reactions are very rare. In pre-treatment medical discussions, all patients will be thoroughly informed about possible risks and side effects.
I would like to experience this therapy, but I don’t have any psychological illnesses. Can I receive the treatment?Sergio Perez2021-05-20T18:13:57+02:00
Augmented Psychotherapy with ketamine is a therapy for treatment of psychological disorders. We do not offer treatment without an existing indication for it. You are welcome to attend one of our information sessions to learn more about Augmented Psychotherapy.
For which mental diseases is Augmented Psychotherapy with ketamine useful?Sergio Perez2021-05-20T18:13:50+02:00
The use of ketamine in mental illness is the subject of current research. Most results are available for the treatment of depression (Memon et al. 2020). Augmented psychotherapy with ketamine additionally utilizes the effect of altered states of consciousness, which is considered one of ketamine’s antidepressant mechanisms of action (Luckenbaugh et al. 2014). With a thorough preliminary psychiatric and physical examination and in psychotherapeutic discussions, we will make sure that therapy with ketamine and altered states of consciousness is appropriate for you. The following are conditions for which augmented psychotherapy with ketamine may be appropriate.
Treatment-resistant depression: after unsuccessful therapy attempts
Depressive symptoms due to pain
Depressive symptoms in palliative care
Depressive symptoms with bipolar disorder (manic-depressive disorder) without frequent manic episodes
For some mental illnesses, there are still too few or negative study results, or therapy with ketamine and altered states of consciousness is inadvisable from a psychotherapeutic point of view. This particularly concerns illnesses for which the possibility of the treatment making symptoms worse cannot be ruled out. These illnesses are listed below. You will be psychiatrically evaluated before starting treatment to minimize any potential mental health risks to you.
Severe personality disorders
Severe substance dependence (esp. stimulants and among others, ketamine abuse)
Severe bipolar disorder (manic-depressive disorder) with regular manic phases
Severe eating disorders
Severe dementia and organic brain disorders
Is the use of ketamine legal?Sergio Perez2021-05-20T18:13:34+02:00
Ketamine is approved as an established anaesthetic and pain medication and is prescription-only. It is not regulated by the German Narcotics Act (Betäubungsmittelgesetz). It may only be administered by physicians. For treatment in our practice, the so-called “off-label-use” is applied: a medical doctor is allowed to use a drug outside of the specific approval framework if there is an indication or medical justification for it. This justification exists in Augmented Psychotherapy with ketamine.
Does Augmented Psychotherapy carry risks?Sergio Perez2021-05-20T18:13:27+02:00
As with every psychotherapy, at the beginning of Augmented Psychotherapy symptoms can briefly intensify before improvements appear. This is precisely why it is important to us that you feel well taken care of through our continuous support. If you should need more help from us after the end of the therapy program, further psychotherapeutic treatment is possible. We also work closely with a network of therapists and institutions in the health care sector, and together at the end of therapy we can decide how things should continue for you.
How long does a ketamine session last?Sergio Perez2023-08-15T23:43:39+02:00
A complete session usually lasts 2 hours. 60 minutes of this is the substance administration, with your therapist supporting you the entire time. Afterwards, you have time to process the experience and can engage yourself creatively in the integration room. Following this, you can discuss the experience further with our medical personnel if needed.
Is it possible that I have a challenging experience?Sergio Perez2021-05-20T18:13:06+02:00
It is possible that you may have intense and sometimes challenging experiences during the substance sessions. Through our therapeutic support and assistance during the experience and integration, often challenging experiences can in fact be transformed into the greatest positive changes. However, in order to find the optimal dose for you and keep the risk of feeling overwhelmed as small as possible, each therapy begins with finding an individualized dose. Furthermore, ketamine administration can be terminated at any time if this is medically or therapeutically necessary.
How many ketamine sessions are there in Augmented Psychotherapy?Sergio Perez2021-05-20T18:01:57+02:00
Our concept includes 25-35 therapy sessions over the course of 9 weeks. Of these, 5 weeks in the middle make up the heart of the therapy, with each week including a 2-hour ketamine session and an integration session the next day. As a general rule, this means that you will have 5 substance sessions with ketamine administration.
What distinguishes your practice’s approach from other institutions that treat depression with ketamine?Sergio Perez2023-08-15T23:40:11+02:00
We see the use of ketamine as an addition (augmentation) to an established course of psychotherapy. The use of medication in Augmented Psychotherapy thus differs significantly from the classic psychopharmacological approach, which focuses more on the neurobiological antidepressant effect. We see the therapeutic potential of ketamine not only in its direct antidepressant effects, but also, among other things, in its mind-altering effects. These altered states of consciousness often make it possible to take a different perspective on oneself and one’s environment. Working with unconscious content and recognizing and breaking old patterns is more often possible. This can enormously enrich and intensify a psychotherapeutic process. Ketamine administration is always monitored by anesthesiologists. Continuous ECG and oxygen saturation monitoring is performed. With the help of the syringe pump, the anesthesiologists can find the optimal dosage of ketamine for therapeutically valuable altered states of consciousness.
Are there information events for interested colleagues?Nikolaj Gründer2021-05-18T10:13:20+02:00
You are welcome to refer your patients to our therapy offer and mention our website. We will also be happy to send you brochures with further information about the therapy. We also organize regular information events for patients. The dates for these events can be found on our website under Info events.
You can obtain materials at firstname.lastname@example.org
Is the treatment reimbursed by health insurance?Nikolaj Gründer2023-08-15T22:08:02+02:00
The current status is that some private health insurers reimburse parts of the treatment (the psychotherapeutic parts), while the costs for the ketamine sessions are mostly not covered. Statutory health insurance companies do not currently reimburse the treatment – not even the psychotherapeutic parts. In any case, we recommend that you check with your health insurer to see if reimbursement – or cost-sharing – is possible.
You should also check whether the treatment costs are tax-deductible.
Can long-term psychotropic medication be continued during therapy?Nikolaj Gründer2021-05-18T09:25:01+02:00
Continued use of long-term medication is possible during Augmented Psychotherapy and accordingly also during the sessions with ketamine. Under certain circumstances, a dose reduction can be attempted over the course of therapy.
Can Augmented Psychotherapy be helpful in the process of discontinuing antidepressants?Nikolaj Gründer2021-05-19T10:24:44+02:00
We develop an individual treatment plan, which can also include the possibility of phasing out and discontinuing psychiatric medication. With Prof. Dr. med. Gerhard Gründer, university professor for psychiatry at the University of Heidelberg and head of the DGPPN department for psychopharmacology, the practice has a psychiatrist who specializes in the process of weaning off and discontinuing psychiatric medication as one of the practice’s psychiatrists at its disposal with his expertise. We are happy to work out an individual therapy plan for discontinuation with the use of augmented psychotherapy and relapse prophylactic therapy.
How does Augmented Psychotherapy interact with an ongoing outpatient psychotherapy?Nikolaj Gründer2021-05-18T18:00:38+02:00
A combination with outpatient psychotherapy can be carried out if Augmented Psychotherapy can thereby be meaningfully embedded in the longer-term therapy process. Thus, by working with altered states of consciousness, Augmented Psychotherapy can deepen long-term positive therapy processes and add a new dynamic to psychotherapy. Also, the direct antidepressant effect of ketamine can be very beneficial for long-term therapeutic work, as it allows psychotherapy with less symptom burden. We see the combination of Augmented Psychotherapy as a specific short-term therapy over about 9 weeks in combination with outpatient longer-term treatment as highly useful. Here we strive for a transparent and constructive exchange between the treatment providers in the interest of the patients. In most cases, a pause of the outpatient psychotherapy for the duration of the augmented psychotherapy is appropriate.
Is ketamine approved for the treatment of mental illness?Nikolaj Gründer2021-05-18T17:58:52+02:00
Ketamine is an anesthetic and painkiller that has been in use for over 50 years. It is not covered by the Narcotics Act. There is a broad range of studies on the use of ketamine in mental illnesses, especially in the treatment of treatment-resistant depression. The esketamine-containing nasal spray Spravato® is currently the only product approved as an add-on for treatment-resistant depression. It is currently still very expensive and is not covered by all health insurers. We use ketamine i.v. via perfusor under anesthesiological supervision. This allows a patient-specific dosage to be administered and the treatment can be discontinued at any time. Ketamine i.v. is used here as an “off-label” drug, which is explicitly explained. In contrast to conventional psychopharmacotherapy, ketamine is only used in a few targeted individual doses as part of the therapy; there is no substitution treatment with continuous intake, as is the case with antidepressants, for example.
Ketamine has been used for over 50 years. It has few side effects and is safe to use. For example, there are no changes in respiratory drive. There is a low dependence potential, which mainly affects people with existing substance use disorders. This risk is explicitly clarified in the preliminary discussions.
What are the risks of Augmented Psychotherapy?Nikolaj Gründer2021-05-04T16:33:51+02:00
As with any psychotherapy, augmented psychotherapy can lead to a brief intensification of symptoms before an improvement occurs. This is exactly why it is important to us that our patients feel well cared for through close-meshed support. If ketamine is not tolerated, therapy can be continued with altered states of consciousness through non-pharmacological methods. If further help is needed at the end of our therapy, there is the option of extension in integrative psychotherapy. Likewise, we help in arranging further outpatient treatment if it does not already exist. In the case of a relapse, a shortened therapy protocol for interval treatment is conceivable.
Can patients have unpleasant experiences in altered states of consciousness?Nikolaj Gründer2021-05-18T17:54:04+02:00
Patients may also have intense challenging experiences during substance use sessions. Through therapeutic support and assistance with integration, the greatest insights can often be gained from challenging experiences. However, in order to find the optimal ketamine dose for our patients and to keep the risk of feeling overwhelmed as low as possible, an individual dose determination takes place at the beginning of each therapy. Furthermore, it is possible to discontinue ketamine administration at any point in the therapy if this should be medically or therapeutically necessary.
How many doses of ketamine do patients receive during this therapy?Nikolaj Gründer2021-05-19T09:36:23+02:00
Augmented Psychotherapy is an intensive short-term psychotherapy over approximately 9 weeks. Of these, 5 weeks in the middle form the core, in which a 2-hour session with ketamine administration and an integration psychotherapy session on the following day take place. Thus, patients usually receive 5-6 sessions of ketamine administration. If patients need more or less therapy units, our concept can be flexibly adapted to individual needs.
What distinguishes your clinical approach from other institutions that treat depression with ketamine?Nikolaj Gründer2021-05-19T10:30:46+02:00
We understand the use of ketamine as an addition (augmentation) to a well-founded psychotherapy. In augmented psychotherapy, the use of medication thus differs significantly from the classic psychopharmacological approach, which focuses more on the neurobiological antidepressant effect. We see the therapeutic potential of ketamine not only in its direct antidepressant effect but also, among other things, in its mind-altering effect. These altered states of consciousness often make it possible to take a different perspective on oneself and the environment. Working with unconscious content and recognizing and breaking old patterns is possible more often. This can enormously enrich and intensify a psychotherapeutic process. In our practice, ketamine is administered intravenously via a syringe pump (perfusor). The administration of ketamine is always monitored by anesthesiologists. Continuous ECG and oxygen saturation monitoring is performed. With the help of the syringe pump, the anesthesiologists can find the optimal dosage of ketamine for therapeutically valuable altered states of consciousness.
What are the side effects of taking ketamine?Nikolaj Gründer2021-05-19T09:06:40+02:00
The altered states of consciousness that occur during ketamine administration are desired and encouraged in Augmented Psychotherapy. In other applications of ketamine, these perceptions are considered mere side effects. We conceive of altered states of consciousness as an authoritative therapeutic tool. In the context of these altered states of consciousness, there is a temporary marked change in perception, feelings and thoughts. Under certain circumstances this change of consciousness can be very intense. That is why we embed it in a specifically developed psychotherapy.
Other physical side effects include a moderate increase in blood pressure and an increase in heart rate. Nausea, vomiting and blurred vision may also occur. Allergic reactions are very rare. All patients are informed in more detail about possible risks and side effects during medical information sessions.
Which COVID-19 safety measures are in place in our clinic?Nikolaj Gründer2021-05-20T18:01:06+02:00
Contraindications: Unfortunately, we cannot offer Augmented Psychotherapy treatment with ketamine if you have any of the following medical contraindications. Please consider this before booking an initial examination.
Severe heart disease/distinctly high blood pressure
Heart attack or stroke within the past 12 months
Severe functional disorder of the liver
Elevated intracranial or intraocular pressure
If you are nevertheless interested in therapy with us, you are welcome to contact us and we can assess the possibility of Augmented Psychotherapy with non-pharmacological methods.
What are the physical contraindications for Augmented Psychotherapy with ketamine?Nikolaj Gründer2021-05-19T09:25:06+02:00
No. After ketamine administration in the context of Augmented Psychotherapy you must be picked up by someone at our practice, e.g. a relative, and accompanied home. If you are staying in a nearby hotel and have traveled here alone, we can also accompany you to the hotel. Unfortunately, we cannot offer this for accommodations which are further away.
Please also consider that you may not operate any vehicle in traffic on the day of ketamine administration. This means you are not allowed to e.g. drive a car, motorcycle, or scooter, or ride a bicycle.