11
1
Single-Session Therapy:
A Brief Outline
I have practised single-session therapy and offered training in it for
over eight years. I hold that it offers people who are looking for a
rapid response to a pressing issue a therapeutic space to get what
they want from counselling without getting caught up in lengthy
bureaucratic procedures and without being offered more help than
they want.
Definition of Single-Session Therapy
I define SST as ‘an intentional enterprise where the client and
therapist embark on the session on the understanding that (a) the
therapist will endeavour to help the client to achieve what they have
come for in one visit and that (b) more help is available to the client
if needed’.
This definition has several features that are worth emphasising:
x SST has a therapeutic purpose: to help a person get help at the
point of experienced need.
x SST is a fully contracted form of therapy: both the client and the
therapist understand the purpose of their meeting and both give
their consent to proceed.
x SST seeks to integrate two seemingly different positions: (i) to
help the client in one session; (ii) to provide the client with more
help if needed.
The Nature of SST
SST is a way of thinking about therapy and its practice, and it is a
way of delivering therapeutic services (see Dryden, 2021). It is not
12 Single-Session Therapy in Action
an approach to therapy. Therapists from a wide range of therapeutic
approaches can and do practise SST (see Hoyt & Talmon, 2014a).
SST is based on the idea that a brief encounter between two persons
can be therapeutic and that the length of therapy is expandable.
The Three Major Foundations of SST
SST is based on three major research and practice findings:
1. The most frequent number of sessions (known as the ‘mode’)
clients have internationally is ‘1’, followed by ‘2’, ‘3’, etc. This
occurs across a range of public and charitable therapy agencies.2
When people hear this, they immediately assume that this
means that the clients ended therapy because they did not find
it helpful.
2. However, 70–80% of those who have one session are satisfied
with that session given their current circumstances (Hoyt &
Talmon, 2014b).
3. Therapists are poor at predicting who will attend for only one
session and who will attend for more. This means that it is not
possible to judge in advance who will benefit from SST and who
will require more help.
Favourable Conditions for SST
I sometimes refer to SST as a plant. A plant needs certain conditions
to flourish and if it does not get these conditions it will wither. The
following are, in my view, the main conditions needed for SST to
grow and develop:
x Help is provided quickly in response to help being sought.
x Time between help-seeking and the appointment is used well.
x Both therapist and client hold realistic expectations about SST.
x The importance of informed consent.
2 It is not known whether this also occurs in private practice although one of
my American colleagues who runs a part-time practice and keeps meticulous
client data was shocked to discover that the mode in his practice was also ‘1.’
an approach to therapy. Therapists from a wide range of therapeutic
approaches can and do practise SST (see Hoyt & Talmon, 2014a).
SST is based on the idea that a brief encounter between two persons
can be therapeutic and that the length of therapy is expandable.
The Three Major Foundations of SST
SST is based on three major research and practice findings:
1. The most frequent number of sessions (known as the ‘mode’)
clients have internationally is ‘1’, followed by ‘2’, ‘3’, etc. This
occurs across a range of public and charitable therapy agencies.2
When people hear this, they immediately assume that this
means that the clients ended therapy because they did not find
it helpful.
2. However, 70–80% of those who have one session are satisfied
with that session given their current circumstances (Hoyt &
Talmon, 2014b).
3. Therapists are poor at predicting who will attend for only one
session and who will attend for more. This means that it is not
possible to judge in advance who will benefit from SST and who
will require more help.
Favourable Conditions for SST
I sometimes refer to SST as a plant. A plant needs certain conditions
to flourish and if it does not get these conditions it will wither. The
following are, in my view, the main conditions needed for SST to
grow and develop:
x Help is provided quickly in response to help being sought.
x Time between help-seeking and the appointment is used well.
x Both therapist and client hold realistic expectations about SST.
x The importance of informed consent.
2 It is not known whether this also occurs in private practice although one of
my American colleagues who runs a part-time practice and keeps meticulous
client data was shocked to discover that the mode in his practice was also ‘1.’
Single-Session Therapy: A Brief Outline 13
x Therapy begins immediately.
x Organisational, administrative and training/supervisory support is
provided.
‘Help Provided at the Point of Need’ Is Based on
Several Ideas
I mentioned earlier that SST is based on providing help at the point
of client need. This way of delivering therapy services is based on
the following ideas.
x ‘Sooner is better.’
x Providing immediate help is more important than carrying out a
case history, a full assessment or a case formulation.
x People have the resources to make use of help provided at the
point of need.
x The best way to see if a client will respond well to SST is by
offering them SST and see how they respond.
x Therapy can be initiated immediately and risk managed if this
becomes an issue.
x Appropriate therapy length is best determined by the client.
The Therapist’s Goals in SST
As mentioned earlier, the main goal of SST is for the therapist to
help the client achieve their stated wants by the end of the session.
It is also possible to consider outcome and process SST goals
from the therapist’s perspective as follows:
The Therapist’s Outcome Goals
x To help the client get ‘unstuck’.
x To help the client take a few steps forward, which may help
them to travel the rest of the journey without professional
assistance
x Therapy begins immediately.
x Organisational, administrative and training/supervisory support is
provided.
‘Help Provided at the Point of Need’ Is Based on
Several Ideas
I mentioned earlier that SST is based on providing help at the point
of client need. This way of delivering therapy services is based on
the following ideas.
x ‘Sooner is better.’
x Providing immediate help is more important than carrying out a
case history, a full assessment or a case formulation.
x People have the resources to make use of help provided at the
point of need.
x The best way to see if a client will respond well to SST is by
offering them SST and see how they respond.
x Therapy can be initiated immediately and risk managed if this
becomes an issue.
x Appropriate therapy length is best determined by the client.
The Therapist’s Goals in SST
As mentioned earlier, the main goal of SST is for the therapist to
help the client achieve their stated wants by the end of the session.
It is also possible to consider outcome and process SST goals
from the therapist’s perspective as follows:
The Therapist’s Outcome Goals
x To help the client get ‘unstuck’.
x To help the client take a few steps forward, which may help
them to travel the rest of the journey without professional
assistance
14 Single-Session Therapy in Action
The Therapist’s Process Goals
x To help the client address a specific concern if this is why they
have come.
x To give the client the space and opportunity to think and explore
an issue when requested.
x To give the client an opportunity to express their feelings about
an issue when requested.
x To help the client see that they have the wherewithal to achieve
their goals.
x To help the client select a possible solution, if relevant, and to
give them the experience of the solution in the session, if
possible.
x To help the client develop an action plan, if relevant.
Single-Session Thinking and Good Practice
The most effective way of practising SST, in my view, is to base this
practice on single-session thinking (sometimes known as the single-
session mindset) rather than on conventional clinical thinking. In
this section, I will show how single-session thinking informs good
practice in SST.
x Approach the session as if it could be the last.
x Create a realistic expectation for SST.
x Utilise the power of ‘now’.
x Focus on what the client wants.
x Engage the client quickly through the work.
x Develop an end of session goal.
x Be parsimonious and don’t overload the client. Help the client
take away one meaning point which they can implement.
x Determine the best helping stance with the client. In SST there
is no one helping stance that characterises this mode of service
delivery. Rather, there are a range of possible helping stances
that a therapist can adopt to help the person with what they have
come for. These include: - focusing on the client’s nominated concern and helping
them to find a solution to this concern.
The Therapist’s Process Goals
x To help the client address a specific concern if this is why they
have come.
x To give the client the space and opportunity to think and explore
an issue when requested.
x To give the client an opportunity to express their feelings about
an issue when requested.
x To help the client see that they have the wherewithal to achieve
their goals.
x To help the client select a possible solution, if relevant, and to
give them the experience of the solution in the session, if
possible.
x To help the client develop an action plan, if relevant.
Single-Session Thinking and Good Practice
The most effective way of practising SST, in my view, is to base this
practice on single-session thinking (sometimes known as the single-
session mindset) rather than on conventional clinical thinking. In
this section, I will show how single-session thinking informs good
practice in SST.
x Approach the session as if it could be the last.
x Create a realistic expectation for SST.
x Utilise the power of ‘now’.
x Focus on what the client wants.
x Engage the client quickly through the work.
x Develop an end of session goal.
x Be parsimonious and don’t overload the client. Help the client
take away one meaning point which they can implement.
x Determine the best helping stance with the client. In SST there
is no one helping stance that characterises this mode of service
delivery. Rather, there are a range of possible helping stances
that a therapist can adopt to help the person with what they have
come for. These include: - focusing on the client’s nominated concern and helping
them to find a solution to this concern.
Single-Session Therapy: A Brief Outline 15
- helping the client to explore an issue to facilitate better
understanding.
- encouraging the client to express suppressed feelings.
- helping the client to explore their options and helping
them to make a decision that they need to make.
x Agree a focus for the session with the client and keep on track.
x Keep up a good therapeutic pace and stop when finished.
x Be clear and foster clarity.
x Make an emotional impact, but don’t push for it.
x Identify and utilise the client’s strengths.
x Encourage the client to use environmental resources.
x Identify and utilise the client’s previous helpful attempts to deal
with the problem.
x Negotiate a solution, if relevant, and encourage the client to
rehearse this in-session before helping them to develop an
action plan.
x Encourage the client to summarise the session and their major
takeaway.
x End the session well and clarify next steps (e.g. how the client
can access further help, if needed).
x Arrange follow-up.
My SST Work at Onlinevents
In this section, I will briefly summarise the work I do on single-
session therapy for Onlinevents. This provides the context for the
transcripts of single sessions that are presented in Chapters 2–12.
x I begin by clarifying the purpose of the conversation with the
volunteer.
x I agree a focus, set a goal for the conversation and retain the
focus.
x I work to understand the underlying process behind the concern.
x I help the person to identify a solution and invite them to
rehearse it in the session, if feasible.
x I help the person to develop an action plan and problem-solve
obstacles.
x I strive to end the session well.
- helping the client to explore an issue to facilitate better
understanding.
- encouraging the client to express suppressed feelings.
- helping the client to explore their options and helping
them to make a decision that they need to make.
x Agree a focus for the session with the client and keep on track.
x Keep up a good therapeutic pace and stop when finished.
x Be clear and foster clarity.
x Make an emotional impact, but don’t push for it.
x Identify and utilise the client’s strengths.
x Encourage the client to use environmental resources.
x Identify and utilise the client’s previous helpful attempts to deal
with the problem.
x Negotiate a solution, if relevant, and encourage the client to
rehearse this in-session before helping them to develop an
action plan.
x Encourage the client to summarise the session and their major
takeaway.
x End the session well and clarify next steps (e.g. how the client
can access further help, if needed).
x Arrange follow-up.
My SST Work at Onlinevents
In this section, I will briefly summarise the work I do on single-
session therapy for Onlinevents. This provides the context for the
transcripts of single sessions that are presented in Chapters 2–12.
x I begin by clarifying the purpose of the conversation with the
volunteer.
x I agree a focus, set a goal for the conversation and retain the
focus.
x I work to understand the underlying process behind the concern.
x I help the person to identify a solution and invite them to
rehearse it in the session, if feasible.
x I help the person to develop an action plan and problem-solve
obstacles.
x I strive to end the session well.
16 Single-Session Therapy in Action
The Conversations
In the following chapters I present transcripts of eleven
conversations. They are presented in date order. As I mentioned in
the Preface, three of the conversations took place with volunteers at
an Onlinevents session on ‘Dealing with Christmas with SST’. The
other eight took place after this event with people who signed up for
a complimentary single session with me on an issue related to
Christmas. In doing so, the person understood that the transcript of
the session would appear in this book. Please note the following:
1. Each volunteer has given their permission to have the transcript
of our conversation published in this book.
2. I have changed the names of the volunteers, unless they
requested me not to do so.
3. I have changed the names of anybody referred to in the session
by the volunteers.
4. I have provided periodic comments on each conversation to
highlight various issues.
5. I sent each volunteer a copy of the transcript and invited them
to provide written reflections on the conversation and what they
got from it. All the volunteers accepted this invitation, and these
reflections appear at the end of the chapter.
It can be noted that there are some recurring themes in the
conversations (e.g. I discuss the setting of ‘boundaries’ with Rose in
Chapter 9 and with Jennie in Chapter 12). I don’t think that this
should be an issue as in SST, we tailor our interventions to the
person and not to the problem. As such, I hope that it will be
instructive for the reader to see how I help people to deal with
similar problems in different ways.
Before presenting the conversations, let me comment on their
length as I am often asked how long a single session should last. The
three conversations that I did that formed a part of the Onlinevents
‘Dealing with Christmas with SST’ two-hour online workshop
lasted from 21 mins 28 secs to 27 mins 1 sec. The eight private Zoom
sessions that I had ranged from 15 mins 45 secs to 45 mins 54 secs.
You might have thought that the private sessions that I did with
The Conversations
In the following chapters I present transcripts of eleven
conversations. They are presented in date order. As I mentioned in
the Preface, three of the conversations took place with volunteers at
an Onlinevents session on ‘Dealing with Christmas with SST’. The
other eight took place after this event with people who signed up for
a complimentary single session with me on an issue related to
Christmas. In doing so, the person understood that the transcript of
the session would appear in this book. Please note the following:
1. Each volunteer has given their permission to have the transcript
of our conversation published in this book.
2. I have changed the names of the volunteers, unless they
requested me not to do so.
3. I have changed the names of anybody referred to in the session
by the volunteers.
4. I have provided periodic comments on each conversation to
highlight various issues.
5. I sent each volunteer a copy of the transcript and invited them
to provide written reflections on the conversation and what they
got from it. All the volunteers accepted this invitation, and these
reflections appear at the end of the chapter.
It can be noted that there are some recurring themes in the
conversations (e.g. I discuss the setting of ‘boundaries’ with Rose in
Chapter 9 and with Jennie in Chapter 12). I don’t think that this
should be an issue as in SST, we tailor our interventions to the
person and not to the problem. As such, I hope that it will be
instructive for the reader to see how I help people to deal with
similar problems in different ways.
Before presenting the conversations, let me comment on their
length as I am often asked how long a single session should last. The
three conversations that I did that formed a part of the Onlinevents
‘Dealing with Christmas with SST’ two-hour online workshop
lasted from 21 mins 28 secs to 27 mins 1 sec. The eight private Zoom
sessions that I had ranged from 15 mins 45 secs to 45 mins 54 secs.
You might have thought that the private sessions that I did with