Spravato (esketamine) treatment in Burien, inside a full psychiatric practice.
If you have tried antidepressants without the result you hoped for, Spravato may be one option to talk through with a psychiatric provider. It is a prescription treatment given and monitored in our certified Burien office. We accept most major insurance plans.
Spravato (esketamine) is a prescription nasal-spray treatment for adults with treatment-resistant depression, regulated under an FDA program that requires it to be given in a certified healthcare setting under direct observation. Counseling Services for Wellbeing provides it at the Burien office, where a provider determines whether it is appropriate after evaluation. We accept most major insurance plans.
You have done the things you were told to do.
You tried an antidepressant, gave it the weeks it needed and waited for the lift that did not come the way you hoped. Maybe you switched to another one, then another, each time starting over and bracing for the side effects, and you are tired of the trial and error of it.
You are not exactly starting from nothing. You may already be in care, already on something, already someone who has read enough to know there is a category of treatment for people whose depression has not responded to the usual steps. What you want now is to understand what is next, and whether a different kind of treatment is one of your options.
That is a real question, and it deserves a real conversation rather than a sales pitch. The next step is not a purchase. It is a chance to talk it through with a psychiatric provider who can look at where you have been and help you understand whether something like Spravato fits.
What Spravato (esketamine) is, described plainly.
Spravato (esketamine) is a prescription nasal-spray medication that the FDA has approved for adults with treatment-resistant depression, used together with an oral antidepressant. It is the S-enantiomer of ketamine, delivered as a nasal spray rather than an infusion. Because of how it must be monitored, the FDA regulates it under a Risk Evaluation and Mitigation Strategy, or REMS program, that requires it to be given only in a certified healthcare setting, under direct observation, with a monitoring period after each dose. Whether it is appropriate is a clinical decision a provider makes after an evaluation.
Tried one or more antidepressants
You gave the medications the time they needed and did not get the relief you were looking for.
Tired of the trial and error
Switching from one medication to the next, starting over each time, bracing for side effects again.
Already in care, looking for a next step
You are not starting from nothing. You want a clear sense of what else exists and whether it could fit.
Have heard about Spravato or esketamine
You want to understand what receiving it actually involves before deciding anything.
Spravato is for adults, and whether it fits is a clinical decision made by a provider after an evaluation. This page meets you in your situation. It does not tell you that you have treatment-resistant depression, and it does not promise a result. The first step is a conversation, not a purchase.
How care works at Counseling Services for Wellbeing.
We treat Spravato as one option a provider may consider within a whole-person plan, not as a standalone procedure sold in isolation. If it fits, it sits inside a bigger picture that already looks at your sleep, your body and the life around the treatment.
Start with a conversation
Reach out by form or call. A psychiatric provider talks through your history, what you have already tried and what you are looking for. No promise is made before anyone has met you.
An evaluation comes first
Only after that evaluation does a provider help you understand whether Spravato is one of your options. It is approved for use alongside an oral antidepressant, and it is not appropriate for everyone. You will have a real say in the plan.
If it fits, treatment is in-office at Burien
Because Spravato is REMS-controlled, you receive it at our Burien office, self-administering the nasal spray under the supervision of the care team, then staying for a monitoring period afterward. We will talk through getting home, since you will need a ride rather than driving yourself after a dose.
Why it is given and monitored in person.
Because Spravato is a REMS-controlled treatment, it is given and monitored in a certified setting rather than taken at home. That monitoring period after each dose is part of how the treatment is given safely, not an inconvenience tacked on. You can read the manufacturer's program details at the Spravato REMS site, and the broader category of treatment-resistant depression is described by the National Institute of Mental Health.
Because Spravato is provided inside a full psychiatric practice, the same team that may provide it also provides the surrounding psychiatry and medication management, so nothing gets handed off between a separate vendor and your prescriber. Depression therapy is available alongside when that fits the work. We will not promise it works when other treatments have not, and we will not guarantee an outcome.
How we compare
Where Spravato access usually comes from, and where we sit.
| Hospital systems | Standalone ketamine clinics | Counseling Services for Wellbeing | |
|---|---|---|---|
| First conversation |
Often a long wait
|
Often quick to book
|
Same-week first conversation
|
| Insurance accepted |
Often takes insurance
|
Often cash-heavy
|
Kaiser, Premera, Regence, Aetna, UnitedHealthcare, Cigna
|
| Certified, monitored setting |
Yes, as REMS requires
|
Yes, as REMS requires
|
Certified in-office Burien setting
|
| Surrounding psychiatric care |
Usually available in-system
|
Often referred back out
|
Same team for the care around it
|
| Ketamine-dedicated volume |
Variable, not the focus
|
High-volume, ketamine-only focus
|
One option within whole-person care
|
| Therapy available alongside |
Varies by program
|
Rarely on-site
|
Therapy available when it fits
|
-
First conversation
-
Hospital systemsOften a long wait
-
Standalone ketamine clinicsOften quick to book
-
Counseling Services for WellbeingSame-week first conversation
-
-
Insurance accepted
-
Hospital systemsOften takes insurance
-
Standalone ketamine clinicsOften cash-heavy
-
Counseling Services for WellbeingKaiser, Premera, Regence, Aetna, UnitedHealthcare, Cigna
-
-
Certified, monitored setting
-
Hospital systemsYes, as REMS requires
-
Standalone ketamine clinicsYes, as REMS requires
-
Counseling Services for WellbeingCertified in-office Burien setting
-
-
Surrounding psychiatric care
-
Hospital systemsUsually available in-system
-
Standalone ketamine clinicsOften referred back out
-
Counseling Services for WellbeingSame team for the care around it
-
-
Ketamine-dedicated volume
-
Hospital systemsVariable, not the focus
-
Standalone ketamine clinicsHigh-volume, ketamine-only focus
-
Counseling Services for WellbeingOne option within whole-person care
-
-
Therapy available alongside
-
Hospital systemsVaries by program
-
Standalone ketamine clinicsRarely on-site
-
Counseling Services for WellbeingTherapy available when it fits
-
This is not a ranking of how well any treatment works. It is a description of where Spravato access tends to come from in the Seattle metro. We provide it inside an established, insurance-accepting psychiatric practice, with the surrounding care under one roof, while whether it is appropriate for you stays a clinical decision a provider makes after an evaluation.
Most major insurance plans accepted
Sychiatric care, so a conversation about Spravato does not have to start with cash-pay rates. Coverage for Spravato specifically depends on your plan and often involves a prior-authorization step, and you can check what your plan covers with your insurer before anything is scheduled.
Meet some of our psychiatric providers.
A deeper bench than the providers here. Spravato is provided only by the providers credentialed in our certified program, and we will match you with the right provider for your situation.
Deeper bench than the providers here. Tell us what you have already tried and we will match you with the right provider.
Spravato is provided at our Burien office.
Because Spravato requires a certified administration site, it is given and monitored in person at Burien, which serves the surrounding South King County area including White Center, SeaTac, Normandy Park and Des Moines. A few logistics matter more here than on a typical visit, because of the monitoring period after each dose. There is parking at the office, and you will want to plan a ride home rather than driving yourself after treatment.
Burien, where Spravato happens
Certified, REMS-monitored in-office setting. White Center, SeaTac, Normandy Park, Des Moines, South King County.
View office →Surrounding care at all offices
General psychiatry and medication management and therapy are available at our Green Lake, Burien and Smokey Point offices.
Psychiatry and medication management →Telehealth for the care around it
The surrounding psychiatry and therapy are available by secure video anywhere in Washington. Spravato itself is in-office at Burien.
Online therapy in Washington →What adults ask before a Spravato conversation.
What is Spravato (esketamine)?
Spravato (esketamine) is a prescription nasal-spray treatment approved by the FDA for adults with treatment-resistant depression, used alongside an oral antidepressant. It is regulated under a federal program that requires it to be given in a certified healthcare setting, under direct observation, with a monitoring period after each dose. You can read the manufacturer's program details at the Spravato REMS site.
Where do I receive Spravato?
You receive Spravato at our Burien office. It is given and monitored in person because the treatment requires a certified administration setting under federal rules. Burien is the office where we provide it, so the conversation and the treatment both happen there.
How do I know if Spravato is right for me?
Whether Spravato is appropriate is a clinical decision a provider makes after an evaluation. We will not tell you it is right for you before meeting you. The first step is a conversation about your history and what you have already tried, and the provider helps you understand your options from there.
Do you take my insurance for Spravato?
We accept Kaiser, Premera, Regence, Aetna, UnitedHealthcare and Cigna for psychiatric care. Coverage for Spravato specifically depends on your plan and often involves a prior-authorization step, so you can check what your plan covers with your insurer rather than relying on a blanket promise of coverage.
What happens during a treatment visit?
You receive the treatment at the Burien office and then stay for a monitoring period afterward, because the supervised in-office setting is part of how Spravato is given safely. You will need a ride home rather than driving yourself, and we talk through those logistics with you ahead of time.
Is Spravato the same as ketamine therapy?
Spravato is a specific FDA-approved esketamine product given under a federal REMS program in a certified setting, which is different from the various ketamine offerings at standalone clinics. We describe it factually, and the best way to understand the difference for your situation is a conversation with a provider.
How soon can I be seen?
The first conversation is available the same week. The treatment itself begins only after an evaluation, since whether Spravato is appropriate is a clinical decision made by a provider. You can start with general psychiatry and medication management while you and your provider talk it through.
You do not have to keep guessing about what is next.
If you have tried antidepressants without the result you hoped for, you can talk it through with a psychiatric provider this week and find out whether Spravato is one of your options. Counseling Services for Wellbeing accepts most major insurance plans, offers same-week first conversations and provides Spravato (esketamine) at our Burien office as one option a provider may consider within a whole-person plan.
