For many therapists, the decision to offer Psychedelic-Assisted Psychotherapy (PAP) starts with clinical curiosity — but quickly becomes a business question: How do I actually build this into my practice?
Currently, the only federally legal form of Psychedelic-Assisted Psychotherapy (PAP) is Ketamine-Assisted Psychotherapy (KAP). This article dives into the business aspects of building a KAP practice, but as of April 2026, there has been accelerated progress for the approval of other forms of psychedelics for mental health. Read more about the latest news for PAP.
In a recent Journey Clinical webinar, two experienced providers walked through what it looks like to launch and sustain a PAP practice: Kelly LaPointe, PMHNP-BC, a lead prescriber on Journey Clinical's medical team, and Brooke Kettering, LMFT, one of Journey Clinical's longest-tenured and most experienced PAP therapists, who has helped train hundreds of other providers.
Their perspectives reflect both sides of the model — the medical infrastructure required to deliver ketamine safely, and the therapeutic container that drives outcomes. What follows is drawn directly from their conversation.
Curious whether PAP is right for your practice? Book a one-on-one consultation with the Journey Clinical team.
Key Takeaways
✦ PAP is a collaborative care model — therapists focus on therapy, Journey Clinical handles all medical aspects.
✦ You can start with your existing caseload. Most therapists begin with 1–2 current clients.
✦ Prep and integration sessions can be billed to insurance; dosing sessions are typically private pay.
✦ Schedule KAP in blocks — dosing sessions run 2–3 hours, and fluctuations are normal week to week.
✦ Marketing KAP means educating people, not promoting a product. Most referrals come from trust.
✦ Having your own KAP experience — if eligible — meaningfully improves clinical confidence.
✦ Keeping 1–2 KAP clients at a time is a sustainable, intentional model for most therapists.
1) Finding a Medical Collaborator: You Can't Offer This Alone
One of the biggest shifts in building a KAP practice is recognizing that you are not responsible for the entire treatment. For a client to receive ketamine safely, they need to be evaluated and prescribed by a licensed medical provider — and therapists need to stay clearly within their scope of practice.
Journey Clinical was built to solve exactly this problem. Finding a psychiatrist willing and trained to prescribe ketamine for mental health is harder than it sounds — they are limited in number, especially outside major cities, and most have no experience with KAP protocols. Even when therapists find someone, coordinating care and maintaining communication can quickly become a significant operational burden.
Brooke described what her training program told her before she found Journey Clinical:
"After my training, what they told us was, okay, so now you can go find a prescriber in your area. And I kind of was at a loss of how to go about doing that. I don't have an office space, because most of my clients currently are virtual. There were a lot of questions that came up. And then I discovered Journey Clinical, and it was kind of like, wow — they can meet the doctor through this, there's a lot of collaboration, and I liked how safe that felt."
— Brooke Kettering, LMFT
Through Journey Clinical's collaborative care model, the medical team handles intake, prescribing, and monitoring — while the therapist leads preparation, dosing support, and integration. From a business standpoint:
- You don't need to source or manage a prescribing partner
- You remain fully within your scope as a therapist
- Your existing liability coverage typically still applies
Kelly emphasized that the collaborative care model is the core of what makes this work — and what keeps providers coming back:
"Collaborative care really is that streamlined and accessible connection between the client, you, and the providers. It enables us to work as a team. That's really the bedrock of Journey's model — and it's why providers continue to work with Journey. It just feels safer. It feels better to work collectively."
— Kelly LaPointe, PMHNP-BC
2) Training and Readiness: What You Actually Need to Get Started
Before offering KAP, therapists go through a structured training program as part of their Journey Clinical membership. The training has three components:
- Didactic training — foundational KAP education covering prep, dosing, and integration (7 CEUs), developed in partnership with the Integrative Psychiatry Institute (IPI), plus Journey Clinical-specific protocols
- Experiential learning — optional personal KAP experience (highly recommended), shadowing, co-facilitation, and peer practice with other therapists
- Ongoing support — case consultations with prescribers, peer consultation groups, office hours on pricing and marketing, and an ever-growing library of CEU trainings
Brooke, who has completed training through Naropa, Prati, IPI, and Journey Clinical, had specific advice for therapists who wonder whether they need to retake training they've already done:
"I'm the type of person that'll do all the trainings. They each have a little something different — their own gems to reveal. Even if it's redundant, it might be worth just refreshing. And the more you go over something, the more easily it flows out of your mouth when you're explaining it to clients."
— Brooke Kettering, LMFT
That fluency matters beyond just competence. Confidence in how you explain KAP to clients directly impacts whether they say yes to treatment — and whether they trust the process once they're in it.
Brooke also spoke to the value of practice opportunities that didn't exist when she started:
"Those didn't exist when I got started, and I would have totally taken advantage of them — instead of telling my clients, 'Hey, I'm brand new to this, are you open to...' You know? It's a lot better to get experience with other people first. It's like when you're in grad school and you practice dyadically in your cohort. It's just a lot safer."
— Brooke Kettering, LMFT
Once you've completed the core training, you're eligible to refer your first client. Learn more about Journey Clinical's training program.
3) Structuring Your Services: How KAP Fits Into Your Schedule
Most therapists don't realize that the majority of sessions in a KAP treatment program are standard therapy sessions — billed to insurance the same way as any other session. Unlike traditional therapy, however, KAP introduces longer 'dosing' sessions intro a treatment plan.
A typical structure includes preparation sessions (standard therapy length, insurance-billed), one or more dosing sessions (2–3 hours, typically private pay), and integration sessions (standard therapy length, insurance-billed). The dosing session is where the client self-administers the sublingual ketamine lozenge and has their inward journey, supervised by the therapist either in person or via Zoom.
Brooke shared how she structures dosing days in practice:
"I started with Friday as a dosing day, and I would often do Sunday dosing days as well. It really depends on the client. For a lot of people, they prefer not to have to take time off work, so I'd think of it from their perspective — not having to wake up for work the next morning. Friday afternoon made sense. And oftentimes I would do dosing on Friday, integration on Monday, because it gives them some time to let the experience settle."
— Brooke Kettering, LMFT
She also described adapting to clients' lives:
"I had a client who was a stay-at-home mom, so when her kids were at school in the middle of the week, that was a really great time — because on the weekends she was full-on with her kids."
— Brooke Kettering, LMFT
Due to the rhythm of a KAP caseload more broadly, Brooke shared that she only takes on a few KAP clients at a time:
"You might have a two-hour dosing and a prep and an integration — four and a half hours with one client in one week. But then maybe you don't see them at all the next week. There's a big fluctuation. So it's kind of nice to have one or two KAP clients at a time."
— Brooke Kettering, LMFT
4) Pricing and Revenue: How KAP Generates Income
Some therapists are entirely private pay for KAP treatment, and offer special rates for this specialized treatment, which typically includes 6-8 dosing sessions, with preparation and integration sessions in between each dosing session. Some therapists host group KAP, which can reduce the cost for participants, or retreats, which can be priced dependent on many factors.
For therapists who accept insurance, KAP introduces a hybrid revenue model. Preparation and integration sessions can typically be billed to insurance using the standard psychotherapy code (90837). Dosing sessions are usually private pay. Brooke described her approach:
"My way has been to bill prep and integration to insurance, and do the dosing session as its own out-of-pocket fee. I also use a sliding scale, so I really try to work with clients on that."
— Brooke Kettering, LMFT
On explaining the full cost picture to clients — which involves medical fees, ketamine cost, and therapy — Brooke was direct about the complexity:
"It's a lot of information. I would recommend having an email template, or just being able to type out an email to follow up, because it is a lot. I'll ask them if they have insurance first, explain that the medical portion will most likely be covered depending on their plan, and that ketamine itself is actually quite cheap."
— Brooke Kettering, LMFT
Journey Clinical supports the financial side of onboarding with insurance benefits checks, a pricing resource page, and a client-facing consultation link so your clients can get their questions answered directly. Learn more about the patient experience at Journey Clinical.
5) How to Get Your First KAP Clients: Start With Who You Already Have
Most therapists assume they need to "market" KAP to build their practice. In reality, most providers start with their existing caseload — identifying clients who feel stuck in traditional therapy, have tried multiple medications, or have expressed openness to alternative approaches.
Brooke described who tends to come to her for KAP:
"Most people who come to me have already tried many different SSRIs. This isn't their first rodeo with therapy. And I think in the last couple of years, psychedelic therapy in general has become so much more destigmatized that people are open. It's not like I have a full practice of ketamine clients — I also wouldn't want that. But a lot of people are pretty open when you bring it up."
— Brooke Kettering, LMFT
The Journey Clinical caseload consultation is specifically designed for this step — a 1:1 call with a prescriber like Kelly where you can go through your existing caseload, discuss who might be a good fit, and get guidance on how to have that conversation with clients. Kelly explained how the utility of the session goes both ways:
"You know your clients in a way that maybe we don't initially. You've often spent much more time with them and understand their patterns, their behaviors, their history, their nuances. When you share insights or recommendations, we take that seriously. We are never about overriding your clinical judgment — it's about complementing it."
— Kelly LaPointe, PMHNP-BC
6) Marketing KAP: Education, Not Promotion
One of the biggest mindset shifts for therapists new to KAP is reframing marketing as education. Most clients don't know what KAP is. Many therapists are hesitant to talk about it. But without education, access doesn't happen.
Brooke described how she positions herself in her community:
"A lot of the things I do and promote have nothing to do with ketamine. But if people know that's something I do, and they know me from something else, there's already that link. Word-of-mouth referrals are primarily about relationship building."
— Brooke Kettering, LMFT
Practical starting points for building visibility:
- Update your Psychology Today profile to include KAP as a specialty
- Add KAP to your website with plain-language explanation of what it is
- Connect with local ketamine clinics — Brooke works with one in San Diego as a consistent referral source
- Host community or clinician education events — Journey Clinical will sponsor local meetups for members
- Offer KAP to other therapists first — 'Heal the Healer' groups build word-of-mouth trust within the professional community
7) What the Medical Collaboration Actually Looks Like Day-to-Day
For many therapists, the most unfamiliar piece of KAP is the medical side. Kelly described how the collaboration is structured to be ongoing. She shared more in depth about the aforementioned collaborative care "caseload consultations":.
"This isn't a one-and-done meeting. You can meet with us at the beginning when you're just getting started, a few weeks in, months later — I've even had people schedule a consultation a year later. Really, just any time you have questions. Multiple check-ins as you build confidence — that's exactly how we want you to use it. We are here throughout your whole trajectory."
— Kelly LaPointe, PMHNP-BC
She also emphasized what the referral process looks like once you're sending clients through:
"There's a place in the referral to tell the evaluating provider anything specific to that client that you want us to know. We really do read those referrals thoroughly. That's your opportunity to share context, concerns, clinical impressions — anything that might help us understand the client going into the evaluation. Once the client is assigned, you have access to messaging in the portal. And you're always going to receive the treatment plans and a personalized note after all our visits, so you and the patient are always aligned."
— Kelly LaPointe, PMHNP-BC
On the safety record of Journey Clinical's model specifically:
"As far as I know, and I ask about this all the time — we have never had what we call a sentinel event. No serious medical issue related to ketamine since Journey started. More often than not when I look at the emergency line, it's not anything emergent that comes up."
— Kelly LaPointe, PMHNP-BC
8) Why Brooke Added KAP — And What She'd Tell Therapists Starting Out
Brooke was honest that ketamine wasn't her original goal — she got certified in psychedelics broadly, and came to KAP as the legal on-ramp:
"I wasn't really interested in working with ketamine when I was doing my certification. I kind of thought, well, ketamine is a foot in the door — that's what's available now, I'll get started with that. But once I started working with it, I really understood the value of it, just in and of itself. Especially because people can continue to take their medications and start ketamine therapy — and they don't have to leave their lives for 3 or 4 days to have a pretty profound experience."
— Brooke Kettering, LMFT
Her advice to therapists who are just starting:
"Have your own experiences, if you can. Having your own sense of where your client is — even though their experience will be completely different — it's helpful to be familiar with the landscape. And the more practice, the better. I know that initially I was so anxious I had the Journey Clinical dosing session timeline up on my screen so I wouldn't forget anything. If I'd had other therapists to practice with first, I could have gotten more fluid before working with real clients. Just like anything — practice, practice, practice, and it becomes a lot more intuitive."
— Brooke Kettering, LMFT
Frequently Asked Questions: Building a KAP Practice
How many clients do I need to start a KAP practice?
Most therapists begin with 1–2 clients from their existing caseload. Brooke recommends keeping it at 1–2 at a time even as you grow, given the scheduling intensity of dosing weeks.
Do I need a medical provider to offer KAP?
Yes. In a collaborative care model like Journey Clinical, the medical team is built into your membership. Learn more about becoming a Journey Clinical member.
How do therapists price KAP sessions?
KAP involves more frequent sessions as part of a 6-8 session treatment cycle, when compared to traditional once-a-week therapy. Some therapists are private pay, others offer a mix of insurance-billed therapy sessions (prep and integration) and private-pay dosing sessions. Brooke uses a sliding scale for dosing fees to keep treatment accessible.
What training is required to offer KAP through Journey Clinical?
A two-part core training: didactic education (7 CEUs, including IPI content and Journey Clinical protocols) and experiential training (peer practice, shadowing, or co-facilitation). Ongoing consultation groups, office hours, and a growing library of specialty trainings are all included in your membership.
Is KAP a full-time practice?
For most providers, it's a specialty within a broader therapy practice. Brooke keeps 1–2 KAP clients at a time alongside a general caseload.
How do I get referrals for KAP?
Start with your current caseload, connect with local ketamine clinics, update your Psychology Today and website profiles, and lean into community education events. Most referrals come from relationship-building and trust, not traditional marketing.
About the Speakers
Brooke Kettering, LMFT is a San Diego-based therapist and one of Journey Clinical's most experienced KAP providers. She has helped train hundreds of KAP therapists and regularly hosts community events and peer education in the San Diego area.
Kelly LaPointe, PMHNP-BC is a lead prescriber on Journey Clinical's medical team, with four years of experience supporting therapists and patients through the KAP collaborative care model.
Ready to build a KAP practice? Learn more about becoming a Journey Clinical member or book a one-on-one consultation with our team.