What is Single Session Therapy?
Single Session Therapy (SST) is a therapeutic approach that focuses on addressing the client’s current concerns in one session while allowing the option for follow-up appointments. Emphasis is on the client’s abilities and resources and the therapist utilizes their full toolbox to assist the client efficiently. SST is a flexible approach that adapts to the unique needs of the client.
Key principles of SST
Single Session Therapy (SST) is a approach that utilizes two key principles for maximum effectiveness:
- one-at-a-time
Addressing one issue per session to maintain a clear focus. - at the point of need
Conducting sessions at the point of need, utilizing the motivation and urgency of the present moment..
‘SST is not a ‘one-off’ therapy but rather a structured first session which attempts to maximize the client’s first therapeutic encounter, understanding that it may be the only appointment the client chooses to attend, while entertaining the possibility of ongoing work.’
Weir, Wills, Young & Perlesz
The key pillars on which SST is built:
- Personal strengths: everyone has the capability to overcome challenges and difficulties. By recognizing and utilizing one’s own unique skills and resources, individuals can find effective solutions that work for them. It is important to trust in one’s own abilities and instincts when facing obstacles.
- Timing: providing prompt assistance allows individuals to promptly make necessary adjustments, which can increase motivation. The availability of a professional at all times can provide reassurance and support.
- Focus: the session focuses on the current situation, on a single issue; what is going on right now? what does the client want to get out of the session? The focus is on what the clients can and wants to do right now, not on in-depth (self) research.
- Mindset: SST is a approach that emphasises the power of positive change and the ability for individuals to solve their own problems with the right support. Instead of viewing problems as illnesses that require professional treatment, SST focuses on the idea that meaningful connections and conversations between people can lead to growth and progress. The goal of SST is to help individuals identify and build on their strengths, rather than solely focusing on their problems..
What makes SST unique?
Single Session Therapy is an approach to psychological support that focuses on addressing specific, immediate issues that employees are currently facing. Instead of engaging in in-depth self-exploration, the therapy aims to provide concrete and practical assistance to help individuals overcome their challenges and achieve their objectives.
The therapy is delivered in a single session, with no intake or multi-session treatment plans. This approach serves as a motivator for employees to make the most of the session and actively engage in the process. The therapist employs a structured conversation that focuses on the current situation and provides concrete advice and tools to empower the employee to achieve their goals.
One of the key features of Single Session Therapy is its personalization. The therapist approaches each session with a flexible mindset and uses a tailored approach for every individual and their specific situation. The therapist is experienced and has a wide range of tools to address various issues that employees may be facing.
In summary, Single Session Therapy is a unique and effective approach to addressing specific and immediate issues that employees may be facing in the present. It provides concrete assistance, practical tools and a personalized approach to help employees achieve their objectives and get back on track.
‘The simple secret of brief therapy is that life is one damn thing after another’.
John Weakland
Single Session Therapy (SST) is a brief, solution-focused approach that emphasizes the client’s ability to deal with difficulties on their own.
The therapist’s role is mainly to help the client use their own skills, talents, relevant experiences, strengths, and resources to address a current issue. The therapist is one of the resources that the client can call upon, but the control lies with the client.
The goal is to help the client get back on track so that they can continue on their own with a sense of relief and more hope. The outcome of the session depends on the situation, the question, and the client’s wishes. Sometimes a different perspective will help the client move on, while other times a practical plan will be developed with the first step being practiced in the session.
The effect of the session can go beyond the current situation and can have a positive impact on other areas of the client’s life. The therapist uses their expertise to ask the right questions, keep the focus of the conversation, provide information, offer alternative views or possible actions, and help the client choose an option and practice it.
Origin & development of Single Session Therapy
Single Session Therapy (SST) is a form of therapy that is focused on maximizing the effects of the first and often only therapeutic encounter. The concept of SST was first named in 1990 by Dr. Moshe Talmon in his book “Single Session Therapy: Maximizing the Effect of the First (and often Only) Therapeutic Encounter.”
The idea of SST has been around for much longer, however, as many clients had historically only attended one session before dropping out of therapy. In the 1980s, Dr. Talmon and his colleagues, Michael Hoyt and Robert Rosenbaum, decided to investigate why this was the case. To their surprise, they found that 78% of clients who had not returned for additional sessions were actually satisfied with the outcome of their first session. This realization led to the development of SST as a recognized form of therapy, which has since been supported by further research.
Ever since Freud, therapy has often consisted of just one session. Not because it was meant to be, but because clients did not come back after the first session. This has long been seen by psychologists as a failure of treatment.
- Independent on the diagnosis, complexity or severity of the problems for which people are seeking help, the most common number of client sessions is 1, then 2, then 3, etc. (Talmon, 1990; Simon, 2012)
- The majority of people who attend only one session are satisfied with that session. On average 70-80% of people say that the one session is enough in the current situation. (Talmon, 1990; Bloom, 2001; Campbell, 2012).
- It is not easy to predict who will attend only one session, and who will (want to) attend more sessions (Talmon, 1990)
Single session therapy (SST) has gained significant attention in recent years as research has shown it to be a common and effective form of therapy. Experts in the field, such as Bobele, Slive, Young, Rycroft Talmon, Hoyt, Rosenbaum, and Dryden have conducted extensive research on the potential and effectiveness of SST in Anglo-Saxon countries like America, Australia and England. The availability of SST is also increasing, with options for both walk-in and scheduled appointments becoming more prevalent (Hoyt, 2018; Mcelheran, 2020).. It is important to note that SST is a viable option for individuals seeking therapy, and should be considered as a possibility when seeking treatment.
Single Session Therapy: Maximizing the Value of One Session
Single Session Therapy (SST) is an approach that focuses on maximising the value of a single session. It is based on the assumption that one session can be sufficient for the client to achieve their desired outcome, but it does not have to be. A variant of SST is One-At-A-Time (OAAT), which makes it clear that there is always an option for follow-up sessions.
SST and OAAT are offered in a variety of settings, such as large organizations and one-man practices. In large organizations, SST or OAAT can be offered as a standard first option, with clients who need more support able to opt for a subsequent session or a longer process starting with an intake. However, SST or OAAT always stands on its own and is not used as an intake for a longer process. The aim is to ensure that the session is valuable in itself and gives the client something to take further with them.
A follow-up appointment is never planned immediately after the session. Clients are encouraged to first reflect on the session, try out, evaluate, and adjust any chosen follow-up steps. After some time has passed, the client can better assess the effect of the session and decide whether or not a next session is necessary.
What is Single Session Therapy suitable for?
Single Session Therapy is a form of therapy that aims to provide mental support for an individual’s specific issue or problem. It is suitable for a wide range of concerns, such as:
- Emotional problems such as fear, gloom, shame, guilt, anger and jealousy
- Dilemmas, doubts
- Relation problems at home and at work
- Issues such as changing jobs, getting married or divorced, having children, empty nest, and retirement
- Problems with self-discipline, procrastination
- Mourning
- Help in taking an important decision.
It is important to note that Single Session Therapy is not suitable for everyone, some people may need more support than one session can provide.
Single Session Therapy (SST) is best suited for individuals who are:
- Motivated to make a change in their lives and are willing to take action to do so
- Willing to take responsibility for their actions and see their own role in the problem
- Realistic about what can be achieved in one session, but still confident in their ability to move forward
- Open to discussing their issues
- Open to receiving suggestions and guidance
- Focused on addressing one specific issue
- Committed to putting in effort during the session and following through with the chosen steps after the session is over.
- Recognise that they have skills and talents that they can use.
- Be prepared to ask for and accept help from people around them.
It’s important to note that Single Session Therapy (SST) is not meant to replace longer therapy sessions. While SST may not be the best fit for individuals dealing with more complex or long-standing issues, such as personality problems, it can still be beneficial for those who have more specific or short-term concerns. It’s important to remember that individuals are more than just their diagnosis and may have everyday issues that can be addressed in a single session.
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What are characteristics of a good SST therapist?
Single Session Therapy (SST) requires therapists to have a high degree of flexibility and creativity as it requires them to react quickly to the client’s needs and establish a good therapeutic relationship within a short period of time.
To do this, therapists must have a diverse range of knowledge and experience in dealing with various issues and be able to adapt to the unique needs and preferences of each client.
Having a solid understanding of therapeutic approaches such as CBT, REBT, and ACT can provide a strong foundation for SST. Additionally, having experience with these methods is crucial as SST does not follow a specific protocol, and therapists must have all the knowledge and tools at their disposal to make quick and effective decisions during the session.
It is important for a therapist to have a large toolbox of techniques that they are familiar with and can easily use in different situations. This allows them to make an informed decision on the most appropriate approach for the specific client and situation.
A good therapist for Single Session Therapy:
- Helps the client to focus on the agreed topic.
- Asks permission, with explanation, to intervene if the session threatens to stray and does so.
- Respects the choices, culture, and beliefs of each client.
- Is experienced and flexible enough to be effective without protocol and without sticking to a specific theory.
- Acknowledges that he or she does not know everything and can be surprised by the session and learn from the client.
- Has an eye for the possible obstacles and pain of change without discouraging the client.
- Helps clients distinguish between what he or she can control and what not, and focus on the former.
- Is focused on the desired future, not on the past and the roots of the problem.
Therapeutic relationship in one session?
The therapeutic relationship is a crucial component of successful therapy. In single-session therapy (SST), there may not be enough time to gradually establish a relationship, but this does not have to be an obstacle to effective cooperation.
By setting shared expectations and goals at the beginning of the session, a positive connection can be quickly established. The therapist’s intention to help the client as much as possible, combined with openness and clarity, are important in establishing a good relationship.
The client’s needs, wishes, and wisdom are always at the center of the session, which not only improves the relationship but also the effectiveness of the therapy (Davis, 2012; Laska, 2014).
The client and therapist will discuss the specific topic and realistic goal of the session, with the final decision on the focus being left to the client. The fact that it is a one-time encounter can actually help the relationship, as clients often find that one session is sufficient for their needs (Carey, 2013; Hymmen 2013, Dryden, 2019).
The option of a single session can also make it easier for clients to discuss personal topics with someone “outside their own world.” Knowing that there are no ties to their daily life can make the conversation more open and intense, and sometimes leave a lasting impression.
Read more about Single Session Therapy?
Books
Talmon, M (1990)
Single Session Therapy: Maximizing the Effect of the First (and Often Only) Therapeutic Encounter
San Francisco, Jossey – bass
Dryden, W. (2019)
Single-Session Therapy: 100 Key Points and Techniques.
Abingdon, Oxon: Routledge.
Hoyt, M.F., & Talmon, M. (Eds.). (2014)
Capturing the Moment: Single Session Therapy and Walk-in Services.
Bethel, CT: Crown House Publishing Ltd.
Dryden, W. (2017)
Single-Session Integrated CBT (SSI-CBT): Distinctive Features.
Abingdon, Oxon: Routledge.
Hoyt, M.F., Bobele, M., Slive, A., Young, J., & Talmon, M. (Eds.). (2018)
Single-Session Therapy by Walk-In or Appointment: Administrative, Clinical, and Supervisory Aspects of One-at-a-Time Services.
New York: Routledge.
Slive, A., & Bobele, M. (Eds). (2011)
When One Hour is All You Have: Effective Therapy for Walk-in Clients.
Phoenix, AZ: Zeig, Tucker & Theisen.
Dryden, W. (2020)
Single-Session Coaching and One-At-A-Time Coaching – Distinctive Features.
New York: Routledge.
Articles
Bloom, Bernard. (2001)
Focused Single-Session Psychotherapy: A Review of the Clinical and Research Literature. Brief Treatment and Crisis Intervention. 1. 10.1093/brief-treatment/1.1.75.
bron: researchgate.net
Campbell, A. (2012)
Single-Session Approaches to Therapy: Time to Review. Australian and New Zealand Journal of Family Therapy. 33. 10.1017/aft.2012.3.
bron: onlinelibrary.wiley.com
Dochat, J. S. Wooldridge, M. S. Herbert, M.W. Lee, N.Afari, (2021)
Single-session acceptance and commitment therapy (ACT) interventions for patients with chronic health conditions: A systematic review and meta-analysis, Journal of Contextual Behavioral Science, Volume 20, 2021, Pages 52-69.
bron: sciencedirect.com
Ewen, V. & Mushquash, A. & Mushquash, C. & Bailey, K. & Haggarty, J. & Stones, M. (2018)
Single-session therapy in outpatient mental health services: Examining the effect on mental health symptoms and functioning. Social Work in Mental Health. 16. 10.1080/15332985.2018.1456503
bron: tandfonline.com
Harper-Jaques, S. & Foucault, D. (2014)
Walk-In Single-Session Therapy: Client Satisfaction and Clinical Outcomes. Journal of Systemic Therapies. 33. 29-49. 10.1521/jsyt.2014.33.3.29.
researchgate.net
Hoyt, M.F., & Dryden, W. (2018). Toward the future of single- session therapy: An Interview. Journal of Systemic Therapies, 37(1), 79-89.
bron: guilfordjournals.com
Hymmen, P. Stalker, C.A., & Cait, C-A. (2013)
The case for single-session therapy: Does the empirical evidence support the increased prevalence of this service delivery model? Journal of Mental Health, 22(1): 60–67.
bron: pubmed.ncbi.nlm.nih.gov
Matthews, K. (2018)
The Integration of Emotion-Focused Therapy within Single-Session Therapy. Journal of Systemic Therapies. 37. 15-28. 10.1521/jsyt.2018.37.4.15.
pubmed.ncbi.nlm.nih.gov
Schleider, J. L., Sung, J. Y., Bianco, A., Gonzalez, A., Vivian, D., & Mullarkey, M. C. (2021). Open Pilot Trial of a Single-Session Consultation Service for Clients on Psychotherapy Wait-Lists. The Behavior Therapist, 44(1), 8-15. abct.org
Schleider, J.L., Dobias, M.L., Mullarkey, M.C. et al. (2021). Retiring, Rethinking, and Reconstructing the Norm of Once-Weekly Psychotherapy. Adm Policy Ment Health 48, 4–8 (2021). doi.org
Slaff, B. (1995). Thoughts on short-term and single-session therapy. Adolescent psychiatry. 20. 299-306. pubmed.ncbi.nlm.nih.gov
Slive, A. (2008). Special Section: Walk-In Single Session Therapy. Journal of Systemic Therapies. 27. 1-4. 10.1521/jsyt.2008.27.4.1. researchgate.net
Slive, A. & McElheran, N. & Lawson, A. (2008). How Brief Does It Get? Walk-In Single Session Therapy. Journal of Systemic Therapies. 27. 5-22. 10.1521/jsyt.2008.27.4.5. researchgate.net
Stalker, C. & Horton, S. & Cait. (2012). Single session therapy in walk-in counselling clinics: A pilot study of who attends and how they fare afterwards. Journal of Systemic Therapies, 31(1), 38-52. researchgate.net
Young, J. & Dryden, W. (2019). Single-session therapy – past and future: an interview. British Journal of Guidance & Counselling. 47. 1-10. 10.1080/03069885.2019.1581129. researchgate.net
Young, J. & Rycroft, P. (2012). Single Session Therapy: What’s in a Name?. Australian and New Zealand Journal of Family Therapy. 33. 10.1017/aft.2012.1 researchgate.net
Young, K & Jebreen, J. (2019). Recognizing Single-Session Therapy as Psychotherapy. Journal of Systemic Therapies. 38. 31-44. 10.1521/jsyt.2019.38.4.31. researchgate.net
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