What Is Single Session Therapy? A Clinical Psychology Podcast Episode.

After subscribing to a few Continued Professional Development newsletters and seeing the option for Single Session Therapy on my university’s counselling form, I finally decided it was time to investigate this type of psychotherapy in more detail. Traditionally, we know that psychological therapy can take months of therapy sessions to be fully effective and to improve a client’s life for the better. Yet some therapists and researchers argue that a single session of psychological therapy is more than enough for some clients. Therefore, in this clinical psychology podcast episode, you’ll learn what is single session therapy, what is the evidence base for single session therapy and how might Single Session Therapy be used in the future. If you enjoy learning about mental health, psychotherapy and psychological treatment then this will be a great episode for you.

Today’s psychology podcast episode has been sponsored by CBT For Depression: A Clinical Psychology Introduction To Cognitive Behavioural Therapy for Depression. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca.

What Is Single Session Therapy?

The main, basic principle behind Single Session Therapy is that a single session of psychological therapy might be more than enough to support clients with their mental health difficulties. Also, this isn’t a theoretical model nor is it a standalone psychological approach, like cognitive behavioural therapy. Instead Single Session Therapy is a framework that helps therapists to conduct their therapy sessions in a way that maximises the efficacy of every session regardless of the type of therapy.

Personally, I think this is an interesting idea because whilst it wouldn’t work for a wide range of mental health conditions. For example, you cannot undo or treat someone’s depression, anxiety, Post-Traumatic Stress Disorder amongst other mental health conditions in a single therapy session. You might be able to support people with subclinical conditions just enough so their mental health difficulties don’t become more severe where they need longer-term, more expensive psychological support for a longer period of time.

That’s actually a really interesting idea. Maybe offering people a single session as a preventative measure so they don’t need to get so severe that they need to be put on a waiting list for longer-term therapy for years.

Furthermore. Single Session Therapy isn’t actually about therapy only lasting a single session. Hoyt and Talmon (2014b) argue that one of the massive misconceptions people have about Single Session Therapy is that it means a client only has a single treatment session.

In my opinion, I would add if you didn’t want people to have that misconception, then don’t include “single session” in the name. To me, that’s common sense but I didn’t name it.

Moreover, this misconception comes from the main idea behind Single Session Therapy. The basic idea is that a therapist works with a client to make sure they get the most out of every session of the therapy with the idea that every single session can potentially be the last one. Maybe this is because of dropout, poor treatment adherence, clients not being ready to start therapy, clients not having the right therapist for them at that moment in time or clients not having a capacity to change at that moment in time.

Interestingly, according to Hoyt and Talmon (2014b), the most common number of therapy sessions a client has is 1. I think that’s fascinating because it shows that if most clients do only have a single session then as aspiring and qualified psychologists, we need to move heaven and earth to make sure the client gets the most out of this session. Even if the client never comes back, I would prefer to give my future clients as much knowledge, techniques and support as possible so if they never return. They might be okay in the future, or slightly better off than they would have been otherwise.

Is Single Session Therapy Enough for Some People?

In my opinion, as someone who has experienced depression, anxiety, post-traumatic stress disorder, anorexia and a bunch of other mental health conditions because of child abuse and rape. I know Single Session Therapy would not be a good fit for me and this would not have been useful in the slightest, but for some people a single session of therapy is enough.

Interestingly, when Talmon (1986) noticed a high dropout rate in the psychotherapy service he was working in, he investigated why there was a high dropout and he found that 78% of clients said they had benefited from a single session of therapy so they didn’t feel like they needed to return.

Additionally, this idea was later confirmed by Hoyt who conducted the first study into Single Session Therapy and out of 60 clients, 58% of them believed they didn’t need additional therapy sessions after their first session. As well as these findings have been confirmed in additional research studies all over the world.

Nonetheless, my issue with Single Session Therapy is it is clear that there is strong potential for Single Session Therapy, especially as a preventative measure. Yet how do we apply this knowledge to the real world? In the United Kingdom, to be able to access psychological support, you essentially need to have two believable suicide attempts otherwise you cannot access therapy. That is how bad and how high the mental health criteria is for public sector mental health support, and this is the biggest employer of psychologists in the United Kingdom.

How Could Single Session Therapy Fit into The Public Sector?

I spoke about this in my book, Clinical Psychology Reflections Volume 6, with the Lanson Model in Cornwall. If there is a clinical psychologist in doctors and in primary healthcare then there is a chance, you might be able to book one session of therapy with a psychologist and hopefully that would be enough to help you decrease your psychological distress, and if you needed more then you would be put on the waiting list for longer-term support.

However, in my experience, as a rape survivor, I know sexual trauma is on the more extreme end of mental health conditions. Yet if I went for a single session of therapy, I started to feel hopeful about the future and then I was put on a public sector waiting list for years that alone would make my mental health worse.

There are no good solutions.

Clinical Psychology Conclusion

At the end of this podcast episode, whilst I have doubts because of my own mental health experiences about the usefulness of Single Session Therapy in the real world. I strongly believe we should be looking into offering clients one therapy session in primary healthcare to act as a preventative measure. This means there is a good chance people’s mental health might not continue to decline to the point where they have clinically significant levels of distress that meet the criteria for different mental health diagnoses and then they need to be put on waiting lists for years.

Our waiting lists for psychological therapies are extremely long, they need to be reduced and the way to reduce the waiting lists is to reduce the need for them in the first place. If we can stop people’s mental health from declining by giving them the therapeutic skills, techniques and self-advocacy to manage their mental health before they get severe enough to need longer-term therapy. Then this could benefit our mental health services in multiple ways. It means we could focus our extremely limited resources on the individuals with the most severe mental health needs, we could give mental health support to everyone regardless of whether they have two believable suicide attempts or not and so on.

Single Session Therapy might not be for everyone, but it might be a game changer in primary mental healthcare if we somehow manage to find the funding, implement it and find mental health services willing and able to trial it out.

And that’s the hard part. Mental health services are already stretched to breaking point and many will not have the resources to trial this brand-new approach without additional funding and staff.

The odds might always be against new ideas, but that’s why we always need to be trying, testing and finding new solutions to old problems.

What do you think?

I really hope you enjoyed today’s clinical psychology podcast episode.

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Clinical Psychology References and Further Reading

Bertuzzi, V., Fratini, G., Tarquinio, C., Cannistra, F., Granese, V., Giusti, E. M., ... & Pietrabissa, G. (2021). Single-session therapy by appointment for the treatment of anxiety disorders in youth and adults: a systematic review of the literature. Frontiers in Psychology, 12, 721382.

Campbell, A. (2012). Single-session approaches to therapy: Time to review. Australian and New Zealand Journal of Family Therapy, 33(1), 15-26.

Hoyt, M.F. & Talmon, M. (2014b). Editors’ Introduction: Single Session Therapy and Walk-In Services. In M.F. Hoyt & M. Talmon (eds.) (2014a), op. cit., pp. 2-26.

Hoyt, M.F. & Talmon, M. (eds.) (2014a). Capturing the Moment. Single Session Therapy and Walk-In Services. Bancyfelin, UK: Crown House.

Hoyt, M.F., Talmon, M. & Rosenbaum, R. (1990). Sixty attemps for planned single session therapy, manoscritto non pubblicato.

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), 60-71.

Kim, J., Ryu, N., & Chibanda, D. (2023). Effectiveness of single-session therapy for adult common mental disorders: a systematic review. BMC psychology, 11(1), 373.

Slive, A., McElheran, N., & Lawson, A. (2008). How brief does it get? Walk-in single session therapy. Journal of Systemic therapies, 27(4), 5-22.

Talmon, M. (1990). Single Session Therapy. San Francisco: Jossey-Bass (Tr. it. Psicoterapia a seduta singola. Milano: Erickson).

Weir, S., Wills, M., Young, J. & Perlesz, A. (2008). The implementation of Single Session Work in community healt. Brunswick, Australia: The Bouverie Centre, La Trobe University.

Young, J., Weir, S., & Rycroft, P. (2012). Implementing single session therapy. Australian and New Zealand Journal of Family Therapy, 33(1), 84-97.

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