Programme with the possibility of racemic ketamine

Program for treatment-resistant depression

Programme with the possibility of racemic ketamine (intramuscular)

The treatment programme is intensive and designed as a “pressure cooker” to facilitate a breakthrough in patients for whom this has previously not been achieved. The programme is tailored individually for each patient.

Magnolia creates optimal conditions to support recovery and applies elements of therapies such as cognitive behavioural therapy (CBT), Acceptance and Commitment Therapy (ACT), psychodynamic therapy and interpersonal therapy (IPT), which are suitable for the treatment of treatment-resistant depression.

The treatment is delivered by a multidisciplinary team of lead clinicians and co-treating professionals.

For selected patients there is the possibility of additional, non-reimbursed pharmacological support with ketamine.

Who is this programme intended for

To participate in our programme it is important that you are under the care of a registered therapist and/or physician (with whom we will be in contact) and that you have already tried at least two different antidepressants without sustained recovery. In addition, an intake and screening will follow, during which we assess your medical and psychiatric history. If you are eligible, you will be matched with a dedicated treatment team.

Reimbursement of our programme by health insurers depends on your policy and typically ranges between 60 and 80 percent

Programme structure

The programme is individually tailored for each patient and includes screening, diagnostics, treatment and aftercare. Our experience shows that on average six weeks are needed to achieve an effective breakthrough, although this varies per person. Progress is evaluated weekly and the treatment plan is adjusted where necessary.

Request for consultation
After your request, we schedule a non-binding introductory consultation. During this conversation we explore your treatment request, explain the programme and discuss the practical and financial framework. Together we then determine whether a formal screening is appropriate.

Screening & diagnostics
During screening and diagnostics we carefully assess whether our programme is medically and therapeutically suitable for you. We also map out what level of reimbursement you can expect from your health insurer. The amount of reimbursement depends on your policy and insurer. In some cases reimbursement may not be possible. We discuss this carefully with you in advance.

Intake & treatment plan
If the screening indicates that further treatment is appropriate, your case is first discussed in a multidisciplinary meeting. Based on this, an intake consultation follows in which the indication, treatment goals and expectations are carefully aligned. After the intake, your personal treatment plan is established. Once you have approved it, treatment begins.

Treatment cycle
The programme lasts on average six weeks and may vary depending on your individual needs and therapeutic goals. After completion, a follow-up phase takes place aimed at consolidation and integration.

Optional pharmacological support with ketamine (not reimbursed)
For selected patients we offer the possibility of additional pharmacological support with ketamine. This intervention is not reimbursed by health insurers.

For the first time in my life, I can say that I experience calm and a sense of safety in my body, even when I am alone. Before, I only lived in my head, but now I live in the world."

The ketamine journeys have provided me with a wealth of wisdom and insights. Thanks to the ketamine, I was able to connect with deeply buried pain, but also with my true desires and abilities. Moreover, the ketamine has helped expand my ‘container,’ allowing me to dare to feel and connect—with my true self and with the world around me.

Together with my psychologist from Magnolia, Wiesje, I worked hard on the themes that emerged from my journeys. I have been able to create safety, both at home and in my relationships. For the first time in my life, I can say that I experience calm and a sense of safety in my body, even when I am alone. Additionally, I feel strength. I am better able to sense and protect my boundaries, which finally allows me to maintain a connection with myself. Slowly but surely, I am emerging from my ‘freeze’ mode; frozen energies (emotions) can now, little by little, leave my body. I can connect with my deepest desires and act from that place; step by step, I am letting go of pieces of my long-standing eating disorder, and the dysthymic disorder is making way for life energy, spontaneity, freedom, and self-compassion.

My heartfelt gratitude goes out to the Magnolia team and Menno Oosterhoff for the warm, loving, and skilled guidance throughout my journey. Movement has been sparked on so many levels—emotionally, physically, spiritually, relationally, and in my conscious “being.” The ketamine journeys turned out to be the missing link in my process toward further healing. Magnolia came into my life at exactly the right moment. Thank you for everything!

“Before, I only lived in my head, but now I live in the world.”

– Marleen, 35, Netherlands

Treatment and guidance during the programme

The program includes two connected treatment sessions each week. This intensive structure creates optimal conditions for recovery in treatment-resistant depression and is aimed at both deep therapeutic change and sustainable integration into daily life.

Change-focused session
In this session we actively work on breaking depressive patterns. We explore recurring thoughts, feelings and behaviours and apply targeted interventions to bring stalled patterns into movement.

The focus includes:

Breaking negative thinking patterns
Activating behaviour
Deepening emotional insight
Working through underlying patterns

This session is aimed at real therapeutic change.

Integration and application session
In the second session the translation to daily life is central. New insights and skills are deepened and applied in concrete situations.

We work on:

Acting in line with personal values
Dealing with difficult thoughts and emotions
Strengthening relationships
Consolidating behavioural change

Here the emphasis lies on consolidation and integration, so that change is not temporary but sustainable.

Optional pharmacological support with racemic ketamine (not reimbursed)
For selected patients, if medically indicated, additional treatment with racemic ketamine may be considered. This intervention takes place under the medical responsibility of a psychiatrist and is carefully integrated into the therapeutic trajectory.

Both the administration of racemic ketamine and the associated treatment session are not reimbursed by health insurers and are not part of the insured care within the programme. If this option is considered appropriate, we will discuss this with you in detail beforehand.

During the programme a consultation with the psychiatrist takes place every two weeks. In addition, multidisciplinary meetings are held regularly in which the treatment team evaluates the indication, progress and treatment strategy and adjusts it where necessary.

Contra-indications

The main contraindications for participation in the program are:

A history of psychosis

Bipolar disorder type I

Acute suicidality

Severe cardiovascular disease

Pregnancy or breastfeeding

Start your first treatment immediately after screening

Costs and reimbursement

The screening is free of charge. The reimbursement you receive from your health insurer for the screening is to be paid to us. A referral to specialist mental healthcare (sGGZ) is required for participation.

Based on a treatment duration of approximately six weeks, the total costs range between €7,000 and €8,700, depending on the involvement of a psychologist or psychotherapist and the exact duration of the program.

The fees are established in accordance with the guidelines of the Dutch Healthcare Authority (NZa). Optional pharmacological support with racemic ketamine costs €175 per session and is not reimbursed.

Reimbursement

Magnolia does not have contracts with health insurers. The treatment therefore falls under out-of-network care.

You can submit the costs to your health insurer for reimbursement. Depending on your policy, typically between 60% and 80% of eligible care is reimbursed. In some cases, reimbursement may not be possible. We will discuss this with you carefully in advance.

Estimate of out-of-pocket costs

The final out-of-pocket contribution depends on your insurance policy and the duration of the program. After the screening, we will provide you with a clear overview, so you know what to expect financially.

Accessibility

If the out-of-pocket contribution presents a barrier, we will work with you to explore what is appropriate and feasible in your situation.

The program at Magnolia brought about a personal transformation after 25 years of therapy-resistant gloom and depression. I have been able to emotionally distance myself from old pain. There is now lightness alongside accepted darkness. Deep gratitude for Magnolia’s professional and warm support."

This year, after an extensive screening, I followed a ketamine program at Magnolia. For more than 25 years, I suffered from chronic melancholy with occasional gloominess, and thus, for more than 25 years, I underwent various therapies.

It’s so incredibly remarkable that, despite therapy resistance, there is a substance that opens new pathways in a stuck brain. Through ketamine therapy, I have genuinely been able to feel changes. My “self” has been expanded through the subconscious with the help of ketamine. This has created new and different paths for me. In my daily life, I have truly been able to distance myself from old, repetitive pain—importantly, not rationally but emotionally. A lightness has emerged alongside an accepted darkness.

Being open to the medicine and the journey was a prerequisite for me. In the safe environment that Magnolia has so expertly created. This isn’t necessarily easy to put into words. But when I compare how I am now to six months ago, a positive transformation has taken place within me and, consequently, around me as well.

I told the Magnolia team that I experience it as a spa for my brain. But that perhaps doesn’t fully capture the deeper effects on the level of neurotransmitters, etc. Gratitude to the Magnolia team. The combination of professionalism and warmth is more than extraordinary. I feel supported by them.

- Olivia, 52, Netherlands

Programme with the possibility of racemic ketamine