Single Session Therapy: Believe in it

“Each new hour holds new chances for a new beginning” - Maya Angelou

Learning how to do single session therapy well has been one of the greatest challenges of my professional career. When I first began practicing single session therapy over ten years ago it was viewed as a wait-list management service. The idea was that a single session consultation couldn’t do any harm and it satisfied the government’s mandate of “checking-in” with clients every few months in order to mitigate risk.  I was therefore facilitating planned single sessions, or sessions where an appointment had been booked and there was agreement between the client and myself that we would only meet once. Even though I was trained in solution focused brief therapy I sometimes had sessions that lasted two hours because I was worried that I was “not doing enough” and that the clients would leave feeling dissatisfied. Those sessions left me with a sense that the conversation had been a complete waste of time as the problems the client described were way too big to be solved in one session. I remember feeling uneasy after the client left, wondering if I had “missed something” important. 

Then one day I received a call from the father of a 6-year old boy I had seen six months before. He wanted to know if it would be possible to schedule another session. I assumed that he wanted to come back because the initial problem had not resolved, but when I asked him about this he replied by saying “That hasn’t come up since we saw you, this is something else entirely!”. This was the first of what is now a pattern in my clinical practice. I consistently receive calls from clients who attended a single session weeks, months, sometimes even years before, asking if they can return for another session about a completely different issue. 

I like to think that over the years I have become a better single session therapist because I have received more training, had more clinical experience, and read more books. I have done all of these things and they have helped.  But I believe that the biggest difference between my early practice and the present is that my own beliefs about single session therapy have shifted.

To do single session therapy well you have to believe that a person can change no matter how big their problems seem. You have to believe that you can ask meaningful questions without knowing a person’s history. You have to believe that people have the capacity to make choices that are good for them, and they can do this without check-ins and follow-ups. You have to believe that people’s lives can get better even if they don’t come back to tell you about it. 

A single conversation can change a person’s life. Believe it.