Therapist Bible

Welcome to Skylight!

We are happy to have you join our community of dedicated therapists supporting our mutual clients throughout their journey with ketamine. Here you will find a survival guide, a manual that will provide you with important information that will help you to foster a safe and supportive healing container for your clients.

Therapist Bible

  • Email: human@skylightpsychedelics.com . Emails will be answered within 24 hours during business hours.

    Please note: the above contact information is for therapists and clients.

    Connecting with our Team

    Dana Lerman, MD her email is dana@skylightpsychedelics.com and our community and relationship liaison, Judy Becker, can be reached at judy@skylightpsychedelics.com

    Our CEO Andrea Stone, MBA can be reached at andrea@skylightpsychedelics.com

    Our Collaborating Pharmacies

    We work with three compounding pharmacies, one in Colorado, California and the other in Pennsylvania. Should your client need to reach the pharmacy please have them reach out to us first.

    Issues with Ketamine Dosing

    If your client has any confusion with the medicine, please have them connect directly with the pharmacy. Each client is aware of which pharmacy their medicine was dispensed from. The information to contact pharmacy is also on the medicine packaging. Please refrain from adjusting client’s doses, this should be done by our healthcare prescribers only. Please email human@skylightpsychedelics.com if you or your client feels the dose needs to be adjusted and our medical team will reach out.

    Issues with Ketamine Experience

    If a client has an issue with a ketamine side effect, reaction, or otherwise complicated journey that requires additional support, please email human@skylightpsychedelics.com and encourage your client to connect via email as well.

  • Step 1 – Clients register as a client on our Patient Portal under clients on the website www.skylightpsychedelics.com . Clients will pay for the service and then set up an appointment via our booking platform. Clients must upload all necessary documents and complete ALL forms or the process will be delayed.

    Step 2 – Your client will undergo a telemedicine visit with one of our healthcare providers.  Their prescription will be sent to the pharmacy and the pharmacy will ship them medicine directly to the client.

    Step 3 – Clients and therapists set up the KAP appointments. We do not recommend scheduling appointments until the medicine has arrived.

    Step 4 – Clients can reach out for further ketamine via filling out a re-evaluation inquiry on our website. If they need any help, they can always email human@skylightpsychedelics.com

    Step 5 – Clients and or therapists can reach out as needed with any issues, but they are not required to communicate with Skylight.     

  • See below for a detailed checklist you can use to ensure that you can proceed safely with a client’s journey.

    1.       Ensure you’ve had preparation visits with your client prior to booking the medicine session. Make sure a trusting relationship has been established.

    2.       Prepare your journey space as described in the training course or as you see fit and ensure you have a comfortable quiet indoor space for your client, an eye mask (or ask them to bring one), a blood pressure cuff (or ask them to bring one), a way to play music (headphones are discouraged as we like for you to be a part of the experience), access to Skylight’s Music via Spotify (if client prefers an alternative playlist please ensure music is novel to them), a bin (in case the client is nauseous and needs to vomit).

    3.       We suggest all therapists know where an AED can be found in their practice’s vicinity. This should be known regardless of ketamine usage during sessions. Training in basic life support is also recommended.

    4.       Conduct a suicide risk assessment at the beginning of each KAP session.

    5.       Prior to taking the medicine, ensure your client has a safe ride home. We discourage clients from accepting a ride from someone they don’t know. Ensure the person waiting to take the client home is aware that the client is asked to remain in the waiting room/office setting for an hour after the medicine session is over. Clients must remain in the office for a total of 2 hours from the time they take the medicine.  

    6.       Ask the client to use the restroom and you should use the restroom as well prior to the KAP session to limit interruptions.

    7.       Ensure all phones and disruptive devices are powered off.

    8.       The client will take their blood pressure. The therapist should NOT take the client’s blood pressure. We explain to clients that they should not proceed with ketamine if their blood pressure is above 150/90. Please offer the client an opportunity to lower their blood pressure with gentle breathing exercises. The client should see their medical provider to optimize their blood pressure, if it remains high.

    9.       Once the client is ready to take the medicine, they will place the rapidly dissolving tablet(s) under their tongue. The tablet will dissolve. Do not ask the client to spit, swish or do anything special with the medicine. Once it is dissolved, they should swallow it. Clients using intranasal ketamine will follow those instructions accordingly.

    10.    Encourage the client put on their eye mask if willing, or they can close down their eyes.

    11.    The medicine usually takes effect within 10-20 minutes. For some clients this may take longer.

    12.    Support your clients as you were trained by Skylight and in your therapy training during their time on the medicine. Remember, some clients will speak throughout the entire session and some will be completely silent. This is ok. Please note that we do not recommend “guiding” someone’s experience.

    13.    Skylight’s playlists are 60 minutes long and once they have ended we suggest you invite the client to remove their eye mask and open their eyes.

    14.    Give the client some time to connect with you about their experience. Some therapists have integration immediately following a journey, some do it days later.

    15.    Clients should not leave your office unless they are oriented to person, place and time and have a stable gait and you have completed a suicide risk assessment and they are not a threat to themselves or others. We also ask clients to check their blood pressure following sessions.

    16.    Discourage your client from leaving your waiting room unless an hour has passed since their medicine session has ended.

    17.    Set up an appointment for integration.

    18.    If you are concerned about your client, connect with Skylight and/or call 911 if needed. 

    19.    Clients are educated by Skylight to refrain from driving, operating any heavy machinery, swimming, bathing and being the sole provider of childcare for small children on the days they receive medicine.

    20.    Should your client develop nausea or vomiting please encourage them to connect with Skylight.

    21.    If you are concerned about your client, please do not hesitate to reach out to Skylight.

    Remind your clients to consider joining the Skylight bi-weekly integration Zoom call for community support. They have the appropriate link to this meeting.

  • See below for the checklists we ask your clients to follow in preparation for and following their journey with you on the medicine.

    1.       Prior to arriving at your therapist’s office please ensure you have a safe ride home with someone that you know who will wait for you after the medicine experience.

    2.       Plan for a day free from distractions and work on medicine session days.

    3.       Consider thinking of an intention for your medicine session.

    4.       Bring an eye mask, blood pressure cuff and journal to the medicine session.

    5.       Remember to bring your medicine to your session.

    6.       Dress comfortably with nothing tight around your neck.

    7.       Avoid food and water for 3-4 hours prior to the ketamine experience.

    8.       Use the bathroom and power down your devices prior to the session.

    9.       Invite a mantra or spirit guide into your session if that is something that speaks to you.

    10.    Avoid using headphones in your session, this will allow you to connect deeper with the therapist and for you to hear them if they are speaking with you.

    11.    Choose the Skylight Psychedelics Spotify playlist that correlates with your journey number.

    12.    Check your blood pressure. Do not proceed if the blood pressure is above 150/90. If your blood pressure is elevated above 150/90, you can try to relax and meditate and retake it. If it remains elevated, we recommend you reschedule your ketamine session for when your blood pressure is optimized after you see your healthcare provider.

    13.    When ready to take the medicine place the tablet(s) under your tongue. Do not spit. Allow the medicine to dissolve, then swallow. Most often, it will start working within 10-20 minutes.

    14.    Place your eye mask on and lie down in the comfortable space provided by your therapist.

    15.    Avoid using any sucking candies during the medicine experience.

    16.    During the experience on the medicine remember to try to surrender, be open, go with the flow. Talk to your therapist if you desire but remember it’s also completely ok to have a silent,  internally focused journey as well.

    17.    The journey should last approximately one hour. Once an hour is up your therapist will shut off the music and invite you to open your eyes.

    18.    Check your blood pressure and make note for your records.

    19.    You should not leave your therapist’s office unless you are alert and oriented to person, place and time AND it has been an hour since your medicine session has ended. Very rarely a person can come out of the medicine experience and go back in. Stay in the therapists office for two hours since the time you took the medicine.

    20.    Ensure you leave your therapist’s office with a safe ride, someone who is known to you. We discourage people from using ride shares or public transportation for safety reasons.

    21.    Avoid driving, operating heavy machinery, swimming, bathing, taking public transportation, and being the sole provider of childcare for the remainder of the day of your ketamine session.

    22.    Ensure you have an integration session booked either immediately following the journey or shortly afterwards in the coming days.

    23.    Proceed with the next medicine session if you are feeling ready to do so. If you are having big experiences, and it is overwhelming, you can pause the medicine sessions and use that time for integration. If you are unsure of what to do, please discuss this with your therapist and you can also reach out to Skylight as needed for additional advice.

    24.    If during your journey you struggled with nausea or vomiting or any other side effect that you need help with, please reach out to Skylight.

    25.    Please remember to journal about your experience and bring this material with you to integration sessions.

    26.    Try to spend as much time in nature as you can.

    27.    Join our community of clients on a similar journey bi-weekly via Zoom with Dr. Elizabeth Wolfson. Links have been provided. If you need help email us at human@skylightpsychedelics.com

    28.    If you are having thoughts of harming yourself or anyone else, please activate your care plan accordingly. If you do not have a care-plan, please call 911 or 988 immediately.

  • Ketamine Dosing

    When working with sublingual ketamine we start off with doses of either 100 mg, 150 mg and 200 mg. Many factors are taken into consideration when our prescribers are treating clients with ketamine and choosing the appropriate dose for the client. Rarely a client can have a starting dose above 200 mg. The maximum doses of ketamine we use at Skylight are 600 mg. Very rarely would a client require more than that dose. When working with Skylight, clients will experience a protocol that increases in dose as they move through the program. If you have a question about a client’s dose or are concerned regarding your client’s experience, please reach out to us. We are here to connect with you.

    Scheduling KAP Sessions

    No one knows the ideal amount of KAP sessions to do when treating clients with ketamine. Every client is different, because every life experience is different. Many clients are able to do 6 ketamine sessions in a 2-3 week period. Other clients use the medicine in therapy once a week. Some clients have such a big experience that they may need to take a few weeks to integrate prior to going into the next medicine session. Work out what makes sense for you and your client. While some clients do 6 sessions, others do 10 or 12. This is up to the client, therapist and medical team to determine what works best for the particular client.

    Scheduling Integration Sessions

    It can be very helpful to have integration sessions immediately following a client’s journey. Clients are typically more open following a ketamine experience and the journey is fresh in their minds making this a great time to talk. On the other hand, a lot of information can come to a client once they leave your office. We recommend utilizing both of these special times for integration whenever that is possible. For clients feeling overwhelmed and struggling following a big experience we recommend considering pausing medicine sessions and using those appointments for integration instead, until the client feels ready to move forward with further medicine.

  • Bi-weekly Case Consulting Zoom with Skylight Psychedelics Team (therapists only)

    https://us02web.zoom.us/j/87648064693

    Bi-weekly Client Integration Zoom with Elizabeth Wolfson, PhD, LCSW (not for therapists)

    https://us02web.zoom.us/j/82622818852

Skylight Music Playlists

We have curated six Skylight Psychedelics Spotify playlists to be paired with each of the six ketamine treatment sessions.