In today’s article we present a research on how Single Session Therapy can prove to be an excellent method in the treatment of situations that can manifest themselves in adolescence .
In several articles of this blog we have seen how SST is a highly efficient method in different situations, contexts and with different people.
I believe, also considering the times we are living in and how the pandemic has affected (is affecting and will affect) the mental health of people and young people, that the possibility of practicing SST and brief therapies can represent a valid opportunity for mental health professionals.
How has the mental health landscape of young people changed with Covid-19?
One in four teenagers has symptoms of Covid-related depression, cases have doubled in 2 years, and 1 in 5 shows signs of an anxiety disorder. This is what emerges from a large meta-analysis just published in Jama Pediatrics, which included 29 studies conducted on over 80,000 young people.
In the research presented by Jessica L. Schleider et al. “ Future Directions in Single Session Youth Mental Health Interventions ” several factors are taken into consideration in order to evaluate how to continue research (and define best practices) in the treatment of adolescents using SST.
The context
The United States, despite spending more money on mental health services than any other country, maintains very low access to those services. This access gap is very large in the youth population with a percentage that stands at around 80% of young people with needs who have no services or ineffective interventions.
Given this data, Single Session Therapy may offer an opportunity to improve access, cost-effectiveness, and completion of treatment pathways for young people.
How to bridge this gap?
More than half of lifetime mental health problems emerge by age 14 (de Girolamo, Dagani, Purcell, Cocchi, & McGorry, 2012; Kessler & Wang, 2008 ), often resulting in chronic impairments and negative impacts for individuals, families, and society. Despite significant advances in the development of psychosocial treatments for youth mental health problems, up to 80% of youth in the United States with mental health needs receive no services (Kataoka, Zhang, & Wells, 2002; Kazdin & Rabbitt, 2013; Kessler et al., 2005; Konrad, Ellis, Thomas, Holzer, & Morrissey, 2009).
What can be imagined to revolutionize the way of doing therapy?
Kazdin (2019) argues for the need to think about therapeutic action through an entirely new lens , stating that future interventions may not rely on the psychological treatments that have dominated research to date. The study reflects the growing body of research that attests to the reach of Single Session Therapy, while also noting that among youth who do enter services, treatment is often brief: U.S. youth who enter therapy attend an average of only 3.9 sessions (Harpaz Rotem, Leslie, & Rosenheck, 2004), and the modal number of sessions they attend is one (Hoyt, Bobele, Slive, Young, & Talmon, 2018a). This creates a need to quantify and capitalize on what can be accomplished, given the appropriate goals and structure, in a short period of time.
State of the evidence on single-session interventions for young people.
Evidence suggests that Single Session Interventions may help reduce or prevent psychopathology in youth . Randomized trials have shown promising effects for several types of youth problems, including specific phobias (Davis, Ollendick, & Ost, 2012), conduct disorders (Mejia, Calam, & Sanders, 2015), and general distress in multiproblem youth (Perkins, 2006).
In a meta-analysis of 50 randomized controlled trials (Schleider & Weisz, 2017), TSS interventions for youth psychological problems demonstrated a significant beneficial effect with a 59% chance that a youth receiving SST would show greater symptom reduction than a youth assigned to a control condition (Ruscio & Mullen, 2012). Numerically, the overall effects of Single Session Therapies are slightly smaller than those of traditional multi-session youth psychotherapy (Weisz et al., 2017; mean g = .46 for treatments lasting an average of 16 sessions). However, their relative brevity and accessibility suggest the potential for broader-scale impact.
Recommendations for the future
Further research is needed to determine the promise and limitations of SST. Because of this, Schleider and colleagues offer 6 recommendations for future research (which are only cited and detailed in this article in the article “ Future Directions in Single Session Youth Mental Health Interventions ”):
- Choose your sizes carefully.
- Please specify methods in advance through pre-registration.
- Use plausible control conditions.
- Optimize the accuracy and predictive power of SSI by assessing immediate outcomes.
- Capitalizing on internal and inter-person data to improve SST response prediction.
- Open source the “SST” program materials.
Federico Piccirilli Psychologist, Psychotherapist Team of the Italian Center for Single Session Therapy
Bibliography
Schleider, J.L., Dobias, M.L., Sung, J.Y., Mullarkey, M.C., (2020). Future Directions in Single-Session Youth Mental Health Interventions. Journal of Clinical Child & Adolescent Psychology, 49:2, 264-278.
de Girolamo, G., Dagani, J., Purcell, R., Cocchi, A., & McGorry, P. D. (2012). Age of onset of mental disorders and use of mental health services: Needs, opportunities and obstacles. Epidemiology and Psychiatric Sciences, 21(1), 47–57.
Kessler, R. C., & Wang, P. S. (2008). The descriptive epidemiology of commonly occurring mental disorders in the United States. Annual Review of Public Health, 29, 115–129.
Kataoka, S. H., Zhang, L., & Wells, K. B. (2002). Unmet need for mental health care among U.S. children: Variation by ethnicity and insurance status. The American Journal of Psychiatry, 159(9), 1548–1555.
Kazdin, A. E., & Rabbitt, S. M. (2013). Novel models for delivering mental health services and reducing the burdens of mental illness. Clinical Psychological Science, 1, 170–191
Kazdin, A. E. (2019). Annual research review: Expanding mental health services through novel models of intervention delivery. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 60(4), 455–472.