Question 1

What is Ketamine-Assisted Psychotherapy (KAP)?

Accepted Answer

Ketamine-Assisted Psychotherapy (KAP) combines the administration of ketamine—a legal, FDA-approved medication with proven antidepressant properties—with structured psychotherapy. The ketamine creates a temporary altered state that can help dissolve rigid thought patterns, reduce depression, and open the mind to new perspectives. Dr. Rosenbach integrates the medicine with preparation and integration therapy sessions to maximize long-term benefits.

Question 2

Is ketamine safe for psychiatric treatment?

Accepted Answer

Yes. Ketamine has been used safely as an anesthetic for over 50 years and has an excellent safety record when administered by a qualified physician in a controlled setting. Dr. Rosenbach conducts thorough screening to identify any contraindications before treatment begins. As with any medical treatment, risks exist and are fully discussed during the evaluation, but serious adverse events are rare in properly screened patients.

Question 3

What conditions can KAP help treat?

Accepted Answer

KAP has shown strong evidence for treatment-resistant depression, PTSD, complex trauma (C-PTSD), anxiety disorders, OCD, and existential distress. It may also benefit people who have not responded adequately to conventional antidepressants or psychotherapy alone. A thorough evaluation is required to determine whether KAP is appropriate for your specific situation.

Question 4

How is KAP different from just receiving ketamine infusions?

Accepted Answer

Standard ketamine infusions focus solely on the pharmacological effects of the drug. KAP goes further by embedding the experience within a full therapeutic framework: preparation sessions help you set intentions and build a safe container; the ketamine session is held by a trained therapist; and integration sessions help you process and apply insights. Research suggests this integrated approach produces more durable, meaningful outcomes.

Question 5

What is the difference between ketamine and esketamine (Spravato)?

Accepted Answer

Esketamine (Spravato) is a nasal spray form of a ketamine derivative, FDA-approved specifically for treatment-resistant depression, administered in certified clinic settings. Racemic ketamine (used in KAP) is the original compound, typically given as an intramuscular injection or sublingual lozenge. KAP with racemic ketamine is often considered to produce a richer, more therapeutically useful psychedelic experience, and the in-home setting allows for a more personal, comfortable container.

Question 6

Is ketamine addictive?

Accepted Answer

Ketamine does have abuse potential when used recreationally in high doses and frequently. However, in the clinical KAP context—therapeutic doses, infrequent sessions, with physician supervision—the risk of developing dependence is very low. Dr. Rosenbach monitors carefully for any signs of misuse and screens for substance use history before treatment.

Question 7

What is the success rate of KAP?

Accepted Answer

Clinical studies show that 60–75% of treatment-resistant depression patients experience significant improvement with ketamine. However, 'success' is individual—some people achieve remission, others experience meaningful but partial improvement. Outcomes depend on diagnosis, treatment history, the quality of set and setting, and engagement with integration therapy. Dr. Rosenbach will discuss realistic expectations during your evaluation.

Question 8

How is Dr. Rosenbach qualified to provide KAP?

Accepted Answer

Dr. (Andrew) Dror Rosenbach is a board-certified psychiatrist with specialized training in Ketamine-Assisted Psychotherapy. He holds medical licensure in Israel and has completed advanced training in psychedelic-assisted therapies. He brings both the medical expertise to safely administer ketamine and the psychotherapeutic skills to provide full preparation and integration support.

Question 9

Is this a medical practice or a wellness service?

Accepted Answer

Mindful Pathways is a private psychiatry practice. KAP is approached as medically supervised psychiatric care for appropriate patients after evaluation, not as a wellness or recreational service.

Question 10

Is treatment available in English and Hebrew?

Accepted Answer

Yes. Mindful Pathways offers care and patient-facing information in English and Hebrew.

Question 11

What should I expect during the evaluation process?

Accepted Answer

The evaluation is a comprehensive 60–90 minute psychiatric assessment covering your mental health history, current symptoms, medications, substance use history, trauma history, and treatment goals. Dr. Rosenbach will review your intake forms and assessments (PHQ-9, GAD-7, PCL-5, etc.) submitted through the patient portal. Based on this, he determines whether KAP is appropriate and designs a personalized treatment plan.

Question 12

Does evaluation guarantee approval for treatment?

Accepted Answer

No. The evaluation is an independent clinical assessment. Dr. Rosenbach may determine that KAP is not the right fit—whether due to medical contraindications, psychiatric risk factors, or simply because a different approach would serve you better. This determination is made in your best interest. If KAP is not recommended, Dr. Rosenbach will discuss alternative options.

Question 13

How do I know if I'm a good candidate for KAP?

Accepted Answer

Generally, good candidates have tried conventional treatments (antidepressants, therapy) without sufficient relief, do not have contraindications such as uncontrolled psychosis, active mania, or certain cardiovascular conditions, are motivated to engage in the therapeutic process, and have a stable enough life situation to support the integration work. The free screening call and formal evaluation will clarify your candidacy.

Question 14

Why can't this treatment start immediately?

Accepted Answer

The preparation phase is not a formality—it is clinically essential. Completing intake forms, assessments, and consent documents gives Dr. Rosenbach a comprehensive picture of your health. Preparation therapy sessions help you build the psychological safety needed to benefit from the experience. Skipping this groundwork increases risk and reduces therapeutic benefit.

Question 15

How many sessions will I need?

Accepted Answer

Most patients start with a series of 2–6 ketamine sessions, often spaced 1–2 weeks apart. The exact number depends on your diagnosis, treatment goals, and response to the medicine. Many patients find significant relief after 2–3 sessions, while others benefit from a longer series or periodic maintenance sessions. Dr. Rosenbach will recommend a personalized plan.

Question 16

What happens if timing changes during the process?

Accepted Answer

Life is unpredictable, and scheduling adjustments are understood. However, certain intervals between preparation, ketamine sessions, and integration are clinically important to maintain the therapeutic momentum. If significant delays occur, Dr. Rosenbach may recommend re-doing preparation work. Please communicate any changes as early as possible.

Question 17

What happens if treatment is discontinued before I complete all sessions?

Accepted Answer

If you choose to stop treatment at any point, that is your right. Partial treatment may still yield some benefit. However, completing the planned series and integration sessions significantly improves outcomes. If treatment needs to end early due to medical reasons or personal circumstances, Dr. Rosenbach will work with you on a safe transition plan.

Question 18

What does a typical KAP session involve?

Accepted Answer

After a brief check-in, Dr. Rosenbach administers the ketamine (typically as a sublingual lozenge or intramuscular injection). You lie comfortably with eye shades and curated music, entering an approximately 45–90 minute altered state. Dr. Rosenbach or a trained sitter is present throughout. Afterward, there is a gentle re-orientation period. A sober adult companion must remain with you for several hours following the session.

Question 19

What happens during a typical ketamine experience?

Accepted Answer

Experiences vary widely. Common elements include a sense of floating or weightlessness, visual or abstract imagery, deep emotional processing, ego dissolution (a reduced sense of separate self), insights about patterns or relationships, and a feeling of expanded perspective. Some experiences are deeply peaceful; others can involve difficult emotions that arise and pass. The therapeutic container is designed to hold whatever emerges.

Question 20

Will I be unconscious or 'knocked out' during the session?

Accepted Answer

No. At therapeutic doses used in KAP, ketamine does not render you unconscious. You will be in an altered state—aware, but in a deeply inward, dream-like space. You can speak and respond, though you may not feel like talking. This is different from anesthetic doses used in surgery.

Question 21

What is the goal of ketamine treatment—is it about having an intense experience?

Accepted Answer

The intensity of the experience is not the goal. The goal is therapeutic change: reduced symptoms, new perspectives, emotional processing, and lasting well-being. Some people have subtle experiences and still benefit significantly. The preparation and integration work is where much of the therapeutic value is created—the ketamine session opens a window; the therapy helps you walk through it.

Question 22

What happens if I have a difficult or scary experience?

Accepted Answer

Challenging experiences ('difficult trips') can be part of the process and often carry significant therapeutic value when held safely. Dr. Rosenbach is trained to provide grounding support throughout the session. Preparation work helps you develop the psychological resources to navigate difficulty. The mantra is: 'trust, let go, be open.' If distress becomes too intense, the session can be adjusted or ended safely.

Question 23

Can family members or friends be present during sessions?

Accepted Answer

For female patients, a trusted adult companion is required to be present throughout the ketamine session for safety and comfort. For all patients, having a sober adult companion available in the home after the session is required. Beyond this, the session space is kept intimate and quiet. Discuss any specific preferences with Dr. Rosenbach during preparation.

Question 24

What music is used during sessions?

Accepted Answer

Music is carefully curated to support the inner journey—typically instrumental, ambient, classical, or world music selected for their emotional arc and therapeutic qualities. Research shows that music significantly shapes the quality of the experience. You can explore and create your personal session playlist through the Music tab in your patient portal.

Question 25

Can I drive after a ketamine session?

Accepted Answer

Absolutely not on the day of your session. Ketamine impairs coordination, perception, and reaction time for several hours after the session ends. You must arrange transport and should not drive, operate machinery, or make important decisions for the remainder of the day. Plan to rest and be in a safe, supported environment.

Question 26

How long do the effects of ketamine last?

Accepted Answer

The acute psychedelic effects typically last 45–90 minutes depending on the dose and route of administration. Residual effects (mild dissociation, emotional sensitivity) can persist for 2–4 hours. The antidepressant effects can begin within hours to days and may last weeks to months, especially when reinforced with integration therapy.

Question 27

How do I prepare for my first ketamine session?

Accepted Answer

Fast (no food) for 4–6 hours before the session; avoid alcohol for 24 hours and cannabis for 48–72 hours prior. Wear comfortable clothing. Arrange a trusted adult companion to be present. Prepare your space to be clean, calm, and comfortable. Your preparation therapy sessions will help you set meaningful intentions, address fears, and build the inner resources for a beneficial experience.

Question 28

What is 'set and setting' and why does it matter?

Accepted Answer

'Set' refers to your mindset—intentions, expectations, emotional state, and psychological readiness. 'Setting' refers to the physical and social environment of the session. Research consistently shows that set and setting profoundly shape the quality and therapeutic outcome of psychedelic experiences. This is why Dr. Rosenbach invests heavily in preparation sessions and why the in-home setting, with familiar surroundings, can be therapeutically advantageous.

Question 29

What is an integration session?

Accepted Answer

Integration therapy is the process of making meaning from the ketamine experience and translating insights into lasting behavioral and emotional change. Without integration, the benefits of a psychedelic experience can fade. Dr. Rosenbach typically recommends 1–2 integration sessions per ketamine session, ideally within days of the experience while it is still vivid and accessible.

Question 30

How is in-home treatment different from clinic-based treatment?

Accepted Answer

In-home treatment allows you to experience ketamine in a familiar, comfortable environment—your own space, your own bed, your own meaningful objects. This can reduce anxiety, deepen relaxation, and create a more personal therapeutic container. Dr. Rosenbach comes to you, eliminating the stress of travel on treatment day. Clinic settings, while medically efficient, can feel clinical and impersonal, which may limit the depth of the experience.

Question 31

Are there any side effects?

Accepted Answer

During the session: dissociation, perceptual changes, nausea (uncommon), elevated heart rate and blood pressure. These are temporary and resolve as the medicine wears off. After the session: mild fatigue, emotional sensitivity, or a period of vulnerability as insights settle. Serious adverse events are rare in properly screened patients. A full side effect discussion occurs during the evaluation.

Question 32

Are there any long-term side effects of ketamine?

Accepted Answer

At recreational doses used chronically, ketamine can cause bladder damage (ketamine cystopathy) and cognitive effects. At therapeutic doses used infrequently in a clinical context, these risks are extremely low. Dr. Rosenbach monitors for any signs of concern throughout treatment. Staying well-hydrated and adhering to the prescribed protocol is important.

Question 33

Can I continue my current medications during KAP?

Accepted Answer

Many medications are compatible with KAP. Some may reduce effectiveness (e.g., high-dose benzodiazepines) or require careful monitoring (e.g., lithium, MAOIs). Dr. Rosenbach will review all your medications—psychiatric and non-psychiatric—during the evaluation. Do not stop or change any prescribed medications without consulting your prescribing physician first.

Question 34

Can I do ketamine therapy if I have a history of substance abuse?

Accepted Answer

A history of substance use does not automatically disqualify you, but it requires careful evaluation. Active substance use disorder (particularly dissociatives or stimulants) is a contraindication. A history of alcohol or other substance problems—now in stable recovery—may be manageable with additional safeguards. Dr. Rosenbach will assess this thoroughly and honestly during your evaluation.

Question 35

What if ketamine doesn't work for me?

Accepted Answer

Ketamine does not work for everyone, and that is an honest reality. If there is no meaningful response after a full series of sessions, Dr. Rosenbach will discuss next steps—which may include other treatment modalities, referrals, or exploring emerging therapies. Not responding to ketamine does not mean there are no options; it means the search continues.

Question 36

Can I know from the website if I am a candidate?

Accepted Answer

No. The website can provide general information, but candidacy requires formal psychiatric and medical evaluation.

Question 37

Can the screening call approve treatment?

Accepted Answer

No. The screening call is only a first step. It can help decide whether formal evaluation may be appropriate, but it does not approve treatment.

Question 38

What might make KAP unsafe or inappropriate?

Accepted Answer

Examples include acute safety risk, current mania or psychosis, unstable substance-use concerns, certain medical or cardiovascular risks, lack of safe aftercare, or need for a higher level of care. The evaluation reviews these issues individually.

Question 39

What happens if I am not a fit?

Accepted Answer

If KAP does not appear appropriate, Mindful Pathways may recommend another form of care, stabilization first, coordination with existing providers, or referral to a different level of support.

Question 40

Does payment guarantee treatment?

Accepted Answer

No. Payment does not guarantee ketamine treatment. All treatment decisions require clinical review and psychiatric appropriateness.

Question 41

What is the difference between Medical Access and Guided KAP?

Accepted Answer

Medical Access focuses on psychiatric evaluation, medically supervised in-home IM ketamine treatment, monitoring, written aftercare, and a follow-up check-in. Guided KAP includes psychiatrist-led preparation or integration psychotherapy as part of the treatment sequence.

Question 42

What is the evaluation fee?

Accepted Answer

The comprehensive psychiatric / KAP evaluation fee is ₪1,800. Completing secure intake forms and uploading relevant records beforehand helps the evaluation focus on clinical assessment and planning; it does not change the published fee. See the full pricing page for all current service and pathway fees.

Question 43

Do you accept insurance?

Accepted Answer

Israeli health insurance (Kupat Holim) does not currently cover KAP. However, detailed itemized receipts are provided for all services, which you can submit to your private health insurance for potential reimbursement.

Question 44

How do I get started?

Accepted Answer

The first step is to schedule a free 15–20 minute screening call using the 'Free Screening' button on this website. This call helps both you and Dr. Rosenbach determine if KAP may be a good fit before committing to a full evaluation.

Question 45

Can I reschedule?

Accepted Answer

Yes, but in-home medical scheduling requires planning. Late cancellations or repeated rescheduling may affect availability. See full cancellation policy on the pricing page.

Question 46

Is telepsychiatry as effective as in-person appointments?

Accepted Answer

For preparation and integration sessions, telehealth (Zoom) is highly effective. The ketamine session itself is always conducted in person, in your home, for safety.

Question 47

Where should I upload records or complete forms?

Accepted Answer

Records, intake forms, consents, and assessments are completed through the secure patient portal after screening, when evaluation appears appropriate.

Question 48

Can I use WhatsApp or email for clinical details?

Accepted Answer

Regular messaging is fine for basic coordination, but sensitive clinical details should be handled through the secure portal or an appropriate clinical communication channel.

Question 49

I already submitted a screening request. Should I submit another one?

Accepted Answer

Usually no. Duplicate requests may slow follow-up. If you need help, use the contact option on the website.

Question 50

Does the home setting matter?

Accepted Answer

Yes. Privacy, quiet, rest afterward, and practical support are important parts of planning an in-home session.

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