the session. The question is not who is appropriate for a single session and who is not, but rather, a useful question may be, “can I stay open to the idea that one session may be enough and yet still feel free to initiate further sessions, if the client and I feel necessary.” In fact, clients who are more reluctant to attend long-term therapy sessions are more likely to accept a one-time session than to make a commitment to ongoing work.
IN JUST ONE HOUR
In a walk-in session, the client presents a concern and a goal(s) is constructed. The aim is to allow cli- ents to leave the session with a sense of hopeful- ness, knowing that they have been heard, and feel reassured that they are capable of managing their problems.
A crucial element of an effective single session is the therapists’ own belief about the effectiveness of brief therapies. Therapists’ expectations of how much change can be achieved in that one hour are communicated overtly and covertly. Single session work relies on the client as the expert in reporting about what kind and how much change is im- portant for them at that particular time, irrespec- tive of whether it is seen by the therapist as super- ficial or deep, significant or insignificant.
The minimal intent for a walk-in session is for the client to leave the session with a sense of emotion- al relief and increased hope. For one client, a posi- tive outcome may be as simple as knowing that someone has heard their story. For another client, it may be a new way of thinking about their problem, and for yet another, the new way of thinking may be that it is not a problem after all. Or a client may leave with information about resources of where to get further help. Single session therapy borrows from solution-focused and narrative therapies. The focus is on the problem as it occurs in the present and not on questions about the past or underlying causes. The therapist works collaboratively with the client to externalize the problem, elicit their reason for change, establish goals, and outline steps to work towards them. It is a strengths-based approach attributing therapeutic change to a strong therapeutic posture that effectively uses existing client strengths and resources. Is it possi- ble in a single session to build a therapeutic rela- tionship? Single session work rests on the philoso-
THE CANADIAN COUNSELLING AND PSYCHOTHERAPY ASSOCIATION SUMMER 2019
phy that even brief encounters have the potential to be therapeutic as the therapist shows “unconditional positive regard and acceptance, genuineness and empathy” (Rogers, 1957) for the client.
In just one hour of the walk-in session, through the therapeutic process, the therapist is able to attend to the client’s motivation for change, focus on the client’s wants, and utilize the client’s strengths and resources, while linking hopes with expectations for improvement. For many clients, a single session is sufficient to take action towards making that small step in the direction they want to move.
Walk-in sessions fill an important need in the deliv- ery of mental health services. It has the advantage of being available at times that fit client needs. It reduces frustration with service availability and long waitlists and often prevents the need for long- term services. Research indicates that approxi- mately 30% of clients require more formal assess- ments, and something other than brief interven- tions (Hoyt 1998b). Thus, walk-in sessions are best thought of as a useful part of a larger mental health service delivery system.
Bloom, B.L. (2001). Focused single-session psychotherapy: A review of the clinical and research literature. Brief Treatment and Crisis Interven- tion (1), 75-76.
Bobele, M. & Slive, A. (Eds) (2011). When one hour is all you have: Effec- tive therapy for Walk-in clients. Phoenix, AZ: Zeig, Tucker & Theisan
Campbell, A. (1999). Single session interventions: An example of clinical research in practice. Australian and New Zealand Journal of Family Therapy, 20, 183-194.
Hoyt, M. F. (Ed.) (1998). Handbook of Constructive Therapies. San Fran- cisco: Jossey-Bass.
Hubble, M. A., Duncan B. L., & Miller, S. D. (Eds) (1999). The heart and soul of change: What works in therapy. Washington, D. C.: American Psychological Association.
Rogers, C. (1957). “The necessary and sufficient conditions of thera- peutic personality change.” Journal of Consulting Psychology. 21(2): 95- 103.
Seligman, M. (1995). The effectiveness of psychotherapy. American Psychologist, 50, 965-974.
Slaff, B. (1995) Thoughts on short-term and single session therapy. In R. C. Marohn & S. C. Feinstein (Eds). Adolescent psychiatry: Developmen- tal and clinical studies. 229-306. Hillsdale, N. J.: Analytic.
Talmon, M. (1990). Single Session Therapy. San Francisco: Jossey-Bass.
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