Starting from the reflection previously carried out on the opportunity to implement a SST service within a health or social institution (public or private), we believe it may be useful to deepen the issue, reporting the results of an interesting research conducted in 2009 in a family service in Melbourne, Australia, the Bouverie Center where Single Session Work (SSW) has been implemented.
The 12-month research focused on the implementation phase of single-session work as the primary model of service delivery for all new family appointments, with the aim of evaluating the experiences of clients and therapists in the face of change in offering clinical services.
But let’s see how the idea of adopting SSW in the Bouverie Center was born?
Before embracing single-session work as a primary model for delivering clinical services to families, Single Session Work was first presented at the Bouverie Center in 1994 by members of the facility who became aware of the work done by the team of the Canberra Child and Adolescent Mental Health at the Dalmar Center in Sydney (Price, 1994) and the writings of Moshe Talmon and his colleagues (1990, 1993).
How was the evaluation process of the Single Session Work structured?
The evaluation of the SSW process experienced by the new customers who contacted the Bouverie Center from November 2009 to December 2010, involved the realization of:
- a telephone contact with an operator who made an appointment with a therapist, sending a pre-SSW questionnaire for each family member to complete and bring to the session.
- a work session with a therapist conducted on the basis of the data collected by the therapists during the pre-session update.
- a telephone follow-up after 2-4 weeks on the progress of the session.
- a post-SSW questionnaire.
Pre- and post-SSW questionnaires (Young et al., 2006) were collected and analyzed as part of the evaluation.
For the evaluation with the therapists, 9 discussion groups were created open to all staff of the organization (director of the clinical program, director of the Bouverie, assistance staff, clinical staff, research and training staff of the SSW) , whose main area of investigation was the experience of staff in adopting SSW as the primary facility for clinical practice.
What results have been achieved by the SSW process evaluation work with clients and therapists?
Of the 139 new families seen during the research, 43% had only one session, 21% two sessions and 36% three or more sessions.
From the Pre-SSW questionnaires carried out by 45% of the families who participated (N = 63) in the study, it emerged that the most common problems that patients brought to therapy concerned:
- problems with a child’s behavior (18%);
- difficulties in family relationships (16%);
- argument or conflict (15%);
- communication problems (15%);
- mental health problems of a family member (15%).
80% of customers (N = 111) said they were concerned about the problem; 75% (N = 93) believed the problem was interfering in their life; and 56% (N = 78) did not feel confident about addressing the problems faced.
Since only about 28% (N = 39) of families completed the pre- and post-SSW questionnaires, the results of these data are not sufficient to produce general considerations.
With respect to the evaluation work with therapists, it emerged that the implementation of SSW as an entire organization’s approach to providing family therapy services was successfully received by the therapists and the Bouverie management group. Although not all therapists were immediately comfortable with using the SSW, they nevertheless took advantage of the discussions to:
- talk about the problems that have emerged in practice;
- explore some clinical dilemmas regarding SSW implementation (e.g. language to be used to describe SSW and the importance of providing clear information concepts, emphasizing the alternative work option; decisions to make on how and when to follow clients; the pros and cons of including written materials as questionnaires in the therapeutic process)
- systematize and create software for diseases.
Conclusion
The evaluation carried out at the Bouverie Center, beyond some limitations relating to data collection (e.g. irregular collection of feedback, relatively low return rates of pre- and post-SSW questionnaires, etc.), strengthened the results of studies similar on single session therapy performed in other settings.
The study also provided an opportunity for in-depth discussion and a connection between members of the clinical team, which led to valuable insights into the experience of family therapists with respect to using SSW in their clinical work. light a number of important considerations for therapists.
Of particular note is the fact that many of the concerns or dilemmas identified by therapists in working with families through SSW were not evident as significant concerns for clients.
Finally, through the process of implementation and evaluation, it was possible to ascertain that the application of SSW has brought some key benefits for clinical work, including the framework to support therapists in keeping the sessions focused and opportunities for the staff of be informed by feedback from families on their therapy experience.
Angelica Giannetti
Psychologist, Psychotherapist
Italian Center team
for Single Session Therapy
Bibliography
O’Neill, I., Rottem, N., (2012). Reflections and Learning From an Agency-Wide Implementation of Single Session Work in Family Therapy, 33 (1). Australian and New Zealand Journal of Family Therapy.
Price, C. (1994). Open days: Making family therapy accessible in working class suburbs. Australian and New Zealand Journal of Family Therapy, 15(4), 191–196.
Talmon, M. (1990). Single session therapy: Maximising the effect of the first (and often only) therapeutic encounter. San Fransisco: Jossey-Bass.
Talmon, M.(1993). Single-session solutions: A guide to practical, effective, and affordable therapy. New York: Addison-Wesley.
Young, J., Rycroft, P. (1997). Single-session therapy: Capturing the moment. Psychotherapy in Australia, 4(1), 18–23.
Young, J., Weir, S., Rycroft, P., Whittle, T. (2006). Singlesession work implementation resource parcel. Brunswick, VIC: The Bouverie Centre.