INNATE Integrative Medicine offers ketamine-assisted psychotherapy to support each patient’s innate ability to heal. Join Dr. Prentice Steffen and Amanda Edwards, LCSW as we learn about the collaboration that brings this work to life.
Getting to Know Prentice Steffen, MD & Amanda Edwards, LCSW
Prentice is Board-Certified in Emergency Medicine and is a Fellow of the American Academy of Emergency Medicine. He worked for over 30 years in Emergency Departments in San Francisco, NYC, and Santa Cruz. As an Emergency Physician, he cared for patients facing every imaginable type of physical and mental health crisis. Prentice is also Board-Certified in Sports Medicine; as Chief Medical Officer, he helped build a professional road cycling team that continues to compete in the Tour de France each July. Like Amanda, Prentice trained in Psychedelic-Assisted Therapy under psychiatrist Scott Shannon, MD at the Psychedelic Research and Training Institute (PRATI) in Fort Collins, CO.
Amanda is a Licensed Clinical Social Worker (LCSW) who brings years of therapeutic experience to create a multidisciplinary approach in her work. She has trained with the PRATI on Psychedelic-Assisted Therapy. As a social worker for the last 15 years, Amanda has worked in fields including community education, domestic violence and sexual assault support, substance abuse and recovery, family & children’s services, and hospice. Pivotal in Amanda’s life and work are connection to body, breath, and nature. Work with Amanda can include breathwork, movement, and other embodiment exercises. Amanda also has a thriving sex & intimacy coaching practice.
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Mission of INNATE Integrative Medicine
INNATE Integrative Medicine is clinic in Santa Cruz, California committed to helping patients heal through the power of ketamine. As Amanda says, “Ketamine can give us access to levels of consciousness and parts of our psyche that would otherwise be unavailable to us, and to really work with those areas in a different kind of way. Being in a non-ordinary state of consciousness can also provide a reprieve from suffering, whether that’s chronic pain…or existential pain. In addition, the integration work following the session can be really powerful in…making long-term changes.”
Prentice highlights impact of ketamine from his perspective as a doctor. “I come from an emergency medicine and a sports medicine background. What impressed me with ketamine is how powerful it is as unsticking people who are stuck. There’s ruminating about their lives, depression, anxiety, trauma, and substance use. Ketamine disrupts circular thinking in a way that I am not clear anything else does. And once unstuck, it’s the integration work and process, the goal of staying unstuck and moving forward in a healthier way.”
Prentice underscores the importance of the paired – or dyad – work that he and Amanda offer at INNATE Integrative Medicine. “We work as a physician and a social worker, and we both bring our special skills, expertise, and experiences together to take care of clients that have issues they are struggling with….The way we work together is a very fluid process depending on the client, what it seems like they need, and what support they are seeking. So, it’s dynamic. Every client is different, and what we provide to each client is different, as individuals and as a team.”
“After my residency, I practiced for 30 years and took care of [physical conditions], but also mental health crises. I was just reasonably clear that our system needed a new direction. It has been a little over a year ago that I started reading about psychedelic assisted therapy and ketamine assisted psychotherapy, and the more I read the more I was intrigued. I did a training with PRATI (where Amanda also trained) and lots and lots of continuing medical education (CME). If I can put in a plug for Psychedelic Support, the coursework there is a like a graduate student level of training. So, I became convinced this was something that needed to be happening and that I needed to be part of.
I worked as team physician for a professional bicycle racing team at the Tour de France level. More than anything, I got the idea of teamwork. At INNATE Integrative Medicine, we have a partnership, not just between the two of us, but with our clients and working towards a common goal. And that’s not winning the Tour de France, it’s living a happy live and getting unstuck from conditions and situations that block that happiness.”
We can be there to help and support in transition and have some tools, but this work is between the journeyer and the medicine and whatever the journey holds for them. We are not the experts in the room. That’s kind of where INNATE came from. We believe in the inherent intelligence of our clients and in their bodies and wisdom and experiences.
As a social worker, Amanda sees how she has integrated the different areas of her social work expertise into her present work, most recently in hospice for the past 9 years. It has informed her work with the “faith that folks are on their own journey. We can be there to help and support in transition and have some tools, but this work is between the journeyer and the medicine and whatever the journey holds for them. We are not the experts in the room. That’s kind of where INNATE came from.
We believe in the inherent intelligence of our clients and in their bodies and wisdom and experiences. We’re there to keep folks safe within a certain container…but other than that, really allowing the experience to unfold and removing the sense of ‘I’m the expert in the room’, which I think a lot of mental health models have with the professionals and the pharmaceuticals as the experts, and not the clients and their experiences. Hospice taught me a lot about that.
My other experiences in addition, recovery, harm reduction, working with children and families, have really taught me the idea that folks make for themselves the best outcome. It’s a collaboration, the team effort, like Prentice said, with heavy emphasis on [the idea] that people have all the wisdom that they need, and they just need to find access to it in some way that’s been blocked.
“My work with clients during the medicine journeys and in our pre- and post-sessions are highly informed by somatic therapy. Dropping into the body, tapping into the wisdom that’s already there, getting out of the chatter in our heads. I think in our cultures [there’s a pressure to] make it make sense, make it rational, make it fair. Coming back to feelings and desires, they don’t have to be rational. They don’t have to make sense in black and white. [It’s about] cultivating that confidence in trusting your body and listening to those sensations. What are they trying to tell you? And how can you follow them?
I trained at the Somatica Institute here in the Bay area. I did the main yearlong program in 2018, and then have done all of the subsequent trainings that they offer. It is specific to sex and intimacy and relationship…So, that’s largely the somatic piece: What’s is your body telling you? You can trust it. [You can] learn the language of those sensations and what it’s trying to tell you, and to believe it and, and drop out of the head and into the body. We’re doing that a lot with this medicine, which is interesting because it’s a dissociative.
When I first started reading about ketamine-assisted therapy and the dissociation piece, I thought, I’m trying to get in my body, not out of it! All my alarms went off in that way. But, part of the magical piece about this medicine is that it’s the reprieve from this loop that…we get stuck in, that we have the same thoughts, that we’re playing the same tape over and over. The disassociated piece allows us to get out of the loop and see these experiences from a completely different perspective. To allow our body to metabolize them in different ways so that we’re not experiencing the same trauma over and over, that we’re not having the same invasive thoughts of anxiety or what could happen or what might happen if we leave the house.”
Journeying with INNATE
Amanda shares that all connections with INNATE Integrative Medicine begin with an introduction call. “So, if anyone is expressing interest – whether its through our website, a community partner, friend of a friend, whomever – we start the process with an intro call between myself and the potential client. Just to explore what’s up, what’s alive, what’s happening, what are some goals? That’s a free call, typically 20 or 30 minutes just to do some exploration and see if it feels like a good fit. If it is, we would schedule the medical social intake, which happens with both of us in the room.”
“We ensure that clients are either working with a therapist or a coach or have some continuity of care, so that we’re not just like grabbing them out from the wind, doing a few sessions, and sending them back out. We want to make sure that there are allies and support people and systems with our clients, so it isn’t just this kind of lone experience. Some folks have continued on with me through multiple integration sessions and transitioned into my coaching practice, which is more sex, intimacy, and relationship focused. What we found is that so often these things are all braided together, with potential clients [experiencing] treatment-resistant depression, anxiety, PTSD, and trauma, and having this existential, psychospiritual pain that can’t quite be encapsulated in any diagnosis…So, we’re really doing an assessment beforehand of, who are your support people? What are your networks? Do you have professionals in your life who you can continue to work with after you come and have this treatment arc with us?”
“Then, we would have at least one intention setting appointment, which happens just with me [Amanda]. This is a time for us to really dig into, what’s happening now? And what would you like to see happening? If you would like to feel different, or have your life be different, as a result of this treatment, what would that look? The third session would be the medicine session, which we’d block out three hours of time for, which is typically more than enough. That happens in-person in our office with both of us present for the entire journey.” Prentice adds that they do a thorough medical-social intake and prioritize safety.
“I learn enough that is relevant about each of our clients to proceed safely with this medication. We then do a 12-minute sublingual dose where the patients hold the ketamine in their mouth for 12 minutes and it absorbs across the mucous membranes. Then, we have them spit, rinse, and get very comfortable. We then do an injection into the arm, similar to a vaccine, [with another dose of ketamine]. We then give them eye shades and noise-cancelling headphones with a lovely playlist, and [the journey begins].”
Amanda highlights that, “[The journey] after the intramuscular injection typically lasts between 60 and 70 minutes. Sometimes, folks are speaking and I’m there to write anything down that they say and capture those words and experiences. Sometimes, people are totally silent. [In all cases] Prentice and I are both present for that entire portion. When the client comes back into their body, they are invited to speak, if they would like to. We find that there’s often not language immediately that can really capture what the experience was. We don’t want to rush the brain back into turning on and having to assign language and classify the experience. We also make sure that they have a ride home, as folks are not in any shape to drive themselves after their journey.”
“Within 1-4 days after their journey, we hold 2 integration sessions with them to hopefully capture more of what their experience was, their insight, if there were any experiences that helped them feel a reprieve from their suffering, or whatever it is that they are experiencing. We try to find a way to capture those insights and literally integrate them back into their everyday. We can always add integration sessions also, and we can add medicine sessions, but at the very least we’re having that five-appointment treatment arc.”
Growing the Ketamine Community
Currently, INNATE Integrative Medicine is working to build community with other ketamine practitioners in their area. As Prentice says, creating a sort of “therapist peer support group. So, we’ve been meeting with them quarterly and that’s super valuable to learn from other peers and [use] a mentorship approach, to some extent. We’re also working to get a group going here in Santa Cruz. I attended a webinar with a marketing speaker the other evening, and he was talking about multimillion-dollar ketamine clinic. That is not really us. We just want to do the work with the people who come to us and help them.”
Amanda adds, “I think the clients who are meant to be here are finding us in various ways. And, we’re still learning about our capacity…I am also super interested in support groups for other practitioners who are doing this work, so that we can really collaborate and create that continuum of care that we talked about. Folks in the community who maybe don’t want to sit with the medicine, but want to know enough about it that they can refer to us and we can send them back for more long-term integration.
I also really love the idea of demographic specific groups, like nurses who have been dealing with the COVID pandemic for the last two years, or social workers, or firefighters. I think there’s also something really powerful about multiple folks journeying at the same time, in various forms.”
Connecting with INNATE Integrative Medicine
Prentice and Amanda would love to connect with you! In addition to be open for introduction calls, the website “has a resources and documents page that has some really great, more accessible, less clinical, information about ketamine. Why ketamine? Why would you start here? What are the benefits?” Reach out and connect with them to learn if healing with this dynamic team is right for you.