Reffering physicians2023-08-15T21:57:34+02:00

FOR REFERRING PHYSICIANS

We are looking forward to working with you

CONCEPT

Learn more about our therapy offer

We would like to expand the spectrum of treatment methods for mental illness with an innovative approach. There is broad evidence for the use of ketamine in the treatment of depression (Memon et al. 2020). Similarly, scientific studies show good efficacy in the use of altered states of consciousness in mental illness (Reiff et al. 2020)

Augmented psychotherapy

In augmented psychotherapy, altered states of consciousness are combined with psychotherapeutic methods specifically designed for this purpose. These states are individually prepared in therapy, induced by means of patient-specific administration of ketamine i.v. or with non-pharmacological methods, accompanied therapeutically and the experience integrated psychotherapeutically. We use therapeutic methods of mindfulness, cognitive-behavioral, psychodynamic as well as body-psychotherapeutic and humanistic approaches.

Repeated sessions of ketamine infusion with the experience of altered states of consciousness and subsequent psychotherapy sessions for integration can make the rapid antidepressant effect of ketamine more sustained. Thus, we embed the various coordinated therapy elements into an intensive short-term psychotherapy. Ketamine infusions are administered by perfusor by anesthesiologists with monitoring of vital signs. Psychotherapeutic support and treatment is provided by licensed therapists in depth psychology-based psychotherapy and behavior therapy.

Indication and costs

Augmented psychotherapy is a psychotherapeutic approach and therefore the indication for therapy is derived from it. The indication for augmented psychotherapy with ketamine is based on the studies available for therapy with ketamine. The treatment of mental illness with ketamine i.v. is an off-label treatment. After augmented psychotherapy, further outpatient psychotherapeutic treatment may be useful to deepen the experience gained in therapy.

Our treatment is not yet covered by public health insurance and must be paid for by the patients themselves. However, the costs may be covered by the health insurance company and must be checked individually with the respective insurance company.

Augmented psychotherapy as a private medical service is billed according to the official fee schedule for physicians (GOÄ). If the therapy requires a particularly large amount of time or if the patient is being treated in a foreign language, the physician can adjust the GOÄ figure by means of an increase factor according to the time and effort involved.

  • Unipolar depression (F32,F33) with currently at least moderately severe depressive episode with therapy resistance to 2 attempts of lege artis medication or 2 attempts of psychotherapeutic therapy.
  • Unipolar depression with a current depressive episode of at least moderate severity and an explicit wish for augmented psychotherapy after a detailed explanation of the off-label status and guideline-based treatment alternatives.
  • Bipolar depression with current at least moderate depressive episode on stable medication phase prophylaxis with no manic episode in the past 6 months, no rapid cycling, and no history of psychotic symptoms.
  • Obsessive-compulsive disorder: KAP as augmentation if psychotherapy has been given
  • Anxiety disorders: KAP as augmentation when psychotherapy has occurred.
  • Somatoform disorders, especially somatoform pain disorder
  • Adjustment disorders in the presence of existential issues.
  • Existential fears in palliative situations

  • Schizophrenic disorders (including schizoaffective disorder) and organic delusional disorders.
  • Severe personality disorders
  • Florid substance dependence (especially party drugs, e.g. ketamine)
  • Florid bipolar disorder with regular manic episodes (rapid cycling, etc.)
  • severe eating disorders
  • Dementias and brain-organic disease (from moderate dementia or without the presence of depression).
  • Lack of capacity for insight due to mental or intellectual disorder

Contraindications: We cannot offer Augmented Psychotherapy with Ketamine to patients who have the following medical contraindications to therapy:

  • Structural heart disease (including heart failure)
  • Unstable, difficult to control or untreated hypertension
  • Unstable Angina pectoris
  • Heart attack and/or stroke in the last 12 months
  • Increased intracranial pressure
  • Untreated or inadequately treated hyperthyroidism
  • Glaucoma
  • Liver cirrhosis, severe liver dysfunction

If patients are still interested in therapy with us, they are welcome to contact us and we can review the possibility of Augmented Psychotherapy with non-pharmacological methods.

KETAMINE INFUSION

Ketamine as psychopharmacological agent

Ketamine was developed as an anesthetic and pain reliever and has been used worldwide for over 50 years. At lower doses, it has a rapid onset antidepressant effect without relevant effects on the cardiovascular system and vigilance. Due to this, it has gained importance in the treatment of depression in recent years and is used when classical therapy methods, such as with antidepressants, fail. Combining this with adapted psychotherapy results in increased treatment efficacy (Luckenbaugh et al. 2014). Intravenous administration of the substance allows precisely controlled dosing to enable patients to access altered states of consciousness. Through integration in psychotherapy, this can be a healing, meaningful experience (Luckenbaugh et al. 2014)(Roseman et al. 2018). Furthermore, the rapid antidepressant effect creates therapeutically efficient treatment intervals. The interaction of psychopharmacological effects and embedding therapy often leads to an optimized treatment outcome.

Possible effects at the targeted dosage in combination with the therapy setting include a sense of detachment from usual thoughts, feelings, and physical sensations. Vivid inner images and insights can occur. The experience of feelings is often amplified. There may be a limitation in the ability to communicate and motor skills are more difficult. The ability to breathe is typically not restricted which makes it very safe as a medication.

MIND Foundation Ketamine Lecture Series

Ketamine
Ketamine assisted Psychotherapy of Opioid Use Disorder
Ketamin bei Depression & komorbidem Schmerz

ALTERED STATES OF CONSCIOUSNESS

Application in our therapy

Altered waking states of consciousness are quite different from the familiar spaces of consciousness. In the context of these states of consciousness, there is a temporary change in perception, emotions and cognition. Effectiveness of altered states of consciousness in the psychotherapeutic treatment of mental illness is more and more confirmed by scientific findings. Thus, during the altered states of consciousness, a distancing from stuck thought loops and beliefs can be observed. Likewise, access to meaningful biographical content and re-experiencing a fuller range of emotions is reported. There is a good memory for the experiences during the altered state of consciousness. We conduct the sessions with altered states of waking consciousness in well-prepared close therapeutic accompaniment with the help of specific music and body therapeutic interventions. To induce altered states of consciousness, body therapy methods such as specially designed strobe lights or specific breathing techniques can be used as non-pharmacological methods. Pharmacologically, we work with ketamine i.v. via perfusor under anesthesiological supervision. This allows patient-specific dosing for optimal induction of altered states of consciousness. Weekly repetition of substance use sessions during our short-term therapy allows therapy effects to be psychotherapeutically solidified through content connections of experiences. During the altered states of consciousness, there may also be challenging experiences for the patient; it is precisely these that can initiate sustainable processes of change as part of a therapeutic process with the help of integration.

By integration we mean all processes that help to process the experiences made in the altered state of consciousness and thus make them useful for the patient. Within the framework of augmented psychotherapy we would like to support an attitude of integration and practice techniques of integration. Each experiential session is followed by at least one integration session in which the particular experience is worked on therapeutically to promote integration. The aim of the integration process is to positively influence the experience, thoughts, behavior or general attitude from the experiences made. Mindfulness exercises learned at the beginning of therapy and the development of possible intentions and goals also contribute to this. Integration also has an important role in intense processes of consciousness, which can be very challenging without therapeutic help. Here, embedding the experience in a psychotherapeutic process with a sustainable therapeutic relationship is particularly important.

TREATMENT STEPS

We accompany our patients in the following steps

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Kontaktaufnahme
01
01    Kontaktaufnahme
In unserer Praxis erwartet Interessierte ein interdisziplinäres Team von engagierten Fachärzt*innen und Therapeut*innen.

Bei regelmäßigen Informationsveranstaltungen und im persönlichen Gespräch stellen wir die Augmentierte Psychotherapie vor und beantworten Fragen rund um dieses Thema.

Wir machen uns ein genaues Bild der gesundheitlichen Situation möglicher Interessenten und prüfen, ob die Therapie für sie geeignet sein könnte.
Slide 5
Vorbereitung
02
02    Vorbereitung
Nach ausführlichen Gesprächen und Voruntersuchungen stellt unser Team aus psychiatrischen und anästhesiologischen Fachärzt*innen die Indikation zur Behandlung. Unsere Patient*innen werden gründlich aufgeklärt und wir entwickeln einen persönlichen Behandlungsplan. In mehreren therapeutischen Sitzungen lernen unsere Patient*innen Ihre persönliche Therapeutin oder Ihren Therapeuten kennen und schaffen mit Hilfe dieser vertrauensvollen Beziehung die Grundlagen, um durch veränderte Bewusstseinszustände positive psychische Veränderungen in Gang zu bringen.

Mit Hilfe von Übungen und gezielter Wissensvermittlung helfen wir, sich optimal auf die Therapie vorzubereiten.
Slide 5
Behandlung
03
03    Behandlung
Diese Sitzungen können wie eine Reise nach Innen gesehen werden. Mit körperorientierten Methoden werden unsere Patient*innen behutsam an veränderte Bewusstseins-zustände herangeführt, was erste Erfahrungen ermöglicht. Danach haben unsere Patient*innen die Möglichkeit, mit Hilfe von Ketamin Ihre Erfahrungen in veränderten Bewusstseins-zuständen noch zu intensivieren. Mit einer auf sie abgestimmten Dosierung in den dafür entworfenen Therapieräumen entfaltet sich unter Musik dabei das therapeutische Potential Ketamin-induzierter veränderter Bewusstseins-zustände. In vertrauensvoller Atmosphäre über mehrere Wochen erfolgt dabei eine enge therapeutische Begeleitung. Ketamin zeigt dabei den weiteren Vorteil einer direkten antidepressiven Wirkung. Die Ketamin-infusionen werden von Fachärzten für Anästhesie durchgeführt, die psychothera-peutische Behandlung von approbierten Therapeutinnen und Therapeuten in tiefenpsychologisch fundierter Psychotherapie und Verhaltenstherapie.
Slide 5
Integration
04
04    Integration
Jeder Sitzung mit Ketamingabe folgt eine Therapiestunde zur Verarbeitung und Integration der gemachten Erfahrungen. Unsere Therapeut*innen helfen dabei diese intensiven Erfahrungen nicht nur zu verstehen, sondern auch für unsere Patient*innen nachhaltig nutzbar zu machen.

Dafür greifen wir auf verhaltenstherapeutische und psychodynamische Ansätze wie auch Techniken der Achtsamkeit und Körpertherapie und die langjährige Erfahrung unserer TherapeutInnen zurück und nutzen die direkte antidepressive Wirkung von Ketamin optimal für die Therapiefortschritte unserer Patient*innen.
Slide 5
Begleitung
05
05    Begleitung
Oft ist eine Augmentierte Psychotherapie nur ein Baustein eines längeren therapeutischen Prozesses der Veränderung. Wir möchten unsere Patient*innen weiter begleiten, sodass Besserungen nachhaltig werden. Sollte noch keine ambulante Psychotherapie bestehen, helfen wir in der Vermittlung einer Therapie, um die Integration weiter zu vertiefen. Ebenso können wir mit unserer psychiatrischen Expertise in der Ausschleich- und Absetzbegleitung von Psychopharmaka behilflich sein, sollten diese nicht mehr notwendig sein.
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TREATMENT STEPS

We accompany our patients in the following steps

Slide 5
01    Kontaktaufnahme
In unserer Praxis erwartet Interessierte ein interdisziplinäres Team von engagierten Fachärzt*innen und Therapeut*innen.

Bei regelmäßigen Informationsveranstaltungen und im persönlichen Gespräch stellen wir die Augmentierte Psychotherapie vor und beantworten Fragen rund um dieses Thema.

Wir machen uns ein genaues Bild der gesundheitlichen Situation möglicher Interessenten und prüfen, ob die Therapie für sie geeignet sein könnte.
Slide 5
02    Vorbereitung
Nach ausführlichen Gesprächen und Voruntersuchungen stellt unser Team aus psychiatrischen und anästhesiologischen Fachärzt*innen die Indikation zur Behandlung. Unsere Patient*innen werden gründlich aufgeklärt und wir entwickeln einen persönlichen Behandlungsplan. In mehreren therapeutischen Sitzungen lernen unsere Patient*innen Ihre persönliche Therapeutin oder Ihren Therapeuten kennen und schaffen mit Hilfe dieser vertrauensvollen Beziehung die Grundlagen, um durch veränderte Bewusstseinszustände positive psychische Veränderungen in Gang zu bringen.

Mit Hilfe von Übungen und gezielter Wissensvermittlung helfen wir, sich optimal auf die Therapie vorzubereiten.
Slide 5
03    Behandlung
Diese Sitzungen können wie eine Reise nach Innen gesehen werden. Mit körperorientierten Methoden werden unsere Patient*innen behutsam an veränderte Bewusstseins-zustände herangeführt, was erste Erfahrungen ermöglicht. Danach haben unsere Patient*innen die Möglichkeit, mit Hilfe von Ketamin Ihre Erfahrungen in veränderten Bewusstseins-zuständen noch zu intensivieren. Mit einer auf sie abgestimmten Dosierung in den dafür entworfenen Therapieräumen entfaltet sich unter Musik dabei das therapeutische Potential Ketamin-induzierter veränderter Bewusstseins-zustände. In vertrauensvoller Atmosphäre über mehrere Wochen erfolgt dabei eine enge therapeutische Begeleitung. Ketamin zeigt dabei den weiteren Vorteil einer direkten antidepressiven Wirkung. Die Ketamin-infusionen werden von Fachärzten für Anästhesie durchgeführt, die psychothera-peutische Behandlung von approbierten Therapeutinnen und Therapeuten in tiefenpsychologisch fundierter Psychotherapie und Verhaltenstherapie.
Slide 5
04    Integration
Jeder Sitzung mit Ketamingabe folgt eine Therapiestunde zur Verarbeitung und Integration der gemachten Erfahrungen. Unsere Therapeut*innen helfen dabei diese intensiven Erfahrungen nicht nur zu verstehen, sondern auch für unsere Patient*innen nachhaltig nutzbar zu machen.

Dafür greifen wir auf verhaltenstherapeutische und psychodynamische Ansätze wie auch Techniken der Achtsamkeit und Körpertherapie und die langjährige Erfahrung unserer TherapeutInnen zurück und nutzen die direkte antidepressive Wirkung von Ketamin optimal für die Therapiefortschritte unserer Patient*innen.
Slide 5
05    Begleitung
Oft ist eine Augmentierte Psychotherapie nur ein Baustein eines längeren therapeutischen Prozesses der Veränderung. Wir möchten unsere Patient*innen weiter begleiten, sodass Besserungen nachhaltig werden. Sollte noch keine ambulante Psychotherapie bestehen, helfen wir in der Vermittlung einer Therapie, um die Integration weiter zu vertiefen. Ebenso können wir mit unserer psychiatrischen Expertise in der Ausschleich- und Absetzbegleitung von Psychopharmaka behilflich sein, sollten diese nicht mehr notwendig sein.
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INTEGRATION-PSYCHOTHERAPY

We also offer in our practice the offer of integration-psychotherapy

What is integrative psychotherapy?

Intense emotional and existential experiences hold great potential for personal change. Often changes i n life do not happen slowly, but in spurts or leaps. Sometimes they are associated with crises. Experiencing altered states of consciousness is such a special, intense experience for many people. It has been shown in academic research that especially existential experiences in altered states of consciousness (for example – but not only – an experience under psychedelic substances) can lead to positive changes in the psychological state of mind (Roseman et al. 2018, Majic et al. 2015).

However, it is not uncommon for very challenging experiences to occur (occasionally also “bad trips“), which are difficult to reconcile with daily life and can be burdensome. In some cases, even new psychological problems can arise from unprocessed experiences. people do not Development from such an experience is not left to chance. In psychotherapy, there is a wealth of experience in dealing with intense psychological processes . Even and especially the challenging experiences that are difficult for individuals to understand and integrate into their lives hold the potential for positive change with the help of psychotherapeutic support.

Young man talks about his psychedelic experience

For whom is integrative psychotherapy useful?

Interested individuals can contact us, if tif they had an intense experience in altered states of consciousness (for example, an experience under psychedelic substances) and want to better integrate it into ttheir lives. For integrative psychotherapy, we draw on knowledge and experience from behavioral therapy, depth psychology-based psychotherapy and humanistic methods.

As a private clinic, we do not require an application process with a waiting period for self-pay patients. The psychotherapy can start directly and we work out with our patients an individual therapy plan with flexible duration of treatment. The provision of services by the statutory or private health insurance funds is checked by means of the health insurance fund substitution procedure, if required.

We also work with our patients to determine the extent to which longer outpatient psychotherapy can be helpful, beyond the scope of pure integration therapy. Either you can do this then with us or we help in the mediation to experienced outpatient psychotherapists. If you have patients in your psychotherapeutic treatment, integration psychotherapy can also take place as a supplement during a break in psychotherapy or as preparation for therapy with you.

Psychiatric co-treatment

Patients can also contact us if they have experienced severe or persistent psychological problems such as anxiety, flashbacks, depressive symptoms, or symptoms of altered perception with, for example, derealization, feelings of persecution, or hallucinations after using psychedelic substances. Often, psychotherapeutic integration of the experiences in the altered state of consciousness can also lead to an improvement of the symptoms. In some cases, additional psychiatric medication may also be helpful. Here we develop an individual therapy plan consisting of integrative psychotherapy and supportive medication, should this be necessary. Furthermore, we can help you find further or even inpatient treatment if needed.

BENEFITS

Integration psychotherapy can help …

… to use the processing of intense experiences in altered states of consciousness for personal psychological improvement.

… to arrange the experiences in altered states of consciousness for themselves in such a way that they can be helpful in a longer-term psychotherapy.

… after intensive experiences in altered states of consciousness e.g. after taking psychedelics (ayahuasca, LSD, mushrooms etc.), certain forms of meditation or Breathwork to implement these experiences for themselves.

… Addressing difficulties in processing experiences in altered states of consciousness with negative effects on one’s life.

… deal with severe psychological problems such as hallucinations, flashbacks or anxiety after an experience in altered states of consciousness. Psychiatric treatment with symptom-relieving medication can also be started here if necessary.

… to continue a further integration of the made experiences following an Augmented Psychotherapy in our practice.

TEAM

Our team is looking forward to working with you

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Gerhard Gründer
Prof. Dr. med. Gerhard Gründer, Facharzt für Psychiatrie - Psychotherapie
Psychiatrie & Psychotherapie
Prof. Dr. med. Gerhard Gründer
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Psychiatrie & Psychotherapie
Prof. Dr. med. Gerhard Gründer
Facharzt für Psychiatrie – Psychotherapie. Mitglied in zahlreichen nationalen und internationalen Fachgesellschaften. Vorsitzender der Arbeitsgruppe „Therapeutisches Drug Monitoring“ (TDM) der Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP). Mehr als 200 Publikationen in internationalen Fachzeitschriften.

A treatment with Prof. Dr. med. Gerhard Gründer is also possible in English.
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Andrea Jungaberle
Image is not available
Anästhesie & Notfallmedizin
Dr. med. Andrea Jungaberle
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Anästhesie & Notfallmedizin
Dr. med. Andrea Jungaberle
Fachärztin für Anästhesie und Notfallmedizin, in Weiterbildung zur Psychotherapeutin (Verhaltenstherapie). Studientherapeutin in der EPIsoDE-Studie zur Untersuchung der Behandlung von schwerer Depression mit Psilocybin (Studienleiter Prof. Dr. med. Gerhard Gründer). Promotion in der Psychosomatik, ehemalige Lehrbeauftragte des Instituts für Medizinische Psychologie (Universität Heidelberg). Mitglied des BDA, der SÄPT und Gründerin der MIND Foundation.

A treatment with Dr. med. Andrea Jungaberle is also possible in English. Le traitement chez Dr. med. Andrea Jungaberle est également possible en français. El tratamiento con Dr. med. Jungaberle también es posible en español.
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Sergio Pérez Rosal
Anesthesiology Specialist Medical Doctor Sergio R. Pérez Rosal
Anästhesie & Notfallmedizin
Sergio Pérez Rosal
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Anästhesie & Notfallmedizin
Sergio Pérez Rosal
Facharzt für Anästhesie und Notfallmedizin, in Weiterbildung zum Psychotherapeuten (Verhaltenstherapie). Ausgebildeter NeuroMeditation Lehrer, Mitglied des BDA und Direktor der MIND Academy.

A treatment with Dr. Pérez Rosal is also possible in English.

El tratamiento con el Dr. Pérez Rosal también es posible en español.
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Nadine Fortmann
OVID Clinic Team Unknown
PRAXISBETRIEB
Nadine Fortmann
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Praxisbetrieb
Nadine Fortmann
Betreuung von Patienten und Organisation des Praxisbetriebs. Ausgebildete Physiotherapeutin.

Assistance is also possible in English.
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FAQ

Learn more

How much does Augmented Psychotherapy cost?2023-08-06T05:04:55+02:00

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?2023-08-07T02:11:12+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:

Other hotels nearby:

Do you offer assistance in planning my trip to Berlin?2021-05-21T14:48:08+02:00

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?2021-05-20T18:30:48+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?2021-05-21T10:43:13+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.

Can you get addicted to ketamine?2021-05-20T18:14:40+02:00

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?2021-05-20T18:14:27+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?2021-05-21T10:43:05+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?2021-05-21T10:42:56+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?2021-05-20T18:14:04+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?2021-05-20T18:13:57+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?2021-05-20T18:13:50+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.

  • Depression
  • 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
  • Obsessive-compulsive disorders: Intensified therapy
  • Obsessive-compulsive disorders with depressive symptoms
  • Anxiety disorders: Intensified therapy
  • Anxiety disorders with depressive symptoms
  • Persistent psychological symptoms in the context of severe stress (e.g. death of relatives, separations, job loss, serious illness)
For which psychological disorders is Augmented Psychotherapy with ketamine not recommended?2021-05-20T18:13:43+02:00

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.

  • Psychotic illnesses
  • 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?2021-05-20T18:13:34+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?2021-05-20T18:13:27+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?2023-08-15T23:43:39+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?2021-05-20T18:13:06+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?2021-05-20T18:01:57+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?2023-08-15T23:40:11+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?2021-05-18T10:13:20+02:00

Once a month, on the first Monday of the month at 6:00 pm, we organize an online information event for referring physicians and interested colleagues. You can find the dates here.

How can I refer patients to you?2021-02-26T09:55:17+01:00

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 info@augmentierte-psychotherapie.de

Is the treatment reimbursed by health insurance?2023-08-15T22:08:02+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?2021-05-18T09:25:01+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?2021-05-19T10:24:44+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?2021-05-18T18:00:38+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?2021-05-18T17:58:52+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?2021-05-04T16:33:51+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?2021-05-18T17:54:04+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?2021-05-19T09:36:23+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?2021-05-19T10:30:46+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?2021-05-19T09:06:40+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?2021-05-20T18:01:06+02:00

During the current corona pandemic, we aim to protect you and ourselves using the following measures:

We ask you not to enter the practice with typical physical signs of illness, but instead to contact us via phone.

General rules inside the clinic:

  • The general rules for social distancing and hygiene apply.
  • We regularly air out all rooms.
  • Sufficient options for disinfecting one’s hands are always available.
  • Our appointment schedules avoid crowding in the waiting area.
  • If necessary, we can currently offer psychotherapy sessions online through a secure channel.

Specifically about and during therapy:

  • Before each session involving altered states of consciousness, we will give you a rapid SARS-Cov-2 test.
  • Our therapeutic team is tested weekly with a rapid SARS-Cov-2 test.
  • For your safety and ours, we currently wear FFP-2 masks during all therapy sessions.
  • If possible, we ask you to also wear an FFP-2 mask. We can provide these.
  • Due to coronavirus restrictions, we cannot currently offer group therapy on site.
What are physical contraindications for Augmented Psychotherapy with ketamine?2021-05-20T18:01:16+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
  • Pregnancy

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?2021-05-19T09:25:06+02:00

Contraindications: We cannot offer Augmented Psychotherapy with ketamine treatment to patients who have the following medical contraindications to therapy:

  • Structural heart disease (including heart failure)
  • Labile, difficult to control or untreated hypertension
  • Unstable angina pectoris
  • Myocardial infarction and/or stroke in the past 12 months
  • Increased intracranial pressure
  • Untreated or inadequately treated hyperthyroidism
  • Glaucoma
  • Liver cirrhosis, severe liver dysfunction

If patients* are still interested in therapy with us, they are welcome to contact us and we can review the possibility of Augmented Psychotherapy with non-pharmacological methods.

Can I go home by myself after ketamine administration?2021-05-20T18:00:25+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.

As a result of the Insight conference at the beginning of September, there were irregularities in the dates of our info event! We kindly ask for your understanding!

Next English info event will take place on 19.09.2023, the next German info event will take place on 26.09.2023!

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