Positive Health Online

For many people, the idea of starting therapy comes with an assumption: it will be a long journey, stretching over weeks or months. But what if meaningful help could begin - and sometimes even happen - within a single session?

Single Session Therapy (SST), is an approach championed by leading cognitive behavioural therapist Professor Windy Dryden. Rather than seeing therapy as an open-ended process, SST starts with a simple, grounded idea: let’s make this one meeting as useful as possible.

Professor Dryden has authored or edited over 118 books in the fields of psychotherapy, counselling, and coaching, mostly dedicated to Rational Emotive Behaviour Therapy (REBT). He notes the most frequently occurring number of therapy sessions that clients attend worldwide is one. 

While traditional therapy training assumes ongoing, long-term care, global data across public and non-profit sectors reflects a different pattern.  The single most common number of sessions attended is one, followed by two, and then three.  Irrespective of Severity: This attendance drop-off happens regardless of the client's specific diagnosis or the complexity of their issue.

A Different Way of Thinking about Therapy

Single Session Therapy is not a new type of therapy, but a mindset. The therapist works as if this might be the only session you attend, focusing on helping you make progress with one specific issue.

That might be a decision you are stuck on, a pattern of anxious thinking, or a situation you are struggling to handle. Instead of exploring everything at once, the session centres on what feels most pressing and changeable right now.

Interestingly, this reflects real-world patterns. Across many services, the most common number of therapy sessions people attend is just one. And research suggests that many of those individuals feel satisfied – they got what they needed at the time.

What Happens Before you even Start

In this approach, some preparation often happens before the session. You might be asked a few focused questions, such as:

• What do you most want help with right now?
• How is this affecting your life?
• What would you like to leave the session with?
• What have you already tried?

This helps the therapist come prepared - and helps you clarify your own priorities.

What a Session Feels Like

At the start, you and the therapist agree on a clear focus. You might be asked:

“What would make this session useful for you today?”

From there, the work is practical and collaborative. Depending on your needs, the session might help you:

• Understand something more clearly;
• Talk something through and feel heard;
• Make a decision;
• Plan a specific course of action;
• Change an unhelpful way of thinking.

For example, if anxiety is the issue, the therapist may help you explore how you are interpreting a situation (the perceived threat) and how confident you feel in coping with it - and then work with you to shift those patterns.

Getting to the Heart of the Problem

Rather than exploring your entire history, the therapist focuses on what is maintaining the difficulty now.

In cognitive behavioural terms, this might involve identifying:

• Unhelpful beliefs (for example, “I must not fail” or “I can’t cope with this”);
• Avoidance patterns (putting things off, steering clear of situations);
• Harsh self-judgements.

The aim is not to dig endlessly, but to quickly understand what is keeping the problem going – and what might shift it.

Making the Session Count

A key goal of Single Session Therapy is that you leave with something tangible:

• A clearer perspective;
• A specific plan;
• A new way of responding to a situation.

For instance, someone afraid of flying might leave with a step-by-step plan for managing their anxiety on an upcoming trip, along with a more balanced way of thinking about the risk.

Therapists often check in throughout: “Is this still the most helpful thing for us to focus on?” This keeps the session grounded and relevant to you.

Ending with Clarity and Choice

The session closes by reviewing what has been useful and agreeing on next steps. You might decide to:

• Try out what you have learned on your own;
• Book another session;
• Return later if needed.

Importantly, there is no pressure either way. Some people find one session is enough for their current concern; others prefer ongoing support.

Is it Right for You?

Single Session Therapy can be especially helpful if you:

• Have a specific issue you want to focus on;
• Prefer a practical, goal-oriented approach;
• Feel unsure about committing to longer-term therapy;
• Want to “try out” therapy in a contained way.

It is not about quick fixes or promises of instant transformation. Rather, it is about making the most of the time you have – helping you leave with something useful, even after just one conversation.

https://www.amazon.co.uk/Single-Session-Therapy-Basics-Windy-Dryden/dp/1914938542

Further Information

Professor Windy Dryden’s book Single-Session Therapy: The Basics explores this approach in more detail for those interested in how it works behind the scenes.

If you are interested in joining in a basic beginners class introduction to REBT and the ABC’s of irrational thinking that can get people’s thinking stuck, Frances Coombes has a free monthly on-line Zoom Introduction to REBT:  francescoombes@yahoo.com