Co-Therapy, a Way of Doing
The following is an abstract and a reflection piece of Co-thérapie avec, tour à tour, trois co-équipières : avantages et inconvénients (Girard et al., 2021), the latest French article with three previous versions written by two clients and two therapists.
Co-Therapy in the method of Somatosensory Pain Rehabilitation (SPR)
Co-therapy is a therapeutic management approach deemed essential for the care of clients suffering from (often chronic) neuropathic pain (Spicher et al., 2025). At the Somatosensory Pain Rehabilitation Center in Freiburg, Switzerland, all clients are followed by two therapists with weekly sessions alternating between one therapist and the other (Girard et al., 2021; Letourneau et al., 2013); efforts were and are continuously exerted to maintain a structural organization that accommodates co-therapy, including half an hour a day allocated for co-therapists to discuss therapeutic strategies for their clients. The foundation of co-therapy lies in the collaboration between client and two therapists who aim to achieve agreed-upon therapeutic goals (Girard et al., 2021; Letourneau et al., 2013).
Perspectives from different parties of interest involved in somatosensory pain rehabilitation have been shared regarding the advantages and disadvantages co-therapy. Its benefits include (Girard et al., 2021; Letourneau et al., 2013): the pooling of clinical skills and experiences strengthens and diversifies the care provided to clients; increased support from colleagues especially in complex situations often observed with clients with chronic symptoms; facilitation of continuous treatments for clients in the absence of one co-therapist (sick leave, vacation, etc.). Difficulties faced in its implementation are (Girard et al., 2021; Letourneau et al., 2013): increased demands and maintenance of work structure and time; egalitarian relationships between colleagues are necessary.
Historical Context of Co-Therapy
Historically, co-therapy is a concept derived from psychotherapy practice, specifically in marriage and family therapy (Lagogianni et al., 2023). The definition of co-therapy may change from one practice to another (e.g., it can also refer to having two therapists in a session with a client) (Lagogianni et al., 2023).
Reflections from Personal Practice in Co-Therapy
Co-therapy is part of my daily practice at the Somatosensory Pain Rehabilitation Center. As a previous student in Occupational Therapy during my last clinical placement and as a junior clinician in 2023, co-therapy facilitated advice-seeking. Advice-seeking relationships between coworkers has been found to promote evidence-based practice (Bunger et al., 2018). In fact, knowledge exchange through advice-seeking in professional contexts has the most powerful influence over behaviour compared to other social relationships, even personal (Bunger et al., 2018). However, this was only possible given the accessibility, the most important determinant (Bunger et al., 2018), the center gives to advice-seeking through co-therapy.
A rapid review on factors associated with intent to leave healthcare professions was conducted by Roth and colleagues in 2023. They found that emotional exhaustion is one of the most important psychological factors leading to intent to leave. Having half an hour each day allocated to discussion between co-therapists has allowed me to feel more confident and more supported with complex therapeutic situations.
Co-therapy may also be difficult to implement within any work environment given that power dynamics inherently exist between colleagues (e.g., based on gender, level of education, years of experience, hierarchal positions, etc.). These power dynamics can be subtle and influence how co-therapy relationships unfold making it difficult to realistically attain an egalitarian relationship; some may say it is even impossible to attain an egalitarian relationship and thinking so would mean ignoring present factors that maintain such power dynamics. Sense of autonomy in workplace and control over decisions were significantly associated with a decrease in turnover intention in healthcare (Roth et al., 2023). Co-therapy can hinder on these two positive factors, especially when power dynamics underlie every professional relationship.
References
Bunger, A. C., Doogan, N., Hanson, R. F., & Birken, S. A. (2018). Advice-seeking during implementation: a network study of clinicians participating in a learning collaborative. Implement Sci, 13(1), 1–12. https://implementationscience.biomedcentral.com/articles/10.1186/s13012-018-0797-7
Girard, A., Murray, E., Bernardon, L. & Létourneau, É. (2021) ÉBAUCHE DE SYNTHÈSE Co-thérapie avec, tour à tour, trois co-équipières : avantages et inconvénients. Somatosens Pain Rehab, 18(3), 83-91. https://www.somatosenspainrehab.com/articles/co-thrapie-avec-tour-tour-trois-co-quipires-avantages-et-inconvnients
Lagogianni, C., Georgaca, E., & Christoforidou, D. (2023). Co-therapy in open dialogue: transforming therapists’ self in a shared space. Front Psychol, 1-12 https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2023.1083502/full
Létourneau, E. (2013). Co-thérapie : avantages et désavantages. e-News Somatosens Rehab, 10(4), 166-168.
Roth, L., Le Saux, C., Gilles, I., & Peytremann-Bridevaux, I. (2024). Factors Associated With Intent to Leave the Profession for the Allied Health Workforce: A Rapid Review. Med Care Res Rev, 81(1), 3–18. https://pmc.ncbi.nlm.nih.gov/articles/PMC10757398/
Spicher, C., Murray, E., Chapdelaine, S. & de Andrade Melo Knaut, S. (2025). Méthode de rééducation sensitive de la douleur : un nouveau mode de penser la complexité bio-psycho-sociale (1e édition) – Préface : Pierre Sprumont. Montpellier, Paris : Sauramps Médical, 396 pages.
