Reflections on cotherapy as a teaching instrument in an institution
Dorfman Lerner, B.
Acta Psiquiatrica y Psicologica de America Latina 27(2): 107-115
1981
ISSN/ISBN: 0001-6896 PMID: 7348070 Document Number: 181377
In this paper I intend to present the different aspects of cotherapy as a teaching function beginning by the definition of the concept and its two meanings: the large one (the totality of means implemented in the treatment of a patient, (P.) and the narrow one (therapy session with two therapists who are present simultaneously). Then I carry on to the need of a basic agreement in therapeutic ideology and of permeability in the therapeutic team (T.T.) for mutual suggestions. I point to the advantages of the inclusion of the inexperienced therapist in the sessions, taping and observation through the Gesell chamber for the formation of therapists. Next there is a division of the treatment period in three stages; pre-session (the stage previous to the initiation of cotherapy for the first time and from then on previous to each one of the following sessions), the session (in which a therapeutic, a teaching and an intrapersonal period are differentiated and the post-session (in which the above mentioned periods are made explicit, are thought over and the therapeutic project is constantly adjusted. The advantages of the cotherapy for the P. are also mentioned. They are: a) betterment of the contention of the P. when his anxiety expresses itself in inadequate acting outs or is manifested in a very noisy manner; b) useful strengthening of the therapeutic action and of the making of limits: the fact that two therapists coincide in their view gives to their words more credibility and authority; c) the fact that there are two therapists instead of one makes the duplication superior to the sum of the same two therapists taken separately respect ot the offer of more information, models, views; d) a greater possibility of dramatizing roles due to the different personalities of therapists (roles that can be maintained by each therapist beyond the session period with the P.), facilitating in that way a better understanding by the P. of therapeutic interventions: e) unlike what happens with individual therapy, cotherapy allows the passage of a situation in which the third person is only included in fantasy to another in which the third one is included in the actual reality facilitating then a larger interplay between projections-introjections and its further comprehension by the P. Amongst its disadvantages there could be named: a) lack of intimacy as experienced by therapists and/or P.; b) risks of ill doing due to a T.T. wrongly combined; c) possibility of development of a "co-transference neurosis" that should require supervision by a third therapist; d) high cost to the institution. The advantages are, nevertheless, superior to the disadvantages so cotherapy is recommendable in any institution in which therapists are trained.