By: Jennifer Bailey
“I had to feel them for the first time in my body, and that was a really powerful and very overwhelming moment for me. But since then, I’ve also just been able to connect more wholly with myself. I think, for me, what psychedelics did was really make me sit with how I felt, not just what I thought my emotions were,” said Michael Toland, the Columbus product management coach and amateur poet, describing the moment psychedelic-assisted therapy helped him access emotions that traditional treatment couldn’t reach.
Toland’s experience reflects a broader shift: Psychedelic-assisted therapy is moving into mainstream medicine as therapists like Jay Karr, LPCC-S, NCC, bring structured, clinical protocols to a treatment once associated with counterculture experimentation.
Psychedelic-assisted therapy is the use of psychedelic substances under the supervision of a trained mental health provider.
Inside Karr’s Columbus practice, Reclaim Your Path, therapy sessions feature comfortable couches, eye masks, and instrumental music—not recreational drug use, but carefully monitored treatment for patients struggling with depression, post-traumatic stress disorder (PTSD), and anxiety.
How It Works in Practice
Karr is trained in and has practiced ketamine-assisted psychotherapy (KAP) since 2022. There are dosage and non-dosage sessions. Non-dosage sessions assess whether clients are appropriate candidates and allow for the creation of a safe, comfortable environment. Dosage sessions involve Ketamine administration prescribed by psychiatrists. If the psychedelic is administered through IV or injected into muscle then a medical professional is present. If it’s through pill or oral rinse (put into the mouth and then spit out) no medical professional is present. The first dose session uses a smaller “handshake dose” for adjustment.
In addition to dosage and nondosage sessions, integration sessions are imperative in the KAP process. Integration sessions should happen within 24 hours of a dosage session to process and integrate the cognitive and physical experience, meaning the therapist will review the experience with the participant and how they can use the knowledge gained in their daily life. Karr said, “Integration is key to ensuring the treatment’s adaptation to everyday life.”
Karr mentions that although KAP has a well-defined beginning, the structure around the trajectory (how many sessions) still needs to be solidified. Karr said he provides a 6-session KAP experience; however, this varies based on the practitioner.
Who This Helps
Although research shows positive results, KAP is currently reserved for specific individuals: those with depression, PTSD, and anxiety spectrum disorders, and especially those with treatment-resistant conditions where traditional medications are ineffective. However, being a candidate for PAT is more than a diagnosis. Karr states, “while the medicine is a powerful catalyst, it is not a passive cure; the client’s engagement determines the long-term outcome.”
Who It Doesn’t Help—and Why
According to the American Psychological Association, psychedelics aren’t recommended for people with a family history or diagnosis of psychotic disorders or bipolar mood disorders. Additionally, because psychedelics increase heart rate and blood pressure, those with heart or blood pressure conditions are not suitable for PAT.
Karr adds that individuals with severe personality disorders, Interstitial Cystitis, or active substance use disorders are not candidates for KAP. A client’s psychosocial environment is also considered because if a client’s home environment is unsafe or they lack a safe support system, there needs to be work on stabilization before doing psychedelic work.
Building Trust with Psychedelics
Karr believes the way to decrease stigma around psychedelic-assisted therapy is through regulation, training, education, and time. Oregon and Colorado, in 2020, passed bills decriminalizing psilocybin. Other states have followed in creating legislation decriminalizing of psilocybin, including Connecticut, Hawaii, New Jersey, Texas, and Washington (Joshua S. Siegel). Karr believes that by the end of 2026 it will be approved for use to aid in therapy sessions. Karr cites programs to get certified in psychedelic-assisted therapy, including Fluence, Polaris, California Institute of Integral Studies, and the Integrative Psychiatry Institute, which provide trustworthy training.
Despite PAT’s popularity, many clinicians are wary of it. Karr has been working to assuage skeptical clinicians’ about PAT by bringing knowledge, clarity, and conversation,through his other business LuminaThera. Karr acknowledges “the lack of a single governing body can be confusing, which is why it is critical to align with organizations like American Society of Ketamine for Physicians, Psychotherapists & Practitioners(ASKP3) and the Ketamine Research Foundation, which have established ethical codes and Standards of Practice.” Lastly, Karr suggests that time is a factor in decreasing stigma, as present success has to continue to counterbalance psychedelics’ colorful past.
Those considering trying KAP should know that it is not inexpensive, and insurance doesn’t cover it. Karr said that dosage sessions run about two hours, which would mean double the rate per session. So if a trained KAP practitioner charges $200 as an hourly rate for regular therapy, that would mean $400 per session, and given that the number of KAP sessions is up to the provider, clients could be spending thousands of dollars for KAP. He goes on to say that although the medicine is cash pay, the psychotherapy and integration sessions can potentially be billed to insurance by a mental health clinician.
When asked his view about PAT being covered by insurance, Karr shared, “Spravato (esketamine) is the only FDA-approved version for depression covered by insurance, but it is strictly a medical model that often lacks the psychotherapy component. Generic ketamine, which we use in KAP, remains “off-label” and is not covered by insurance.”
Karr’s business LuminaThera mentioned previously, also provides KAP sessions in a group format, making it accessible through a pay-what-you-can-model.
Karr hopes people and clinicians interested in KAP will understand that ” the medicine clears the path, but you still have to walk it. The healing doesn’t come from the drug; it comes from the client’s own innate capacity to move toward wholeness once the obstacles are removed. “
Takeaways
- Psychedelic-assisted therapy is structured, intentional, and grounded in clinical care, not a recreational experience.
- Integration, not the substance itself, is what makes lasting change.
- Psychedelic-assisted therapy holds promise, and access, ethics, and education remain the challenges for this intervention to overcome.
