Welcome to Ketamine-assisted psychotherapy with Dr. Tracy Bennett. By signing this form, you are agreeing to participate in sessions where you will be under the influence of ketamine, a medication that can create an “out of reality” sensation.
As your psychologist, I will be talking to you and guiding you through your therapeutic experience which may result in a variety of emotions from sadness to euphoria. We may discuss core issues or traumatic issues during this time period based on your comfort level. I’ll be helping you cope with whatever emotions you are experiencing around these issues throughout your infusion. Dr. Stefany Wolfsohn, M.D. will be on hand in case your infusion needs adjusting.
Please understand that, as a licensed psychologist, I still have the reporting requirements listed in my regular informed consent, which you signed prior to your first appointment with me. If a reportable safety issue is disclosed during a ketamine session, I will discuss it with you before making any type of report or contacting your emergency person on file.
Please be patient and realize that the long-standing issues you are working on have likely been developing for some time and there is no miracle cure.
The risks of any type of therapy include problems getting worse and dealing with uncomfortable feelings of sadness, anger, grief, and frustration, among other things. However, the benefits could be feeling better, learning coping skills that can be used throughout your lifetime, living a more functional life, increasing communication skills, decreasing depression, etc.
If you have any questions about this information you may contact Dr. Tracy Bennett, Licensed Clinical Psychologist, at (805) 383-0882.