The aim of today’s article is to delve into one of the main skills that the Single Session Therapist must acquire when receiving training in the application of this intervention method.
In this regard, we follow some indications provided directly by Windy Dryden (2020) as a trainer of Single Session Therapy , who focuses attention on the importance of the therapist creating and maintaining a focus during the single session.
Why is it so important to maintain focus?
To make Single Session Therapy effective, the therapist must adopt a single-session mindset and help clients identify a focus to work on together. This will help the therapist and client make the most of their time .
Let’s see some practical tips on how to identify and maintain focus on the goal in Single Session Therapy.
Once the client has agreed to participate in the individual consultation , the therapist ‘s main goal is to help him create a focus to work on throughout the session . This aspect of the individual interview requires two important skills from the therapist : the first is to ask specific questions that can help the person identify the focus , the second is to know how to interrupt the client when he moves away from the objective and gradually bring him back to it.
Let’s deal with the questions first!
There are several questions that the single session counselor can use to help the client create focus. These questions can be problem – oriented , solution- oriented , or goal- oriented . Let’s look at them below:
- Questions that help create a problem focus for the session.
What is your most pressing concern that I could help you solve today?
What problem can I help you with today?
- Questions that help create a solution focus for the session.
If I helped you find an effective way to deal with your problem today, what would your answer be?
If I helped you find a solution to your problem today that you could use to achieve your goal, would you be interested?
- Questions that help create a goal for the session
What would you realistically like to achieve by the end of the session that would make you glad you came today?
This evening when you are at home, reflecting on today’s session, what do you think you wish you had achieved?
Once the therapist has asked the client a focused question, the client’s response will provide a first clue on which to direct subsequent questions, until the focus to work on is clear. Let’s see an example of how to proceed:
Therapist: What problem can I help you with today?
Client: I’ve been very anxious lately.
Therapist: Anxious about what?
Client: Anxious that my son will not get into the school of his choice.
Therapist: How does your anxiety affect you?
Client: I have sleepless nights and can’t concentrate on work .
Therapist: How do you hope I can help you with this problem today?
Client: Help me get some sleep and help me concentrate on my work .
Therapist: So if I can help you resolve your anxiety about your child’s school so that you can sleep and focus on your work, what would you want? Do you think about that?
Customer: That would be great.
Therapist: So, we agree that this is going to be the focus of the session?
Customer: Yes.
Let’s now see how to help the client maintain focus on the agreed problem (solution or objective)!
Once the therapist and client have agreed on the focus, it will be the primary task of the counselor to ensure that attention is maintained on it. To do this the counselor will need to use a series of skills.
- Seek and obtain permission to interrupt the client.
In the past, interrupting the client was not considered an appropriate action for the therapist. The therapist’s main role was to encourage the person to explore their concerns rather than to guide them in a direction. In single-session therapy, however, interruption is considered an important responsibility that the therapist must take on in order to keep the client focused. Since interrupting the client may be seen by the client as a rude way of acting, the therapist will first need to provide a reason for his or her action, and then ask the client’s permission to do so (Dryden, 2020).
Let’s see an example :
Therapist: So now we have agreed on a focus for the session, we both need to maintain that focus. OK?
Customer: OK.
Therapist: In any conversation between two people it is easy for one or both of them to wander from topic to topic and in a social conversation that is fine, but in a therapeutic conversation when we have agreed on a focus, that is problematic. So if that happens with us, I would like to interrupt you to bring us back to the center of attention. I will try to do this as sensitively as possible, but I will need to do it. Do I have your permission to do that?
Customer: Yes, that’s fine. I tend to wander around sometimes .
Advisor: And feel free to interrupt me if I go off topic too.
Customer: (laughing) I will .
- Make sure both maintain attention .
Sometimes it is difficult for the counselor to know whether or not a client has strayed from an agreed upon goal. When this happens, the therapist checks with the client to ensure that attention is maintained.
Therapist: Can I just check in with you?
Customer: OK.
Therapist: We decided to focus on your anxiety about your son’s school, and I… I know we’re talking about that now, so I’m not sure how that fits in with your wife spending a lot of time with her sister.
Customer: That’s not it. I was going off track .
Therapist: So, let’s get back to your feelings of anxiety about your son, shall we?
Customer: Yes .
Below is an example of a digression from the focus that nevertheless clarifies it.
Therapist: Can I just check in with you?
Customer: OK .
Therapist: We’ve decided to focus on your anxiety about your son’s school, and I… I know we’re discussing that now, so I’m not sure how that fits in with your daughter’s issues with dance school.
Client: The way I see it, they are both examples of my anxiety that my children may be blocked from getting what they really want in life .
Therapist: OK, I get it. They are connected. Would it make sense for us to keep the focus on your son and then see if we can generalize this to your daughter?
Client: If we could do both today, that would be great.
Advisor: OK, let’s do it .
This last example shows how the single-session therapist can work with both a specific focus and a general focus, always ensuring that both types of focus are connected (Dryden, 2020).
Conclusion
In conclusion, the skills described in this article represent a specific competence of the therapist who practices SST . Not putting these maneuvers into practice would mean invalidating the process that guides the client towards the direction he desires.
Angelica Giannetti
Psychologist, Psychotherapist
Team of the Italian Center
for Single Session Therapy
Bibliography.
Cannistrà, F., & Piccirilli, F. (2018). Single-Session Therapy: Principles and Practices . Giunti Editore.
Dryden, W. (2020). The single-session therapy primer: Principles and practice . Monmouth: PCCS Books.
Hoyt, M. F., & Talmon, M. F. (2014). What the literature says: An annotated bibliography. In M. F. Hoyt & M. Talmon (Eds.), Capturing the moment: Single session therapy and walk-in services (pp. 487–516). Bethel, CT: Crown House Publishing.
Talmon, M. (1990). Single-session therapy: maximizing the effect of the first (and often only) therapeutic encounter. San Francisco: Jossey-Bass.
Dryden W. (2020). Creating and Maintaining a Focus in Single-Session Therapy from https://www.windydryden.com/post/creating-and-maintaining-a-focus-in-single-session-therapy ever-increasing waiting periods with session limitations