Interview with Bill Roller & Vivian Nelson

By Venus Masselam

VM: Being Group Co-Therapists is a very dynamic and rewarding experience and we welcome your presentation at this year’s fall conference. Since you are both husband and wife and Co-Therapists I wondered which came first?

B & V: The desire to be together as a couple and the desire to work together as co-therapists developed for us simultaneously across time. Just as personal relationships require a substantial commitment in energy and effort, so the co-therapy relationship requires a different, but equal level of commitment and dedication.

VM: Why did you choose ethical issues to be at the heart of your presentation on Co-Therapy?

B & V: Based on our research of the AGPA membership and reported in The Art of Co-Therapy: How Therapists Work Together, more than 80% of group therapists practice co-therapy sometime in their career. Too often the topic of co-therapy is excluded entirely from the conversation about group therapy . Co-therapy involves many ethical issues that, if not explored in advance, can compromise the co-therapy relationship and our effectiveness with patients in group. The Ethical Guidelines and Professional Standards for Group Psychotherapy, ratified by the membership of the International Association of Group Psychotherapy and Group Processes, stipulates the following: “Group psychotherapists who practice co-therapy have an obligation to their patients to meet the standards in the field, including the co-therapists’ balance of clinical skills, compatibility of theoretical viewpoints, openness in communication with each other and equality of participation as they co-lead their groups.”

VM: What theories provide the basis for your work together as group Co-Therapists?

B & V: The findings of our research indicate specific co-therapy behaviors which lead to good therapeutic outcomes. A few of those behaviors are mentioned in the ethical guidelines quoted above. James Dugo and Ariadne P. Beck have elaborated a theory of co-therapy development that is based in part on Beck’s phases of group development. We shall cover each of the nine phases of co-therapy team development in our presentation.

VM: Would you share some examples from your experience of the benefits and pitfalls of being Co-Therapists?

B & V: Co-therapy provides a widened perspective for the co-therapists and widened transference possibilities for their patients. Co-therapy provides greater opportunity for therapists to check and balance their behavior giving as it were, on the spot peer supervision. These benefits favor both therapists and their patients. Co-therapists can reach an impasse if they allow unrecognized competition to flourish in their relationship. It does not bode well for the group or the co-therapy relationship if the co-therapists conflict over who is right or who is in charge. Another problem arises if insufficient equality exists in the relationship and one therapist becomes dependent or develops a co-dependent bond with the other.

VM: How should participants in the fall conference prepare themselves for your presentation?

B & V: Participants will benefit from reading our text which was cited above. From it they will gain insights into some of the more subtle aspects of the co-therapy relationship. The practice of co-therapy is complicated and requires experience and reflection to grasp its deeper significance in creating a therapeutic context for a group. Participants ought to discuss with their co-therapists some of the questions that reading our text stimulate. Therapists in search of a partner to work with will find help by referring to the co-therapy questionnaire in the back of the book. Just as important, participants ought to view our six-hour video series of a spontaneous group, The Promise of Group Therapy: a Live to Tape Video of a Time Limited Group, to discover the various ethical dilemmas that emerged and how we responded to these challenges.

VM: What should participants expect to take away from your presentation?

B & V: Although co-therapy requires both time and personal commitment, the benefits which clinicians derive from its practice are deep and long-lasting. The bonds which co-therapists form are often profound and have impact in their lives beyond the work environment. They learn from each other , they console each other in times of loss, and by their empathy and respect for each other, they can overcome the sense of loneliness that can envelop the practitioner who works alone.

VM: Thank you for sharing your thoughts with us today.