As you may have already guessed from the title, this article is mainly aimed at all those psychologists and psychotherapists who carry out their profession within health or social institutions (public or private), who have the desire to contribute to the improvement of their structure, both in terms of quality and effectiveness of the service, operating through innovative and effective methods of intervention, both in terms of service efficiency, reducing waiting lists and responding in a short time to as many people as possible.
The goal of this article, in fact, is to illustrate a simple process for implementing a TSS in your institution.
At this point, so you may be wondering, but where to start? How to implement such a revolutionary process in our daily working life?
Before embarking on a change of this nature, it is essential to know and deepen similar experiences already existing in the world, not only to be inspired, but to be able to understand more deeply the organizational and methodological aspects necessary to access this transformation.
We remind you that TSS has been a methodology applied in several countries (United States, Australia, just to name a few) for many years, therefore many therapists before us have encountered some clinical and organizational dilemmas, finding effective solutions to deal with them. Today these experiences can represent a valid support to implement a new working process.
An example of this comes from the Bouverie Center in Melbourne (Australia), a center for training, research and family therapy.
What is the experience of the Bouverie Center?
The Bouverie Center in 2009 decided to implement a single session work process for 12 months, called Single Session Work (SSW), as the main model of providing services for all new family appointments, evaluating their experience.
The SSW was first presented at the Center in 1994 when a number of staff members learned about the work of the Dalmar Center in Sydney (Price, 1994), the work of the Canberra Child and Adolescent Mental Health team, and the writings of Moshe Talmon and his colleagues (1990, 1993). However, from 2009 the SSW process was developed by the staff over a period of 17 years, thus becoming the basis of their academic teaching and professional training (Young, Weir, Rycroft, & Whittle, 2006).
But what were the key points of the SSW process from which to draw inspiration?
The SSW was based on two key points:
- the first, represented by counseling and therapy services, which for most clients lasted one or two sessions (Boyhan, 1996; Price, 1994; Talmon, 1990; Weir, Wills, Young, & Perlesz, 2008) ;
- the second, from customer follow-up studies followed through SWW (Boyhan, 1996; Harper-Jaques, McElheran, Slive, & Leahy, 2008; Perkins, 2006; Perkins & Scarlett, 2008; Price, 1994; Talmon, 1993 ).
In adopting this process as the primary framework for providing clinical services to families, another key aspect was to put in place organizational processes that would support staff to explore and practice SSW such as staff training, trained in theory and practice. by Bouverie clinicians with experience in this area.
But how is the SSW process articulated?
All new customers who contacted the Bouverie Center between November 2009 and December 2010 had:
- a first contact with a telephone operator, who described the SSW process when booking the initial appointment. This worker sent out a letter and a pre-SSW questionnaire for each family member involved, to be completed and brought to the session. The pre-SSW questionnaire asked clients to identify the problems leading them to counseling, and how they hoped the counseling would be helpful for them;
- collection of questionnaires by the therapists during the update before the session. The questionnaires were then used later to guide the session;
- Conduct of the session Ninety minutes to two hours are allowed for the face-to-face session and family members are followed by telephone after a negotiated time period. It is at this time that the therapist and family decide together whether further appointments will be made. So a single session frame encourages therapists to keep in mind the possibility of unexpected changes occurring after the session and that a session could be the whole family;
- administration of a post-SSW questionnaire, in which family members were asked to review how much the problems they brought to attention were still a difficulty.
Finally, to support the implementation of the SSW, further additional features were included including the SSW open days, i.e. the opening days of a single session scheduled four times a year. These were used by other services to gather staff around the SSW practice (Curtis, Whittaker, Stevens & Lennon, 2002; Price, 1994). The days involved staff scheduling appointments to see new families at the same time.
To conclude, therefore, the fundamental ingredients for implementing a simple TSS process in your institution can be summarized as follows: training staff in the practice of TSS to provide a methodological framework that encourages therapists to keep in mind the possibility that changes can occur already after a single session; the activation of counseling and therapy services lasting a single session; finally, the evaluation of the process and the results obtained.
Italian Center team
for Single Session Therapy
Boyhan, P. (1996). Clients’ perceptions of single session consultations as an option to waiting for family therapy. Australian and New Zealand Journal of Family Therapy, 17 (2), 85–96.
Curtis, A., Whittaker, A., Stevens, S., & Lennon, A. (2002). Single session family intervention in a local authority family center setting. Journal of Social Work Practice, 16 (1), 39–41.
Harper-Jaques, S., McElheran, N., Slive, A., & Leahey, M. (2008). A comparison of two approaches to the delivery of walk-in single session mental health therapy. Journal of Systemic Therapies, 27 (4), 40–53.
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O’Neill, I., Rottem, N., (2012). Re ﬂ ections and Learning From an Agency-Wide Implementation of Single Session Work in Family Therapy, 33 (1). Australian and New Zealand Journal of Family Therapy.
Perkins, R. (2006). The effectiveness of one session therapy using a single-session therapy approach for children and adolescents with mental health problems. Psychology and Psychotherapy: Theory, Research, and Practice, 79, 215–227.
Perkins, R., & Scarlett, G. (2008). The effectiveness of single session therapy in child and adolescent mental health. Part 2: An 18month follow-up study. Psychology and Psychotherapy: Theory, Research, and Practice, 81, 143–156. Price, C. (1994). Open days: Making family therapy accessible in working class suburbs. Australian and New Zealand Journal of Family Therapy, 15 (4), 191–196.
Reason, P. (1999). Integrating action and reflection through co-operative inquiry. Management Learning, 30 (2), 207–226.
Talmon, M. (1993). Single-session solutions: Aguidetopractical, effective, andaffordable therapy. New York: Addison-Wesley.
Weir, S., Wills, M., Young, J., & Perlesz, A. (2008). The implementation of single session work in community health. Brunswick, VIC: The Bouverie Center. Young, J., & Rycroft, P. (1997). Single-session therapy: Capturing the moment. Psychotherapy in Australia, 4 (1), 18–23.
Young, J., Weir, S., Rycroft, P., & Whittle, T. (2006). Single session work implementation resource parcel. Brunswick, VIC: The Bouverie Center.