
Your Space for Safe + Transformative Care
Concierge Psychiatric + Mental Wellness Services
Therapy
~ Ketamine-Assisted Therapy @ the City Sanctuary~
~ EXPANDED Method Sessions ~
~ Parent Training + Early Childhood Intervention ~
~ Psychedelic Medicine + Spiritual Health (The EXPANDED Collective) ~
Integrative Psychiatry
~ Comprehensive Psychiatric/Ketamine Assessment ~
~ Pharmacotherapy + Med Management ~
~ Functional Nutritional Psychiatry ~
~ Sleep + Circadian Rhythm Disorder Management ~
Ketamine-Assisted Therapy (KAT)
(Gianna + Domonique)
Ketamine- assisted therapy can offer rapid relief for individuals struggling with depression, anxiety, PTSD, OCD social anxiety and trauma, including reduction in symptoms previously unresponsive to traditional therapy.
When administered in a safe, supportive environment with a trained therapist, ketamine acts as an accelerant and a medical ally, promoting deeper understanding, psychological flexibility and new perspectives. During virtual and in-office sessions, we help you navigate the experience, ensuring safety, emotional support, and integration of insights for lasting change. This evidence-based approach empowers you to achieve transformational breakthroughs and reclaim your wellbeing.
We work with each patient to design a treatment best-suited to needs based on a variety of factors, including goals, budget, timeframe and psychiatric history.
In-office medicine sessions include restorative wellness and comfort items (i.e., heated PEMF mat, wellness beverages, eye masks, ambient candles, weighted blanket, high quality headphones, etc.), and may also include a variety of preparatory or integration techniques such as breathwork, guided meditation, intention-setting, and forms of therapy such as Acceptance and Commitment Therapy, somatic processing, specific phases of EMDR and/or Emotional Freedom Tapping (EFT)
Four to six preparatory sessions (virtual or in-office) are used to build the best possible therapeutic experience by leveraging science-backed strategies that reduce harm and optimize benefit, such as exploring goals and past traumatic events, setting intentions for medicine sessions, ensuring all questions are answered and otherwise preparing for optimally beneficial ketamine journeys.
Four to six integration sessions (virtual or in-office) are used to process your overall experience, curiously assess details of your specific journeys, and to transition new insights, perspectives and beliefs into real-life changes and healing.
Pricing:
Full psychiatric evaluation and KAT medical consult (60 min): $325
Medicine session, therapy and amenities (2 hours) : $695*
First experience offer — we offer a “meet and greet” with ketamine for patients new to this experience, allowing patients to try KAT at a reduced cost: $500
*Medicine not included. Ketamine is quite affordable at approximately $3-$4 per lozenge and can be shipped to your home from one of our compounding pharmacies
EXPANDED Sessions
(Gianna)
For many individuals with mental health challenges, one of two routes are taken to avoid trauma, pain, discomfort or even the act of making small changes : the Excess Escape (i.e., trauma looping/ruminative thoughts, overconsumption of food, alcohol, material items or media, etc) and/or the Estrangement Escape (i.e., dissociation, isolation, masking, inertia, etc). These escape behaviors function to avoid undesired thoughts, feelings or events in the hope that relief and peace will soon follow naturally. However, this attempt to avoid pain, called experiential avoidance, exacerbates or maintains psychological distress. Individuals inadvertently strengthen neural pathways that can make it more difficult to heal.
We understand that talk therapy doesn’t work for everyone, and that simply talking about anxiety, depression or trauma may at some point result in a plateau, or even create an unnecessary focus on the symptoms you are trying to alleviate.
In EXPANDED Method sessions, I create bespoke, trauma-informed treatment sessions that alchemize and integrate the mind and body, which may include theta wave (deeply relaxing) states, psychedelic medicine or somatic experiencing in combination with Internal Family Systems, Acceptance and Commitment Therapy and Eastern psychology practices.
Learn more about the EXPANDED Method here.
Pricing per session (60-75 minutes): $300
Early Childhood + Caregiver Therapy
(Gianna)
According to a 2024 Advisory from the Surgeon General, parents are facing a unique and staggering mental health crisis. This service addresses the urgent need to better support parents and caregivers as they continue to care for their families, themselves and one another.
For parents and caregivers of children with autism or behavioral challenges, this service combines adult therapy and Greg Hanley ‘s ethical, modern “Today’s ABA” approach to early childhood Applied Behavior Analysis. This approach focuses on creating learning environments encouraging happy, relaxed and engaged children in a joyful experience.
Appointments are held virtually (M-Th) or in-person (M-W), and may include Gianna working directly with your child depending on needs and availability.
This service is ideal for :
those whose children are currently on a waitlist for ABA therapy
those struggling with the stresses of parenting or behavioral challenges
those needing support in navigating the process of diagnosis, education and therapy for their child
Pricing per session (time depending upon needs):
Monthly/bi-monthly sessions w/video reviews and supplemental materials (75 min) - $350
Psychedelic Medicine + Spiritual Health: The EXPANDED Collective
(Gianna)
The EXPANDED Collective is dedicated to destigmatizing and normalizing the therapeutic use of psilocybin (a compound contained in some mushrooms) through psychedelic-psychoeducatio, high-quality, research-informed products, therapeutic support and harm reduction protocols. This service provides individuals the opportunity to work with a psychedelic-assisted therapist who is trauma-informed and certified in psychedelic harm reduction and integration.
This service is beneficial for:
High achievers, wellness seekers, and spiritually curious individuals who want transformation that fits into their lives.
Those who have tried therapy but felt like something was missing or who desire a deeper, more embodied, and integrated approach.
People who value self-inquiry & personal growth, but don’t feel they need open-ended, years-long therapy.
Disclaimer: Through the EXPANDED Collective, we operate under a fully I-81 compliant model in Washington, D.C., ensuring that our approach to psilocybin remains within the legal framework of Initiative 81. This means we prioritize education, harm reduction, and community-based access while adhering to the city's regulations that make entheogenic plants among the lowest law enforcement priorities.
Comprehensive Psychiatric Assessment
(Domonique)
Required for ketamine clearance and other services such as functional nutrition and sleep disorder treatment
In these informative and holistically-focused sessions, you will receive:
Detailed psychiatric evaluation, evaluating mental, emotional, and physical health factors contributing to psychiatric symptoms.
Diagnosis of mental health conditions based on DSM-5 criteria
Assesses cognitive, emotional, and behavioral symptoms
Discuss nutritional deficiencies, inflammation, hormonal imbalances, and gut-brain
interactions
Evaluates social, medical, and psychological history
Incorporates genetic testing (e.g., pharmacogenomics) to personalize medication and
supplement recommendations
Pricing per session:
Initial/new patient consult and evaluation, including ketamine clearance (60 minutes) - $325
Medication Management + Pharmacotherapy
(Domonique)
This service integrates the selecting and monitoring of medicine with critical patient education to achieve optimal therapeutic outcomes. These sessions are expertly tailored to meet your current needs and may include:
Prescription of psychiatric medications, including antidepressants, mood stabilizers, antipsychotics, anxiolytics, ketamine and other psychotropic drugs
Adjustment of dosages based on symptom response and side effects
Patient education on medication use, risks, and benefits
Monitoring and notes for medication interactions and adverse effects
Discussing additional supportive avenues such as functional psychiatric nutrition and circadian management
Pricing per session:
Initial session (45-60 minutes): $325
Follow-up sessions (30 minutes): $175
Functional Nutritional Psychiatry
(Domonique)
According to the Institute of Functional Medicine, the emerging field of nutritional psychiatry acknowledges a positive relationship between diet quality, mood and mental health. Recent research suggests that while nutritional habits, dietary patterns, and diet quality may all effect overall mental wellness, they may also be preventable or modifiable risk factors for mental disorders.
Your functional psychiatry sessions are tailored to your specific needs and may include:
Identify and address micronutrient deficiencies that impact mood and cognition (e.g., Vitamin D, B12, Omega-3s, magnesium, zinc)
Provides guidance on amino acid therapy for neurotransmitter support (e.g., 5-HTP for serotonin, L-tyrosine for dopamine)
Includes Integrative Pharmacology & Supplementation
Mind - Body and Lifestyle Psychiatric Interventions (Sleep Optimization, Exercise + Movement Therapy, Breathwork, Meditation)
Pricing per session:
Initial session (45-60 minutes): $325
Follow-up sessions (30 minutes): $175
Sleep + Circadian Rhythm Management
(Domonique)
Circadian rhythms are closely linked to mental health, and managing them can help improve mental health outcomes. Disrupted circadian rhythms can contribute to mental disorders like anxiety, depression, and psychosis, and can also be an early sign of relapse for mental disorders. Psychiatric symptoms may also worsen with poor sleep.
Similar to our functional nutritional psychiatry sessions, each meeting is uniquely designed for your current needs and experiences. Your session may involve:
Assessing and manages insomnia, circadian rhythm disruptions, and sleep disorders secondary to psychiatric conditions
Learning and practicing cognitive-behavioral strategies for insomnia (CBT-I)
Prescription of non-controlled sleep medications as appropriate
Pricing per session:
Initial session (45-60 minutes): $325
Follow-up sessions (30 minutes): $175
FAQs
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EXPANDED is considered “out of network” with all insurance providers. However, you will receive superbills to submit to your insurance provider for all eligible visits. We cannot guarantee reimbursement for all services, as this decision is determined by your insurance carrier.
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Absolutely. EXPANDED warmly welcomes all individuals assigned female at birth (AFAB), including transgender, nonbinary, and gender non-conforming people. Our practice is designed to be a safe, affirming space that honors your identity while addressing your specific health needs and experiences.
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Yes. While our practice specializes in women's mental health and wellness, we welcome men who are seeking our services and who respect our female-focused environment. Men can play an important role in supporting and advancing women's health, and we're committed to providing excellent care to all our patients.
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We offer both in-person appointments at our Washington, DC office and convenient telehealth services via Simple Practice, a secure HIPAA-compliant platform. We currently serve patients throughout DC, Maryland, and Virginia. Availability for in-person visits varies; please contact us to discuss options that best suit your needs.
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Ketamine Assisted Therapy (KAT) (also known as Ketamine Assisted Psychotherapy/KAP) is an evidence-based form of psychedelic-assisted therapy that combines ketamine treatment with professional therapeutic support to create opportunities for powerful breakthroughs in healing. This innovative approach has shown significant potential in treating various mental health conditions, including depression, anxiety, OCD, PTSD, and substance use. During KAT, ketamine is used thoughtfully as a catalyst for therapeutic transformation, always in conjunction with skilled professional support and guidance.
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EXPANDED takes a comprehensive, therapeutically-informed approach that goes beyond symptom management. While traditional infusion clinics focus primarily on medication administration in a clinical setting, we view the ketamine experience as an opportunity for meaningful transformation. Our approach emphasizes thorough preparation and integration, creating a supportive environment for deep healing work. We combine medical expertise with professional therapeutic support to help you achieve lasting positive change, not just temporary symptom relief.
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Yes - while under medical supervision by a provider/doctor or nurse practitioner, and while working with a trained therapist, ketamine is not only extremely safe, but has been shown to positively address social anxiety, depression and other mental health challenges. Please visit the research page and blog for additional information.
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Our approach prioritizes your safety and therapeutic growth through comprehensive, professionally guided care. Unlike mail-order services that may offer minimal oversight and support, EXPANDED provides thorough preparation, professional monitoring during in-office treatment, and meaningful integration support. We believe that ketamine-assisted therapy requires careful medical supervision and skilled guidance to be both safe and truly transformative. Our structured program ensures you receive appropriate dosing and professional support throughout your healing journey, rather than managing powerful experiences alone at home.
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The EXPANDED Method is ideal for individuals seeking a research-based, trauma-informed approach to healing and reclaiming their wellbeing. Grounded in neuroscience, behavioral science and somatic practices, this approach integrates consciousness-expanding techniques for a deeper, more effective and integrative approach to therapy.
This method may be right for you if you:
• Struggle with recurring patterns or behaviors that limit your progress.
• Are navigating major life transitions or seeking clarity in one or more areas of life.
• Want to shift old beliefs or heal past trauma through modern, evidence-based strategies that promote deeper exploration, self-awareness and insight.
• Are open to exploring emerging therapeutic modalities, including expanded states of consciousness.
• Seek a trauma-informed, scientifically grounded framework for treating anxiety, depression or if you experience strong rigid thinking patterns.
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Examples of topics include but are not limited to: anxiety, depression, shame, grief, patience, peace, leadership, creativity, gratitude, mood shifts, resilience, nervous system regulation, pervasive negativity, anger, hopelessness, overconsumption, avoidance, or life shifts as in your career or relationships. In general, this work moves more deeply into your life experiences, trauma, beliefs and blockages to expansion and mental health.
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EXPANDED is absolutely active and was designed to move forward in small, achievable and actionable steps over the course of 3-4 months. That being said, we begin wherever you are each and every session. Difficult emotional content does arise, and there is no hurry. If a session is particularly challenging, we will spend time releasing those emotions and tending to self-care to preserve your wellbeing. The aim is to take noticeable steps each session, so you leave feeling a greater sense of peace or lightness, with new insights or ideas, or other beneficial outcomes. Ketamine is very likely to accelerate this process.
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While we highly recommend a commitment of 3-4 months, especially if pairing your therapy with ketamine, you are able to stop or start therapy at any time. Your experience is yours, and we believe that each patient knows what is right and beneficial for them.

A Regenerative, Matriarchal Business Model for the Collective Good
I wanted to create a business model that honored the spirit of this work by positively contributing to the collective. It made sense to build EXPANDED using a matriarchal, regenerative business model, so that individuals investing in their own healing and betterment would naturally contribute to someone in need.
A percentage of net profits are used for pro bono therapy sessions or are reinvested into local, vetted organizations to support individual, family or community mental health.