Many people assume that one-on-one physical therapy is superior to group-based or home exercise programs. But does the research actually support that idea? Let’s take a closer look.
1. Are Outcomes Better With One-on-One Therapy?
Research shows that for most common musculoskeletal conditions, outcomes are similar between one-on-one and group-based physical therapy. In fact, some studies suggest that group therapy may offer additional benefits, such as motivation, accountability, and cost-effectiveness.
This means that patients don’t necessarily need one-on-one care to achieve good results—other models can be just as effective, if not better in some cases.
2. Group-Based Therapy Can Improve Access to Care
One of the biggest challenges in healthcare is accessibility. One-on-one therapy is often expensive, requires insurance approval, and may not be available in all areas.
Group-based physical therapy or structured home exercise programs can:
• Lower costs for both patients and providers
• Increase access to care, especially in underserved areas
• Improve consistency with structured guidance and peer support
3. Does Individual Supervision Improve Results?
Many believe that having a therapist watch every rep leads to better outcomes, but studies have shown that individually supervised exercise often offers no advantage over group-based or home-based exercise.
Instead, consistency, therapist expertise, and patient engagement are the biggest factors in success, not whether therapy is done one-on-one or in a group.
4. Social Factors Matter More Than Therapy Models
Social determinants of health (SDH)—things like income, location, and insurance coverage—have a greater impact on healthcare access than the specific type of therapy a person receives.
For many patients, insurance-based clinics are the only option, and framing one-on-one therapy as the “best” can discourage new therapists from working in high-need areas, further limiting access to care for underserved communities.
5. The Problem With Favoring One-on-One Therapy
Pushing the idea that one-on-one therapy is the gold standard can:
• Limit access to care by making it seem like other options are inferior
• Increase costs without improving outcomes
• Create barriers for those who rely on insurance-based clinics
• Discourage new therapists from entering high-need areas
Final Thoughts
• One-on-one therapy isn’t always superior—group and home-based programs can be just as effective.
• Access to care is more important than therapy format—patients need options that fit their financial and social circumstances.
• Narratives that prioritize costly models can harm underserved communities—we should focus on improving access and outcomes for all patients.
Instead of insisting that one-on-one care is the only way, we should advocate for evidence-based, patient-centered approaches that work for a variety of needs and circumstances.
