Sometimes single session CBT is all that is needed
I’m surprised at how often just one session with a client is all that is needed to deal with the issue that has brought them to therapy.
Its usefulness has its limits, but is most helpful where a single issue needs a speedy and practical solution. To that extent it can be said to be a collaborative solution focused approach.
So what kinds of issues might benefit from this time limited approach? Certainly issues around procrastination where there is usually a lack of immediate motivation and often an inability to formulate a plan and carry it through. One session of guided discovery and the in-session formulation of a plan that the client agrees they will commit to would normally be sufficient.
The presenting problem is often a case of the client not being able to see the wood for the trees, so there is often a lack of clarity around a situation. This is usually the case with clients who come with a feeling of being overwhelmed. They are too “in it” to see things objectively. The client may not have the ability to see things from the perspective of others or they may have failed to recognise or consider other viable ways of approaching things. This regularly happens for example with those who have a habit of thinking they are the only ones who are competent to take responsibility for a situation.
Those overwhelmed by workloads for example are often overwhelmed because they cannot trust others to do their jobs properly. Of course, what it leads to is stress, so the session could involve some workload management, getting them thinking about strategies which include others rather than thinking they have to do it all themselves.
Where conflict between an individual and an organisation or institution is the issue, some psycho-education may be helpful. Clients are not always consciously aware of what they are and what they are not in control of. It is often not in their awareness that they cannot change the behaviour of others or outside events but that they can choose to change themselves and think and act differently. If that resonates with them and they accept that that is the case it may then just be a matter of leaving the client to make a conscious choice about how to move forward. Acceptance is a big part of this process.
If a conversation is going to be needed to resolve the conflict, then coaching the client through role play to find the right words to communicate effectively and positively and to regulate their emotions may give them all the tools they need for resolution.
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