The Benefits of Co-Therapy

17 September, 2020
Did you know that some therapies may be more effective when they're applied by more than one mental health professional? This is known as co-therapy and it has many advantages. Learn more with us!

Often, therapy sessions are led by one psychologist. However, there are situations where having two mental health professionals can bring great advantages, both for the patient and for the therapists themselves.

Carl Whitaker, a pioneer in family therapy, was one of the first to highlight the importance of two-therapist approaches. Consequently, he developed a co-therapy model, which ended up being a great contribution to the world of family therapy.

When we talk about co-therapy, we refer to the application of therapy, either individual, couple, or group, by two mental health professionals. They work as a team in an integrated and synergistic way to reach a common goal, which is usually the improvement of the patient’s disorder or issue.

Who are these two mental health professionals?

They’re usually psychologists who may or may not belong to the same therapeutic trend. In some cases, both of them are experts on the matter. However, sometimes, one of them may be an apprentice. This is quite common in family therapy and couples therapy, for example.

Nonetheless, in many cases, one of the professionals is a psychologist, while the other is a pharmacotherapist (psychiatrist). This is more common in more serious mental disorders that require pharmacological treatment in addition to psychological treatment.

There’s another very common scenario in co-therapy. Sometimes, the professional may train a non-professional person from the patient’s environment to act as their collaborator. This way, they’re able to help the patient carry out the tasks they set during therapy. For example, they can jointly perform live exposure exercises to treat a phobia.

This also occurs when the therapy is meant for a child. It can be very useful in the treatment of a child with autism spectrum disorder, nocturnal enuresis, or mental retardation, for example. It’s vital that parents and/or teachers learn to act as co-therapists as well in order to continue treatment outside of the consultation.

This is also important in the case of older people, especially those that suffer from some type of dementia. If the individual’s family members and caregivers receive training, they’ll be able to adapt to the patient’s pathology, learn to manage it, and improve their living conditions and environment. In addition, it makes it possible to continue with the treatment at home and with the necessary cognitive stimulation activities.

Conditions for co-therapy to be beneficial

  • The responsibilities of each of the therapists and the authority of each must be well-established. For example, if one of the two is an expert and the other an apprentice, the latter is likely to assume the role of observer.
  • Belonging to different therapeutic currents isn’t really an obstacle in therapy. Instead, both professionals must take advantage of this difference. In this sense, it’s possible to carry out an integrated treatment through the use of techniques of different currents. Of course, these will depend on their effectiveness or the type of patient or problem.
  • The relationship between the two therapists should never be competitive. Both professionals must be able to recognize the strengths and limitations in themselves and in their partner. It’s important for both of them to recognize that they’re an essential part of the therapy.

Advantages of co-therapy

The presence of two therapists brings great benefits; not only to the patients but also to the therapists themselves:

  • It’s possible to achieve deeper and faster changes than with a single therapist.
  • Having two therapists allows patients to have more resources than a single therapist can provide. A broader range of tools is generated at the patient’s disposal. This is most clearly seen in individual therapies led by two therapists.
  • Having two professionals in charge of the evaluation and treatment allows a holistic approach to both the problem and the treatment. In turn, this allows for better data collection, which leads to a more complete diagnosis.
  • When it comes to family or couples therapy, having two therapists makes it easier to perform role plays. Both mental health professionals can act out different members of the relationship (romantic or family) and play out the different situations to get better a perspective on the problems.
  • It’s possible to create a very beneficial learning space when one of the therapists is an expert in the field. Additionally, they can guide the apprentice’s first steps in psychotherapy.
  • Having a therapy partner may take away some of the pressure and stress that a sole therapist may have. In this case, having someone to back up their analyses and contribute to them is relaxing.

The psychologist – psychologist dyad

As we mentioned above, it’s common to find two psychologists working together in co-therapy. This happens a lot in family therapy, couples therapy, and in other therapies for disorders that don’t require additional pharmacological treatment.

In the context of couples therapy and family therapy, having two psychologists is great since they act out different roles in the relationship. This can help solve certain problems and allows the patients (the couple or family union) to have two different points of view regarding their issues.

In addition, this allows therapists to act as role models for parents when it comes to learning to properly interact with their children. One of the main advantages of co-therapy is that it helps to avoid possible alliances between one of the members of the couple or family union and the therapist against another member of the union. Believe it or not, this may happen sometimes in regular therapy.

One of the most popular co-therapies out there (with two professionals of different sexes) is the sexual therapy of William Masters and Virginia Johnson. They designed it in 1970 for the treatment of sexual dysfunctions. However, couples therapy was first proposed by Mittelman in 1948 and he applied it in 1961.

William Masters and Virginia Johnson.

The psychologist – psychiatrist dyad

In this case, co-therapy consists of an integration between pharmacological and psychological therapy. This is especially necessary for serious mental disorders, since they require multimodal intervention.

First off, the administration of drugs improves certain symptoms that can interfere with the development of a person’s normal life. Doing this allows patients to be more inclined to respond to psychotherapy. In the same way, psychotherapy can help improve the understanding of the need to take drugs and improve adherence to the treatment.

A wide variety of disorders benefit from this therapeutic discipline:

  • Substance abuse disorders. For the treatment of substance addiction (especially alcohol and heroin), a pharmacological treatment is necessary to reduce withdrawal symptoms. In this case, psychological therapy is necessary for training in self-control, social and coping skills, and prevention of relapses, among others.
  • Psychotic disorders such as schizophrenia. This disorder depends on pharmacological treatment in order to reduce its main symptoms. However, it needs to be complemented with psychological therapy to improve the patient’s family situation and social competence. Also, it’s vital in order to carry out cognitive rehabilitation in the patient and help them face the main symptoms of the disease (such as hallucinations).
  • Some mood disorders, such as severe and chronic depressive disorders, which require psychotherapy along with pharmacological treatment. In the case of bipolar affective disorder, the main treatment is pharmacological. However, psychotherapy is essential to promote adherence to it and to encourage non-pharmacological coping strategies.
  • Some eating disorders, such as bulimia nervosa. In this case, the benefits that psychological treatment offers can be complemented with the effects of drugs. Believe it or not, they improve the patient’s mood and also have antibulimic effects.
Two psychologists discussing a clinical case.

Working together for the patient’s sake

We need to make something clear here. Not all treatments or therapies need to be applied by more than one therapist. In fact, from the point of view of systemic therapy, it can sometimes be counterproductive.

However, as you can see, a wide variety of disorders respond better when treated in co-therapy, no matter if it’s two psychologists, a psychologist along with a psychiatrist, or a member of the patient’s environment trained to collaborate in the treatment. Therefore, this is an important option to take into account when treating certain disorders or certain patients.

Like all therapies and treatments, it also presents difficulties derived mainly from the relationship between the therapists. Therefore, when resorting to co-therapy, it’s vital to remember that it only works if both professionals complement each other for the benefit of the patient.