Category Blog Post

How to promote hope in Single Session Therapy

Today ‘s article focuses in particular on one of the therapeutic (or change) factors that acts in a particular way within Single Session Therapy (SST), namely hope .

As we know, SST is a widely used method in mental health services as it represents a clinically effective solution for reducing long waiting times and overcoming difficulties in accessing psychotherapy.

The aim of the article is therefore to provide useful information on how to promote this factor during Single Session Therapy sessions .

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Single Session Therapy: “one at a time” or both?

With today ‘s article we talk about two ways of naming Single Session Therapy, namely “Single Session Therapy” or “One at a Time” Therapy (in English Single-Session One-At-A-Time ) in order to understand better understand the meaning and reasons for the different usage .  

Some scholars such as Windy Dryden, for example, prefer to use both terms in a combined manner with the aim of dispelling some myths created around SST by those approaching the method for the first time.

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SST and Research: Can a Single Group CBT Session Be Effective for Treating Insomnia?

With today ‘s article we report the data of a research carried out in 2013 at the Kaiser Permanente Medical Center in Fontana , California aimed at demonstrating the effectiveness and efficiency of Group Single Session Therapy associated with Cognitive Behavioral Therapy for the treatment of chronic insomnia ( TCC-I ).

  

What was the objective of the research?

Dennis Hwang , Medical Director of the Department of Sleep Medicine at Kaiser Permanent says the goal of the study was not to prove whether Cognitive Behavioral Therapy was an effective treatment for insomnia, but to find out whether a different way to use it could make it effective not only for a single individual, but for a larger population .

  

From what need did this research arise?

Again according to Hwang, the need to find innovative solutions is linked to the fact that chronic insomnia is a very common condition that affects up to 30% of the population . Traditional programs run individually or in small groups have always required multiple visits, limiting the volume of patients who can access them. The program for the treatment of insomnia at Kaiser Permanente Fontana , however, represented a real innovation as it was carried out with a larger group of people ( 20 participants ) who participated in just one session , followed by follow-up telephone.

 

 How did the experimentation take place?

The center offered two weekly sessions , each lasting 2.5 hours with a maximum of 20 people experiencing chronic insomnia.

The program, taught by a physician assistant , addressed sleep hygiene, sleep beliefs, relaxation techniques, sleep restriction therapy, and optimal sleep position.

  

What results were obtained?

 The following data emerged from research findings presented at the SLEEP 2013: Associated Professional Sleep Societies 27th Annual Meeting conference:

321 (88%) of 363 adults with insomnia who completed the TCC-I program reported improvement in their insomnia based on subjective feedback .

Overall sleep time improved by an average of 1.5 hours , and time to fall asleep

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SST and Mental Health: The New Brunswick Experience and Mental Health Services Empowerment Plans

With today’s article we once again open our gaze to the world to learn about the different systems for providing mental health services .

The global crisis due to the health emergency we are experiencing has highlighted important gaps compared to the health service delivery models implemented so far. This situation has put us in a position to begin to reflect and imagine effective solutions for the future capable of healing or strengthening some health sectors, in particular that of mental health which today appears to be particularly difficult.

So what is the objective we aim to achieve with today’s article?

Starting from this premise and from sharing what recently happened in the New Brunswick region in Canada, where a young girl committed suicide due to a failure to respond to her request for help in an emergency room at Fredericton’s Chalmers Hospital, Let’s look at the plan to strengthen mental health services proposed by the New Brunswick Ministry of Health led by Dorothy Shephard. 

 What were the proposals?

In March 2021 Dorothy Shephard ordered a review of the mental health system, announcing 21 recommendations from the Department of Health and regional health authorities. For 2021-2025 the recommendations have been grouped into four main areas: education , emergency departments , community addiction and mental health services.

 Let’s see them in detail!

  1. Training area. Provide training to emergency room personnel , police and other first responders on trauma care . These modules are designed to support staff in a busy emergency department environment.
  2. Launch a provincial awareness campaign for services aimed at addictions and mental health crises.
  3. Develop and distribute crisis care educational materials to community service providers.
  4. Re-establish and streamline the use of the emergency number as a 24-hour response line for addiction and mental health issues.
  5. Complete the proposed Suicide Crisis Response, Intervention and Prevention Plan.

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Clinical Case Study: Single Session Therapy for the treatment of anxiety related to Covid-19 in a pediatric emergency department

Clinical Case Study: Single Session Therapy for the treatment of anxiety related to Covid-19 in a pediatric emergency department

The spread of Single Session Therapy throughout the world is now a certain fact, as evidence of this phenomenon are the multiple applications of the method in the various areas of mental health .

 

Through the exposition of a clinical case in which the three phases of a Single Session Cognitive Behavioral Therapy intervention in a pediatric setting are described for the treatment of anxiety related to the spread of Covid-19 (P Lee & Simpson, 2020), we really want to highlight the different ways in which the single session mindset is expressed, proving to be a fundamental resource for improving the quality of services and making them accessible to a larger population.

  

How can the Single Session mindset represent a resource in pediatric mental health?

Even before the Coronavirus (Covid-19) pandemic , visits to pediatric emergency departments had increased (Sheridan et al. 2015). Over half a million children (a significant portion of whom come from families in conditions of socio-economic disadvantage) were taken to psychiatric emergency rooms every year for mental health problems, of which almost half with symptoms attributable to an anxiety disorder . With the pandemic, this phenomenon has increased (Jiao et al . 2020) (e.g., children experience anxiety connected to the epidemic and the health of relatives, poor sleep, physical discomfort, agitation and separation anxiety) and with it the need to provide a more effective response in order to reduce further psychiatric emergency admissions in general (P Lee & Simpson, 2020).

 

 Clinical case.

A 10-year-old American Indian girl arrives at the pediatric emergency room accompanied by her mother, presenting with chest pain, abdominal pain, nausea and decreased appetite for a few weeks. She had no significant medical or psychiatric history. Her vital signs and laboratory tests were reassuring. At the time of the initial evaluation, the child’s mother expressed concern about her daughter’s anxiety and discomfort related to the Covid-19 epidemic.

The team offers the family a visit with the service’s specialized behavioral health counselor. The mother reports to the counselor that the Covid-19 pandemic had been difficult. The child felt “down” and she experienced increased irritability, loss of pleasure (anhedonia), tearfulness, racing thoughts, and worry. The child reported struggling with social isolation and not being able to see her friends, who she previously saw at school. Additionally, the little girl was worried that her family members might contract the coronavirus; two of her brothers had poor health. She also feared that her abdominal pain was an indication of a serious health problem. The little patient had not reported suicidal thoughts or substance use.

The behavioral health counselor began a brief three-phase cognitive behavioral therapy (CBT)

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What does it mean to introduce Single Session Therapy into an organization? Practical tips and guidance

With today’s article we take up a topic already addressed in the previous article regarding the existence or otherwise of criteria that establish an effective use of Single Session Therapy with clients, extending it to its use in the context of health services.   

The objective of the article will, in fact, be to identify the indications and contraindications for the implementation of SST in health services. The question we ask ourselves, in fact, is whether Single Session Therapy can be a valid tool for providing psychological interventions in healthcare organizations and what can make its introduction more effective.

 

To answer this question we will again make use of Windy Dryden (2019) who suggests some indications and contraindications capable of predicting whether SST will be used as an effective method within an organization.  

 

 What indicators does Dryden  believe will predict whether HST will flourish as a method of psychological service delivery within an organization?

Service support . It is important that the majority of workers in an organization support SST as a means of service delivery. Before the method is introduced, all interested parties must be able to share their enthusiasm, raise doubts, reservations and objections and discuss them in a respectful manner. Managers, therapists and administrative staff must all be involved in the decision regarding whether or not to introduce SST into the organization. Furthermore, where some therapists do not wish to be involved, they should be respected, so any covert attempts to sabotage SST will be minimised.

Adequate training . Before implementing SST in an agency it is important that all staff are sufficiently trained. This should involve both skill development and the opportunity to share and discuss doubts, reservations and objections about the method.

Ongoing support and supervision . Before SST is rolled out within a healthcare agency, it is important that there is ongoing oversight of how it is practiced to hone skills and protect client well-being.

Adequate administrative support . Within an organization, if there is not enough administrative support to incentivize SST service, it will soon fade away. Therefore, in organizations where SST grows, administrative staff actively participate in the team offering crucial feedback to ensure the smooth functioning of the service.

TSS integrated with other services . It is important that SST is fully integrated with the delivery of the organisation’s other services and not seen as a separate part of what the agency provides, managed by one or two enthusiastic individuals.

Accessible to the public . It is important that the SST service is accessible to the public,

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Are there indications and contraindications for the use of single session therapy?

In this article we address a topic that is of profound interest to both scholars of Single Session Therapy and those who are eager to learn it, namely the existence or otherwise of criteria for establishing its use with clients.

 

Windy Dryden (2019), one of the most important scholars of Cognitive Behavioral Therapy in the world and a scholar of psychotherapies, maintains that there are two different ways of addressing the issue: the first is the one which provides for the existence of indications and contraindications, the second is the one that does not foresee any at all.

  

What kind of indications and contraindications do therapists rely on the existence of criteria to decide whether or not a client can receive a TSS intervention?

Let’s see some!

TSS can be indicated with :  

People who have daily living problems (non-clinical/emotional) such as non-pathological anxiety, depression, guilt, shame, anger, grief, jealousy and envy, or relationship problems at home and work .

People who experience self-discipline issues on a daily basis .

People predisposed to single intervention and ready to take care of their non-clinical problems , especially to prevent more serious problems.

People predisposed to single intervention and ready to take care of their own clinical problems such as simple phobias (Davis III et al ., 2012) or panic attacks (Reinecke et al ., 2013).

Stuck people who need help to free themselves and move forward.

People who see therapy as intermittent help throughout the life cycle.

People with personal development or coaching goals .

People with clinical problems , but ready to tackle a non-clinical problem, for example, a person with a personality disorder who wants help to overcome the problem of procrastination.

People who are open to therapy, but want to try it before committing.

People who want preventative care .

People with meta-emotional problems (e.g. shame of being anxious).

People who require timely and targeted crisis management.

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