A New Era in Psychiatry: Medicine Assisted Therapy and the Pendulum of Progress
The field of psychiatry has undergone dramatic shifts over the past century. From its psychoanalytic roots to the advent of biological psychiatry, where neurotransmitter imbalances became the dominant explanation for mental health conditions, the pendulum of practice has swung widely. Today, medicine-assisted therapy (MAT) stands at the forefront of a new paradigm—one that integrates the best of relationship-based psychotherapy with the profound potential of pharmacotherapy. At the Centre for Medicine Assisted Therapy (CMAT), we are committed to stewarding this approach responsibly, prioritizing best practices and high standards of care.
A History of Shifts in Psychiatry
Before the rise of biological psychiatry, psychotherapy was psychiatry’s primary treatment modality. Psychoanalysis and other forms of relationship-based therapy sought to understand patients as complex individuals shaped by their unique developmental, sociocultural, and family histories. But with the development of SSRIs and other medications, the focus shifted. Biological psychiatry simplified mental health conditions to problems of neurochemical imbalance, often sidelining the nuances of a person’s psychological and social experience.
While pharmacotherapy brought significant relief to many, it also reduced the focus on the therapeutic relationship—a critical element in long-term healing. The pendulum, it seemed, had swung too far.
Medicine-Assisted Therapy: Restoring Balance
Medicine-assisted therapy heralds a shift back toward balance. This emerging modality combines the psychoemotional depth of relationship-based therapies with the catalytic power of psychedelic medicines like MDMA, psilocybin, and ketamine. Unlike traditional pharmacotherapy, MAT is not a passive, pill-based solution; it’s an active, immersive process. The medicine opens a door, but it is the therapeutic relationship, preparation, and integration that guide the client through it.
Critically, MAT aligns with established models of combining drug and therapy treatments for better outcomes—such as SSRIs paired with CBT or tobacco cessation medications supported by counseling. However, psychedelic medicines offer profound, acute effects that can accelerate insight, emotional processing, and behavioral change when used in expertly guided therapeutic contexts.
Research and the Role of Context
The resurgence of research into psychedelic medicines over the past 20 years has underscored the importance of context. Studies consistently show that outcomes are not determined by the medicine alone but by the therapeutic setting, client preparation, and the expertise of the providers. Key factors include:
Client Intentions and Preparation: Understanding the client’s goals and creating a sense of readiness.
Therapeutic Environment: Establishing trust, safety, and a supportive setting.
Provider Expertise: Therapists’ depth of training, self-awareness, and personal psychological growth are critical in navigating the vulnerable states these medicines induce.
At CMAT, we emphasize that becoming a therapist in this field requires more than attending a weekend workshop. This work demands a deep commitment to personal and professional development, along with rigorous training in trauma-informed care and non-ordinary states of consciousness.
Building Upon the Past
Interestingly, the very foundation of biological psychiatry owes much to the study of psychedelics. The discovery of serotonin’s role in neurobehavior was spurred by the recognition of structural similarities between LSD and serotonin. This paved the way for the development of SSRIs and the broader field of neuropharmacology. Today, we come full circle, applying this knowledge in a way that respects both the biochemical and the psychological aspects of mental health.
Stewarding a New Era
Medicine-assisted therapy represents an exciting frontier in psychiatry, but its potential for healing is matched by its capacity for harm if not practiced responsibly. At CMAT, we are committed to setting the highest standards in this field. Our protocols and training programs prioritize the integration of medicine and therapy, ensuring that treatments are delivered with the care, expertise, and respect they require.
As we enter this new era, let us remember the lessons of the past. By finding balance—integrating the relational depth of psychotherapy with the transformative potential of psychedelic medicines—we can offer a model of care that is as comprehensive as it is compassionate. This is not a handoff to a prescription pad; it is a partnership between medicine, therapist, and client, fostering profound healing and growth.
At CMAT, we are honored to be at the forefront of this movement, helping to shape a future where psychiatry once again embraces the full complexity of the human experience.
Dr. Devon Christie, CMAT Co-Founder & Medical Director
