This article is inspired by an interview conducted by W. Dryden with M. Hoyt in 2018 , Toward the future of single-session therapy: An interview , in which the two authors questioned the future of single-session therapy . At that time, the pandemic scenario that occurred shortly thereafter was certainly not imagined, but have the ideas on how SST could evolve changed that much?
Since Moshe Talmon ‘s 1990 book, Single-Session Therapy: Maximizing the Effects of the First (and Often Only) Therapeutic Encounter , SST has received a lot of attention. Thanks to the first work conducted by M. Hoyt , R. Rosenbaum and M. Talmon it was possible to discover how many people find a single session useful and sufficient for a series of problems. Since then, SST has been translated into many languages, and numerous scholars (Hoyt, Bobele, Slive, Young, & Talmon, 2018; Hoyt & Talmon, 2014) have confirmed that one session may be, for many clients, all they need. need.
Let’s see in more detail what developments have taken place since that moment?
After 1990:
a first development concerned the recognition of the fact that the highest frequency of psychotherapy sessions is 1 . Before Talmon’s book there were only sporadic testimonies on the implementation of single interventions. Thanks to in-depth literature research and the implementation of quantitative studies on the use of SST, it has been demonstrated that a single session is the most common duration of a treatment.
a second development occurred with the carrying out of research which documented the effectiveness of single session therapies (Hoyt & Talmon, 2014).
a third development concerned the fact that there is not just one way of doing SST, but the method can be applied with different models (solution-centered, cognitive-behavioral, MRI, narrative, psychodynamic).
a fourth development was that relating to the recognition of SST as an intervention method rather than as a particular theoretical approach (Slive & Bobele 2011, 2018). SST, in fact, focuses on the way in which the therapist can help the client in that encounter, considered as complete in itself.
Another development concerned international awareness of SST.
What do you expect from the future?
According to the two authors, a first prediction for the future is that the use of SST and walk-in services will be increasingly widespread and that this diffusion will also be linked to the creation of single sessions via the Internet . Many people around the world use technology (Skype, FaceTime, WhatsApp or other apps) to ask questions and get information online. The pandemic has already put us in front of this path, showing us how this can guarantee people to have more accessible mental health services even in emergency conditions.
A second prediction is that there will be more publications, more writings, more training and more teaching . For example, several international publications have already been made starting from the book Single-session therapy by walk-in or appointment: Administrative, clinical, and supervisory aspects of one at a time services (Hoyt, Bobele, Slive, Young and Talmon, 2018) , the Italian text Single Session Therapy: Principles and Practices (2018) by Flavio Cannistrá and Federico Piccirilli and the Swedish book on single session therapy with couples to name a few. Finally there were two international symposiums on SST in Melbourne in 2012 and 2019, another in Banff, Canada in 2015 and now there is one planned for 2022 in Italy .
What are the hopes instead?
Development of walk-in clinics available to all , especially disadvantaged people who cannot afford so-called “regular” therapy. These could predominantly be public interventions capable of offering easily accessible mental health services.
Development of a SST that is more attentive to different cultural nuances: therapy can be much more effective and efficient if the person’s cultural context is known (Soo-Hoo, 2018).
Development of interventions that focus more on people’s capabilities and resources . Diagnosis in some circumstances can have a useful purpose, it indicates where there are problems or weaknesses. The risk, however, is that we remain too oriented towards dysfunction and illness.
What developments would you rather not see?
One of the aspects that could compromise the correct and functional use of SST is its diffusion as an indistinct intervention for everyone due to the economic advantages that this could entail. Let’s
think of those countries in which the therapy is guaranteed by private health insurance systems, which could choose SST as the only financed intervention to save money. Sometimes people need continuous support and it is important to be able to guarantee it beyond the single session.
Another fundamental aspect is that SST continues to remain a method and not a particular theoretical approach : the principle behind the single session is to do what works for the client, drawing from the different approaches what can be useful for solving the problem . Research on the common factors of psychotherapies suggests that the alliance and what the client brings are the most important aspects for the implementation of the intervention.
Conclusions
One year after the Pandemic , in a moment of reflection on what has happened and what will happen, let’s try again to question ourselves about the future of TSS as M. Hoyt and W. Dryden did years ago . Following this question we cannot fail to realize that many of the hopes expressed by the two scholars are still present, first of all that relating to the greater diffusion of SST as a method of intervention and even before that as a way of thinking at the basis of every psychotherapeutic or mental health service. Since the interview, many steps have certainly been taken and SST is increasingly known throughout the world, but this is still not enough. The Pandemic as a global catastrophe has put us face to face with all the critical issues of the systems for providing health services in general and mental health in particular and we want to start from this to imagine a future in which Single Session Therapy is taken concretely. considered as a valid solution to overcome these difficulties and enhance services.
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.
Hoyt, M. F., Bobele, M., Slive, A., Young, J., & Talmon, M. (Eds.). (2018). Single-session therapy by walk-in or appointment: Administrative, clinical, and supervisory aspects of one at a time services. New York, NY: Routledge.
Hoyt, M. F. & Talmon, M. (Eds.). (2014). Capturing the moment: Single-session therapy and walk-in services. Bethel, CT: Crown House Publishing.
Soo-Hoo, T. (2018). Working within the client’s cultural context in single-session therapy. In M. F. Hoyt, M. Bobele, A. Slive, J. Young, & M. Talmon (Eds.), Single-session therapy by walk-in or appointment: Administrative, clinical, and supervisory aspects of one at a time services (pp. 186–201). New York, NY: Routledge.
Talmon, M. (1990). Single-session therapy: Maximizing the effect of the first (and often only) therapeutic encounter. San Francisco, CA: Jossey-Bass.