SINGLE SESSION
CAN A SINGLE SESSION BE ENOUGH?
“Is brief therapy possible? Just one or possibly two sessions? My sister was in therapy for 15 sessions, which cost her thousands of rands and I’m just not prepared for that. But brief therapy? Surely there can’t be lasting results? So, therapy is apparently not meant for me.”
This may be what you think when you read the rest of this piece, because my topic is “brief therapy” and how it works. I am going to try to answer the question: Does it produce lasting results?
In my previous life as a therapist I worked with my clients in therapy for fairly long periods, often at least 7–10 sessions. This is the way I was trained and I really believed that it was the best way. However, I realised that a considerable percentage of my patients only came for one session and that raised serious question for me: Did I fail them during the only session I had with them? Was the person dissatisfied and was that why he or she did not come back? I closed those files with a heavy heart. But to my surprise it was often those clients who referred other people to me, which made me wonder: How does this work?
From 2013 onwards I began to derive professional inputs from other sources than the ones I had previously used. I began to read up a great deal on newer movements in psychology such as Positive Psychology and I began to attend courses that were a departure from the ones I had previously attended, such as a variety of training courses on Solution Focused Brief Therapy. I read a great deal on these directions in psychology (thanks to Amazon’s Kindle!). And I came across wonderful new ways of thinking and professional practice which I would like to share with you:
*It is possible (very possible!) to do excellent therapy with lasting value within a single session (or possibly two sessions). I read a wonderful book by Moshe Talmon, Single Session Therapy, which examines this phenomenon in great detail. At the clinic where he worked they found that up to 30% of people only turn up for one session and when they followed these clients up a year later they found that those single sessions had brought about significant and lasting change. According to Talmon, it is estimated that as many as 80% of people achieve satisfactory results after one session, and even achieve results that are in no way inferior to those of people who have been in therapy for a very long time!
*Solution Focused Brief Therapy (my preferred therapy) is eminently suited to short-term therapy – not necessarily just one session, although in some cases a single session is enough. (Read more about SFBT)
*A therapist can tailor her first session so that there is an optimum chance that it will be the “only session”, especially since some people do not turn up for a second session. The therapist needs to make the best of what could be her only chance!
Clients who are best suited to brief therapy fall into the following categories:
People who do not respond well to a single session:
You may be asking yourself: Am I a “one-session person”?
It is difficult to answer that question. If you fall into group 1 (clients suitable for short-term therapy), it may be worthwhile to commit yourself to a single two-hour session. You could then decide whether you want to follow up in a month or two. I know one thing for certain: after that first session you are going to have a good deal to think about and begin to apply …
Read about Moshe Talmon’s book under REVIEWS
Cizelle Louw
Psychologist Pretoria
***
Cizelle het vir meer as 20 jaar langtermyn terapie gedoen en was aangenaam verras oor die resultate wat sy sedert 2014 gekry het met korttermyn terapie. Volgens navorsing is korttermyn terapie en langtermyn terapie ewe suksesvol en die langtermyn effek is dieselfde.
Cizelle Louw
Kliniese Sielkundige Pretoria vir korttermyn terapie
“Is brief therapy possible? Just one or possibly two sessions? My sister was in therapy for 15 sessions, which cost her thousands of rands and I’m just not prepared for that. But brief therapy? Surely there can’t be lasting results? So, therapy is apparently not meant for me.”
This may be what you think when you read the rest of this piece, because my topic is “brief therapy” and how it works. I am going to try to answer the question: Does it produce lasting results?
In my previous life as a therapist I worked with my clients in therapy for fairly long periods, often at least 7–10 sessions. This is the way I was trained and I really believed that it was the best way. However, I realised that a considerable percentage of my patients only came for one session and that raised serious question for me: Did I fail them during the only session I had with them? Was the person dissatisfied and was that why he or she did not come back? I closed those files with a heavy heart. But to my surprise it was often those clients who referred other people to me, which made me wonder: How does this work?
From 2013 onwards I began to derive professional inputs from other sources than the ones I had previously used. I began to read up a great deal on newer movements in psychology such as Positive Psychology and I began to attend courses that were a departure from the ones I had previously attended, such as a variety of training courses on Solution Focused Brief Therapy. I read a great deal on these directions in psychology (thanks to Amazon’s Kindle!). And I came across wonderful new ways of thinking and professional practice which I would like to share with you:
*It is possible (very possible!) to do excellent therapy with lasting value within a single session (or possibly two sessions). I read a wonderful book by Moshe Talmon, Single Session Therapy, which examines this phenomenon in great detail. At the clinic where he worked they found that up to 30% of people only turn up for one session and when they followed these clients up a year later they found that those single sessions had brought about significant and lasting change. According to Talmon, it is estimated that as many as 80% of people achieve satisfactory results after one session, and even achieve results that are in no way inferior to those of people who have been in therapy for a very long time!
*Solution Focused Brief Therapy (my preferred therapy) is eminently suited to short-term therapy – not necessarily just one session, although in some cases a single session is enough. (Read more about SFBT)
*A therapist can tailor her first session so that there is an optimum chance that it will be the “only session”, especially since some people do not turn up for a second session. The therapist needs to make the best of what could be her only chance!
Clients who are best suited to brief therapy fall into the following categories:
- People who want to solve a specific problem.
- People who want to know: “Am I normal if I or one of my loved ones have certain feelings or act in a certain way?”
- People who are open (with the support of the therapist) to identifying the following: solutions and how they were able to find solutions successfully in the past.
- People who feel that they have got “stuck” in certain feelings (anger, guilt, heartache, etc) in respect of previous events and who have had enough and want to move on.
- People with problems to which there is really no solution – here the client could be helped to replace his obsession with trying to solve the problem with something more meaningful so that he or she could enjoy life again.
- People with an “adjustment disorder” respond best in a single session. This means that the client has developed an emotional or behavioural symptom in response to an identifiable stressor. The stressor is usually something that has happened within the family, such as a failed romantic relationship, a death, marital problems, remarriage, a new baby, problems at work or at school.
People who do not respond well to a single session:
- People who require in-patient psychiatric treatment, especially where there may be a risk of suicide. Clients with psychoses, that is people who are subject to hallucinations and lose contact with reality. People who abuse substances or alcohol also fall into this category.
- People suffering from a condition with a strong genetic, biological and chemical component such as bipolar disorder and schizophrenia.
- People with a pronounced neurological problem or brain damage (dementia, Alzheimer’s etc)
- People who request long-term therapy from the start, especially people who have prepared themselves to sort out their life history and personal identity.
You may be asking yourself: Am I a “one-session person”?
It is difficult to answer that question. If you fall into group 1 (clients suitable for short-term therapy), it may be worthwhile to commit yourself to a single two-hour session. You could then decide whether you want to follow up in a month or two. I know one thing for certain: after that first session you are going to have a good deal to think about and begin to apply …
Read about Moshe Talmon’s book under REVIEWS
Cizelle Louw
Psychologist Pretoria
***
Cizelle het vir meer as 20 jaar langtermyn terapie gedoen en was aangenaam verras oor die resultate wat sy sedert 2014 gekry het met korttermyn terapie. Volgens navorsing is korttermyn terapie en langtermyn terapie ewe suksesvol en die langtermyn effek is dieselfde.
Cizelle Louw
Kliniese Sielkundige Pretoria vir korttermyn terapie
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