One of the strengths of Single Session Therapy is that it is not an approach, it is a method.
Therefore, it can be integrated into virtually any form of intervention, both at the level of psychological counseling and psychotherapy.
Below I have translated some excerpts from an article by two Brazilian authors, which show how the Single Session can be easily integrated with psychodrama, to produce changes in a single, short encounter. A similar integration is not uncommon: within our training courses in Single Session Therapy we each time host therapists belonging to approaches that are also very different from each other.
The following is an opinion article, not a trial. Also I state that I am not a psychodrama expert. They are the authors of the original article (of which there are references at the bottom) and I thought, however, that those interested in this approach might find the article interesting.
Below you will find the translation of her excerpts, which have been faithfully translated, although the bolds and paragraphing are mine. The reference to the original and complete article is available at the bottom.
Changes and problems in the modern era
We live in a world where technological advances happen rapidly and communication is instant and global.
In his article, Colombo (2012) draws attention to the changes that are taking place in modern society, which is being transformed with such speed and liquidity that, driven by the personal compulsions of consumers, it generates detachment and emotional isolation between people. He states that “everything happens a lot in immediacy, life goes on galloping making the new seem to have an eternity, compared to the brand new” (p.27).
Moreno, psychodrama and interpersonal involvement
Jacob Levy Moreno (1889-1974) devoted his life to working with groups.
He sought a method that could increase the involvement of people in society, raise awareness and promote social inclusion (Motta, Esteves, & Alves, 2011). He did it because, at the beginning of the twentieth century, he had foreseen the “robotization” of man (Moreno, 1975), thus dedicating his whole life to finding a way to develop people’s spontaneity, improve their expression and communication, and promote rapprochement between them.
The power of the therapeutic group
The World Health Organization (WHO) (2008) states in its manual on integrating mental health into primary health care that groups represent an important strategy for the promotion of mental health, in view of which therapeutic groups and / or support services to several people at the same time. One of the main objectives that the WHO emphasizes is to create networks that guarantee attention and attention to the community. Therefore, groups are identified as an important resource that increases the breadth of the intervention, allowing community service and support to be provided to more people.
Single Session Therapy and Psychodrama
The methodology of the therapeutic act, or single session work used by Costa, Guimarães, Pessina and Sudbrack (2007) is “a unique, intense, powerful, focal service, which is carried out without the commitment of other forms of assistance and without an excess of technical, personal or methodological investment by professionals “(p.105). Acts occur in a single encounter and are often thematic, or are aimed at a specific population, such as a group of people with diabetes or a group of women.
A great example of this type of initiative is reported in the article by Almeida (2010), which recounts her experience with Psychodrama at the Cultural Center, describing social acts, open to the community, organized weekly, on Saturdays, in the Cultural Center of São Paulo. These groups have been held regularly for more than twelve years, coordinated by a group of psychodramaticians and aim to raise awareness among participants on global and social issues, increasing awareness and a sense of individual and social responsibility.
In this study, the relevance of the therapeutic act as a method of intervention is considered, considering its practicality in offering support and empowerment in a single intervention for several people working together. Unlike therapeutic processes, the act is performed with a focus on the current question, with the intention of creating involvement and reaching a conclusion on the same day. Professionals who wish to work with a single session should ensure that they have methodological and technical knowledge to manage it, and it is recommended that they feel capable and able to differentiate the requests presented to them, while maintaining their position as mediators in relation to the group.
The psychodramatic act can be done for a small audience of 4-10 people or for large groups of 30 to more than 100 people. It is not a new methodology, but a modus operandi of functioning, which uses methods and techniques of psychodrama.
It begins with a conversation about how the meeting will take place, its brevity, the care needed between the participants and the possibility of support after the meeting. Participants then start a warm-up that directs them to the topic in question, or a warm-up that looks for a proton theme to work on. The session follows with a deepening of the question, the request of a participant or the construction of a group of a collective character. Eventually, participants share how they felt and how this practice relates to their lives.
Elements for a Single Psychodrama Session
Theater therapy The one-act (single or single session) has been widely applied around the world, and has proven to be a powerful tool for improving flexibility, creativity, mental and psychological health, and dynamic responses, as shown by the research by Paul and Ommeren (2013). They draw attention to the need for each individual act to be carefully adapted so that it addresses the needs of each specific culture in a macro-context, such as society and civilization, or in a micro-group, such as the family.
Paul and Ommeren (2013) present a literature review article addressing the single session methodology. The authors point out that one therapeutic act may be sufficient to address the problems of many people, while others may require continued and longer treatment. They assert that there is no single model for the therapeutic act: some focus on the resources of the participants, others focus on the crisis or problem in question. The common aspect is that they focus on the themes of the person’s present time.
In relation to the initial contact with the group participants, the practitioner must establish a relationship quickly, maintain an investigative but welcoming position, inform that the group will only be held for one meeting, work collaboratively with the participant to develop the session. For this, it is necessary that the practitioner have the creativity and flexibility to deal with the singularities of each group, with an arsenal of methods and techniques to assist him (Paul & Ommeren, 2013).
When talking about a thematic psychodrama in single encounters, Toloi and Souza (2015) underline the importance of building a protected context. The target audience should be considered so that the practice offers the maximum benefit and the least harm, while respecting the vulnerabilities and resistances of the participants. The theme must be careful to arouse curiosity and a sense of identification in people, so that there is a spontaneous expression and a commitment to the proposal.
Effectiveness of the Single Session
In their article, Paul and Ommeren (2013) state that the single seat model was very efficient. Several authors discuss the use of this modality and the good perception by the participants after a single session (Bloom, 2001, Costa et al., 2007; Liberali & Grosseman, 2015). These surveys show that many people have received satisfactory psychological support in a single session. According to them, the therapeutic act is considered suitable for people, who can benefit from a single intervention in which, in a single meeting with the professional, they are able to provoke reflections and changes in future thoughts and behaviors, recognizing that many significant changes occur outside the therapeutic process.
Toloi and Souza (2015), concluded that thematic meetings were efficient in qualitative research on group movements, including dynamics, conflicts and relationships; the participants showed great enthusiasm with the co-construction process, which allows an awareness of the content presented up to a transformation. In short, work of this type represents a powerful resource towards the transformation of the social fabric, which appears devoid of belonging and above all marked by the immediacy of extreme individualism, ephemeral relationships and existential emptiness.
An example of a Single Session with Psychodrama: Hector and the end of a relationship
We will present here an example of the power of a psychodramatic act in which the first author acted as a director. It is a practice conducted in the context of a specialization course in performing arts. On that day, with a time of 20 minutes for the demonstration of a therapeutic act, it was necessary to shorten all the processes so that all the phases of a psychodrama could be carried out, including the warm-up, the dramatization and the sharing.
The warm-up was short and consisted of asking the audience who volunteered for the short demonstration. A student, who in this work will be called Hector, raised his hand and offered himself. When Hector volunteered, the director said he couldn’t be the volunteer himself. The director then invited Hector into the enclosed space for the drama and asked him to report to everyone how he felt about his attitude. Hector said he felt strange and rejected. With that, the director asked him to focus on the feeling of rejection, to close his eyes and to look for another moment in his memories of him when he felt the same way.
Hector said he felt that way when he divorced his first wife. The director then asked him to identify a scene that represented this feeling, and portrayed the moment in which the couple had left the lawyer’s office after signing the separation documents. A person from the audience was invited to represent Hector’s wife and the scene was set with the two saying goodbye. In the scene, Hector told his wife that he didn’t understand why he wanted to separate, because he was willing to change and try to reconcile. The auxiliary ego (from the audience), in place of the wife, replied by stating that it was a definitive decision. Hector was overcome with sadness, showing this by lowering his head and interrupting the dialogue.
Another member of the audience was invited to attend and take Hector’s place, while he, accompanied by the director, watched the scene from the outside. The director then asked what he would like to do for himself at that moment. Hector went without hesitation to the auxiliary ego that had represented him previously, and said: “Now it seems very bad, very difficult but, believe me, your life will be very beautiful, you will build a wonderful family and you will be very happy”. At that moment, he embraced his past self and the scene closed.
In the circle, Hector shared the fact that he had enjoyed visiting this moment in his life and re-signifying the abandonment he had felt. The auxiliary ego who had played the role of the ex-wife shared that he was experiencing a similar moment and that he liked being in the complementary role represented, because he had made him understand better the partner who had left her. The audience, involved in the scene, shared the feeling of feeling the emotions of the characters and understood the potential of the scene, which had allowed them to revisit and redefine feelings and experiences.
Conclusions (by Flavio Cannistrà )
This article shows an interesting and useful variation of Single Session Therapy.
This is one of the many examples of how, with a training in Single Session Therapy, the approach or orientation that is already practiced can be used in order to maximize its effectiveness. This is useful both for those contexts in which the therapist cannot always conduct more than one session (or considers it necessary not to), and to offer an additional service (the possibility of a single meeting) to those who request it and for all those people. and users for whom this form of intervention is most useful.
Flavio CannistrÃ
Psychologist, Psychotherapist
Founder of the Italian Center
for Single Session Therapy
Original article
Inues, A. L. S. & Conceição, M. I. G. (2017). Intervenção psicodramática em ato: ampliando as possibilidades. Revista brasileira de Psicodrama, 25, 2, 19-27.
Bibliographic references cited
Almeida, C. M. C. D. (2010). Ato socionômico temático: Despertando consciência das ecologias pessoal, social and natural environment. Revista Brasileira de Psicodrama, 18 (1), 103-120.
Bloom, B. L. (2001). Focused single-session psychotherapy: A review of the clinical and research literature. Brief Treatment and Crisis Intervention, 1 (1), 75-86.
Colombo, M. (2012). Modernidade: A construção do sujeito contemporâneo and a sociedade de consumption. Revista Brasileira de Psicodrama, 20 (1), 25-39.
Costa, L. F., Guimarães, F. L., Pessina, L. M., & Sudbrack, M. F. O. (2007). Single session work: only intervention with family and adolescent and conflict with her. Journal of Human Growth and Development, 17 (3), 104-113.
Liberali, R., & Grosseman, S. (2015). Use of psychodrama in medicine in Brazil: A review of the literature. Interface-Comunicação, Saúde, Educação, 19 (54), 561-571.
Moreno, J. L. (1975). Psychodrama. São Paulo: Cultrix.
Motta, J. M. C., Esteves, M. E. R., & Alves, L. F. (2011). Psicodrama público: Um projeto social em Campinas. Revista Brasileira de Psicodrama, 19 (2), 33-39.
Organização Mundial da Saúde (WHO) (2009). Integração da saúde mental nos cuidados de saúde primários: Uma perspectiva global. Portugal: Autor.
Paul, K. E., & Ommeren, M. (2013). A primer on single session therapy and its potential application in humanitarian situations. Intervention, 11 (1), 8-23.
Toloi, M. D. C., & Souza, R. M. D. (2015). Sociodrama themático: Um procedure de pesquisa. Revista Brasileira de Psicodrama, 23 (1), 14-22.