Single Session Therapy: “one at a time” or both?

Single Session Therapy: “one at a time” or both?

With today ‘s article we talk about two ways of naming Single Session Therapy, namely “Single Session Therapy” or “One at a Time” Therapy (in English Single-Session One-At-A-Time ) in order to understand better understand the meaning and reasons for the different usage .  

Some scholars such as Windy Dryden, for example, prefer to use both terms in a combined manner with the aim of dispelling some myths created around SST by those approaching the method for the first time.


One of these myths is that it is not possible to obtain a result through a single session , the other, on the opposite side, is that SST must necessarily last only one session .


 Let’s delve deeper into the differences between the two terms!

  • Jeff Young (2018), an exponent of SST in Australia and around the world, claims that the term Single Session Therapy is imprecise, given that even when people access services where SST is offered, further sessions are always available. However, it is a term that should be retained as it challenges traditional clinical thinking that a result cannot be achieved through a single encounter.
  • The term “One-At-A-Time” Therapy (OAAT) was introduced by Michael Hoyt (2011), founder of the method, with the aim of conveying the idea that “one-off” does not necessarily mean “one-off”. This may not appeal to people who are intrigued by the term SST, but it would minimize resistance to the simple term “single session therapy.”



Let’s now see the main characteristics of Single Session Therapy “one at a time”!

According to Dryden, working as a SST therapist “one at a time” implies that the therapist and client make complementary contributions to the process and success of the intervention. This idea is the basis of SST in general and below we list the respective contributions of the therapist and the patient.


  • The therapist’s contributions.
  • Focus on the here and now and create a realistic expectation towards SST “one at a time”.
  • Ask the customer how they can best be helped.
  • Develop an end-of-session goal.
  • Agree on a focus for the session.
  • Stay on track.
  • Identify and utilize the client’s strengths.
  • Encourage the customer to use environmental resources.
  • Identify and use the client’s previous attempts to address the problem.
  • Negotiate a solution.
  • Encourage the customer to try the solution.
  • Encourage the client to reflect on the session, digest what they have learned, act on it, let time pass before seeking further help.
  • Merge what the client and therapist bring to the therapy process (Bloom, 1992; Hoyt & Talmon, 2014)


Customer contributions.

Client contributions to the SST process have been spelled out in a number of publications (Dryden, 2019; Hoyt, Bobele, Slive, Young & Talmon, 2018; Hoyt & Talmon, 2014; Talmon, 1990).

  • Express what you want from the process.
  • Set a realistic goal.
  • Take an active role in the session.
  • Identify and utilize internal strengths in the process.
  • Identify and use external resources in the process.
  • Specify past attempts to resolve the problem and prepare to use building blocks from these attempts.
  • Express an open mind about solutions.
  • Be prepared to try the solution you choose in the session.
  • Develop an action plan to implement the solution.
  • Express doubts and reservations about any aspect of what was discussed in the session.
  • Engage in the process of reflection and decision-making after the session.


Now let’s see the contributions to the process of Dryden’s “one time” SST!

Dryden in his approach combines the general principles of “One-At-A-Time” therapy listed above with some specific components of his way of practicing it such as: the theory of the working alliance; pluralism; Rational Emotive Behavioral Therapy (REBT).

  • Working alliance theory: Bordin (1979) proposed a tripartite model of the working alliance (the bond, the objectives and the tasks) to which Dryden (Dryden, 2011) added a fourth component (the visualization). This model holds that effective therapy relies on the therapist and client having a good working bond with shared views on salient issues, in which both implement tasks to achieve therapeutic goals.
  • Therapeutic pluralism: A pluralistic perspective on psychotherapy encourages therapists to take a ‘both-and’ rather than ‘either-or’ stance towards clinical phenomena. It also allows therapists to take clients’ opinions on their problems and possible solutions very seriously and consider that different therapeutic approaches can offer a lot in One-At-A-Time Therapy.
  • Rational Emotive Behavioral Therapy (REBT): While the main goal in One-At-A-Time Therapy is focused on the client’s vision of the problem and what they think is the best solution to the problem, there are times when the client wants to hear the therapist’s view of the problem and what he proposes as a solution. When this occurs, Dryden uses the ABC framework to offer a Rational Emotive Behavior Therapy-based problem assessment to see if this makes sense for the client (Ellis & Dryden, 1987).



To conclude, “One-At-A-Time” SST is a combination of what the client brings to the process and what the therapist brings to the process. Furthermore, in the article, the approach adopted by Dryden was taken as an example of this combination , which provides a combination of general principles of “One-At-A-Time” TSS that can be supported by the majority of practitioners of the method and specific components of his practice that derive from the theory of the working alliance , pluralism and Rational Emotive Behavioral Therapy .


Angelica Giannetti
Psychologist, Psychotherapist
Team of the Italian Center
for Single Session Therapy




Cannistrà, F., & Piccirilli, F. (2018). Single Session Therapy: Principles and Practices . Giunti Editore.

Dryden, W. (2020). Single-Session One-At-A-Time Therapy: A Personal Approach, Australian and New Zealand Journal of Family Therapy from

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Bordin, E.S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research & Practice, 16, 252– 260.

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Talmon, M. (1990). Single Session Therapy: Maximising the Effect of the First (and Often Only) Therapeutic Encounter. San Francisco: Jossey-Bass.

Young, J. (2018). SST: The misunderstood gift that keeps on giving, 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. 40– 58). New York: Routledge.

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Rosita Del Medico

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