Traditional Therapy FAQs
Yes, we are! You can click here to book a consultation appointment to get started or you can reach out to us via our contact form here
Nope! Depending on which therapist you are looking to work alongside their availability varies. During your (free) consultation call you can discuss your scheduling needs and ensure your therapist can see you at a time that is convenient for you!
No, Fostering Greatness is not in-network with any insurance carriers, which means insurance is not accepted for therapy and you are responsible for the full session fee at the time of scheduling your appointment. However, we do provide a superbill should you wish to utilize your out of network benefits.
Fostering Greatness is not in-network with insurance for a number of reasons. Most importantly, insurance companies often like to dictate the type of treatment you are able to receive and/or the amount of sessions you are able to have per year. At Fostering Greatness it’s recognized that therapy must be individualized for each client and true healing and change doesn’t work like that – in predetermined formats. Instead, you are a part of the treatment process determining how often you’re seen for therapy and in what format, tailoring the treatment to you and what will be most effective for you.
Yes! Some insurance policies have out of network benefits and if you have those and wish to use them to reimburse you a portion of the session fee, to offset the cost of therapy to you out of pocket, you can request a “superbill,” which Fostering Greatness will provide to you.
A superbill is a receipt the insurance company requires for you to submit for your out of network reimbursement. Fostering Greatness provides superbills on a monthly basis, for sessions attended the month prior. It is important to note that in order to provide you with a superbill, Fostering Greatness is required by your insurance company to give you a psychiatric diagnosis to prove “medical necessity” for your therapy sessions.
Depending on which service you are looking for, session fees vary. To learn more about our session fees, view our fees.
On your online, secure client portal you will input your credit card information before your intake session, as part of completing your intake paperwork. Then, your card is charged (via your secure client portal) as you schedule your sessions. All credit cards are accepted as well as FSA cards.
Sessions are 45 minutes long and occur weekly to start.
All traditional talk therapy sessions are virtual at Fostering Greatness. In person sessions are available for Ketamine therapy.
The first step in the process is scheduling your (free) consultation call, which is a free 15-20 minute consultation via phone to answer whatever questions you may have prior to booking your intake appointment. This call gives you a chance to assess the “fit” with your therapist and to explore the type of therapy they provide as well as to discuss logistics like scheduling. You can book your consultation call here or if you’d prefer you can use our contact form to request an appointment by clicking here.
Ketamine-Assisted Therapy FAQs
Traditional antidepressants primarily work by increasing levels of neurotransmitters such as serotonin, norepinephrine, and dopamine, which can gradually influence mood over time. Ketamine and esketamine work in a fundamentally different way by acting on the brain’s glutamate system, a key network involved in communication between brain cells. This action rapidly activates pathways related to neuroplasticity—the brain’s ability to form new connections—which play an important role in mood, anxiety, learning, and memory. By temporarily increasing flexibility in these brain circuits, ketamine-based treatments may help loosen deeply ingrained patterns of negative thinking and emotional reactivity. Because of this distinct mechanism, some individuals who have not responded to multiple traditional antidepressants may still experience significant benefit from ketamine-based therapies.
Spravato (esketamine) is FDA-approved for adults with Treatment Resistant Depression (TRD) and Major Depressive Disorder (MDD) with acute suicidal ideation or behavior. Clients who are receiving treatment with Spravato are diagnosed with one of these two diagnoses.
Ketamine is most effective against treatment-resistant depression, suicidal thinking, trauma, and post-traumatic stress disorder. However, being that many mental health conditions are so deeply ingrained in the mind and body we have found that working with an experienced therapist during your ketamine infusion can enhance outcomes with a variety of conditions in addition to the above, including anxiety, OCD, eating disorders, and chronic pain as these are often closely intertwined with depression and trauma.
Furthermore, there is emerging evidence that alcohol use disorder, when comorbid with depression and anxiety, can be treated with ketamine infusions particularly when combined with oral medications, such as naltrexone and baclofen, and therapy to address the underlying cause(s) and process how your drinking has impacted your day-to-day life and begin to form healthier habits and routines.
And, certain neuropathic pain disorders such as complex regional pain syndrome (CRPS/RSD), fibromyalgia, and migraine headaches can be quite responsive to ketamine infusions (at higher doses than we use for depression) and we have found success with clients when including therapy as well.
Because working with us at Fostering Greatness means working alongside the doctors of Initia Nova as well, we are able to offer treatment for all of the aforementioned concerns.
KAP stands for ketamine-assisted psychotherapy and is sometimes also referred to as KAT, or ketamine-assisted therapy. SAP stands for spravato-assisted psychotherapy and is sometimes also referred to as SAT, or spravato-assisted therapy. Some practices may also call SAP treatment EAP/EAT, which stands for esketamine-assisted psychotherapy/therapy. Spravato is the brand name of the medication and the generic name for the medication is esketamine.
KAP & SAP refer to a patient receiving both the medicine (ketamine or Spravato) and concurrent therapy treatment as a catalyst for psychological healing and growth. These treatments allow you to change thought and behavior patterns, see things from a new perspective, gain insight, process difficult experiences and emotions, gain motivation for behavioral change, and feel better mood-wise overall. The KAP/SAP experience is one of relaxation – feeling relaxed in your body and mind. In the KAP/SAP session your mindset and defense systems soften, which allows you to explore new ways of thinking and feeling and gives you the ability to explore, process, and discuss difficult topics. You will also have the opportunity to experience the reduction of heavy emotions, like anxiety and depression, within your session.
There are many different styles of KAP/SAP as different practitioners offer the therapy component at different times (before ketamine treatment, during, immediately after, in the days following). In our offices we provide the therapy component before by way of preparation sessions where we guide and support you in learning how to get the most out of your medicine sessions, during by way of KAP/SAP sessions where you will have the therapist present with you while you experience the medicine, and immediately after via time following your medicine experience to integrate the session content as we have seen that this provides the most substantial and lasting change.
One of the many benefits of KAP/SAP is that your therapist will not only help you within your session – to feel safe, to explore what you want to explore – but will also help you to understand and integrate the insights, thoughts, and feelings that arise from your session into your day-to-day life, which will ensure the benefits of your ketamine session will live on after your session ends and impact your daily life for the better. KAP/SAP can lead to significant growth, change, and shifts in mood and overall well being. You may have done therapy before, but you’ve never done therapy quite like this!
Ketamine can be administered in several different routes of administration including oral, intranasal (IN), intramuscular (IM), and intravenous (IV). Spravato only comes in the intranasal route, which is detailed below.
At Fostering Greatness we utilize either Spravato (IN) or intravenous (IV) routes of administration. With Spravato you receive esketamaine as a nasal spray. With IV you receive ketamine as a 40-minute intravenous infusion.
Below I will explain more about all of the routes of administration noted & what treatment looks like with us in our office:
For oral ketamine you typically place a lozenge under your tongue and hold your saliva in your mouth for 10 or 15 minutes before spitting it out. This method is often used by therapists who collaborate with a treating prescriber, but said prescriber does not work with them in their office and they may not have a working relationship other than connecting you to said provider for your ketamine prescription. Often when you receive ketamine treatment via the oral route you are not being monitored during your ketamine experience by your medical professional. Some drawbacks are the very bitter taste, the fact that you cannot talk for 10-15 minutes due to a mouthful of saliva, and the fact that each experience will differ depending on how much medicine is actually absorbed. This approach provides some mild ketamine effects and can help with mild cases of depression or for a client who may feel stuck in their current therapy process. This route can also be used for clients to augment maintenance sessions following IV treatment to spread their maintenance IV sessions out farther.
Intramuscular (IM) involves your provider injecting you with Ketamine from a needle in the back of your upper arm. This method provides a rapid effect, but it is more sustained than IN. The biggest drawback to the intramuscular route is that once it’s in, it’s in – there is no pausing or adjusting the dose and your experience will last anywhere from 40 minutes to an hour, so you are committed to riding the ketamine journey to its end.
Intranasal (IN) involves you spraying ketamine into your nose. For Spravato treatment, you will spray two sprays every five minutes for three times total, so six sprays over ten minutes. Each experience will differ depending on how much medication is actually absorbed in your nasal mucosa, but by the third spray you will be feeling the effects. The effects come on more rapidly, meaning you will feel the medicine come on fast, and then they just as quickly end. Spravato is an FDA approved form of IN ketamine, but is not the racemic ketamine you will receive otherwise — it is esketamine as it was formulated to produce less of a psychedelic effect. Therefore, Spravato is a great option for those that do not want to experience a psychedelic effect of the medicine and would prefer for the experience to be more mild, while still maintaining the antidepressant effect. Another benefit to Spravato is that it is likely covered by your insurance for the medical portion of the treatment (not the therapy), making this route of administration more financially accessible. Drawbacks typically include that there is no therapy offered with Spravato, but this is not the case in our office! We offer Spravato-assisted therapy (SAP). One important thing to note about Spravato treatment is that you will need to be monitored in the office following your medicine session, so the appointment time commitment is longer at two hours.
Intravenous (IV) involves your provider (in our office this is our ER-trained nursing staff) inserting into your vein – typically in your arm or hand – a small, flexible plastic tube via a needle, which is then removed, leaving behind only the soft tubing, which is secured with medical tape. You then receive ketamine via this IV over a 40-minute infusion. This method allows for you to receive 100% of the medication dose, but provides a slow, soft onset of the medicine. Unlike ketamine infusion clinics, in our office you are not set up with your IV and then left alone with the dose you were given. Instead, we remain involved throughout your medicine experience and are physically present in the session with you, supporting you. Therefore, this allows us the ability to stop, pause, or adjust the dose (up or down) at any time, thus putting you in full control of your experience at all times. Because we can adjust the dose we can ensure you receive a strong, robust effect from the medicine – one where you achieve your treatment goals, but the dose remains at a level that is not anxiety-producing, scary, or “too much,” while on the flipside isn’t so mild you don’t get much out of it. As mentioned previously, because we offer therapy during your infusion (as well as immediately following) we adjust your dose each session, as needed, to reach the precise amount that will allow you to feel ketamine’s psychedelic effects while still being able to talk to your therapist, should you want to and choose to. This technique was developed and perfected by Dr. Sullivan of Initia Nova and Rena Beyer of Fostering Greatness starting back in 2017 and has proven to be profoundly beneficial for our clients. IV ketamine infusions provide the most robust antidepressant and anti-suicidal properties, pair great with therapy, and the the effects wear off quicker than oral and IM (within about 5-10 minutes), with less side effects! With IV ketamine treatment you can expect to be in the office for about an hour to an hour and a half.
There are numerous things that set our office apart from other offices offering IV ketamine and Spravato, and other routes of administration, and these differences are important to note when choosing your provider!
At Fostering Greatness we partner with the doctors of Initia Nova to provide this treatment and therefore your therapist will have a working relationship with your doctor – they will actively and daily collaborate on your care. Furthermore, our doctors are on site at all times and they will meet with you prior to every session and at the end of every session, collaborating with you and your therapist on your care. They are actively involved in your treatment at all times and they are invested in your progress. And, because they are always on site, they are able to intervene at any time if needed either medically or to assess your dose (with the IV route of admin) in real time.
And, unlike other offices, your therapist is on site, working with you during your session and immediately following it, and is available for integration sessions as well. Your therapist will also conduct preparation sessions with you – sessions to best prepare you for your medicine sessions, what to expect, how to prepare, and what to do following and in between. Your therapist is a part of your treatment team ensuring you are reaching your goals and your medicine dosage (when participating in IV sessions) is correct for the work you are attempting to accomplish, actively discussing this with your doctor and collaborating with you and your doctor at every session!
Furthermore, at Fostering Greatness we believe in offering therapy during your infusion – giving you the ability to actively process and explore what is coming up during your session with your therapist should you want to and choose to – which is not offered elsewhere (unless the therapist has been trained by Rena!). In other offices if KAP is being offered during your time with the medicine, what you are usually being offered is quiet time to introspect, sometimes with music playing, while a therapist is present holding space for you and only after your ketamine experience do you then get to process the session with your therapist, sometimes days later. This is by no means “bad,” but you should have the option to choose when to talk and process and when to be introspective, which sometimes both happens within one session with us and it often varies from session to session – but it is always at your discretion and following what the ketamine journey is bringing up for you. On the other hand, sometimes when offices are offering “KAP” what they are actually offering is a referral to a therapist outside their office who will integrate the ketamine session with you after the fact, but isn’t actually offering KAP during your medicine session at all. At Fostering Greatness we offer both KAP sessions and integration sessions & we also offer to collaborate with your current therapist should you already be connected to one, to help them provide integration for you. It is unlikely you will find the kind of care we provide elsewhere and we are proud to be offering such a comprehensive, person-centered treatment option!
This is a nuanced answer because it can be different for everyone and differs based on the route of administration of the medicine. For this reason it is best to work with an experienced doctor and therapist who can ensure your experience feels safe and allows you the ability to get the most out of your medicine experience as the safer you feel the better the experience typically is.
If you opt for the IV administration of ketamine in our office, you will experience the onset of the ketamine as a slow, soft onset. You can think of the medicine experience much like a bell curve where the medicine gently enters your system and you begin to feel some of the effects within 5-15 minutes, it reaches a peak after about 30 minutes where it will remain for about ten minutes, and then following the 40-minute infusion the medicine will slowly leave your system. Within 10-20 minutes of the ketamine IV finishing you will feel much like yourself again. Therefore, the session time is about 60-90 minutes total in the office.
If you opt for Spravato (esketamine) treatment, the flow of the medicine experience is similar. The onset will be slow and soft and the experience feels like a bell curve as well, however the effects of the medicine are more mild than IV ketamine treatment. There is typically no loss of ego or identity, visuals are subtle and not immersive, and the experience is short. You will experience the onset of the medicine within 5-15 minutes, it reaches a peak after about 30-40 minutes and then the sensations will fade slowly from your system. You will remain in the office for two hours post-administration, so you will feel much like yourself again in about 60-90 minutes after administration, but you will be monitored by staff for the full 120 minutes (2 hours).
With IV ketamine, some people report seeing shapes or colors. Some people report time feeling like it is moving slower or faster. Some people feel floaty. Most people report feeling more willing, able, and safe to discuss and process their thoughts and feelings. People report feeling free to be themselves and discuss what is on their mind without judgement.
It is normal to feel anxious before your first session, not knowing what to expect. The medicine guides you into feeling relaxed. Your worries tend to float away or you may experience the feeling of caring about them less. The medicine makes it much easier to discuss important or difficult topics, which is why combining therapy with the medicine is so useful. Many of our clients have reported being able to discuss traumatic events for the first time, discuss their inner thoughts or past experiences that they had not been able to talk about before due to shame or guilt, or described KAP/SAP as being like 50+ regular therapy sessions wrapped into one.
At the medicine’s ‘peak’ you may feel “weird” or “strange.” We embrace these feelings and in fact, when using IV administration, we target our dosing to get you to that point – the point where you are experiencing the medicine’s psychedelic properties, but are not in a fully psychedelic space that feels overwhelming or strong. With Spravato, there are two dosing options and they are mild so you will feed “weird” and have dissociative effects, but they are not psychedelic.
The best part about doing KAP with IV infusions is the control and flexibility, we can always pause, slow down, or speed up an infusion if need be, which would either lessen, stop, or increase the ketamine’s experienced effects. Each session will be a little different as we adjust the dose and you explore further in your own mind.
Whether you opt for Spravato-assisted therapy or Ketamine-assisted therapy, we will be there to guide you every step of the way to ensure you are reaching the treatment goals you have set, you feel safe and comfortable to do the work you need to do in sessions and outside of them, and we will support you in knowing what to do within your sessions to get the most out of the treatment.
The number of sessions you will need varies based on the route of administration you choose – IV ketamine or Spravato. And, yes, you can book just preparation sessions, integration sessions, or medicine sessions – or a combination of your choosing (see more details below).
For IV ketamine treatment we recommend 3 preparation sessions – the first one being your psychological intake session – and 8 KAP/medicine sessions. Prior to beginning these 11 sessions you will have an intake session with your doctor from Initia Nova.
For Spravato treatment we recommend 3 preparation sessions – the first one being your psychological intake session – and 6 SAP/medicine sessions. Prior to beginning these 9 sessions you will have an intake session with your doctor from Initia Nova.
Typically medicine sessions occur twice weekly. Therefore, your treatment will take place over 6-8 weeks. This depends not only on the route of administration you choose, but also on your treatment needs as we personalize the treatment schedule for each client based on their urgency to start treatment, their schedule, and their treatment needs.
While most providers will recommend 6 KAP sessions to start regardless of the route of administration (and then moving on to maintenance), some offering preparation sessions and some not, we recommend the 8 sessions for IV ketamine treatment to not only ensure you meet your treatment goals sufficiently before moving on to maintenance ketamine sessions (and therefore spacing out your sessions by weeks), but to also ensure you have a gentle experience moving from having twice weekly sessions to having a break between sessions. Oftentimes at session 6 you are just starting to feel better and you are just starting to make lasting change in your day-to-day life that then having a break from sessions for four weeks (or more) would be detrimental to your progress.
However, that being said, as we personalize the treatment for each client, the amount of sessions you opt to have therapeutic support is completely up to you. On our fees page you will note pricing for all levels of support – from full support for all sessions to support for just 4 sessions.
We recommend the preparation sessions to ensure you know what to expect from your treatment, all of your questions are answered, you are educated on how to make the most out of your treatment during your sessions and in between them, and you are fully resourced for how to manage the change that will rapidly occur for you, which is exciting and what you’re looking for, but can be overwhelming or anxiety provoking if you don’t have the resources prior to manage this. Clients can opt to just book preparation sessions without booking any other sessions with us.
And, clients can opt to only book integration sessions with us, too.
We are happy to collaborate and personalize the treatment to you – please reach out to discuss the sessions you are interested in learning more about and view our services page here. We also support clients who are receiving medicine treatment outside of Initia Nova as well.
Please click here to view our fees & learn about us being out of network with insurance and utilizing superbills. You can also learn more about using Care Credit as a payment option. The doctors’ fees can be found on their website here. To help you with inquiring about this treatment and the coverage you have with your insurance, in order to find out what they will reimburse you, see our OON resources page here.
Getting started is quite easy! First, you would begin with a consultation call with one of our collaborating doctors from Initia Nova to discuss the medical aspects of this treatment. Then, you may opt to have another consultation call with Rena at Fostering Greatness to discuss the therapeutic aspects of this treatment. If you are looking to receive your treatment in Cherry Hill, NJ, send an email to Dr. Sullivan at info@myinitianova.com. For Wilmington, DE, send an email to Dr. Dougherty at InitiaNovadelaware@gmail.com.
You can also opt to start with a consultation call with Rena and you can easily book a FREE consultation call here.
You sure can! I offer preparation, medicine sessions, and integration sessions to all, whether they work with my medical team in my office or not. We can personalize the sessions to fit your needs and the treatment protocol of your current prescriber – you can opt for all sessions or choose the ones you need! For example, you can schedule only integration sessions if you wish.