KA-EMDR stands for Ketamine-Assisted EMDR. It combines EMDR, the structured, evidence-based approach we use to help your brain reprocess difficult memories, with a low, carefully measured dose of ketamine prescribed and monitored by an independent medical provider. The ketamine piece supports neuroplasticity and emotional flexibility, which can help EMDR reach memories that have felt stuck or hard to access through talk therapy or standard EMDR alone. KA-EMDR was developed by Danielle Ciccone and Michele Topel, and I'm certified in their model through the Ketamine-Assisted EMDR Institute, where you can read more about how the model was developed if you're curious.

EMDR (Eye Movement Desensitization and Reprocessing) is a well-established, extensively researched therapy for trauma. It's not a new or fringe approach, it's recognized by major health organizations as an effective treatment for PTSD and trauma-related symptoms. If you'd like to read more about the research behind it independent of anything I say here, EMDRIA, the EMDR International Association, is a good place to start. KA-EMDR builds on that established foundation by adding ketamine to support the reprocessing work EMDR already does.

At a low dose, ketamine affects two types of glutamate receptors: it temporarily blocks NMDA receptors while stimulating AMPA receptors. That combination is part of what helps the brain form new synaptic connections and appears to boost neural circuits involved in regulating stress and mood. In plainer terms, this is the mechanism behind the neuroplasticity and "window for change" described above, it's not just a feeling of openness, there's a real neurochemical shift happening that creates favorable conditions for EMDR's reprocessing work.

When prescribed and monitored by a licensed medical provider and used at the low, carefully measured doses used in the KA-EMDR model, ketamine has a well-established safety profile for this kind of clinical use. Every client completes a medical screening before starting, and sessions are supervised throughout.

No. The KA-EMDR model uses a low, psycholytic dose specifically because it keeps you alert, oriented, and able to actively participate in your EMDR work. It's not the same as a high-dose psychedelic ketamine experience. Most clients describe it as feeling more open and less defended, not disoriented.

Not me. I am a therapist, not a medical provider, and I have no role in evaluating, prescribing, dispensing, or billing for ketamine or any medication. That is handled entirely by a separate, independent licensed medical provider. I partner with Avesta Ketamine and Wellness in Bethesda, MD for this piece. You'll have your own separate appointments and billing relationship with them (or another qualified prescriber), and you must be medically approved by them before we begin reprocessing sessions.

Here's how it typically unfolds:

1. Intake session (60 minutes), where we talk through your history and goals and decide together whether KA-EMDR is a good fit

2. If it is, I refer you to Avesta (or another qualified prescriber) to begin your medical evaluation

3. While that evaluation is in progress, we continue with preparation sessions (60 minutes each) to build readiness, the pace and number of sessions depends on what you need

4. Once you're medically approved and we agree the timing feels right, we move into dosing sessions (90 minutes)

5. Integration sessions (60 minutes) follow as needed, for ongoing clients this is simply your regular weekly session

For some clients, yes. Because ketamine can help loosen blocks that have kept certain memories or patterns stuck, sometimes for years, despite other approaches, people occasionally move through processing that once felt stalled in fewer sessions than standard EMDR alone might have taken. This isn't true for everyone, and it isn't something I can promise going in, but it's part of why this model exists: to help create the conditions for stuck work to finally move, and in some cases, to get you to the other side of it more efficiently than you might expect.description

This work isn't right for everyone, and that's okay. Certain medical and psychiatric conditions rule it out, and that determination is made by the prescribing medical provider as part of your evaluation, not by me. If KA-EMDR isn't a fit, we'll talk about what approach makes more sense for where you are.

Not necessarily, but a solid foundation of safety and resourcing is essential before this work begins. If you're new to working with me, we'll start with an intake and preparation to make sure you're ready before introducing ketamine into any session.

Not unless we decide together that it should. Some clients fold KA-EMDR into their existing weekly care. Others prefer to keep it separate and focused. We'll talk through what makes the most sense for your treatment as a whole during your intake.

Many ketamine clinics offer medical ketamine treatment with limited or no structured psychotherapy alongside it. KA-EMDR is different: it's a specific, researched protocol that integrates EMDR's structured trauma-reprocessing approach directly with the ketamine experience, facilitated by a therapist trained in both modalities. My role throughout is as your EMDR therapist, that's the work I specialize in, and ketamine is a tool that can support it, not a replacement for it.

That's set by and paid directly to your prescribing provider, not to me. As a general range, the medical evaluation typically runs around $250, and the ketamine medication itself is typically low cost. I don't collect any payment for or profit from this portion of your care.

I'm an out-of-network provider, so coverage and reimbursement depend on your specific plan. I'm happy to talk through what that typically looks like during your intake.

A limited number of sliding-scale spots are available for KA-EMDR dosing sessions. If the standard rate is a barrier, reach out and we'll talk about what's possible. I'd rather have that conversation than have cost be the reason you don't get this kind of support.

Preparation is a real part of this process, not a formality. Before any ketamine is introduced, we'll spend time building safety, resourcing, and grounding skills, and making sure you feel informed about what to expect. You'll also receive guidance directly from Avesta as part of your medical evaluation.

Some parts of the process may be appropriate for telehealth, but ketamine sessions themselves typically require an in-person, supervised setting for safety. I'll talk through what's appropriate for your situation during intake.

EMDR sessions are held at my Rockville, MD office. The medical evaluation and ketamine prescribing take place through our partner clinic, Avesta Ketamine and Wellness, in Bethesda, MD. I work with clients throughout Montgomery County, the greater DMV area, and across Maryland and Virginia.