There is no single correct way to experience this treatment. This guide is simply a set of tools to help you feel more supported and grounded as you move through your own process.
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Music & Meditations
Curated playlists for every phase
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Visual Journeys
Calming videos & visuals
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Mind-Body
Breathing & grounding practices
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Journaling & Integration
Before, during & after your session
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Activities
Light games & creative tools
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Comfort & Refreshments
Everything available during your visit
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Podcasts
Healing-focused listening
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Reading
Recommended books to explore at home
About Spravato
What it is, how it works & why consistency matters
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After Your Session
What to expect & integration guidance
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Music & Meditations
Choose one playlist, set a comfortable volume, and set your phone aside.
If anything feels overstimulating, switch playlists, lower the volume, or choose silence.
Optional screen-based videos some patients find grounding or immersive.
Keep brightness low, volume off. If you feel dizzy or overstimulated — stop and return to audio only. Avoid flashing content if you have migraine sensitivity.
Abstract & Psychedelic
Pattern-based visuals. Best for patients who enjoy this type of imagery.
At each area, notice: heavy or light, warm or cool, tight or relaxed. No need to change anything.
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Safe Place Imagery
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Bring to mind a place where you feel calm and safe — real or imagined.
Picture the details: colors, sounds, how the air feels.
Imagine yourself fully there, sitting comfortably, supported and safe.
"I can come back to my safe place. I am here. I am supported."
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Gratitude Reflection
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Bring to mind one person, moment, or thing you feel grateful for.
Spend a few breaths holding that in your awareness. Notice how it feels in your body.
Silently say: "Thank you for ______." Repeat with one or two more things if you like.
Journaling & Integration
Use as much or as little as you like. There is no right way to do this.
Even a single word or short phrase is enough. Write in your Renue Journal, on your phone, or simply hold these questions in mind. There is no right way to do this.
Before Your Session
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What brings me to treatment today?
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How have I been feeling emotionally and physically this week?
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Is there one thing I hope this treatment might help shift or soften?
During Your Session
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Images, memories, or sensations that stand out
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Any themes or patterns that keep returning
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Moments that feel especially calming, meaningful, or intense
Landing Period
Gentle prompts while you are still in the clinic
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What is one word that describes how I feel right now?
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Is there an image, color, or feeling I want to remember?
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What does my body need in this moment?
Integration
Integration is how insights become changes. The prompts and practices below support the days and weeks after your session.
Days 1–3
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What is one image, feeling, or moment from the session that keeps returning to me?
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Is there something I understood differently during the experience than I usually do?
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What does my body feel like right now compared to before treatment?
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How do I feel now compared to before the session?
Days 4–14
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What small shift — in mood, thought, or behavior — have I noticed since my session?
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Is there a belief about myself I am ready to loosen my grip on?
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What is one concrete thing I want to do differently in my daily life?
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Who or what am I feeling more grateful for?
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Is there one small insight I would like to carry into daily life?
Integration Practices
Small, consistent actions in the days after treatment tend to have the biggest impact.
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Move your body gently
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A slow walk outside — especially in nature — can help ground insights in the body.
Gentle stretching or yoga can help process emotions that feel stuck.
Avoid intense exercise in the first 24 hours if you feel emotionally tender.
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Create something
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Drawing, painting, collaging, or making music can help express things that do not have words yet.
The goal is not to make something good — it is to give the experience somewhere to go.
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Spend time in nature
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Natural environments can support the openness you may feel after treatment.
Even sitting near a window with sunlight or tending to a plant counts.
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Talk to someone you trust
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Sharing your experience with a therapist, close friend, or loved one can deepen its meaning.
If you are working with a therapist, try to schedule a session within a few days of treatment.
Books to explore at home — at your own pace, whenever you feel ready.
These books complement the work you are doing in treatment. They are not required reading — simply an invitation to explore at your own pace, at home, whenever you feel ready.
Trauma & Healing
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The Body Keeps the Score
Bessel van der Kolk
The gold standard on how trauma lives in the body and how to heal it. Deeply relevant to this work.
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When the Body Says No
Gabor Maté
Explores the connection between emotional repression, stress, and physical illness. Validating and eye-opening.
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It Didn't Start with You
Mark Wolynn
A short, accessible guide to inherited family trauma and how to break the cycle. Many patients find it immediately resonant.
Depression & Mental Health
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Lost Connections
Johann Hari
Reframes depression as disconnection rather than a chemical imbalance. Hopeful, practical, and very validating for patients.
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The Noonday Demon
Andrew Solomon
A deeply human, award-winning exploration of depression in all its forms. Patients often feel profoundly seen by this book.
Mindfulness & Acceptance
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Radical Acceptance
Tara Brach
A compassionate guide to meeting yourself with kindness. Especially resonant during and after healing work.
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The Untethered Soul
Michael Singer
On learning to let go of the inner voice that limits us. Deeply complementary to ketamine integration work.
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When Things Fall Apart
Pema Chödrön
On sitting with difficulty and uncertainty with grace. Short chapters, profound and gentle.
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The Four Agreements
Don Miguel Ruiz
Four simple principles for personal freedom and authentic living. Easy to dip into a page at a time.
Psychedelics & Consciousness
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How to Change Your Mind
Michael Pollan
The most accessible mainstream exploration of psychedelic therapy. Many patients arrive having already read this — and those who haven't often find it answers questions they didn't know how to ask.
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The Doors of Perception
Aldous Huxley
A classic, short, and surprisingly readable account of altered consciousness and what it reveals about the mind.
Joy & Meaning
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The Book of Joy
Dalai Lama & Desmond Tutu
Conversations between two of the world's great teachers on finding joy in the face of suffering. Warm, accessible, and deeply human.
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Warrior of the Light
Paulo Coelho
Brief meditations and reflections. Perfect for reading one page at a time during quiet moments.
After Your Session
The hours and days after treatment are an important part of healing.
For the Rest of Today
You may feel tired, emotionally open, or a bit "out of it." This is normal and will gradually fade.
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Do not drive, operate machinery, or drink alcohol today.
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Avoid making major decisions for the rest of the day.
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Choose gentle, low-stimulation activities: rest, quiet time, light movement.
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Hydrate and eat when you are able.
Over the Next Few Days
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Revisit the Journaling & Integration prompts.
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Talk with a therapist or trusted support person.
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Notice small changes in sleep, energy, motivation, and outlook.
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Build in extra spaciousness — slower schedule, fewer obligations, more rest.
When to Contact Us
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Strong or persistent emotional distress
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Worsening anxiety, depression, or intrusive thoughts
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Any side effects you are unsure about
If you experience thoughts of harming yourself or others, or any emergency — seek immediate medical care or call your local emergency number.
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Schedule Your Next Appointment
Consistent treatment leads to the best outcomes. Before you leave today, please check in with your care coordinator to book your next session.
Ask at the front desk
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How was your experience today?
Your feedback is anonymous and helps us improve the experience for every patient.
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Submit Feedback
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Thank you — your feedback means a lot to us and helps us take better care of every patient who comes through our doors.
Thank you for being here.
Healing happens in small moments over time — through rest, connection, and the way you show up for yourself between sessions.
About Spravato
Understanding your treatment — what it is, how it works, and why staying consistent matters.
What Is Spravato?
Spravato (esketamine) is an FDA-approved nasal spray used to treat treatment-resistant depression (TRD) and major depressive disorder with suicidal ideation. It is the first nasal spray antidepressant of its kind — a breakthrough that works differently from traditional antidepressants and can begin helping where other treatments have not.
How Is It Different?
Most antidepressants target serotonin and can take weeks to work. Spravato works on a different pathway entirely.
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It targets glutamate, not serotonin
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Traditional antidepressants (SSRIs, SNRIs) work by increasing serotonin over weeks or months.
Spravato works on the glutamate system — the brain's most abundant signaling pathway — producing effects much more rapidly.
This is why some patients notice a shift within hours or days rather than weeks.
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It promotes neuroplasticity
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Spravato stimulates the growth of new neural connections — a process called neuroplasticity.
This helps the brain become more flexible and resilient, breaking out of entrenched patterns of depression and anxiety.
Think of it as creating new pathways where old ones have become blocked or worn down.
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It can work rapidly
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For patients with treatment-resistant depression, Spravato can produce meaningful relief within hours to days of starting treatment.
This rapid onset is particularly important for patients experiencing suicidal thoughts, where waiting weeks for relief is not an option.
The speed of response varies from person to person — some feel it quickly, others notice gradual improvement over several sessions.
What to Expect During a Session
Before
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You will self-administer the nasal spray under the supervision of your care team.
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Let your care team know how you are feeling that day — physically and emotionally.
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Avoid eating for at least 2 hours and avoid drinking liquids for at least 30 minutes before your session.
During
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You may feel dissociative, drowsy, dizzy, or perceive things differently. This is normal and expected.
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These effects typically peak within 40 minutes and subside during the 2-hour monitoring period.
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Your blood pressure will be monitored throughout. Let your care team know if anything feels uncomfortable.
After
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You will be monitored for 2 hours after administration before being cleared to leave.
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You must have a trusted person drive you home — you cannot drive yourself.
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Most patients feel back to themselves within a few hours of leaving the clinic.
Why Consistency Matters
Spravato is not a one-time treatment. The research is clear — the more consistently you complete your treatment schedule, the better and more lasting your results.
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The treatment works in phases
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Induction (weeks 1–4): Two sessions per week. This is the most critical phase — the brain is building new pathways and establishing response.
Maintenance (month 2+): Sessions taper to once weekly, then once every two weeks. This phase locks in and sustains the gains made during induction.
Skipping sessions — especially during induction — can interrupt this process and reduce overall effectiveness.
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Improvement is often cumulative
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Many patients do not feel dramatic change after a single session — and that is completely normal.
The neuroplastic effects build over multiple sessions. Patients who complete the full induction phase consistently report the strongest outcomes.
If you are not noticing effects yet, please share this with your care team — we can discuss what to expect at your stage of treatment.
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Stopping too soon risks relapse
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Feeling better is a sign the treatment is working — not a reason to stop.
Clinical studies show that patients who discontinue Spravato after feeling improvement are significantly more likely to relapse than those who continue maintenance treatment.
Think of it like physical therapy — you continue the exercises even after the pain subsides, because that is what keeps the injury from returning.
Common Questions
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Is Spravato covered by insurance?
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Spravato is FDA-approved and covered by most major insurance plans, including Medicare, for qualifying patients with treatment-resistant depression.
Our team handles prior authorization and works with your insurance to maximize your coverage. If you have questions about your specific plan, please speak with our billing coordinator.
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Can I take it with my other medications?
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Spravato is typically used alongside an oral antidepressant, not instead of one. Your provider will guide the best combination for you.
Always inform your care team of any changes to your medications, supplements, or health status before your session.
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What if I miss a session?
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Life happens — please reach out as soon as possible to reschedule. The sooner you get back on schedule, the better.
During the induction phase especially, try to keep sessions as close to schedule as possible. Let your care team know if there are barriers making this difficult — we will do our best to work with you.
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How will I know if it is working?
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Signs that Spravato is helping can be subtle at first — slightly better sleep, a moment of lightness, less heaviness in the morning, small things feeling more manageable.
Track your mood between sessions using the journaling prompts in this app. Patterns often become clear over time that are hard to notice day to day.
Share observations with your care team at each visit — even small shifts are important clinical data.
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Keep Your Treatment on Track
Consistent sessions are the single most important thing you can do to get the most from Spravato. Before you leave today, please confirm your next appointment.
