The Challenges of Cotherapy

Why use cotherapy? No justification can be found in the outcome literature, but the literature is not sufficiently sophisticated to address the issue adequately. Cotherapy might be chosen when the therapy is difficult, when role modelling is called for, or when a relationship is needed to soak up projections. It may be chosen primarily for the benefit of the therapists, though as a teaching format it has drawbacks. The relationships developed between cotherapists may be challenging and benefit from supervision. They may be understood by analogy to other relationships, e.g. marriage, and the therapeutic alliance between therapist and patient. The technical pros and cons of cotherapy call for systematic study. In general, though, a case can be made for the use of cotherapy, and for other procedures such as live supervision, as ways of influencing the therapeutic culture for the better.