Single session therapy - adapting to client need in modern times

At one time, the image that came to mind when people thought of psychotherapy was that of a musty old room, a ticking clock and a couch draped in rich fabric, as in Freudian times. Therapy sessions such as these could go on for weeks, months or even years.

Most of us no longer hold these images of what therapy looks like and have updated ideas of a face-to-face meeting in a comfortable room decorated in calm pastels and soft furnishings.

The pandemic then lent itself to adapting the therapeutic space to include online work as well as walk and talk therapy. In addition, you can now find therapists offering everything from eco therapy to equine therapy. There is therapy for individuals, couples, families and groups. Again, these sessions can run for weeks, months or even years, but today I would like to focus on a less talked about therapy, single session.

First, let us look at what brings people to therapy to begin with.

How problems occur

Many of us in our lifetime will experience periods of stress, anxiety, low mood, relationship difficulties or a loss of direction. Deep inside we can feel lost, stuck or confused by the troubles we face and have a sense of discomfort that no matter how we try, we just can’t seem to figure things out.

In these times, we may turn to friends or family, books or podcasts, searching for answers, comfort or direction. And sometimes that is what we find, a chink of light, an ‘aha’ moment or some gentle wisdom that begins to unlock the mystery of our troubles.

Other times, we hit a wall. We don’t want, however well-intentioned, advice from our loved ones. We can’t find any insights or answers in the books we pore over. It feels like no one could understand something we are struggling to understand ourselves. 

Looking for professional support

This may be a time when we consider therapy. It’s not unusual to play around with this idea for some time before we act. It can feel like a big step, a step into the unknown for those of us who have never entered this world. A world where we tell a perfect stranger the details of our lives, our innermost thoughts and feelings and do something we rarely choose to do - be vulnerable.

So if this is you and you are swaying in and out of the idea of therapy, I am writing to tell you a little about different options that are out there, beginning today with single session therapy.

The world of therapy is constantly evolving to meet the needs of people whose lives are busy or unpredictable, and who are limited by finances, health problems or time. Or people who feel like they just want to dip their toe into the water and find out if therapy is for them. 

Single session therapy

Single session therapy (SST) is a good place to start if you are facing a dilemma or feel the need to offload or process something that is troubling you. How this is delivered may differ between practitioners, but I would suggest someone trained to deliver SST safely, ethically and within a suitable framework is ideal.

In my practice, SST is one 90-minute single session of therapy, followed by two 30-minute follow-up sessions to check in on your progress and monitor any difficult emotions that may have surfaced during our initial session. Following this, you get to decide if you would like to continue with regular therapy sessions. Practitioners may vary in their approach, so do check in with them how they work

What to expect from single session therapy 

An often-used formula would likely begin with the client making contact, usually via email, where an initial brief meeting is arranged to chat through what is hoped for from the therapy session and importantly, whether or not this is a suitable situation for brief, solution-focussed therapy.

The session itself will usually begin with an overview of the presenting issue; what led you to seek support at this moment in time, how you perceive the situation or difficulty and what, if anything, you have already done to try to resolve the issue.

From here you and the therapist can work together to form an alliance from where you can explore what is going on for you, how the problem developed, what is keeping it going, and what you wish to be different. It might be useful for the Therapist to establish what you feel you hope to come away with to make the time spent, well spent, and of value to you. 

Together you can co-create a vision of how matters may be resolved or made better or more tolerable. You can explore how to attend to your emotional well-being and move towards the changes you wish to see. The therapist may interject at times to offer perspectives or clarify what is being said, as it is important to make good use of the time. They will likely check on your support systems and your current circumstances in order to get a rounded view.

In summary, towards the end of the session, you might decide together what has been useful during the session, what you feel you can take away with you, and what you might do if you feel yourself falling back into familiar, unhelpful patterns.

What can I bring to single session therapy?

Sometimes it is a general issue that needs addressing: a career change, a lifestyle change or a relationship difficulty. Other times the focus might be anxiety over an upcoming event, a stuck way of perceiving something or a dilemma that needs unpicking. Either way, the therapist should guide you towards realistic expectations, and options for future therapy if that is the path you choose to take.

The future of therapy

I believe these new adapted approaches to therapy are the way forward. We are not all the same; our circumstances, personalities, backgrounds, abilities, outlook and ways of learning and connecting can vary greatly. Choice and accessibility to seek the support we richly deserve is so very important, and my hope is that mental and emotional well-being continues to adapt and grow for the benefit of all.

To find out more about other therapies mentioned in this article, go to the Counselling Directory website and click ‘Types of therapy’, where you will find information and therapists who offer a wide range of options.