Regardless of the basic training of each professional, there are some assumptions that transversally distinguish the Single Session Therapy approach.
Rather than modeling itself around predetermined psychotherapeutic assumptions or focusing on particular diagnoses, SST is characterized by a mindset that places the tools, methods and interventions of a wide range of approaches at the service of the client in a creative way, always bearing in mind that every single session could be the last.
If you have an entire hour
Thinking about it, it becomes clear that when we don’t know if we will have another chance, our concentration is 100% focused on the here and now, giving our best to get now what we may not have the opportunity to make happen in the future. This means that even if there has already been a previous session or there may be another later, the single session therapist considers each meeting as a whole, with its completeness, its skeleton, its strength. and an organicity that allows that single encounter to be not only useful, but also compact and cohesive in itself, capable of being valid for itself (Slive, A. & Bobele, M., 2014):« A crucial element in conducting successful single session therapy are the therapist’s own beliefs about the effectiveness of brief therapy. The therapist’s expectations regarding the degree of change and the speed of the expected change» in fact end up being communicated to the patient, either voluntarily or unintentionally, either explicitly and implicitly. (Hoyt, 2009; Scamardo, Bobele & Biever, 2004; Hunsley, Aubry, Verstervelt, & Vito, 1999).
If the therapist, in conducting his own therapeutic intervention, thinks he has only one hour available and therefore what he can obtain will be very little and not very significant, it will be very different and will obtain much lower results from the same therapist who instead conducts the meeting aware that he has a whole hour available to work with those in front of him.
Learn how to focus
Paradoxically, the TSS therapist is asked not to speed up, but to sit down, slow down, take a deep breath and focus. In fact, according to an epistemological assumption of a constructionist matrix, the therapist knows that in any case he will find himself working with a selective and partial knowledge, and, above all, with a narrative construction of the problem, premises and implications built together by client and therapist during the session. (White & Epston, 1990)
The objectives then will not be to wear the helmet of the psychological miner and painstakingly explore what is established in advance is true or relevant, but:
- listen with great attention and curiosity to the problem as it presents itself in the here and now, in the narrative, relational and contextual texture of the client, as it represents it;
- establish a dense and meaningful therapeutic relationship made up of empathy, acceptance, confirmation and encouragement;
- identify which part of the problem is also part of the solution, critical issues that are also a strength, the potentially useful elements to be used to reach events from which to start in order to have a spontaneous solution / healing, by leading the customer to defining what he could do to exploit hi/her impact and strength;
- working together with the client, not with the aim of proposing the most correct diagnosis on him or implementing the right standard protocol, but to generate the most efficient and effective intervention with all and only the time available, less intrusive and more flexible to help people help themselves, maximizing the therapeutic effectiveness of each individual intervention (Talmon, 2014);
- leverage the customer’s motivations, towards its goals, agreed upon in specific behavioral terms and to combine a general hope for the future with specific expectations for improvement;
- Create a context that allows the customer to recognize the resources he has and that can be useful to him, playing a leading role in this discovery process, verifying its effectiveness and adequacy thanks to customer feedback.
The customer is the agent of change
The overall conception of the customer in TSS is in fact that:
- the client knows better than anyone else what is effective for him/her: it is necessary to respect his choices, his culture and his belief system, and remember that we do not know everything but that we could learn something;
- the client is much less interested in psychotherapy than the therapist is,and tend to prefer short therapeutic session;
- the client usually expresses a high level of satisfaction with respect to the single session they attended (Miller, 2008);
- the client will in any case have had the experience of a session from which he can get a feeling of relief and hope due to the fact that someone wanted and knew how to listen to his story, to which he will be able to think in different and more functional terms.
The mindset to be adopted in a Single Session Therapy
In short, we can summarize the overall mindset of the TSS therapist through these solicitations:
- always be there: that is, offer your mindfulness, but also consider that moment and what you are saying to yourself as a gift, as a present that is, precious, to be discarded with respect, and to be exchanged for new perspectives of great value in the here and now;
- stay focused: do not be distracted by potentially dispersive elements, otherwise you risk losing yourself in the same complexity that weighs down the problem and leads it adrift;
- don’t complicate things: the client doesn’t care how good you are or what wonderfully innovative tricks you come up with – they care about getting better now;
- be brief: take the motivation that has allowed you to be together in this moment to make it as useful and precious as possible, and full of transformative possibilities for the future;
- remain humble: there is not a solution to everything, and every situation (as well as every person, client and therapist included) has its limits;
- when possible, use a win-win approach.
Tania Da Ros
Trainer per l’Italian Center
for Single Session Therapy
Hunsley, J., Aubry, T.D., Verstervelt, C.M., & Vito, D. (1999). Comparing therapist and client perspective on reasons for psychotherapy termination. Psychotherapy: theory, research, practice, training, 37(4), 380-388.
Miller, J. (2008). Walk-in single session therapy: a study of client satisfaction. Journal of systemic therapies, 27, 78-94.
Scamardo, M., Bobele M., & Biever, J.L. (2004). A new perspective on client droupouts. Journal of systemic therapies, 23 (2), 27-38.
Slive, A. & Bobele, M. (2014). One Session at a time: When you have a Whole Hour. In M.F. Hoyt & M. Talmon (eds.) (2014), op. cit., p. 100.
Talmon, M. (2014). When less is more: Maximizing the effect of the first (and often only) therapeutic encounter. In Hoyt, M.F. & Talmon, M. (eds.) (2014), Capturing the Moment, Crown House Publishing Ltd.
White, M. & Epston, D. (1990). Narrative means to therapeutic ends. New York: Norton.