
Today’s episode is one I’ve really been looking forward to because we’re diving into something that’s transforming the way we think about mental health treatment: low-dose ketamine therapy. My guest, Dr. Sharon Niv, is the co-founder of Joyous, a public benefit company helping make this kind of care more accessible and affordable than ever before.
Dr. Niv brings a fascinating background in cognitive psychology, meditation, and technology, and she’s helping bridge the gap between neuroscience and therapy in a way that’s incredibly gentle, safe, and empowering for both clients and clinicians.
We’ll talk about what makes psycholytic, or low-dose, ketamine different from traditional psychedelic experiences, how it can enhance the therapeutic process, and how you, as a therapist, can get trained to integrate it into your own work.
This is one of those conversations that opens your mind to what’s possible in therapy, so let’s jump in.
Meet Sharon Niv, Ph.D. 
Dr. Sharon Niv is a cognitive psychologist and co-founder of Joyous Team, a Public Benefit Corporation dedicated to making evidence-based mental health treatments accessible and affordable. Her work bridges the worlds of neuroscience, technology, and therapy with a focus on how scalable, data-driven approaches can enhance emotional well-being.
Dr. Niv earned her Ph.D. in Brain and Cognitive Science from the University of Southern California, where she conducted research on EEG biomarkers, neurofeedback, and the neural underpinnings of mood and behavior. She also holds a B.A. in Molecular and Cellular Biology from UC Berkeley and an M.A. in Clinical and Cognitive Psychology from USC.
Before founding Joyous, Sharon worked on developing virtual-reality interventions for chronic pain and neurofeedback programs designed to help people improve emotional regulation and resilience. A long-time meditation practitioner, she combines scientific rigor with a deep understanding of mindfulness and experiential learning.
Through Joyous, Sharon and her team are pioneering low-dose (psycholytic) ketamine therapy, creating safer, more sustainable pathways for individuals and therapists to experience healing and insight. Her mission is to empower both clinicians and clients with practical tools that promote neuroplasticity, compassion, and mental clarity.
What Is Low-Dose (Psycholytic) Ketamine Therapy?
Unlike high-dose ketamine sessions that can create a deeply dissociative or psychedelic experience, psycholytic ketamine uses gentle, repeated low doses to create a state of openness, calm, and safety.
Dr. Niv explains that this subtle shift allows clients to approach difficult emotions or trauma without being overwhelmed. As she describes it:
“People often say it feels like they’re bigger than their body. The anxiety or pain is still there, but it feels smaller and more manageable. That’s where real healing happens.”
This “spacious” mental state supports emotional processing, enhances neuroplasticity, and promotes new patterns of thought—much like EMDR or other somatic therapies that help the brain reconsolidate memories in a healthier way.
How Joyous Team Is Making Treatment Accessible
Joyous Team is a Public Benefit Corporation, which means its mission comes before shareholder profits. Their focus is on affordable, evidence-based mental health care, especially for people who can’t access traditional in-office treatments.
Through Joyous, patients receive medication and daily digital guidance tailored to their unique responses. The company combines medical oversight, personalized dosing, and digital therapeutics—including meditations, journaling prompts, and online community tools.
And for therapists, Joyous is developing a free certification program (with an optional sliding-scale fee) in partnership with Palo Alto University, helping clinicians learn how to safely and ethically integrate psycholytic ketamine into therapy sessions.
Why Therapists Are Paying Attention
For therapists, low-dose ketamine therapy offers a new way to help clients who are “stuck” in old patterns or trauma responses. It doesn’t replace therapy—it enhances it.
Clients often become more open, less resistant, and more connected to their own insight and compassion. For clinicians trained in modalities like CBT, EMDR, or IFS, this approach can amplify the work they’re already doing.
“It’s just a regular session,” Sharon says. “It just goes better.”
The Future of Healing
What stood out most in this conversation is how psycholytic ketamine invites both clients and therapists into a new kind of therapeutic space – one that’s grounded, mindful, and empowering rather than overwhelming.
As Sharon put it, “This isn’t about escaping—it’s about expanding.”
It’s an inspiring reminder that innovation in mental health doesn’t always have to mean something radical. Sometimes, it’s the gentle, consistent practices that create the deepest change.
Sharon Niv The Practice of Therapy Podcast
Gordon Brewer: Well, hello everyone and welcome again to the podcast and I'm really happy for you to get to know today, Dr. Sharon niv. Hello, Sharon. Glad you're here.
Sharon Niv, Ph.D.: Hi, Gordon. It's so nice to be with you. Thank you.
Gordon Brewer: Yes. And Sharon is her company is joyous Team, is that I'm saying that correctly. And that's our website.
Yeah, yeah, yeah. Joyous team. So, yeah, and I, you'll get to hear all about that. But Sharon is, I talk with, as I begin with everyone, tell folks a little more about yourself and how you've landed where you've landed. Absolutely.
Sharon Niv, Ph.D.: So my background is cognitive psychology. That's my doctorate work now.
At the time I was doing the coursework for clinical psychology, but didn't end up going through with internships. So I am not a licensed clinician, but my whole life I've been just a therapy groupie. And after I graduated for, from my psychology work. I began looking for ways in which technology can scale wellbeing.
So I did some work in neurofeedback. I did some work in virtual reality aimed at helping people get better relationships with their chronic pain. But always I was a pretty serious meditator and I really believed in the power of practice and the power of skill building to help individuals.
Come to better mental habits that can really promote wellbeing. And at some point I was met with the opportunity to explore the low dose ketamine pathway as a potential company to start to scale some of these available technologies as well. And what really attracted us about low dose ketamine as opposed to high dose ketamine is that it's extremely gentle.
And what. We love high dose Ketamine, we love as the psychedelic opportunities, but they're just a very different animal than what we're doing here. Mm-hmm. What we're doing here with these doses that we're calling Psycholytic, that is a technical term, but it's not so well known, so I do wanna highlight that term.
Is giving people repeated experiences of a very gentle state of openness. And I'm happy to describe sort of the, the cognitive mm-hmm. Facets of the state and why it works so well when it's when it makes sense to do that. But these repeated exposures to the state really help. Our patients. And then in therapy, the clients who bring it into their therapy sessions gradually build skills with a, what one described, one therapist described as a blanket of safety.
Mm-hmm. Mm-hmm. So there's this thematic experience of spaciousness. Ketamine is a anesthetic dissociative, and so of course at high doses. That means people can be completely out, but at low doses, it means that they have a slight sense of distance between their sense of self and the somatic sensations of their body.
So when I learned about this potential state, mm-hmm. It reminded me of so much stuff that I learned in my meditation work. Where you can drop into a sense of awareness. And from there have I would say like the observer stance, the mindful stance mm-hmm. Where you can see things arise for yourself without being so identified with them that it's overwhelming and that you cannot make progress.
So as I learned about this opportunity, I became very, very excited to co-found Joyous. We are a public benefits corporation. We've been live for about three and a half years. First patients in July of 2022, so far, 83,000 patients. Wow. And the outcomes have been really, really significant. Happy to get into any of that.
Whatever interests you, Gordon.
Gordon Brewer: Yeah, yeah, sure. So I, I know that, you know, the whole use of lytics or psych, you know, the my mind's drawing a blank, the word I'm looking for, the psychedelic psychedelics. Yeah. And all of that, you know, is it's been around a little while now. I'm trying to remember when I first started learning about it, I guess it was.
Mm-hmm. Like, you know, maybe a little before COVID, which is interesting how we mark time now. But but and I think more and more people are discovering it. I know I've even had clients that have, they didn't come to me obviously for, I mean, they didn't come to me for that, but they had worked with other therapists that had done ketamine treatments and mm-hmm.
Yeah. So maybe for folks that might not be quite as familiar, you wanna kinda pull back the curtain and tell us a little bit about why it works? How it works, and why it works.
Sharon Niv, Ph.D.: Yeah, sure. Let's start with how it works. So when people have heard of higher dose ketamine assisted psychotherapy, typically what happens is patients come, clients use that.
The therapist vernacular. Clients come for three to four hours. You do some preparation work, you maybe meditate a little bit. They then take a very high dose, and then they typically lie down with eye shades and they go through a journey. There's not so much of an intentionality. That's not true.
You can set an intention, but you can't intentionally direct your attentional system. You are on a ride of your subconscious, and that can be a beautiful and therapeutic thing. Again, I'm, I am not opposed to high dose at all. And then afterwards there's some integration work that happens. Typically, there's a preparation session before this three to four hour period in an integration session after, and it's, it can be a very transformative experience.
I think the term that's been used is. Epistemically transformative, like it really can shift things for you in a huge way. Mm-hmm. Psycholytic therapy is very different. The ketamine experience lasts about 40 to 60 minutes and depending on people's metabolism, so it fits within a regular period of therapy session.
Mm-hmm. And the experience itself is so gentle that patients remain fully oriented. That is, they know exactly who they are, where they are, what they're doing, and they can be extremely intentional with a, with their attention system. It's just that they're operating from a little bit of a a sense of safety and spaciousness.
I'll get into the cognitive science in a second, but mm-hmm. One of my best friends is a psychiatrist who went to. The MAPS conference, psychedelic science, I think in 2023, and there was a session held live. With Dick Schwartz and I believe Sunny Strasberg, where they did a couples therapy session on Psycholytic Ketamine.
Oh, wow. And her quote, I, I love to say it because it's, it's so funny and so true. She was like, it was really boring to watch because it was just a regular session. It was just going well. So I think what that illustrates there is if you get, if you get your clients coming in and they are. Less resistant, more open, more prone to insight and more neuroplastic, because the ketamine itself is a neuroplasticity agent, it just tends to go better.
You know? Mm-hmm. They're able to go there with more ease because they're not feeling overwhelmed by the nervous system sensations that are typical of negative emotionality and history of trauma attachment wounding. You know, when we think about what it means to have issues in, in mental health, it, it is typically about.
The unpleasant bodily sensations associated with depression, with anxiety, with nervous system and dysregulation. Mm-hmm. Related to past traumas. And of course those can be so overwhelming that people tend to avoid and resist going there and exactly. The mechanism of ketamine is that spaciousness, that partial dissociation, you suddenly feel a little bit bigger than your body.
There's a sense in which people can describe it as being permeable. I'm both inside and outside my body. I've heard someone say it feels like I am in a big room now. My body, mm-hmm. Used to be my body and my nervous system sensations were overwhelming and now I'm the whole room. The nervous cys and sensations are still happening there, but they're relatively so much smaller that they're not as intimidating.
I can work with them. Mm-hmm. I can be present with them and allow them to be fully felt and relieved. So these are some of the things that happen in. A ketamine session with a therapist and often spontaneously when they do it on their own too. But of course, having a therapist present is only going to enhance outcomes.
Gordon Brewer: Yeah. To kind of direct where, where things are going. Yeah. Yeah. And I, and from what I know and have Rob learned about this, you know, it's not it's comparing apples to oranges, but much like EMDR. It causes your brain to process things differently and and re you know, really change the way that you you process the story.
I mean, it's a, it's, it's been fascinating for me. There's a, there's a podcast that I listen to pretty regularly. I'm not promoting them by any means, but it's called the, the hidden brain. And they talk a lot about, you know, and particularly with people with trauma or even in relationships, when we begin to process and think about the situation differently, it takes on a new meaning.
And then we can, we can manage all of that in a much different way.
Sharon Niv, Ph.D.: Yeah, a hundred percent. Yeah. It's interesting you bring up EMDR for, for two reasons. The first reason is that it's often an example I give to therapists who ask. Who is a good fit for this, for this kind of therapy? Mm-hmm. And I often tell 'em something like, if you think a client is well matched to EMDR, that is, they have, they have work to do.
Perhaps they have some plateaus, but they're resourced enough that they're not going to fall apart completely. If they reach upon some deeper material, they're probably a good fit for psycho. Ketamine therapy as well. Right. But it's a good comparison on that front, but then exactly what you were saying.
Mechanistically both EMDR and Psycholytic ketamine are involved in memory reconsolidation, which basically means, you know, any memory we have is kind of like a, well, not any memory that's, mm-hmm. A traumatic memory tends to be a full brain activation. And with that, there's a simulation that happens in the body of the original nervous system response.
So, mm-hmm. That, and that's exactly why it's still traumatic. You got, you're, you're re-experiencing the overwhelm that happened and didn't get fully processed and released. And so what memory reconsolidation means is that that memory can be pulled up, brought into active working memory space, but then as the nervous system sensations do resolve and release, it can then be restored that memory.
Separate from those original sensations so that later it can be viewed semantically or perhaps people describe it as viewing a movie, right? Mm-hmm. Rather than re-experience it in in, in first person. Right. Yeah. In the more autobiographical memory sense, it
Gordon Brewer: kind of puts it in a place of not being something within themselves, but outside themselves.
Sharon Niv, Ph.D.: A hundred percent. Well said.
Gordon Brewer: You know, and the, you know, borrowing from the, the ideas from narrative therapy. The problem is the problem, not the person is the problem. And
Sharon Niv, Ph.D.: that's, I hadn't heard that. That's great. Yeah.
Gordon Brewer: Yeah.
Sharon Niv, Ph.D.: Yeah.
Gordon Brewer: So that's good. That's good. So yeah, so what else do you think is important for people to know just about using low dose ketamine and that whole process?
And maybe, maybe just talk that's good segue into talking about what Joyce does and how mm-hmm. How you kind of came up with that and how that's evolved.
Sharon Niv, Ph.D.: Sure. So I'll start with joyous generally our mission is to increase mental wellness mental health, and to do it as accessibly and affordably as possible.
So if people don't know what a public benefits corporation is, we are a regular corporation. But in our structure, we're we're sending a message to potential shareholders. That mission comes above shareholder value. So we are allowed to make decisions that benefit the patients over the shareholders, which is great.
Mm-hmm. Mm-hmm. And so part of that affordability, accessibility piece is we really want it to be the most affordable approach for people who are looking to try to work with this medicine but can't afford the $2,000 IV treatments or don't have s bravado covered by their insurance. Mm-hmm. So that's how we started out.
And the protocol itself is a, at least in the beginning, a daily protocol. We, we have a pretty extensive mechanism for, making sure that the right patient gets the treatment and the wrong patients do not. So there are some written intake forms. There is an online evaluation with a medical prescriber.
And you know, a, a couple of different points where we try to rule out any psychiatric contraindications, medical contraindications, contraindicate, medications. And, and, and perhaps some like instabilities in life too, that mean this might not be the right time. Mm-hmm. So assuming that the patient gets through all of these you know, potential screening points, they then receive their medication straight to their home, and we begin giving them daily guidance on exactly how much to take and when to take it.
So they're taking daily check-ins that look at symptoms. They look at side effects, sleep, mood general outlook on life, and a couple of other things. And through that, the system starts to learn. You should be taking a little bit more, you should be taking a little bit less, you perhaps take it earlier in the day.
Perhaps it's disrupting your sleep, things like that. So it is, it is very personalized how we recommend that they take their medication. Mm-hmm. And along with that, we have some digital therapeutics in an online portal where they can communicate with other patients. And we do some live meditations as well now.
And the reason that we are digital therapeutics is because, due to the fact that we wanna be the most affordable, we know that not all of our patients can afford therapy, so, mm-hmm. We know that something like 40 to 45 or 40 to 48, depending on the survey we sent out of patients, already have therapists.
Awesome. This is where Joyce for therapists came in. The other guys. Mm-hmm. And unfortunately we haven't democratized mental health care to the extent that we need to. So we try to provide them with digital therapeutics. That said, so we started asking the patients who told us, Hey, I'm already in therapy.
Have you ever considered bringing it into your own therapy session? And we found out that 30% of those guys, so we're estimating something like 15% of our total patient base has already tried this with our therapist. Mm-hmm. Wow. It's just, it was just really interesting and, and the ones who responded were uniformly it was 70% positive and about 25 to 30% neutral.
Like it didn't move anything one way or another. But no negative. We had zero people say there was a negative outcome of bringing this into therapy. So we started looking into what it would look like to train therapists. Because if they're going to be doing this, first of all, therapists by their nature and understandably, are cautious people.
They have like people's lives and, and deepest truths in their hands. They also have licensees to protect, and all of that means they're, they're cautious and they wanna know what they're doing. So we partnered with a school called Palo Alto University. Which is a fully a PA accredited institution. They have like a consortium with a Stanford University for their s ID program, and they have an online CE credit portal for, for programs of that sort.
Mm-hmm. So we partnered up with them and yesterday was the final module was sent in for a certificate program that we're going to be coming out with in November. Oh, great. This certificate program will teach people. The basics and some, some advanced topics in what it means to bring psycholytic, ketamine into their therapy.
Mm-hmm. Now, what we think of this value proposition for therapists is, one, the training required here is considerably lesser than the training required for psychedelic therapy. There's just very little risk for medical or psychiatric emergency. So, while training, of course, is always important the, the degree of acuity necessary for, for extensive training, it's just, it's just not the same animal.
Mm-hmm. Two, this allows therapists to do their work. So we, I've heard from enough therapists in the program, you know, I did the high dose stuff and some of it's really transformative, but it was just me sitting there with a client lying on the floor with eye shades on, and I, I'm not using my skills. I use my skills in the integration session, but with Psycholytic therapy, I'm an active participant.
Mm-hmm. As I am doing what I already do, just with a client who is more open and less resistant and able to go there and derive the insights that they've been perhaps seeking and not breaking through to. Right. The third thing is we wanted to make this free. So the program itself is free to therapists.
We are working on ways to securely, you know, HIPAA compliant connect between therapists and patients so that if the patient is willing, we can share outcomes, collaborate with the therapist, tell 'em what we know. I'm, I'm, we working currently on some AI-driven, you know, digital therapeutics, that if the patients want to participate and they want to journal just a couple of sentences after.
Each session. Each session, we would be able to provide therapists with additional insight on how the patient is doing throughout the week as well. So we're really hoping we can mm-hmm. Create an ecosystem that is really mutually beneficial to everyone. Mm-hmm. I will say, I, I, want some skin in the game when it comes to the certificate program.
So there's gonna be some nominal call, I'm thinking like $200, but I am gonna put out a forum for requesting financial aid. And honestly, for any reason we'll give financial aid. Right. Like, you know, sliding scale down to zero. If you're, if you're a young therapist, if you're working primarily with, you know, low income, popul, whatever, as long as you're willing to fill out an application, take it.
Right. We want you to have these skills. Yeah. These are really powerful sessions that are, that integrate into your usual schedule. You don't have to schedule mm-hmm. Three hours, four hour breaks and Right. And they're, and they're powerful. And
Gordon Brewer: they're powerful. Yeah. Right, right. So, yeah, you wanna maybe walk us through kind of a typical session,
Sharon Niv, Ph.D.: Mm-hmm.
Gordon Brewer: And just kind of maybe some hypothetical issues and maybe I don't know. I'm, I'm just thinking, thinking off the top of my head, maybe a case example or, or two.
Sharon Niv, Ph.D.: Yeah, sure. So a typical session may start out with. I, I will say people have different preferences for when to take the medicine. I've heard everything from, I like to take it at the very beginning of the session so that my experience, the psychoactivity sort of peaks with the intensity of the session as it were.
As we get deeper and deeper into stuff, the more open I am. Some people say I like to take it 15 to 30 minutes ahead of time so that I already come in, kind of in the, the peak and I'm able to. Start off, hit the ground running, and some people say, I like to have the entire psychoactive experience in the hour prior.
To the session. And then there's kind of like an afterglow for two to three hours where you just feel more open, much calmer, much less discursive thinking. The narrative mind is quieter. And so that's also an optimal state for therapy. So it does really differ. But I'll tell you about my own therapy because certainly I can anonymize and tell you some stuff I've heard from mm-hmm.
Clients and I'll be happy to do that, but mm-hmm. I'll tell you about my own therapy. I like to take it at the beginning of the session for sure. And my therapist and I do like to spend some time dropping into the body. Accessing, you know, what we call true nature, like the, which is very similar to what if FS might call self, right?
Mm-hmm. The part of me that is self-compassionate, compassionate to others, that is sort of deeply aligned with integrity, that is free of the various distortions of the egoic thinking mind. So we spent some time just kind of dropping into that. And, and then seeking, is there anything here that really is calling out to be loved?
Calling out to, to be held with compassion, to be understood. And of course, something arises fairly quickly every time. Mm-hmm. And we spend some time there getting to know. The pattern that's arisen or the part in parts language, getting to understand what images come with it. There is a way in which the ketamine state does kind of foster some creativity.
Sometimes the images come more quickly, sometimes the associations come more quickly. And in a, in a sense they're like, they're quite full. It can be really a, a s simulation of the origins of whatever pattern it's that I'm working with and right. You know, from then on, it really is just a bit of, I, I do a lot of somatic work and parts work with my therapist at this time.
So it looks very much like a regular session. Yeah. It's just that I'm so much more at ease. I'm so much more connected to my true nature as it were. Mm-hmm. That things just feel kind of seamless. I could share happily some stories from past patients that I, you know, I, I interview and talk to a lot of our patients and ask them how it's going therapy.
There's also this great little interview reel we did with a couple of patients. Happy to send it over if it can, you know, if it would be good in the show, in the show notes. Sure. Yeah, yeah, yeah. Where, yeah. There's this woman who just says, you know, all the stuff that I usually think, oh, I don't wanna go there.
Suddenly I just think, yeah, I can go there today. Mm-hmm. And that reminds me of a particular patient of ours that I spoke with. Mm-hmm. Who, who said he brought in his ketamine to a session where he was hoping to explore sort of some of the, some of the anger that he felt in his marriage his marriage of like 15 years or so.
Mm-hmm. And as he sort of took the medicine and they dropped into his body and started, they, they were a bit more of A CBT orientation. Their therapist. I hadn't spoken to the therapist just to him, but that's my gathering of what he, what he told me. But even with something like CBT, which is less, you know, less mindfully based, less somatically based, at least.
At least usually, you know, obviously some therapists incorporate a lot of that right? Uhhuh. They were really able to identify in a much clearer way, like some of the thoughts that he wasn't so aware of that underpinned some of the anger that he felt. Toward his wife that he sort of felt like he always had to be the one to take care of everything.
He was the responsible party at all times. Whereas she sort of got to live free and you know, live her life as she will. And through the ketamine state, which does provide this kind of third person perspective at times. It's not like you're out of your body, you're not dissociated, but that partial dissociation allows for a shift in perspective that's sufficient enough to see things with new eyes.
Mm-hmm. He was able to serve a, see like, first of all, my wife is pregnant right now. Mm-hmm. Like of course I want her to be as, as relaxed as possible. She's growing our child. That was something that hadn't been clear to him before, but also he was able to sort of go back. See some of the origins of this feeling of always needing to hold up the world.
He, he said, he described an image that came up to him of Atlas, like I am, I am the guy holding up the world. And he was able to connect with some old memories of childhood where he was parentified in particular ways. And, and the, and the ketamine just provided this beautiful, safe, you know, bubble. In which he was able to explore this without being overwhelmed by any of it, make these connections joyfully.
And then his therapist did provide him with some suggestions on how to journal about it, how to integrate, how to be soft with himself in the following few weeks. Yeah. And it was a really transformative session for him. He really felt like,
Gordon Brewer: yeah. Yeah. He got some insight
Sharon Niv, Ph.D.: there.
Gordon Brewer: Yeah, that's really, really cool.
It's really it kind of a, as I think about it, kind of a catalyst for using kind of Cogniti CBT language is a, a catalyst for a reframe. That was pretty significant. Yeah.
Sharon Niv, Ph.D.: Yeah.
Gordon Brewer: Yeah. That's great. That's great. So if people are interested in maybe the training or maybe getting started and finding out more, tell.
Tell us the process for that.
Sharon Niv, Ph.D.: Absolutely. So the website is, as you said, joyous team, and then it's just joy f team slash therapy for the therapist. Mm-hmm. The process there is pretty simple. Right now you, you go ahead, you sign up you'll start receiving some. A few emails, a few text messages from me just saying, welcome.
We, we like to give therapists coupons that they can pass to their own clients. Mm-hmm. Which will later. We wanna incentivize clients to say, yes, I'm in therapy. And then to through the coupon, we can kind of identify, okay, this is the therapist that they're with too. Mm-hmm. And. At, at this point in time, there is a very basic training available on the therapist portal.
It's only a couple of hours and it touches upon some of the most important safety components and some of the clinical framework that is most useful. And many of our therapists have just found that to be enough to hit the ground running. But as I said, we, we know that therapists want training.
They wanna know what's going on. And so the certificate program. Should be out in the next two to three weeks. And so for those therapists who just wanna sign up and wait for that to happen, great. You will, we will be there for you within the next couple of weeks, right? And there's no, we, we as a company, don't interfere with how you and your clients deal with money or scheduling or anything like that.
Mm-hmm. It is a very loose program in that sense at this point. Mm-hmm. We just kind of wanna support you in feeling comfortable doing what you're doing. I'm in the process of putting together two tools that one is client facing and one is therapist facing. That suggests sessions out session.
Protocols outlines uhhuh based on, okay, the therapist facing one is a case conceptualization, you know, what, what do you think the, the client is working on? What are some blind spots? What are some strengths, any risks involved? We, and, and what kind of theoretical orientation do you work with? What interventions do you prefer?
And then it really suggests, all right, spend the first five to 10 minutes, you know, doing this. Spend the next 35 minutes exploring some of these questions, perhaps exploring these parts, you know, whatever it is that you like to do as a therapist. Mm-hmm. And then here are some integration suggestions.
Here are some journaling prompts that we might, you might suggest to the client. And of course, this is all very loosely held. No rigidity, just, just suggestions. And the reason that we did that is because, you know, therapists still wanted to have the confidence of, what do I do with this medicine? Right?
Our original thought was, you just do what you're already doing. Your, you know, your client's coming in more ready, but you just do what you're already doing. But people still felt nervous. We were like, okay, let's, let's give you some help. Yeah. So, so that'll be pa therapist facing, I'm building one that's client facing too, where they can sort of say, what do you wanna work on today?
I wanna process and release something. I wanna grieve some grief. I wanna come to understanding, I wanna make a decision. So, and then there's some follow up questions that then also suggest. To the therapist, here are some things that you might wanna work
Gordon Brewer: on. Right, right. Yeah.
Sharon Niv, Ph.D.: Yeah.
Gordon Brewer: That's that's great.
That's great. Well, I'll have links in the show notes and show summary. Cool. You know, one question that comes to mind for me, Sharon, is, how does prescribing work with all of this? Yeah. And that was sure. You know, I forgot to ask that earlier. Yeah,
Sharon Niv, Ph.D.: no problem. I think we're live in 29 states. Every once in a while we add a state or drop a state due to various legal reasons over telehealth.
So the providers that we have are licensed in those 29 states. The telehealth appointment lasts about 15 to 20 minutes where they review all of the patient's medical and psychiatric information, make sure that nothing was missed, and then talk about the the treatment itself. Make sure that the patient understands what's gonna happen answer any questions that they may have.
And if everyone agrees they're on board, they think it's a good idea. The telehealth prescription goes into a network of pharmacies that. Our compounding pharmacies that we work with, and they are able to prescribe specific strengths. Mm-hmm. So everyone starts with 60 mg, well, not everyone. If you, if you tell us that you are particularly sensitive to medication, we'll start you with an even lower one which is 40 milligrams.
So, but the average. Patient receive 60 milligram trophies, but then they're asked to, it would've been smart to bring my trophy pack, but I, I didn't think about that. Mm-hmm. They're asked to then split the dose into four for their first experience. Mm-hmm. Which is 15 milligram. And the bioavailability of the.
Form that we use, which is called buccal, that means cheek. So you kind of put it mm-hmm. Between cheek and gum, like tobacco sniff uhhuh the bioavailability is low. It's like 25%. So with 15 milligrams, you know, you are, you are getting like four milligrams of ketamine in your system. Mm-hmm. And most people barely feel that it starts mm-hmm.
Very, very low. Mm-hmm. And very, very gentle. And we raise it only after a couple of days if there are no side effects. And again, raise it until we feel that we've. Achieve clinical significance in your right, in your symptom prompt.
Gordon Brewer: What? Yeah. So what's the typical length of treatment with this?
Sharon Niv, Ph.D.: Yeah. The average patient I believe is with us for five to eight months.
Okay. Yeah. Okay. And we're very happy with that. We want our patients to graduate. We are not here to ask people to be on Ketamine forever. That's not, that's not what it's about.
Gordon Brewer: Okay. Well, perfect. Well, perfect. Well, Sharon, I've, I guess we need to be mindful of our time and I'm so glad we got to have this conversation.
And again the website is joyous team, is that correct?
Sharon Niv, Ph.D.: Joyus team? Yeah. And the therapist site is joyous team slash therapy.
Gordon Brewer: Okay, great, great. And again, we'll have links in the show notes and the show summary for people to find that easily Amazing. Hopefully we can have another conation conversation here soon.
Yeah,
Sharon Niv, Ph.D.: yeah. I would absolutely love that. Thank you so much, Gordon. What a pleasure.
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