By now you know, the reason that prompted Moshe Talmon and his research group to start research in Single Session Therapy was a significant fact: in psychotherapy the most frequent number of sessions is 1.
Talmon, Hoyt, and Rosenbaum verified this finding on over 100,000 patients and was subsequently confirmed by studies around the world (Talmon, 1990; Hoyt, Rosenbaum & Talmon, 1990; Weir et al., 2008; Hoyt & Talmon, 2014).
As you already know if you have read this article, the data shows that the highest frequency (fashion) in therapy is only one session.
You can try it too: take a table with numbers from 1 to 10+ (where 10+, for convenience, represents the set of all therapies lasting more than 10 sessions) and for each therapy you have concluded put an X below the number of sessions you have done. Taking a large enough sample (even if you don’t need excessive numbers, a few tens of therapies are enough), you will see that most of the X’s will fall below number one.
Why are we sure? Because we did the test also here in Italy.
 The most frequent number of sessions in Italy
The results are fresh, but before publishing them in specialized magazines we want to group still others and make further studies and reflections.
Today, however, we share on this page the first results with those in Italy who are interested in Single Session Therapy. In fact, although all the researches in TSS have been conducted in Europe, America and Asia by different scholars, obtaining the same results, there are no specific studies in Italy. So, with the Italian Center for Single Session Therapy we are working to fill this gap.
And we started with the basic question: 1 is the most frequent number of psychotherapy sessions in Italy too?
499 therapies examined
So far we have looked at a total of 499 therapies. In short, we have taken each therapy * concluded, regardless of the outcome (so we go from resolved cases to dropouts – meaning with this term the unilateral conclusion of the therapy by the client at any time), and we counted how many sessions lasted each.
The answer was unequivocal: even in Italy the most frequent number of sessions is 1.
So far, the data has been collected in 3 different contexts, all within Lazio:
- a Mental Health Center of an ASL (229 therapies examined)
- a center for families which is part of a social cooperative (109 therapies)
- private practice (161 therapies)
In all three situations, 1 is the number of sessions that is done most often by people: out of 499 therapies examined, 124 last only one session.
 1 in 4 people only have one session
This data is even more significant if we look at the position it occupies within the entire sample. In fact, that single psychotherapy session represents 24.8% of the total sessions. It means that 1 in 4 people come for just one session. This data seems plausible to us, since in line with world and Italian research on drop-out and, in particular, on abandonment after a single session (Swift & Greenberg, 2012; Wells et al., 2013; de Girolamo, Bassi, Neri, Ruggeri, Santone & Picardi, 2007).
The data is even more interesting in light of the potential of Single Session Therapy and its ability to maximize the effectiveness of each individual meeting: even if it should be the last or if there should be a premature interruption by the person, the chances of effective therapeutic change increase.
The frequency of the other sessions
Other considerations are also surprising.
For example, one might expect that taking all therapies lasting more than 10 sessions (therefore all 11 sessions, all 12 sessions, all 13 ones, etc.) and adding them together, the total number of them would exceed that of therapies lasting a single session.
It is not so. The sum of all therapy sessions that lasted more than 10 sessions is less than that of the therapies alone that lasted one session: 98 for the first and 124 for the second. In other words, only 19.6% of people continue beyond the 10th session. Although all the necessary analyzes will have to be made, this data also seems to be in line with the literature (Wells et al., 2013).
 Single Session Reception
Another interesting fact comes from the analysis of the family center. On that occasion, the welcome interviews were also examined. This is a preliminary meeting with the user with the aim of accepting his request (thus listening to the problem presented) and then sending it to an internal therapist with whom to start the actual path.
Well, in the case of the center for families the number of welcome sessions was the same as that of the “first sessions”: both, therefore, obtained the highest frequency compared to all the other sessions. It means that most of the consultations / therapies lasted either just one session, or just the time of the welcome meeting. One reason could be that for many people it is enough to simply be able to talk about their problem and receive questions to guide their perception. It is not at all strange when one adds that still other research has shown that just making an appointment with the therapist triggers a process of improvement in several people (Talmon, 1990).
Returning to the initial data, which was also examined in different research by other authors, we are faced with a completely different vision of the welcome interviews and what can already be done in them: knowing that a considerable part of people will not come after this ” simple ”meeting we should ask ourselves what we can do to maximize its effectiveness.
And still other similar situations could be explored.
An example in private practice are the “free interviews” or “knowledge” given by many psychologists. If simply talking about your problem and having an initial discussion on it is decisive, you may wonder how many people decide not to have a further interview after the “knowledge” one precisely because they have found the latter to be sufficient.
1 for all
Although the data have not yet been analyzed by segmenting the sample examined (for example to see if 1 is the most frequent number of sessions in a certain age group or for certain types of problems), the latter was heterogeneous in several points of sight:
- age, sex, income, education level and other socio-demographic characteristics
- types of problems presented (from anxiety disorders to mood disorders, from couple problems to sexual dysfunctions, from disorders considered more typically in need of psychiatric / psychotherapeutic support to those more oriented towards counseling and psychological support)
- type of service offered: counseling or therapy; individual, couple or family; with or without drug support etc.
Furthermore, the data collected at the CSM and the family center comes from people visited by different professionals, with different educational backgrounds, and none with training in Single Session Therapy (except one in the CSM and one in the center). It is confirmed, as in the literature of other countries, that the theoretical orientation of the therapist does not affect this data.
And finally, it should be noted that the results are similar both in the public and in the private sector.
 Future developments
There is certainly work to be done. First, while the results are clear, the data will be further analyzed to understand even better trends, implications and interpretations. Furthermore, as mentioned, it will be interesting to carry out further segmentations and refinements: for example, only in the center for families were the reception areas present; and in private practice, some sessions made with a TSS scheme were also counted (less than a dozen, having no influence on the final result), which in a more detailed analysis can be separated from the others. The sample, then, is quite large: 499 therapies examined in 3 different contexts. However, we are also waiting for data from other centers to improve representativeness even more; and it will be necessary to collect more data from the public and private sectors, so as to see if the absence of significant differences (already found in international studies – Talmon, 1990) is confirmed. And obviously it will be interesting to conduct the same studies also in other parts of Italy, in order to be able to generalize them with absolute certainty to the entire Italian population.
However, it remains that these first 499 therapies examined seem to give us unequivocal confirmation: even in Italy the most frequent number of therapy sessions is 1.
Of course the next question is: why do most therapies only last one session?
The response of the international literature, even of that independent of TSS studies, is that most people feel that they are better after that one encounter.
 If you want to know more about Single Session Therapy and learn more about the method, you can read our link (click here) “Single Session Therapy. Principles and Practices ”or participate in one of our workshops (click here).
Flavio CannistrĂ
Federico Piccirilli
Angelica Giannetti
Pier Paolo D’Alia
Antonio CannistrĂ
Tania Da Ros
Italian Center team
for Single Session Therapy
 * for convenience we use the term “therapy” here, but in reality it also includes psychological counseling and, as explained later in the article, welcome meetings.
Bibliography
de Girolamo, G., Bassi, M., Neri, G., Ruggeri, M., Santone, G. & Picardi, A. (2007). The current state of mental health care in Italy: problems, perspectives, and lessons to learn. European Archives of Psychiatry and Clinical Neurosciences, 257, 83-91. doi: 10.1007/s00406-006-0695-x
Hoyt, M.F., Rosenbaum, R. L. & Talmon, M. (1992). Planned Single-Session Psychotherapy. In Budman, S.H., Hoyt, M.F. & Friedman, S. (a cura di), The First Session in brief Therapy (pp. 59-86). New York: Guilford Press.
Hoyt, M.F. & Talmon, M. (eds.) (2014a). Single Session Therapy and Walk-In Services. Bancyfelin, UK: Crown House (in traduzione).
Rosenbaum, R., Hoyt, M.F. & Talmon, M. (1990). The Challenge of Single-Session Therapies: Creativing Pivotal Moments. In R.A. Wells & V.J. Giannetti (eds), Hanbook of the Brief Psychotherapies, New York-London: Plenum Press, pp. 165-189.
Swift, J. K. & Greenberg, R. P. (2012). Premature discontinuation in adult psychotherapy: a meta-analysis. Journal Of Consulting And Clinical Psychology, 80(4), 547-559. doi: 10.1037/a0028226.
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.
Wells, J. E., Oakley Browne, M., Aguilar-Gaxiola, S., Al-Hamzawi, A., Alonso, J., Angermeyer, M. C., Bouzan, C., Bruffaerts, R., Bunting, B., Caldas-de-Almeida, J. M., de Girolamo, G., de Graaf, R., Florescu, S., Fukao, A., Gureje, O., Ruskov Hinkov, H., Hu, C., Hwang, I., Karam, E. G., Kostyuchenko, S., Kovess-Masfety, V., Levinson, D., Liu, Z., Medina-Mora, M. E., Nizamie, S. H., Posada-Villa, J., Sampson, N. A., Stein, D. J., Viana, M. C., Kessler, R. C. (2013). Drop out from out-patient mental healthcare in the World Health Organization’s World Mental Health Survey initiative. The British Journal of Psychiatry, 202(1), 42-49. doi: 10.1192/bjp.bp.112.113134