Are you able to guess what essentially the most generally attended variety of remedy periods is? It’s one session. With this in thoughts, single-session interventions (SSIs) goal to maximise a one-off interplay with psychological well being assist, with out assuming that the particular person will return or full one other session. They’re described as “structured packages that deliberately contain just one go to or encounter with a clinic, supplier, or program” (Schleider et al. 2020), and have beforehand been blogged about on The Psychological Elf by Dr Maria Loades and Georgia Kemp.
Whereas SSIs have been round for a number of many years, curiosity in them has skyrocketed over the previous 10 years. That is probably because of the enchantment of a low-cost, scalable means of reaching extra individuals in want (significantly if they’re delivered on-line) at a time when many spend months on ready lists, which solely occurs as soon as they’ve met thresholds for accessing formal psychological well being assist within the first place (Loades & Schleider, 2023).
Because of the enhance in medical trials evaluating the advantages of SSIs for psychological well being issues, researchers from the Lab for Scalable Psychological Well being within the US sought to carry all of them collectively and consider their effectiveness in an umbrella overview (i.e., a scientific overview of systematic opinions).
Single-session interventions goal to maximise the effectiveness of a one-off therapeutic intervention. However do they really obtain this?
Strategies
Schleider et al. (2025) combed by the literature to seek out systematic opinions (SRs) measuring the effectiveness of SSIs (outlined as interventions that deliberately concerned only one go to or encounter with a clinic, supplier, or program) by medical trials for a variety of psychological well being issues, substance use, or engagement with psychological well being providers. They adopted the usual process for umbrella opinions, and systematically searched well-known databases (e.g., MEDLINE, PsycINFO) and thesis platforms, in addition to hand-searching for any ongoing opinions.
The inclusion of meta-analyses (a statistical means of mixing findings from totally different research) was elective, however narrative opinions (those who solely described the findings with out combining them in a standardised means) have been excluded. Different exclusion standards included SSIs focusing on motivation or readiness to hunt therapy, SSIs that used pharmacotherapy, and SRs centered on Essential Incident Stress Debriefing for posttraumatic stress.
The search resulted in 1,391 papers, of which the authors chosen 63 as appropriate for full-text overview, and ended up together with 24 systematic opinions that matched all standards they have been on the lookout for.
Lastly, a generally used software (AMSTAR 2) to measure the accuracy and transparency of every included systematic overview was used, to evaluate the scientific rigour with which every overview was carried out.
Outcomes
Research traits and general results
- 24 systematic opinions containing 415 particular person medical trials have been included within the umbrella overview. These trials concerned roughly 40,629 contributors with ages starting from 5 to 90 years previous.
- 62% of the systematic opinions have been revealed between 2019 and 2024, displaying a pointy enhance in newly revealed medical trials evaluating the advantages of SSIs lately.
- Of the 24 included systematic opinions, 20 discovered general advantages of SSIs on a variety of medical outcomes. Solely two systematic opinions centered on SSIs to enhance engagement with psychological well being providers, highlighting a scarcity of proof on this space.
- 12 of those opinions included a meta-analysis. Based mostly on these, the authors discovered a small, constructive general impact of SSIs throughout numerous psychological well being issues and age teams, in comparison with management contributors in these research (g = −0.25).
- To place this into perspective, current umbrella opinions evaluating multi-session psychotherapies throughout all psychological well being issues discovered an general impact of g = -0.34, which can be thought-about small.
Which medical outcomes profit from SSIs?
- Eight of the ten systematic opinions evaluating SSIs for substance use discovered general advantages on problematic alcohol use and smoking cessation, each amongst younger individuals and adults. Most SSIs used motivational interviewing as their ‘energetic ingredient’.
- Eight of 9 systematic opinions specializing in anxiousness discovered general advantages. SSIs focused particular phobias and generalised anxiousness utilizing cognitive behaviour remedy (CBT) strategies, graded publicity for particular phobias, and even train comparable to yoga because the ‘energetic ingredient’.
- 5 of six systematic opinions specializing in despair discovered general advantages, with SSIs utilizing CBT parts or behavioural activation (serving to individuals do extra of what they get pleasure from).
- One in all two systematic opinions assessing SSIs for consuming issues, together with weight-reduction plan, physique mass, skinny very best internalisation, and physique dissatisfaction, discovered general advantages.
Does mode of supply have an effect?
- Every of the 4 systematic opinions on self-guided SSIs for younger individuals reported general advantages for no less than one of many psychological well being outcomes measured.
- Nevertheless, most research centered on human-delivered SSIs (e.g., with a therapist), with 14 of 16 opinions discovering general advantages of one of these SSI in comparison with management teams.
How lengthy do the advantages final?
- It’s tough to inform as a result of the follow-up instances diversified significantly amongst particular person research within the included systematic opinions. They ranged from measuring outcomes instantly after the SSI to 2 years post-SSI.
Which is finest – single-session or multi-session interventions?
- 4 meta-analyses in contrast SSIs with multi-session interventions, with blended findings. Two meta-analyses discovered no important variations, one discovered a single-session motivational interviewing intervention to be extra useful than a multi-session programme, whereas one discovered a number of periods to be extra useful.
- This makes it difficult to conclude precisely how SSI carry out in comparison with conventional multi-session remedy.
This umbrella overview recognized 24 eligible systematic opinions, combining knowledge from 415 particular person trials. Total, 83% of the opinions discovered useful results of single-session interventions for no less than one medical end result.
Conclusions
Based mostly on the 24 included systematic opinions, this umbrella overview discovered an general small-to-moderate impact of SSIs on a variety of psychological well being issues, together with substance use, despair, anxiousness, and engagement with psychological well being providers. This impact is barely decrease that the results normally discovered for conventional, multi-session psychotherapies.
Regardless of the smaller impact, provided that SSIs are a low-cost possibility with the potential to succeed in extra individuals at a faster price, Schleider et al. (2025) concluded that SSIs might be useful to individuals with numerous psychological well being issues. Importantly, they don’t counsel that SSIs ought to substitute multi-session remedy; quite, they suggest that SSIs ought to be a complementary provide to conventional or extra high-intensity types of assist.
Single-session interventions shouldn’t substitute conventional, multi-session assist; as a substitute, they will complement what’s already on provide.
Strengths and limitations
That is the primary umbrella overview bringing collectively systematic opinions evaluating SSIs for psychological well being issues, that means it fills a vital hole within the literature and aids medical suggestions to be made on the implementation of SSIs. The authors completely searched the literature, together with unpublished opinions, to make sure the searches are as updated as attainable. They assessed the standard of particular person opinions and commented on their transparency and strengths and limitations, growing the transparency of the umbrella overview itself. Nevertheless, the authors do level out that many particular person systematic opinions didn’t report pre-registration, that means it’s attainable that a few of the outcomes have been selectively or not transparently reported.
Whereas the authors mentioned the restrictions of the included opinions, they didn’t touch upon any limitations of the umbrella overview itself. Nevertheless, there are some limitations, together with the truth that not all of the opinions included simply randomised managed trials, that are thought-about the ‘gold normal’ for measuring the effectiveness of psychosocial interventions. As some opinions contained non-randomised trials, it isn’t clear how the management teams in these research have been arrange and whether or not sure contributors (e.g., volunteers for the intervention situation), have been extra more likely to share some traits, comparable to motivation or psychological well being signs. This will make it tough to attract conclusions about the effectiveness of the intervention itself versus different shared components among the many contributors.
SSI period diversified significantly between research and subsequently assessing them collectively means we can’t inform whether or not session size makes a distinction to the effectiveness. Equally, SSI effectiveness was measured at numerous timepoints after the intervention, so it’s not clear how long-lasting the advantages are.
The principle energy of this umbrella overview is in its thorough and clear reporting. Nevertheless, the inclusion of non-randomised trials may introduce bias to the findings.
Implications for apply
This umbrella overview considerably contributes to the literature on SSIs by being the primary to synthesise obtainable systematic opinions assessing their advantages. As proven on this umbrella overview, the variety of developed and examined SSIs has been repeatedly rising, and there’s hope that they will complement present psychological well being service provision (Loades & Schleider, 2023). As such, it’s vital for clinicians and researchers to have the ability to overview and draw on evidence-based suggestions and potential advantages of SSIs, significantly these from meta-analyses as they’re thought-about the strongest sort of proof for intervention effectiveness within the analysis world.
I perceive that there might be scepticism round SSIs, e.g.:
- How can a one-off intervention presumably assist somebody in want?
- Will this substitute 12-week programs of remedy and the laborious work of therapists?
- What about managing threat?
I believe this umbrella overview is clear about what it could actually inform us about SSIs. Whereas the proof right here does present their potential medical advantages, significantly as a few of the particular person opinions discovered that multi-session therapies didn’t outperform SSIs, the authors additionally spotlight many areas that also have to be investigated so as to enhance the implementation and advantages of SSIs. Comply with-up instances differ significantly, making it tough to attract conclusions on how long-lasting the results are. Even when the SSIs are helpful, with out realizing how and to what extent they are often applied in actual life, their advantages will probably be restricted, so extra analysis is required on this.
Personally, after I consider the promise of SSIs, I consider a teen who’s coping with a particular phobia and who receives a one-off session whereas on a ready record for multi-session remedy. The one-off session teaches them some fundamental abilities and the way graded publicity remedy works, giving them a way of company and motivation whereas they wait. I consider a younger grownup coping with delicate low temper signs, however who isn’t fairly certain what’s taking place but. They arrive throughout a self-guided, on-line SSI educating them behavioural activation abilities. This one-off session helps them perceive their struggles and put it into phrases. This empowers them to hunt additional assist whereas practising behavioural activation workouts as they discover psychological well being assist of their space.
Regardless of my optimism, I might echo what the authors mentioned – SSIs are most certainly to enrich, quite than substitute multi-session assist provision. There are individuals for whom one or a number of one-off interventions could also be sufficient, and for others, they are going to want additional assist. However at a time when persons are struggling to entry any sort of psychological well being assist or assist, SSIs could also be an extra software below the belt of psychological well being assist techniques.
For some individuals, SSIs could possibly present them with the assist that they want; for others, SSIs might present a stepping stone to additional assist. Both means, SSIs seem to be a useful software within the toolbox.
Assertion of pursuits
NK was not concerned within the research summarised above, however she is a PhD researcher growing a single-session intervention. Her analysis group collaborates with a few of the authors of the research on this weblog on growing and adapting SSIs for younger individuals within the UK.
Hyperlinks
Major paper
Schleider, J. L., Zapata, J. P., Rapoport, A., Wescott, A., Ghosh, A., Kaveladze, B., … & Ahuvia, I. L. (2025). Single-session interventions for psychological well being issues and repair engagement: Umbrella overview of systematic opinions and meta-analyses. Annual Evaluate of Scientific Psychology, 21.
Different references
Loades, M., & Kemp, G. (2022). Only one shot at it: single session interventions for adolescent despair. The Psychological Elf.
Loades, M. E., & Schleider, J. L. (2023). Expertise Issues: On-line, self‐assist single session interventions may increase present provision, enhancing early entry to assist for younger individuals with despair signs, together with minority teams. Baby and Adolescent Psychological Well being, 28(4), 559-561
Schleider, J. L., Dobias, M., Sung, J., Mumper, E., & Mullarkey, M. C. (2020). Acceptability and utility of an open-access, on-line single-session intervention platform for adolescent psychological well being. JMIR Psychological Well being, 7(6).
