Can Single Session Therapy be used with families?
Yes, and that’s what Bouverie Center has been doing for twenty-five years.
When I went to Melbourne, Australia ten months ago, I did it to learn about TSS from what, in my opinion, is the Center that has been able to integrate it best, both in terms of structure and technical and application development.
Directed by Jeff Young, the Bouverie Center is a center for families active both from a clinical point of view, providing daily therapies and consultations for families and individuals, and training: in addition to training hundreds of therapists in TSS, a few years ago it was commissioned by the Department of Health of the State of Virginia to implement Single Session Therapy in approximately twenty health facilities across the country – a fantastic job that we studied in detail at the Italian Center.
But how does the Single Session Therapy of this family center work?
Single Session Work
First of all, it should be noted that at Bouverie they call TSS interventions in a peculiar way: Single Session Work, which in Italian we could render as Single Session Activities or Interventions.
This is because SST is in fact a very customizable methodology, an implementation to clinical practices that can be used at multiple levels. Although in our courses we teach it to psychologists, psychotherapists and psychiatrists, with the appropriate modifications you are able to make it also used by social workers, nurses, doctors and other professionals recognized for helping relationships.
Of course, what can and cannot be done by each of them depends to a large extent on what the law provides, but the fact that TSS is a methodology that allows you to maximize the effectiveness of each individual meeting, to help the person to identify and use their resources to overcome, unblock, or even begin to improve their problems and difficulties, ensures that over the years the Bouverie (and not only, as we will see in other articles) has wisely and diligently declined it for different professional figures.
After all, these are all professions in which interaction with the person plays a fundamental role, and is a strategic lever to improve the effectiveness and efficiency of the work to be done together.
The general structure of the Single Session Work
In reality, the change of the name is only a desire to use a more appropriate label: the fundamentals of SST remain the same, obviously in the personal declination of the Bouverie Center – which is one of those that has also mainly influenced our work at Italian. Center for Single Session Therapy.
Briefly, the structure of their work, as far as the Bouverie Center is concerned, is divided into 3 main phases:
1 – Reception (In-take)
This phase includes both telephone contact and the moment in which the person arrives at the facility.
The phone call, as Talmon (1990) had already suggested, is an important moment to gather some information in a few minutes and to give a hint about TSS. In fact, on the phone it becomes possible to have an initial idea whether the problem presented may or may not be adequate for a TSS. Although this methodology is suitable for maximizing the effectiveness of each individual meeting, even in a path made up of several sessions, some particular conditions may prove unsuitable for offering the possibility of a single visit from the outset.
I deliberately do not specify “what conditions”, because in my opinion this is a choice that largely depends on the professional and the structure.
Before even arriving at the Bouverie, to the person is sent a questionnaire (very similar to the one we have been giving so far – although we are about to implement a different one, more aimed at helping the person and the professional to identify what to work on) which allows them to define a primary and secondary goal he would like to focus on in that session, and the degree of motivation and expectation he feels he has.
The person will have to bring the completed questionnaire on the day of the meeting, but if they do not have an email, if they have forgotten it, or if it is not possible to send it to them, the questionnaire is given to them directly as soon as they arrive (this is what we generally do at the Italian Center), being able to fill it out in a few minutes.
Specifically for families, the questionnaire can be completed by the applicant or by the parents.
2 – The session
At this point the family, or the individual (individual therapies are also done, of course), meets the therapist for the face-to-face meeting.
The family therapy session at the Bouverie Center normally lasts around 60-90 minutes, but remember that in the literature there are TSS of 30, 50, 60, 90, 120 and 150 minutes, meaning that the time factor is a choice. at the complete discretion of the structure or the professional.
The session is carried out following the principles that we will deepen in a subsequent article. Among these, in summary, the therapist aims to help the person to identify a precise goal to be achieved in that session (with the help of the questionnaire), helps him / her in a kind way to stay on the focus and priority they have given themselves, and manages the time available in order to maximize the effectiveness of the session.
An important element is that risk situations (e.g. suicide risk, violence, etc.) are assessed during this. In this case the usual safety procedures of the center are followed, implemented in such situations. Otherwise, if at the end of the session it is established that that one meeting is sufficient, an appointment is made 1 to 3 weeks later for a telephone follow-up.
3 – Follow-up
During the telephone follow-up, which lasts approximately 10-20 minutes, the professional investigates the short-term effects of the meeting: he asks, that is, how the weeks following the Single Session went, evaluating the effects of the latter together with the person.
If necessary he provides further assistance, for example by making a new appointment. In this case the options are different: you can opt for a new Single Session, or to start a progressive therapy (ongoing therapy, the traditional form of therapeutic path in several sessions), or you can direct the person to another service / program.
If, on the other hand, it is not necessary, we simply say goodbye by leaving the door open for any other need, both relating to what was dealt with in the Single Session, and relating to any new requests / difficulties.
In addition, always during the follow-up, the professional fills out a form in which he records the results of the session, and warns the patient that the Center could send him a questionnaire to evaluate the satisfaction of the intervention.
Conclusions
The Bouverie Center method is in our opinion one of the most systematic, both in the form of the entire intervention (just seen), and in particular in the structure of the Single Session. Together with the method of Hoyt, Talmon & Rosenbaum (Talmon, 1990) and that of Slive & Bobele (2011), it is the one that has most influenced us in the development of the Italian Center model.
In particular it proves very useful for health facilities, which in fact in Australia have implemented TSS with varying success in recent decades. In a future article we will also analyze the general results of this implementation.
Flavio Cannistrà
Psychologist, Psychotherapist
Founder of the Italian Center for
Single Session Therapy
Bibliography
Slive, A. & Bobele, M. (2011). When One Hour is All You Have: Effective Therapy for Walk-in Clients. Phoenix, AZ: Zeig, Tucker & Theisen.
Talmon, M. (1990). Single session therapy: Maximizing the effect of the first (and often only) therapeutic encounter. San Francisco: Jossey-Bass.
Weir, S., Wills, M., Young, J. & Perlesz, A. (2008). The implementation of Single Session Work in community healt. Brunswick, Australia: The Bouverie Center, La Trobe University.