Today’s article is specifically aimed at colleagues who practice Single-Session Therapy (SST) or who intend to train in this method.
My name is Anna Falco, and I am a psychologist currently specializing in Brief Systemic-Strategic Psychotherapy at the ICNOS Institute, in Rome. In my therapeutic work with adolescents, adults, and young adults, I have increasingly experimented with and refined the various elements that make up SST, making that single encounter both useful and meaningful.
I would like these lines to serve as a sort of informal guide, so that anyone embarking on this journey can avoid losing their way.
What Single-Session Therapy Is Not
Since training in Single-Session Therapy, the greatest difficulty I have encountered has been explaining what I do without people thinking I am crazy. Conducting SST does not mean promising a miracle or claiming that all of a person’s problems will disappear in just one session. In fact, the opening phase explicitly involves keeping our door open should the person feel the need for additional meetings.
If that single session—or a subsequent one—proves sufficient, it will be because we have made the most of it through our therapeutic work. SST therefore means striving to make each individual session as effective and efficient as possible.
How to Know You Are Not Practicing Single-Session Therapy
If you are unable to “translate” what the person wants into a specific goal, if their problem remains unclear to you, and if you have the feeling that you are going around in circles, then you are on the wrong track. As Michael Hoyt reminds us in his famous golf metaphor: “You’ll spend a long day on the golf course if you don’t know where the hole is.”
You cannot make the most of a session unless you adopt the language of the person sitting in front of you and view reality from their perspective. Whether they are talking about a problem or about what they want to change or improve, you must guide them toward describing it in a less vague and abstract way, without resorting to technical jargon.
For example, you cannot help someone improve their self-esteem if you do not know what having self-esteem actually means to that particular person.
Asking questions, driven by genuine curiosity, keeps us away from interpretation and allows us to begin charting a course without overlooking the person’s resources. And if we feel that gathering all this information is taking too much time, we should ask ourselves who is steering the ship. Even after placing the person at the center of the therapeutic process, we may have lost focus, neglected to explore exceptions to the problem, or forgotten to ask for feedback.
Let us remember that the person has chosen to meet with us because they want help. Therefore, in order to respond to that need, whenever we realize we are being “led around,” it is our responsibility to bring them back to the here and now.
Conclusion
Research (Hoyt, Bobele, Slive, Young & Talmon, 2018) tells us that many people generally attend at least one therapy session. Why not ensure that they get the most out of the time available to them?
This is precisely what adopting the Single-Session Therapy mindset means.
Our goal, as clinicians of any theoretical orientation, is to rise to the challenge and approach each session as if it were the last. Because only when we already know that a session will be the last do we naturally prepare ourselves to give our very best, ensuring that the person leaves with what they came for.
Knowing what to do in order to conduct a good SST session does not prevent us from making mistakes; adopting the SST mindset, however, can.
Anna Falco
Psychologist, Trainee in
Brief Systemic-Strategic Therapies
at the ICNOS Institute
References
Haley, J. (1969). The art of being a failure as a therapist. American Journal of Orthopsy chiatry, 39, 691–695.
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. Routledge.
Hoyt, M. F., & Cannistrà, F. (2021). Common errors in single-session therapy. Journal of Systemic Therapies, 40(3), 29-41.