Ketamine Assisted Psychotherapy
What is Ketamine Assisted Psychotherapy (KAP)?

Ketamine Assisted Psychotherapy (KAP) is a unique treatment approach with psychotherapy guidance or counselling to enhance IV ketamine therapy or low dose (sub-anesthetic) oral ketamine together.

The goals of KAP are to help integrate the ketamine experience through psychotherapy, to explore emotions, root causes of suffering, non-ordinary states of mind, process emotions, develop flexibility in thinking and an authentic way of being in a therapeutic, safe and guided context.

How will I know if this therapy is appropriate for me? 

Ketamine therapy has been used to treat depression, post-traumatic stress disorder (PTSD), headaches, certain pain conditions and addiction disorders.  

Our changepain specialist will assess you and review if ketamine therapy is appropriate.   As we maintain the highest safety standards, we follow the standards set out by the College of Physicians and Surgeons of BC. Hence you will receive questionnaires as part of your assessment for sleep apnea and blood clotting risk factors.    

Our changepain KAP counsellors have specific qualifications in Psychedelic Assisted Therapies and Research, MDMA Assisted Therapy, and Ketamine Assisted Psychotherapy.  They also will assess you to confirm if you are appropriate and help prepare you for this treatment.  

How much does it cost?
Cost (*)

The initial full cycle involves the 4 phases and costs $1,500*  

At the integration session, if follow-up sessions are recommended, the follow-up sessions involve the combination of one KAP and one integration session. Each follow-up combination costs $1,000*.

The above fees cover the costs of the medication (ketamine), monitoring facilities, and the registered counsellor feeFees for the medical specialist assessment are covered by MSP or private pay. 

* Please note: 5% GST will be added to this service. We are required to add GST for all “registered clinical counselling services”.

Tatiana Santini, Ketamine Assisted Psychotherapist

Tatiana is a Psychotherapist, Clinical Counselor, Trauma Therapist, and a Ketamine Assisted Psychotherapist. She holds a Bachelor degree in Health Science, and Master’s degree in Adlerian Psychotherapy and Counseling. In addition, Tatiana has a Postgraduate Certificates in Psychedelic Assisted Therapies and Research, MDMA Assisted Therapy, Ketamine Assisted Psychotherapy, and she is a Somatic Experiencing Practitioner.

Read more about Tatiana Santini

Tatiana Santini


Tatiana Santini, is a Psychotherapist, Clinical Counselor, Trauma Therapist, and a Ketamine Assisted Psychotherapist. She holds a Bachelor degree in Health Science, and Master’s degree in Adlerian Psychotherapy and Counseling. In addition, Tatiana has a Postgraduate Certificates in Psychedelic Assisted Therapies and Research, MDMA Assisted Therapy, Ketamine Assisted Psychotherapy, and she is a Somatic Experiencing Practitioner.

Tatiana has been working extensively with Ketamine Assisted Psychotherapy as well as other psychedelic assisted therapies in clinical and research context, and as a trainer and an educator. Tatiana has been a faculty at City University in teaching clinical supervision capacity. Tatiana has been working in the public and private sector with patients struggling with trauma, substance and alcohol use disorders, PTSD, veterans, and first responders. She is an experienced clinician who has been working as a group therapist and on individual basis using various therapeutic modalities, from Somatic Experiencing, EMDR, Mindfulness Based cognitive therapies, to short term psychodynamic psychotherapy.

Tatiana is passionate about assisting her clients on their healing journey, facilitating exploration of non-ordinary states of consciousness, and mind-body relationship. Tatiana’s compassionate and non-judgmental approach allows individuals to explore unconscious aspect of their psyche, thoughts, feelings, and urges that are outside their awareness, while allowing clients to gain insights into how those are related to their life, current physical and mental health, as well as their interpersonal relationships.

Prior to psychotherapy, Tatiana worked as a respiratory and anesthesia therapist, for almost two decades in various intensive care and trauma units, ER’s as well as operating rooms. Tatiana is a Registered Clinical Counsellor, member in good standing with British Columbia Association of Clinical Counselors, Registered Psychotherapist in Ontario, and a Registered Respiratory Therapist with Canadian Society of Respiratory Therapists.

In her spare time, Tatiana enjoys forest bathing, classical music, hiking, and yoga

Tatiana Santini
Clinical Counsellor, Ketamine Assisted Psychotherapist


Ketamine belongs to a group of medicines that work on N-methyl-D-aspartate (NMDA) receptors. Ketamine is understood to work on certain brain receptors and neurotransmitters that affect mood and emotional regulation, hence allowing for processing emotions, while experiencing a shift in state of consciousness. Ketamine therapy has been used to treat depression, post-traumatic stress disorder (PTSD), headaches, certain pain conditions and addiction disorders. 

Patients choosing IV infusion of ketamine undergo this with our pain anesthesiologists and the counselling guidance sessions are scheduled before and after the IV infusions. KAP may also be used before and after the IV infusion ketamine therapy. 

Patients choosing KAP will receive one to one psychotherapy at the same time they take the lozenges.  At changepain, we use Ketamine lozenges compounded by a specialized pharmacy.  On the day of the KAP session, the therapist provides the Ketamine Lozenge to the patient who will let it absorb slowly through the mucous members under the tongue or in the side of the mouth.  The dose per session is adjusted with careful supervision by specially qualified therapists experienced with this therapy. The dose typically ranges between 50mg to 300mg to optimize the experience with minimal side effects.   
  • Anyone allergic to ketamine 
  • Anyone with uncontrolled Hyperthyroidism 
  • Anyone with Glaucoma 
  • Anyone with abnormal heart tracing, requiring a pacemaker or AICD, or other certain heart conditions like cardiomyopathy or congestive heart failure 
  • Anyone with heart medications would need to be reviewed in more detail 
  • Anyone with uncontrolled seizures 
  • Anyone with severe liver or kidney disease  


If you have been recommended KAP, before scheduling sessions, you will need to complete laboratory testing to ensure this treatment is safe for you, including liver function testing, ECG, bloodwork, and urine testing. The specialist will review these prior to the ordering of your medications. 

Possible Side Effects

Overall, this treatment has very few risks. However, as with any procedure, there are some risks and possible side effects. The following are rare but possible. 

Mild-side effects include slight drowsiness, transient increase in blood pressure, or heart rate headache, light-headedness, nausea

Moderate side effects include marked sleepiness, nightmares, dizziness, confusion, anxiety restlessness, vomiting, dissociation or hallucination symptoms.  

Severe risks include Very Rare: Seizure and heart rhythm disturbances. 

Throughout the ketamine treatment, we pay careful attention and monitor for any misuse or abnormal cravings to prevent reliance or addiction to ketamine.  We monitor for any mood deterioration or suicidal thoughts that require additional assistance.  We aim for the least dose required to prevent side effects of long-term use such as bladder irritation, discomfort or liver dysfunction. 

Ketamine Assisted Psychotherapy involves four phases: Initial consult, preparatory phase, drug administration phase, and integration phase:  

  1. Initial consult (90 min): the therapist conducts the initial assessment by phone, video or in person to clarify the individual treatment intentions and goals and provides a personalized plan. 
  2. Preparatory phase (60 min): In a separate session, the therapist then meets with the patient by phone, video or in person to prepare the patient for the ketamine sessions Once the client is prepared for the dosing session, they proceed to the next phase, the ketamine lozenge administration phase.  
  3. Ketamine Administration phase (180 min) is when the patient comes to the clinic and takes the ketamine lozenge with the supervision of the KAP qualified therapist to enter a shift in consciousness while still remaining alert.  Thereafter, the patient is supported by the therapist to explore their emotions, pain, experiences, goals and challenges. Ketamine assisted psychotherapy helps individuals access deeper inner understanding to facilitate breakthroughs in therapy, or processing of past trauma.  
  4. Integration (60min): is the phase following the ketamine session that takes place 1 to 3 days later by phone, video or in-person. Integration is a crucial component of therapeutic process. During integration, therapist helps the patient process and integrate their experience, make sense of the insights and experiences gained during the ketamine session, as well as provide guidance on how to implement the knowledge into everyday life for long term personal growth and healing. 

Cancellation and Refund Policy 

We require at least 48 hours‘ notice to cancel your appointment. If you cancel more than 48 hours in advance, we will refund your deposit with a $50 deduction for the admin fee.  

If you cancel in less than 48 hours, the deposit is non-refundable. However, if you cancel with less than 48 hours’ notice, and re-book your appointment before your prescription expires in 5 months the deposit is applied. Be advised that you will be required to pay the difference in order to complete the 50% deposit.

 ***Please know that we do not provide refunds once your KAP or counselling session has started. This includes if the session is stopped early for safety reasons. 

Ketamine Counselling is a counselling service specifically designed for those who are undergoing ketamine infusions at changepain for either chronic pain or depression or those who are prescribed at home ketamine.


Ketamine counselling will be focused on individuals needs and unique indication for ketamine therapy. Therapist and client will address various aspects of upcoming therapeutic ketamine infusions. Counsellor will assist client with emotional readiness, setting intentions, education about ketamine session, and coping strategies in relation to chronic pain or mental health.


While preparation for ketamine is important, integration is just as important. During the integration, counsellor assists client with integrating ketamine experience by exploring the insights, emotions, and memories that may have emerged during the ketamine session, helping the client make meaning of their experiences, and relate them to their therapeutic goals. Cognitive reframing or what we call meaning-making is the process in which the therapist helps client reframe and reinterpret their experiences in the context of their personal growth, healing, and intentions.


Counsellor assists client in integrating the insights gained during the ketamine sessions which may be conducted at the clinic or at home. Counsellor helps individual’s understanding of themselves and their life circumstances, while exploring intentions, goals, and behaviors that will contribute to longer lasting change and overall improved outcome.

Please contact our Private Pay Services Coordinator:

Call 604-566-9101, ext. 105 or

Cost of Initial Assessments - Non-MSP Medical

Private Medical Consultation (PMC) Multidisciplinary Private Assessment (MDPA)
Description Expedited, focused assessment to determine fit for non-MSP covered services requested:
IV Lidocaine Infusion, Ketamine Therapies, Prolotherapy, BOTOX, Platelet Rich Plasma (PRP).
Comprehensive functional and medical assessment with a multidisciplinary report addressing the biopsychosocial issues identified.
Care Team Pain Specialist Pain Specialist
Functional Movement Specialist
Duration 30 minutes 2 hours
Cost $450.00 $3,500.00

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Cost of Initial Assessments - Allied Health

Assessment Duration Cost
Chiropractic Initial 60 minutes $165.00
Physiotherapy Initial 60 minutes $160.00
Kinesiology Initial 45 minutes $90.00 (+ tax)
Counselling Initial 90 minutes $250.00
Acupuncture Initial 45 minutes $140.00
Ketamine Counselling Initial for Ketamine Assisted Psychotherapy 60 minutes $250.00

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