Referring a Client for Spravato: How Collaboration Works
Spravato (esketamine) treatment is most effective when it is clinically well-structured and supported by strong continuity of care. If you are a therapist or prescribing provider referring a client—or you would like to collaborate during a client’s Spravato course—we aim to make the process clear, coordinated, and easy to navigate, while keeping safety and communication at the center.
Collaboration can look different depending on your role, your preference, and the client’s needs. In many cases, we provide evaluation and clearance, prescribing, and REMS-compliant in-office administration while you provide ongoing psychotherapy and support between sessions. In other cases, clients may receive both their Spravato care and psychotherapy through our office. Either way, our goal is the same: reduce fragmentation, maintain consistent monitoring, and make sure the client’s treatment plan stays grounded in real-world functioning—not just symptom change during office visits.
A typical Spravato flow begins with a behavioral health intake to assess fit, goals, readiness, and baseline symptom measures. This is followed by medical and psychiatric screening and clearance, including medication review, relevant history, and safety planning. When required, we support the prior authorization process and help coordinate scheduling so the client can move into treatment with fewer delays. Spravato sessions are delivered in-clinic under REMS requirements, with supervised administration and medical monitoring. Throughout the course, we track symptoms and response trends, adjust the treatment plan as needed, and support ongoing therapy and integration work when appropriate.
On our side, we provide evaluation, prescribing, and REMS-compliant in-office administration. We monitor clients during and after sessions, including vitals, safety assessment, and discharge readiness. We also provide structured treatment planning and symptom tracking so decisions are data-informed and clinically grounded. We prioritize clear communication about scheduling, readiness, aftercare instructions, and safety precautions, and—when the client signs a consent—we provide continuity notes and care coordination to support a unified plan.
If you are the primary therapist, your role typically includes ongoing psychotherapy and treatment planning throughout the course of treatment. That often means supporting integration between sessions, continuing goal tracking, and helping the client translate improvement into skills practice, behavior change, and stabilization in daily life. With client consent, we welcome any relevant clinical context that supports safe treatment—such as risk factors, contraindications, and treatment history—so we can coordinate responsibly and reduce avoidable setbacks.
Spravato tends to be a strong fit for clients who are appropriate for outpatient care and able to engage in a structured process with consistent monitoring. Clients need to be able to participate in safety planning and follow clinic instructions, including the requirement to have a transportation plan after sessions, as driving is not permitted post-treatment. Best outcomes are typically supported by willingness to engage in ongoing therapy and symptom monitoring so gains can be maintained and strengthened over time.
Communication is a key part of effective collaboration. With a signed release of information, we can share session dates and attendance, the general course of care, response trends and themes (rather than psychotherapy transcripts), and safety or care-coordination notes when clinically relevant. When appropriate, we can also share treatment plan updates, as well as discharge or maintenance planning so the transition out of intensive dosing is well-supported and clear.
To discuss a referral or collaboration, contact Inner Journey at 406-541-2012 or connect@innerjourneyhealthcare.com
