The Uses and Abuses of Co‐Therapy

Abstract

The literature on co‐therapy suggests increased interest in this treatment procedure. There is some agreement over advantages and disadvantages, but there is also confusion on indications and counter‐indications. This paper summarizes the current use and abuse of co‐therapy. The reported clinical experiences of several co‐therapist teams, including spouse co‐therapists, are also discussed. It appears that co‐therapy will remain controversial until outcomes are rigorously measured and compared with the results of other therapeutic modalities in a standardized, acceptable way.

Dialogical Co‐therapy

“…Co-therapy has also been criticised (e.g., Bowers & Gauron, 1981;Foulks, 1975;Haley, 1987). The main areas of criticism include (i) expense (Haley, 1987;Hendrix et al, 2001, p. 68), (ii) the difficulty of managing the personal differences of co-therapists (Berger, 2002;Foulks, 1975, p.109), (iii) a potential for reducing the therapist's ability to take 'decisive and immediate action' (Hendrix et al, 2001, p. 68), and (iv) potential erotic issues between co-therapists that could become problematic (Russell & Russell, 1980).…”

Group Coleadership: A Critical Review

“…Livingston (2001) asserted that a "good enough" relationship between coleaders can facilitate a restructuring of participants' relational patterns and rules. Others, notably L. W. Hoffman and Hoffman (1981), Low and Low (1975), Roller and Nelson (1991), and Russell and Russell (1970) have noted that married therapists who colead or engage in cotherapy run the risk of disturbing the equilibrium of their marital relationship. Thus, the coleader dyad is cautioned to intentionally attend to these relationship issues (Bowers & Gauron, 1981;S.…”

“…Group dynamics (e.g., group stage, roles) can have an impact on the coleader relationship as well, and unresolved conflict between leaders can promote splitting within the group (Heilfron, 1969;Yalom, 1995Yalom, , 2005. Finally, monetary concerns about sharing cotherapy fees in practice settings can further complicate issues (Roller & Nelson, 1991;Russell & Russell, 1970); if these concerns are effectively addressed by the leaders, the resolution of these issues can facilitate dyadic and group development (B. Levine, 1991).…”

Pairs for Pairs: A Theoretical Base for Co‐Therapy as a Nonsexist Process in Couple Counseling

“…Too often female-male co-therapy teams reinforce patterns of behavior that are oppressive to women (Gingras-Baker, 1976). Russell and Russell (1979) indicated that a typical scenario is a senior professional who is a male psychiatrist and a relative neophyte in family therapy, leading a female psychologist, psychiatric nurse, or social worker who is much more experienced in the area of family therapy. To avoid this problem, Rice and Rice .…”

“…In addition to modeling an egalitarian relationship, femalemale co-therapists must be able to talk freely through their own relationship problems, (Reding & Ennis, 1964;Russell & Russell, 1979) and exceptional care must be taken in maintaining their relationship.…”