What to Expect from a Ketamine Clinic: Insights from Dr. Brian Richards
Choosing a ketamine clinic is an important decision on your mental health journey. At Gladstone Psychiatry and Wellness, our approach to ketamine-assisted psychotherapy goes far beyond simple medication administration. We recently hosted a webinar featuring Dr. Brian Richards, a nationally recognized leader in psychedelic medicine, who explained what sets a comprehensive KAP clinic apart and how this emerging field of experiential medicine is transforming mental health care.
Watch the Full Webinar
Learn more about our ketamine clinic model by watching the complete recording on Gladstone’s YouTube channel.
What Makes a Quality Ketamine Clinic Different?
Not all ketamine clinics are created equal. Dr. Richards emphasizes that many ketamine clinics focus solely on medication administration, whether through Spravato or infusion therapies, with minimal therapeutic support. Patients often experience temporary relief that fades within weeks, returning to the same self-negating patterns and deep dissatisfaction with life.
A quality ketamine clinic provides what Dr. Richards calls a “therapy envelope,” comprehensive support that transforms ketamine’s otherwise unpredictable effects into lasting, meaningful change. This is the foundation of what we call experiential medicine: going beyond symptomatic treatment to facilitate profound, transformative experiences that inspire lasting changes in behavior and perspective.
The Experiential Medicine Approach at Our Ketamine Clinic
Experiential medicine represents an emerging field in mental health care. Rather than simply reducing depression or anxiety symptoms, the goal is to occasion memorable, meaningful experiences that inspire lasting transformation. Currently, ketamine is one of the few psychedelic compounds available through insurance-covered treatment at specialized ketamine clinics like Gladstone.
As research continues on psilocybin, MDMA, and other psychedelic compounds, the field is working toward making these therapies normative healthcare benefits. For now, ketamine-assisted psychotherapy offers accessible, evidence-based care that’s covered by insurance.
The Science and History Behind Ketamine Therapy
The use of psychedelic compounds for healing has deep roots. Archaeological evidence suggests human use of psychedelics dating back to 9000 BC. For over a millennium in ancient Greece, the Eleusinian Mysteries offered citizens the opportunity to participate in rituals involving visionary experiences, likely through ergot fungi, an analog of LSD.
Modern ketamine clinics draw on this wisdom while integrating contemporary neuroscience and rigorous clinical standards. Ketamine itself is listed by the World Health Organization as an essential medicine and has been used safely for decades. Recent research discovered that sub-anesthetic doses can occasion expanded states of consciousness, which is the foundation for its therapeutic use in ketamine clinics today.
Dr. Richards presented compelling data from a 2010 Lancet study showing that ketamine has relatively low abuse liability compared to substances like alcohol, heroin, and methamphetamine. This safety profile, combined with decades of medical use, makes ketamine an ideal candidate for therapeutic application in clinical settings.
Research-Backed Outcomes from Ketamine Clinics
One of the most striking aspects of the webinar was Dr. Richards’ discussion of research with cancer patients. In studies at Johns Hopkins and other leading ketamine clinics, some terminal cancer patients who received psilocybin experienced profound transformations. They transcended their fear of death.
These weren’t temporary effects. Patients who had been “absolutely stricken, fearful, resentful, non-accepting of the inevitability of death” had experiences so profound that they fundamentally changed how they lived, even while dying. The experience became what researchers call noetic—having a quality of absolute truth, deeply known and understood.
While this research used psilocybin, similar transformative experiences occur in ketamine clinics when the proper therapeutic framework supports the journey.
What to Expect at Gladstone’s Ketamine Clinic
When evaluating ketamine clinics, it’s essential to understand what comprehensive care looks like. Dr. Richards outlined Gladstone’s evidence-based model:
Rigorous Screening: Comprehensive medical and psychiatric evaluation to ensure ketamine therapy is safe and appropriate for you
Advanced Screening: Understanding how you experience symptoms and organize your sense of self
Preparation Sessions: Developing intention, addressing fears, creating psychological safety, and discussing shame or trauma openly
Assigned Therapist: Dedicated therapeutic support throughout your journey at our ketamine clinic
Six to Eight Sessions: Treatment protocol delivered over an eight-week period
Dose-Ranging: Finding your optimal therapeutic level through careful titration
Integration Sessions: Meeting 24-48 hours after each ketamine session to make sense of experiences
Behavioral Support: Guidance for initiating positive changes during the neuroplastic window that follows treatment
Unlike many KAP clinics that don’t work with insurance, Gladstone’s program is covered by insurance with a transparent copay across all procedures, making evidence-based ketamine therapy accessible and affordable.
How Ketamine is Administered at Gladstone
At Gladstone’s KAP clinic, medication is administered sublingually, meaning through oral absorption over approximately 20 minutes. This method creates a gradual, gentle onset that patients find more comfortable than faster routes like injection or infusion.
The sublingual route also significantly reduces abuse potential compared to faster-acting methods. During the experience, patients recline with eye shades and headphones, allowing them to focus inward while the therapist remains nearby to provide support and ensure safety.
The Importance of Set and Setting in Ketamine Clinics
The therapeutic effectiveness of any ketamine clinic depends heavily on set and setting:
Set refers to your mindset—your fears, expectations, sense of trust in yourself and the therapeutic team. Quality ketamine clinics invest significant time in preparation to optimize your mindset before treatment.
Setting refers to the physical and interpersonal environment. At Gladstone’s ketamine clinic, treatment rooms are designed to feel comfortable and safe in living room-like spaces with soft lighting, carefully chosen art, and warm-hearted therapeutic presence.
Dr. Richards shared a helpful metaphor: imagine throwing a boomerang as hard as you can. Your awareness may arc out further than you ever imagined, but it will return to you. This helps patients let go of fear and remain open and curious during the experience.
How KAP Supports You Through Challenges
Not every ketamine experience is comfortable. Patients may encounter deep grief, overwhelming fear, or what seems like terrifying darkness. This is why choosing a ketamine provider with comprehensive therapeutic support is so important.
Dr. Richards emphasizes the importance of witnessing—remaining curious and open rather than becoming identified with difficult thoughts or emotions. Remarkably, even challenging experiences often prove valuable in retrospect.
Patients discover a different relationship with their thoughts, developing mindfulness, the capacity to observe thoughts without reacting as if they’re facts. For someone with treatment-resistant depression stuck in unrelenting rumination, shame, and self-negation, this shift in perspective can be profoundly healing.
Mystical-Type Experiences: What Research Shows
Leading ketamine clinics and psychedelic research centers have developed validated instruments to measure what are called mystical-type experiences. These aren’t vague, subjective claims. They’re characterized by specific qualities that have been published in top-tier journals including Nature and JAMA Oncology:
• A sense of unity with all of life
• Deep reverence and sacredness
• Transcendence of time and space
• Profound positive mood—joy, peace, love
• Paradoxicality (experiencing opposites simultaneously)
• A noetic quality—feeling it as ultimately true
• Ineffability—difficulty finding words to describe the experience
These experiences can fundamentally reframe a person’s understanding of reality and their place in it, leading to lasting positive changes in well-being and life satisfaction.
Integration: A Key Differentiator Among Ketamine Clinics
What separates exceptional ketamine clinics from basic medication services is the integration process. Having a profound experience is one thing; translating it into lasting change requires skilled therapeutic support.
After ketamine sessions, there’s a window of increased neuroplasticity—the brain becomes more flexible and capable of new learning. At Gladstone’s ketamine clinic, integration sessions help patients:
• Unpack and make sense of their experiences
• Identify what was useful and what they want to bring into their lives
• Initiate behavioral changes that capitalize on this neuroplastic window
Dr. Richards shared the story of a patient with severe agoraphobia who, after his ketamine experience, challenged himself to sit in a train station—a previously unbearable situation. Through self-generated exposure during the neuroplastic window, he successfully overcame his social phobia.
How KAP Clinics Address Shame and Trauma
Dr. Richards highlighted research showing that inadequate preparation at ketamine clinics can lead to increased shame in a significant minority of patients. This underscores why Gladstone’s model includes asking every patient about shame, guilt, and trauma during preparation sessions.
“All of it is welcome. All of it is our shared humanity,“ Dr. Richards emphasizes. “There is nothing that is unspeakable.”
By creating a sense of safety and non-judgment before treatment begins, patients can encounter difficult emotions without being overwhelmed. This preparation distinguishes therapeutic ketamine clinics from medication-only services.
Common Questions About Ketamine Clinics
During the Q&A session, Dr. Richards addressed important questions that many people have when considering a KAP clinic:
Age considerations: Most ketamine clinics, including Gladstone, require patients to be 18 or older per FDA protocols. For young adults without contraindications (like bipolar disorder or psychotic disorders), these experiences can be profoundly helpful during critical periods of identity development.
Insurance and cost: Unlike many ketamine clinics that operate on a cash-only basis or provide receipts for out-of-network reimbursement, Gladstone bills insurance directly with a transparent copay across all procedures, making it one of the most affordable, accessible options available.
The Future of Ketamine and Experiential Medicine
The field of experiential medicine is rapidly developing. Dr. Richards mentioned numerous organizations working toward FDA approval and nationwide accessibility of various compounds. In the near future, some clinics may offer multiple FDA-approved experiential medicines, some with psychedelic effects, others that increase neuroplasticity without subjective experiences.
As the field evolves, patients and providers at forward-thinking clinics will work together to determine the best approach for each individual’s unique needs and goals.
Is Ketamine Assisted Psychotherapy Right for You?
Choosing the right ketamine clinic is an important decision. This blog post provides an overview, but to truly understand the depth and nuance of ketamine-assisted psychotherapy, including the neuroscience, historical context, and moving patient stories, we encourage you to watch the full webinar recording on YouTube.
Whether you’re exploring ketamine for yourself, a loved one, or as a professional interested in this emerging field, Dr. Richards’ presentation provides a comprehensive foundation for understanding how experiential medicine is transforming mental health care.
Gladstone Psychiatry and Wellness operates across Maryland with locations in Baltimore City, Hunt Valley, Columbia, Frederick, and Bethesda. Our evidence-based, insurance-covered ketamine-assisted psychotherapy program provides the comprehensive therapeutic support that research shows is essential for lasting transformation.
To learn more about our ketamine clinic or to schedule a consultation, visit www.gladstonemd.com or contact us at any of our Maryland locations. Our team is here to answer your questions and help you determine if ketamine-assisted psychotherapy is the right next step on your wellness journey.
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