Transcend Therapy Services

Ketamine-Assisted Psychotherapy for Treatment-Resistant Depression (TRD)

When Standard Treatments Haven’t Worked, There’s Still Hope

All of you is welcome here.

1 (833) 313-2512
Ava Kool
Care Cordinator

For individuals struggling with treatment-resistant depression (TRD), it can feel like you’ve tried everything — therapy, multiple medications, lifestyle changes — yet the heaviness remains. Many clients arrive at Transcend feeling like they’ve run out of options.
But the truth is: ketamine-assisted psychotherapy (KAP) often succeeds where other treatments have stalled. Clinical research and our experience show that the success rate of KAP for TRD is remarkably high.

How Ketamine Works Differently Than Traditional Antidepressants

Most antidepressants target serotonin, dopamine, or norepinephrine — chemicals that regulate mood. Ketamine, however, acts on the glutamate system, which plays a major role in neural communication, learning, and emotional regulation.

This difference in mechanism allows ketamine to:

  • Rapidly increase neuroplasticity — the brain’s ability to form new, healthier connections

  • “Unstick” rigid patterns of thought and behavior that maintain depressive cycles

  • Create a temporary state of openness where deeper emotional and behavioral change becomes possible

Why Combine Ketamine with Psychotherapy

Ketamine opens the door biologically, but therapy helps you walk through it.
For many people with depression, even when they intellectually know what changes would help — setting boundaries, reaching out for connection, adjusting self-talk — it can be extremely difficult to put those changes into action. Ketamine can sometimes make it more possible for individuals to actually implement new behaviors that previously felt impossible.

It’s also common for people to feel stuck or unsure what to focus on in therapy. Ketamine can naturally enhance awareness, often bringing to light the deeper emotional truths or unresolved experiences that are truly driving distress. With this clarity, therapy can move beyond surface-level symptom management and begin addressing the root causes of suffering.

If you’ve already tried multiple antidepressants or months (or years) of therapy without significant improvement, the odds that “more of the same” will suddenly make the difference are statistically low. KAP offers a new avenue — one that combines biological and psychological change to achieve meaningful progress.

The Transcend Difference

At Transcend Ketamine, our clinicians and therapists specialize in working with individuals who have struggled to find relief elsewhere. We understand the unique frustration and hopelessness that often accompany TRD, and we meet it with compassion, precision medicine, and evidence-based psychotherapy.

Our Austin and San Antonio clinics are designed for safety, comfort, and depth of care — so that change feels not just possible, but sustainable.

"The Transcend Team has been INCREDIBLE with our family!  They have been so caring and their knowledge of how to conduct the infusion session in tandem with the therapy session is the best approach!  My daughter has joy again."
Susannah
Therapy services:
  • Ketamine-Assisted Psychotherapy
  • In-person Therapy
  • Virtual Therapy
Frequently Asked Questions.

Ketamine Infusion Therapy/Ketamine Assisted Psychotherapy is ideal for people suffering from treatment resistant depression, anxiety, suicidal ideations, OCD, PTSD and chronic pain conditions with no relief from other medications or therapeutic interventions.

Ketamine is a very short acting medication. Generally speaking, any side effect experienced from Ketamine will be short-term and will subside after the infusion has stopped. It can be normal to have slight increases in blood pressure and heart rate during an infusion. A small percentage of patients do experience some nausea during or right after the infusion. Nausea, elevated blood pressure and heart rate are easily managed through IV medications during the session should these arise. Most patients who do not eat for three hours prior to the session, and keep their eyes closed or use eyeshades during the session, will not experience any nausea.

In high doses and/or with very frequent administration Ketamine can be irritating to the bladder. For the purposes of facilitating KAP, doses of ketamine are low and most patients will only do one or two sessions per week. In this dosing and frequency there is an extremely low risk of developing bladder irritation caused by the administration of Ketamine. We have never had a patient develop bladder issues from this treatment at our clinic.

During your medical intake, we will determine if you need to alter your medication regimen prior to treatment. There are only a few medications that should be altered prior to initiating treatment. For instance, stimulant medications, benzodiazepines, and medications like Lamictal may need to be held or adjusted prior to treatment.

We request that you don't eat a meal within 3 hours of the start of your appointment time.

After receiving a ketamine infusion, it is normal to feel slightly tired or loopy for several hours. It would be unsafe to drive after a session so we do require that you arrange a family/friend to pick you up or utilize a taxi or other ride service.

It is best to provide time to fully process the therapeutic content that may have been worked through in the session. We encourage our clients to journal and integrate in the time following the session.

At Transcend, it is our goal to have this treatment be a highly transformative, short term intervention for you.

One of the reasons to undergo the KAP process with a therapist vs. receiving Ketamine infusion or injection-only is because most people are able to avoid needing maintenance treatment long-term with KAP. When symptom reduction has occurred through the chemical effects of ketamine only, there is often a need to re-administer ketamine every 20-30 days to keep symptoms at bay. With KAP, symptom reduction is more often secondary to therapeutic progress which does not dwindle in time, and therefore maintenance treatments are often not required.

The majority of our clients will reach sub-clinical levels of distress after an average of 6-10 sessions. Most of our clients will discharge from our care after these sessions and won't need any form of maintenance therapy. Some people do benefit from revisiting KAP intermittently throughout the year following the initial series as needed to continue therapeutic progress but this is not the most common treatment plan at Transcend.

For chronic pain treatment, it is more difficult to keep baseline pain levels down and flare-ups without maintenance infusions ongoing. The majority of patients with chronic pain will do sessions every 30-90 days to keep the baseline pain levels reduced.

You can expect to be at the clinic for approximately 2 hours. There are many factors that influence the length of the infusion but most patients will receive a 35-50 minute ketamine infusion. Your Ketamine Assisted Psychotherapy trained therapist and a registered nurse will be by your side throughout your entire time during the infusion. Your therapist will be with you before to help set goals for the session, during for guidance and processing, and after for continued therapy, integration, and reflection.

Have another question? Don't hesitate to reach out to us.