Being a psychotherapist is a profession. But I think that it cannot be “just” a profession: Its characteristics make it probable (if not desirable, or even necessary) to find inside elements such as vocation, passion, intellectual honesty, responsibility … However, it is certainly also a profession. And it is certainly not the first nor the only, which puts itself at the service of people to help them overcome a state of malaise or to achieve more complete well-being.
This raises a crucial question: the trained psychotherapist, to continue doing his job, must be able to conduct an economically sustainable activity. Otherwise in a short time he will be forced to stop his activities.
The question at this point is: does Single Session Therapy lead precisely to this risk?
Business design
3 reasons to talk about it
1 – Because this is a widespread reason for resistance, affecting both SST and short therapies. In his book “Short Psychotherapies. Principles and Practices” Michael Hoyt analyzed how some therapists are worried about the thought of decreasing earnings. Actually this is not the case, as I will explain shortly talking about SST.
2 – Because it is a understandable concern. In fact the psychotherapist, both to support his own activity and to live, needs to have sessions (obviously I am speaking of private practice and of those who only have this activity as income source): it is therefore really easy, almost mathematical, to think that doing a therapy that decreases number of sessions (even bringing them to a single one) also reduces the overall gain.
3 – Because I have been involved in business design for years, that is the part of business innovation which helps professionals and companies to make their business sustainable, constantly updated to keep pace with changes of the world, responding to people’s needs while maintaining their values and founding principles.
I did it with Beople, the first Italian business design company, who had a series of meetings with psychologists, in which I participated as a trainer (both for the ENPAP and for the Order of Psychologists of Lazio).
4 ways to make SST sustainable
Here 4 ways to make SST sustainable. Note: the most important thing about this points is that they can be perfectly integrated with each other, so you can implement them all together.
1 – Psychotherapy on demand: in 1995 Nicholas Cummings, past president of the American Psychological Association, spoke of “intermittent psychotherapy” or “life cycle psychotherapy”:
he conceptualized a therapy that can be done as needed, when the person needs it, for what he needs at that moment and for the number of sessions he deems necessary.
I add one thing: it is a conceptualization of a psychotherapy that is not necessarily a horizontal process (first session, second session, third session etc …), but also vertical (a session, a session, a session …).
In other words, psychotherapy that responds to what the client asks.
Consider that in Italy from 77 to 92% of people with psychological problem do not ask for help (as explained in another article). One of the reasons is probably because the idea of having more sessions (maybe even “many”), even though it may be the best thing for them, discourages them from getting in touch with the therapist.
Proposing a Single Session Therapy responds to these needs and to those of the 77-92% of people who need a psychologist / psychotherapist but do not call him.
2 – Cost of one session vs cost of many sessions: this is , in my opinion, the simplest topic, but also the most delicate. It is simple because it concerns mathematics: SST helps you to reduce the total number of sessions, even bringing it to just one.It is obvious that offering this service can allow you to ask for a higher fee, which will be more convenient for the customer:Just to say: a session of 180 € is immensely cheaper than 10 sessions of 50 €; not to mention that this convenience must also be seen in terms of time (the client comes fewer times) and a sense of self-efficacy (the client who takes fewer sessions, even one, to solve the problem feels more capable). But it is also a delicate point, for two reasons.On the one hand, it is necessary to know how to communicate and explain this possibility in the right way. For example, if you charge €180 for one session and then the client decides to return two weeks later because he feels he needs another session (note: the basic principle of SST is “leave the door open”, i. e. people always have the possibility to return), what do you do? There is a risk: the person does not come back because he fears that each session costs € 180!For example, in these situations I make it clear that, if there are other sessions, they will be less expesive (and I immediately say the price: I never hesitate to say it, since people who pay for a service have to know how much it costs).In my experience this calms people down.
On the other hand, then, we must consider the difficulties encountered by therapists! For somebody, go from asking 50€, 70€ or even 90€ per session (because therapy was conceptualized as a process of several sessions), to asking double or even more for a Single Session is not easy. However, it is helpful, after due consideration, figure SST logics out (as well as learning the best way to communicate this to the customer).
3 – An additional service: SST can be seen as an additional service.Let me make a business design suggestion: it must be seen like that.
It means offering people a service that fits his requests. Attention, it does not mean that the person must unilaterally decide the duration of treatment (provided that he can do it whenever he wants, since that some research shows that 70-80% of therapies ends because patient decides not to come anymore): decide duration of treatment is certainly within the therapist’s competence. But it means that people has the opportunity to be able to do something that feels closer to their needs.
He is told that if necessary, if he deems it appropriate, if he “feels” that it is the best thing, he can come even just for a session. It will then be in that session that therapist will evaluate and communicate to the person if he believes that he can find more benefit from other sessions (given that, in the end, this decision will have to be joint).
4 – A specific service: you can decline SST as a characteristic service for a specific problems or for a specific type of customers (families, couples, managers etc.).
This point fits easily with the previous one: give the opportunity to have just one meeting (and then evaluate together to have others), aiming to communicate this opportunity in a specific area or for specific problems.
This is also a point that absolutely meets modern needs: it is about differentiation of the professional. In an era of overcrowding of professional figures (and I remind you that in Italy we have 1/4 of psychologists from all over the world) the key word is “focus”, that is to become the specialists of something: of a type of problem, of a specific professional category, of a type of family system (above I spoke of “families”, but the professional can specialize in “families in crisis”, “recomposed families”, “multicultural families”, “single-parent families”, “families with same-sex parents “etc.).
The SST strongly embraces this possibility: addressing these categories with a dedicated service.
The added value
The initial question was: “If the total number of my sessions is reduced, how can I not reduce (and maybe even increase) my income?”. These 4 examples already give the answer that any professional must give himself: putting the person at the center.
But actually there is an even more direct answer to this question: your total number of sessions simply does not decrease. Increase.
If I just offer something in the way I want to offer it, I will have a hard time finding people who choose it. Especially today, where the offer is immensely varied due to the large number of professionals. And this means that people are more likely to find someone who offers them something more in line with their needs.
Attention, it is not just a “marketing” question. This is about the “possibility of choice”. Also in medicine people select the professional according to the offered services.
In addition we must consider the added value of… added value.
Today in the rest of the world, Single Session Therapy is a service that meets the needs of people, in both the public and private sector: we can expect the same also in Italy. But before that, professionals who offer a service that people feel really suited to their needs are perceived differently. For this reason, they can expect to receive more requests (and not just SST requests) precisely because they are seen as offering greater value. Characteristics such as “competence”, “professionalism”, “adequacy” etc. will be directly associated with your account and thus increase your attractiveness.
Flavio Cannistrà
Psyhcologist, Psychoterapist
Founder dell’Italian Center
for Single Session Therapy