One of the most commonly asked question is: Can single session therapy be applied to only one context?
The answer is NOT
In the previous articles dealt, we talked about “how” and “if” a Single Session Therapy could be enough to handle the critical issues of people who turn to an help service, and they also demonstrate how, according to many researches, 1 is the most frequent number of sessions.
Now the question is: where can we apply the principles of TSS?
Setting behind the Single Session Therapy makes it a flexible, dynamic and creative approach, suitable for responding to many needs relating to mental health and psychosocial risks.
Many researches, which we will deepen in the next articles, have shown how the typical mindset of this approach is suitable in multiple contexts with many positive results: on the one hand, it shortens waiting lists, a very big problem in public services, and on the other, it restores emotional well-being (gives the opportunity of improve human health and well-being of our people) in the shortest time possible.
Where to practice TSS?
A review, althoug not exhaustive, of concrete experiences is the best way to understand the multiplicity of contexts in which to practice Single Session Therapy, in addition to private practice.
1. FAMILY SUPPORT SERVICE
In Canada, since 1990, the Eastside Family Centre (EFT), a non-profit organization , provides the local community to give an immediate and free response, working in a network perspective (in agreement with schools, hospitals, medical services, etc.) acting as an easily accessible and proximity service and wolk-in (without an appointment) for a large daily time slot.
The Service is dedicated to children, teenagers and families using Single Session Therapy, but it keeps, as specified in other articles, the “open door” for all the family and educational problems that that may require more psychological session.The data shows that among the families who access the Service once, 65% do not consider another appointment necessary. It means that about 2 out of 3 people solve their problem with a single session. But with what results and degree of satisfaction? Hoffart & Hoffart (1994) indicate that 89% of users of the service expressed satisfaction, a condition that persisted even 6 months after treatment.Miller (2008) analyzed 403 questionnaires concerning the degree of satisfaction, noting that the majority of people were satisfied or very satisfied with the TSS session, with a percentage that ranged from 83.4% (couple conflicts) to 93.1% (behavioral problems of children).
1. MENTAL HEAL H SERVICES
Why Use Single Session Therapy in Mental Health Services? There are so many reasons, but let’s limit ourselves to one of the most obvious: the reduction of waiting lists.
Let’s start with some practical considerations: in the current health service the waiting lists are getting longer and longer. A person who contact a Public Service can see his request accepted after a long time (from a few days to a few months!).
During the time between the first telephone contact to the first interview the person has to manage the situation on his own, and then, once the time for the “fateful interview” has come, spend additional time for the assessment process.
The possibility of a Single Session treatment shortens waiting lists and prevents that 50% of people, who trying to access a Mental Health Service from leaving the company, avoiding the risk of a sensational drop out (Barrett et al., 2008).
The basic idea, even when thinking about complex situations that are frequently found in the Mental Health Services, is that people are not simply a diagnosis, but have problems that can be solved in a single session.
However, as we said, the context of Mental Health Services is very complex and wide.The results of TSS in this sector – where it is widely used – are not limited to the reduction of waiting lists, but also to the reduction of costs, the efficiency of the services, the improvement of team-working and more. Due to the importance of the topic, we will return on it with dedicated articles.
2. EMERGENCY MANAGEMENT AND FIRST AID SERVICES
TSS is also widely used in emergencies and first aid.
For example, a noteworthy experience, in which the Single Session Therapy demonstrates its effectiveness in intervening in situations of PTSD (Post Traumatic Stress Disorder), is offered by a Service, active in Mexico, which addresses the victims of street robbery, which in 2012 amounted to 118.1 per day only to Mexico City (source: Procuradia General de Justicia).
A service designed to break down the barriers of the Cultural System to which it belongs, and which overcomes 3 obstacles that often limit access to help systems: social stigma, economic barriers and accessibility of the service.
The Mexican experience experiments with Single Session Therapy as a treatment strategy for those situations that risk inducing the typical symptoms of a PTSD.
Platt and Mondellini (2014), despite being in an initial phase of experimentation, declare the great potential of TSS in emergency contexts, as an accessible and non pathologizing path, even in a cultural context like the Mexican one, where the saying “dirty clothes are washed at home” summarizes the common thought.
Further experience of how TSS can be adapted to contexts where emergency management is necessary comes from Colombia, country with ongoing armed conflicts, (nation permeated by numerous fire conflicts), where the staff of Doctors Without Borders, not having the possibility to plan or monitor interventions after first session, practice TSS to people (who come to the Service) with depressive symptoms.
Studies find that 67 out of 71 people (94.4%) claim how, immediately after treatment, a Single Session was helpful. People say that TSS “helped them to get out of the labyrinth they got lost in and found some answers, which helped them to feel stronger and to identify their real resources ” (Urrego et al., 2009).
1. HOSPITALS
The food for thought to verify how Single Session Therapy can be applied in hospital settings comes from the studies of Gibbons and Plath (2012).
The authors propose a research based on the considerations of some students during their training as social and health workers. The young workers realized, in a simple but enlightening way, that in hospital organizations the most frequent number of sessions is 1. From this observation, the idea that inspired the experimentation of the TSS practice was the awareness of having only one chance “to do it well”.
Now try to move your attention from that situation to your personal life. I think that the insight these students had is known to anyone who has experienced situations of hospitalization, where operators tend to meet patients only once.
About your personal experience, would you have wanted to meet someone who, properly trained, would offer you a contribution in understanding the meaning of what was happening, with positive effects in the management of stress and anxiety related to these events?Rhetorical question, right ?!
Conclusions
The above is only a small part of “where” and “how” Single Session Therapy can help. Other contexts in which to practice TSS, which we will deepen along the way, are:
1. Student and professional orientation
2. addiction treatment services
3. companies and organizations.
Other insights can be found in our next articles.
Furthermore, as already seen in other articles, research reported has shown the adaptability of TSS in different countries and in different cultural contexts. In addition to the United States, this article talked about Canada, Mexico and Colombia. In the next articles we will also talk about England, Australia, New Zealand, China and others. We will also bring our first Italian studies results.
I would like to conclude by quoting a sentence I used to hear during my University years: “How many psychologists does it take to change a light bulb? One, if the light bulb really wants to change!”
Ergo, why couldn’t a single session be enough, starting from the same premises?
Federico Piccirilli
Psicologo, Psicoterapeuta
Co-founder dell’Italian Center
for Single Session Therapy
Bibliographical references
Barrett, M.S., Chua, W., Cits-Crstoph, P., Gibbons, M., & Thompson, D. (2008), Early withdrawal from mental healt treatment: Implications for Psychotherapy practice. Psychotherapy: Theory, Research, Practice, Training, 45, 247-267.
Gibbons, J. & Plath, D. (2012). Single Session Social Work in Hospitals. Australian and New Zealand Journal of family Therapy, Volume 33, Issue 1, pp. 39-53.
Hoffart, B. & Hoffart, I. (1994). Program evaluation of Eastside Family Center. Calgary: Synergy Research Group.
Hoyt, M.F. & Talmon, M. (eds.) (2014). Capturing the Moment. Single Session Therapy and Walk-In Services. Bancyfelin, UK: Crown House.
McElheran, N., Stewartm J., Soenen, D., Newman & J., Bruce, M. (2014b). Walk-in Single Session Therapy at The Eastside. In M.F. Hoyt & M. Talmon (eds.) (2014a), op. cit., pp. 177-194.Miller, J.K. (2008). Walk-in single session team therapy: A study of client satisfaction. Journal of Systemic Therapies, 27, 78-94.
Paul, K.E. & Van Ommeren, M., (2013). A primer on single session therapy and its potential application. Humanitarian situations. Volume 11, Number 1, Page 8-23.
Platt, j. & Mondellini, D. (2014). Single Session Walk-in Therapy for Street Robbery Victims in Mexico City. In M.F. Hoyt & M. Talmon (eds.) (2014), op. cit., pp. 214-231.
Slive, A. & Bobele, M. (2014). Walk-in Single Session Therapy: Accesible Mental Healt Services. In M.F. Hoyt & M. Talmon (eds.) (2014), op. cit., pp. 73-94.
Urrego, Z., Abaakouk, Z., Roman, C. & Conteras, R. (2009). Evaluation of results of a single-session psychotherapy intervention in people affected by the Colombian internal armed coflict. Unpublished manuscript.