Before You Ever Arrive: The Intake and Consultation Process

Ketamine therapy at Soft Reboot Wellness begins by calling us at 650-419-3330 or emailing hello@softrebootwellness.com. We send you an intake packet to complete, Dr. Herman reviews it, and then determines whether to schedule a consultation. That consultation covers your mental health history, prior treatments, current medications, and what you are hoping to address.

If you have an existing psychiatrist, therapist, or prescriber, we contact them, with your explicit consent, to coordinate on your treatment plan. We are not a replacement for your existing care team; we work alongside them. For patients who do not have outside providers, we work independently and document everything through the Osmind EHR platform, which also includes a mood-tracking app you will use throughout treatment. You can get a detailed overview of what to expect from our clinical process on our dedicated page.

The medical and psychiatric consultation comes before any infusion is scheduled. Dr. Sara Herman or Dr. Natasha reviews your full history to determine whether IV ketamine therapy is appropriate for your specific situation. Not every patient who comes to us is a good candidate, and we will tell you honestly if we do not think we are the right fit. Ketamine is an off-label treatment for mental health conditions, meaning the FDA has not formally approved it for specific psychiatric diagnoses, and candidacy depends on a careful individual assessment.

The Day of Your Infusion

Plan to have someone drive you to and from your appointment. You will not be able to drive yourself home, this is a non-negotiable clinical requirement, not an abundance of caution. Most patients find it helpful to think of the infusion day as a rest day: clear your schedule afterward, have light plans for the evening, and arrive without rushing.

Eat a light meal two to four hours before your infusion and avoid alcohol for at least 24 hours prior. Wear comfortable clothing. You are welcome to bring music, many patients find it significantly shapes the quality of their experience, and we have recommendations if you want them. Our post on music as medicine explores how sound can support the ketamine experience.

When you arrive at our Menlo Park clinic, you will be settled into a comfortable infusion space. Dr. Herman personally administers all IV lines and monitors all sessions from start to finish. A small IV catheter is placed, typically in the arm, and the infusion begins at a slow, controlled rate. Vital signs are monitored continuously throughout the session.

During the Infusion

Effects begin within minutes of infusion onset. What you experience will be personal, no two sessions are identical, and no two patients describe them in quite the same way. That said, certain qualities are consistent enough to be worth describing.

Most patients notice a shift in how their thoughts feel. The relentless quality of anxious or depressive rumination, the loops, the self-criticism, the weight of it, typically softens. Some patients describe it as the mental noise turning down. There may be perceptual changes: a dreamlike quality, altered sense of time, mild visual patterns with eyes closed, or a sense of the mind becoming loosened from ordinary reference points. Some patients experience emotional content, memories, feelings, or imagery that feels significant. Others find the experience largely calm and interior.

The dissociation that many patients fear beforehand tends, in practice, to feel less frightening than anticipated. You remain aware that you are in a clinical setting, that the experience is temporary, and that the care team is present throughout. Research confirms that side effects from a single antidepressant dose of IV ketamine are mild and brief, supporting its safety profile in clinical settings (National Institutes of Health). The session typically runs between 45 minutes and two hours depending on your protocol, and the acute effects resolve fully before you are discharged.

For patients in our ketamine-assisted psychotherapy (KAP) program, the in-office infusion sessions are two hours each. The extended time is designed to allow for a fuller experience and a gentler return, with space for initial reflection before you leave.

Immediately After the Session

The hour following infusion is a transition period. Most patients feel relaxed, occasionally tired, and emotionally open. Some feel moved by what arose during the session; others feel simply quiet. You will rest in the clinic space until you are fully alert and your vital signs have returned to baseline, this typically takes 30 to 60 minutes following the end of the infusion.

After your session, your integration coach checks in before discharge. You go home with your designated driver, and we recommend a gentle evening: no major decisions, no demanding social commitments, no alcohol.

The Integration Window: 48 to 72 Hours After

Research shows that 48 to 72 hours after a ketamine session is the optimal window for integration, the period during which the neuroplastic changes initiated by the infusion are most active and the brain is most receptive to new patterns (American Journal of Psychiatry). This is not the time to push through a demanding workload or ignore what arose during the session. It is the time to pay attention.

Integration coaching sessions are timed around this window. We use the Internal Family Systems (IFS) framework, a model in which different internal states, memories, and protective patterns are understood as distinct “parts” of the self, to help patients engage with whatever surfaced during the infusion in a structured, compassionate way. Dr. Herman has completed training in IFS combined with ketamine-assisted psychotherapy specifically because we believe this window, when used well, is where much of the lasting therapeutic work happens.

For all patients, we encourage journaling, light physical movement, and continuing to log mood data in the Osmind app so we can track your response across the full induction series. Our integration inspirations page offers additional resources for making the most of this period.

What the Full Induction Series Looks Like

A standard induction series at Soft Reboot Wellness involves four to six IV infusions over four to six weeks. Research shows that starting with a series of six infusions produces longer-lasting symptom reduction than fewer sessions, though we calibrate the specific protocol to your clinical response, some patients need fewer, some may benefit from more (American Journal of Psychiatry). Sessions are scheduled once weekly.

The reduction in depressive or PTSD symptoms following the induction series typically lasts approximately five weeks on average, with a range of three weeks to two months for most patients. Subsequent single maintenance infusions, booster sessions, may be used to sustain symptom improvement, typically scheduled anywhere from three weeks to three months after the initial series depending on your individual response pattern.

Addressing the Scheduling and Cost Questions

A ketamine infusion session does not require days of recovery. Most patients return to their normal schedules the following day. We offer appointment times that accommodate demanding professional schedules, because we work primarily with Silicon Valley professionals whose time constraints are real.

IV ketamine for mental health is an off-label treatment, and insurance coverage is inconsistent. We do not want cost to be a surprise, contact us at 650-419-3330 or hello@softrebootwellness.com before your consultation to discuss what the financial commitment looks like for your specific treatment plan. Results vary by individual, and we encourage you to discuss your options with your current providers before beginning.

Frequently Asked Questions

What if I have a difficult experience during an infusion? Challenging experiences during ketamine infusions do occur for some patients, and our clinical team is prepared for them. Dr. Herman monitors all sessions in person and can adjust the infusion rate or intervene if needed. Patients are never left alone during a session. If difficult emotional content arises, this is sometimes part of the therapeutic process, particularly for patients with trauma histories, and our integration coaching is designed to help you work with it rather than simply wait it out.

How will I feel the day after my first infusion? Most patients feel rested or emotionally lighter the day after. Some feel temporarily more fatigued than usual, particularly after their first session. A small number of patients experience mild headache or nausea in the hours immediately following infusion, though these typically resolve quickly. The day-after experience tends to improve across the induction series as the body adjusts.

Can I go back to work the day after a session? For most patients, yes. The acute effects resolve fully before you leave the clinic, and most patients function normally the following day. We recommend not scheduling high-stakes professional obligations on the infusion day itself or the immediate evening after, but the following morning is generally fine.

How do I know if the treatment is working? We track your response through the Osmind mood-tracking app throughout your induction series, so your progress is documented rather than relying on subjective memory. You and our care team review this data together. Meaningful symptom changes typically emerge across the first two to four infusions, though the timing varies between individuals.

What happens at the end of the induction series? At the end of your induction series, we review your mood data and clinical response with you and discuss next steps. Some patients do well without further treatment for an extended period. Others find that occasional maintenance infusions help sustain the gains they have made. We work with you and your outside providers, if applicable, to develop a follow-up plan that fits your actual response pattern.

Key Takeaways

• Ketamine therapy at Soft Reboot Wellness begins with a thorough intake and consultation before any infusion is scheduled; not everyone who inquires is an appropriate candidate.
• Infusion sessions are personally administered and monitored by Dr. Herman; you will need a driver and should plan the treatment day as a rest day.
• The acute experience, altered perception, mental quieting, is temporary and resolves fully before discharge; for most patients it is calmer than anticipated.
• The 48 to 72 hours following infusion are the optimal integration window; our KAP program is specifically structured around this period.
• A standard induction series involves four to six infusions over four to six weeks, with maintenance sessions available afterward based on individual response.

Knowing what to expect removes one of the largest barriers to starting. If reading this has moved you closer to a decision, we are ready to continue the conversation. Call us at 650-419-3330 or email hello@softrebootwellness.com to schedule your consultation at our Menlo Park clinic.

References

1. National Institutes of Health. NIH research confirms that side effects from a single antidepressant dose of intravenous ketamine are mild and brief, supporting its safety profile in clinical settings. https://www.nih.gov/news-events/news-releases/side-effects-mild-brief-single-antidepressant-dose-intravenous-ketamine
2. National Institutes of Health. The National Institute of Mental Health highlights new research supporting ketamine as a rapid-acting depression treatment, offering hope for patients who haven’t responded to standard care. https://www.nimh.nih.gov/news/science-updates/2024/new-hope-for-rapid-acting-depression-treatment
3. American Journal of Psychiatry. Research shows that both single and repeated ketamine infusions can treat treatment-resistant depression, with maintenance infusions extending the duration of benefit. https://psychiatryonline.org/doi/10.1176/appi.ajp.2018.18070834
4. National Institutes of Health. Research supports the integration of psychotherapy with ketamine treatment, showing that the combination may produce more durable and meaningful outcomes than ketamine alone. https://pmc.ncbi.nlm.nih.gov/articles/PMC9207256/

Reviewed by Dr. Sara Herman

The post What to Expect During Ketamine Therapy: A Complete Session Walkthrough appeared first on Soft Reboot Wellness.

Why What You Bring to the Session Matters

Ketamine works in part by promoting neuroplasticity, temporarily loosening the brain’s entrenched patterns and creating a window of increased receptivity to change (National Institutes of Health). This window is not passive. What you choose to focus on, reflect on, or remain open to during and after the session can shape what the brain does with the new neural architecture the infusion creates.

Research on how psychedelic-type treatments promote healing points to the role of emotional processing and intention in determining outcomes (National Institutes of Health). Patients who approach their sessions with a defined intention, something specific they want to examine, release, or understand, tend to report more meaningful experiences than those who treat the infusion as something to simply endure or wait out. This is one of the central premises of our ketamine-assisted psychotherapy (KAP) program, which is built around the preparation and integration work that surrounds each infusion, not just the pharmacology itself.

None of this means you need to have a plan for every moment. The session should not feel like a performance or an assignment. The goal is to arrive with orientation, a direction, not a script.

Setting an Intention Before You Arrive

In the days before your session, we encourage patients to spend some quiet time identifying what they most want to bring into the experience. An intention is not a goal in the productivity sense. It is not “fix my depression” or “resolve my trauma.” It is simpler and more personal than that.

Some examples of intentions patients bring to sessions at Soft Reboot Wellness: an openness to understanding where a particular emotion is coming from; a willingness to observe a chronic thought pattern without being inside it; a desire to reconnect with something that has felt inaccessible, joy, creativity, a sense of self that existed before the depression took hold. These are starting points, not destinations.

The Internal Family Systems (IFS) framework that Dr. Sara Herman has trained in offers a useful lens here. IFS treats the mind as a system of distinct internal parts, some that protect, some that carry pain, some that have been exiled. A session intention framed in IFS terms might sound like: “I want to meet the part of me that keeps me working beyond exhaustion and understand what it’s afraid of.” This is more actionable than “I want to feel better” and more honest than pretending the session is simply a medication administration.

Mindfulness practice in the days before your infusion can also be helpful, not because the session requires you to meditate, but because the skills of present-moment awareness and non-judgmental observation are genuinely useful when unusual internal experiences arise (Mindful.org). If you have an existing mindfulness or meditation practice, lean on it before your session. If you do not, even brief daily attention to breath and body in the days prior can create a more grounded starting point. Our post on five ways to turn inward offers practical techniques you can begin before your first session.

During the Infusion: Openness Over Control

Once the infusion begins, the most useful orientation is one of openness rather than control. The altered state ketamine produces, the quieting of ordinary thought, the perceptual shifts, the loosening of the usual mental categories, is working in your favor. Resisting it, or trying to steer the experience toward a predetermined outcome, tends to work against the therapeutic process.

If difficult emotions or memories arise, the most effective response is generally to observe them rather than either suppress them or intensify them. The IFS model is helpful here too: rather than identifying with a difficult internal state (“I am overwhelmed”), you can relate to it as information, a part of you that is asking to be seen. This perceptual shift is subtle but meaningful, and it is one reason Dr. Herman’s IFS training is built into the KAP program rather than treated as supplementary.

Some patients find it helpful to use music during their session, it provides structure to the experience and can serve as an anchor when the altered state becomes intense. Others prefer silence or nature sounds. We are happy to discuss music selection in your preparation session, because the choice matters more than most patients expect. Our post on music as medicine explores how intentional sound selection can deepen the therapeutic experience.

Above all: you do not need to figure anything out during the infusion. The neuroplastic work is happening whether or not you consciously direct it. Your role is less to think and more to receive, to stay present with whatever arises without forcing it toward resolution.

What to Do With What Arises

The 48 to 72 hours following a session are what researchers call the integration window: the period during which the neuroplastic changes initiated by the infusion are most active, and the brain is most open to consolidating new patterns and associations (National Institutes of Health). What you do in this window is not incidental. It is part of the treatment.

Journal. Not to produce polished writing, but to capture what arose, images, emotional residue, insights, questions. The specific language matters less than the act of externalizing what was internal. Patients frequently find that experiences that felt opaque during the session become clearer when written down in the hours afterward.

Move gently. Light walking, stretching, time outdoors, physical movement supports the integration process in ways that are not fully understood but consistently reported by patients. Avoid intense exercise, alcohol, and stimulants during this window.

Bring the material to your next therapy session if you have an outside therapist. Many patients find that a ketamine series deepens their ongoing therapeutic work in ways they did not anticipate, the loosening of habitual defenses that the infusion produces often makes previously defended emotional territory more accessible.

Integration coaching sessions are timed specifically around this 48-to-72-hour window. Our certified psychedelic integration coach, trained by Being True to You, works with you to make sense of what the session opened and how to carry it forward. You can explore additional integration ideas on our integration inspirations page.

Preparing for a Full Series, Not Just One Session

It is worth framing the experience correctly from the start: a single ketamine infusion is the beginning of a series, not a standalone event. Research shows that repeated ketamine sessions produce cumulative antidepressant benefits and extend remission periods, each infusion builds on the neuroplastic foundation laid by the previous one (National Institutes of Health). Approaching the series as a sustained commitment, rather than waiting for one session to produce a definitive result, tends to produce better outcomes.

This means the intention and integration work is not a one-time exercise. Before each session in your series, we encourage you to revisit your intention, it may evolve across sessions, and that evolution is informative. After each session, the journaling and integration practices apply again. Mood data tracked through the Osmind app across the full series gives you and our clinical team an objective record of your trajectory.

Results vary by individual. Not every patient finds the intention-setting or integration work immediately natural, and that is normal. Our care team is here to support this process throughout, not just during the infusions themselves. For a complete picture of what each session involves day by day, see our full post on IV ketamine therapy at Soft Reboot Wellness.

Addressing the Practical Before and After

On the day of your infusion, we ask that you avoid alcohol for at least 24 hours prior and arrive having eaten lightly two to four hours beforehand. Wear comfortable clothing. Arrange your driver in advance, you cannot drive yourself home afterward, and this is a clinical requirement without exceptions.

Plan to protect the afternoon and evening of your infusion day. The most common post-session experience is feeling relaxed and emotionally open, but scheduling demanding commitments for the same evening works against the integration process. The following day, most patients return to their normal professional routines without issue.

IV ketamine for mental health is an off-label treatment, and insurance coverage is not standard. The cost commitment is real, and we encourage you to discuss it with our team at 650-419-3330 or reach us through our contact page at hello@softrebootwellness.com before your consultation so it is part of your planning rather than a surprise. We also encourage you to discuss all treatment options with your existing healthcare providers before beginning. Results vary by individual.

Frequently Asked Questions

What if I don’t know what my intention should be before a session? That is completely normal, especially before a first session. Our preparation session is specifically designed to help you identify a workable intention. It is a facilitated conversation, not a test. Arriving with openness and genuine curiosity is itself a strong starting point.

Is there anything I should avoid thinking about during a session? Rather than thinking in terms of avoidance, we suggest thinking in terms of orientation. Trying to suppress specific content tends to amplify it. A more effective approach is to hold a broader intention, openness, curiosity, compassion toward whatever arises, and let the session unfold from there. If something difficult comes up, the most useful response is to observe it rather than fight it or pursue it.

How do I know if my integration practice between sessions is working? Progress in integration is rarely linear or dramatic. Signs that it is working include: finding habitual thought patterns slightly more available for observation, noticing emotional states with a little more space between stimulus and response, or simply feeling incrementally more present in daily life. The Osmind mood data gives you an objective reference point alongside these more qualitative signals.

What role does my outside therapist play during the ketamine series? We encourage patients with existing therapists to bring the material from their ketamine sessions directly into their ongoing therapeutic work. The neuroplastic window opened by ketamine often makes previously defended emotional territory more accessible in therapy, many patients describe a ketamine series as accelerating months of therapeutic work into weeks. We coordinate with outside therapists with your consent throughout treatment.

Key Takeaways

• What you bring to a ketamine session, intention, openness, willingness to observe what arises, shapes the therapeutic outcome alongside the pharmacology.
• Setting a simple, honest intention before each session gives the neuroplastic window opened by ketamine a direction to work with.
• During the infusion, openness over control is the most effective orientation; resistance and forced steering tend to work against the therapeutic process.
• The 48 to 72 hours following infusion are the integration window, journaling, gentle movement, and reflection during this period are part of the treatment, not afterthoughts.
• Our KAP program at Soft Reboot Wellness is structured specifically around preparation and integration as clinical steps, not optional add-ons.

Preparation is how you meet ketamine halfway. If you are ready to start thinking about what this process might look like for you, we are glad to be part of that conversation. Call us at 650-419-3330 or email hello@softrebootwellness.com to schedule a consultation at our Menlo Park clinic.

References

1. National Institutes of Health. Research explores the neurological mechanisms behind psychedelic-assisted therapy, including how these treatments promote emotional processing and neuroplasticity. https://pmc.ncbi.nlm.nih.gov/articles/PMC10786285/
2. National Institutes of Health. Ketamine promotes neuroplasticity, the brain’s ability to form new neural connections, which may explain its rapid and sustained antidepressant effects. https://pmc.ncbi.nlm.nih.gov/articles/PMC8190578/
3. National Institutes of Health. Research supports the integration of psychotherapy with ketamine treatment, showing that the combination may produce more durable and meaningful outcomes than ketamine alone. https://pmc.ncbi.nlm.nih.gov/articles/PMC9207256/
4. National Institutes of Health. Multiple ketamine infusion sessions have been shown to produce cumulative antidepressant benefits and extend remission periods in patients with depression. https://pmc.ncbi.nlm.nih.gov/articles/PMC6236511/
5. Mindful.org. An accessible overview of mindfulness practices and their documented benefits for mental health and stress management. https://www.mindful.org/what-is-mindfulness/

Medical Disclaimer: The information in this blog is for educational purposes only and does not constitute medical advice. Ketamine therapy should only be pursued under the supervision of a licensed medical provider familiar with your full medical and psychiatric history. Individual results vary. Off-label treatments like IV ketamine for mental health conditions carry risks that should be discussed thoroughly with a qualified provider before beginning. If you are experiencing a mental health crisis or thoughts of self-harm, please call or text 988 to reach the Suicide and Crisis Lifeline or go to your nearest emergency room.

Reviewed by Dr. Sara Herman

The post What to Think About During Ketamine Therapy: Preparing for Your Session appeared first on Soft Reboot Wellness.