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) intention 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 a long time, curiosity in them has skyrocketed over the previous 10 years. That is probably as a result of enchantment of a low-cost, scalable approach 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).
As a result of 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 deliver all of them collectively and consider their effectiveness in an umbrella evaluation (i.e., a scientific evaluation of systematic critiques).
Single-session interventions intention 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 critiques (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 critiques, and systematically searched well-known databases (e.g., MEDLINE, PsycINFO) and thesis platforms, in addition to hand-searching for any ongoing critiques.
The inclusion of meta-analyses (a statistical approach of mixing findings from totally different research) was elective, however narrative critiques (people who solely described the findings with out combining them in a standardised approach) have been excluded. Different exclusion standards included SSIs concentrating on motivation or readiness to hunt remedy, SSIs that used pharmacotherapy, and SRs targeted 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 evaluation, and ended up together with 24 systematic critiques that matched all standards they have been searching for.
Lastly, a generally used software (AMSTAR 2) to measure the accuracy and transparency of every included systematic evaluation was used, to evaluate the scientific rigour with which every evaluation was carried out.
Outcomes
Research traits and total results
- 24 systematic critiques containing 415 particular person medical trials have been included within the umbrella evaluation. These trials concerned roughly 40,629 contributors with ages starting from 5 to 90 years previous.
- 62% of the systematic critiques have been revealed between 2019 and 2024, exhibiting a pointy enhance in newly revealed medical trials evaluating the advantages of SSIs in recent times.
- Of the 24 included systematic critiques, 20 discovered total advantages of SSIs on a variety of medical outcomes. Solely two systematic critiques targeted on SSIs to enhance engagement with psychological well being providers, highlighting a scarcity of proof on this space.
- 12 of those critiques included a meta-analysis. Primarily based on these, the authors discovered a small, optimistic total 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, latest umbrella critiques evaluating multi-session psychotherapies throughout all psychological well being issues discovered an total impact of g = -0.34, which can be thought of small.
Which medical outcomes profit from SSIs?
- Eight of the ten systematic critiques evaluating SSIs for substance use discovered total 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 critiques specializing in anxiousness discovered total advantages. SSIs focused particular phobias and generalised anxiousness utilizing cognitive behaviour remedy (CBT) methods, graded publicity for particular phobias, and even train equivalent to yoga because the ‘energetic ingredient’.
- 5 of six systematic critiques specializing in despair discovered total advantages, with SSIs utilizing CBT elements or behavioural activation (serving to individuals do extra of what they take pleasure in).
- Considered one of two systematic critiques assessing SSIs for consuming issues, together with weight-reduction plan, physique mass, skinny superb internalisation, and physique dissatisfaction, discovered total advantages.
Does mode of supply have an effect?
- Every of the 4 systematic critiques on self-guided SSIs for younger individuals reported total advantages for at the least one of many psychological well being outcomes measured.
- Nevertheless, most research targeted on human-delivered SSIs (e.g., with a therapist), with 14 of 16 critiques discovering total advantages of the sort of SSI in comparison with management teams.
How lengthy do the advantages final?
- It’s tough to inform as a result of the follow-up occasions assorted drastically amongst particular person research within the included systematic critiques. They ranged from measuring outcomes instantly after the SSI to 2 years post-SSI.
Which is greatest – single-session or multi-session interventions?
- 4 meta-analyses in contrast SSIs with multi-session interventions, with combined findings. Two meta-analyses discovered no vital variations, one discovered a single-session motivational interviewing intervention to be extra helpful 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 evaluation recognized 24 eligible systematic critiques, combining knowledge from 415 particular person trials. General, 83% of the critiques discovered helpful results of single-session interventions for at the least one medical final result.
Conclusions
Primarily based on the 24 included systematic critiques, this umbrella evaluation discovered an total 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, on condition that SSIs are a low-cost possibility with the potential to achieve extra individuals at a faster charge, Schleider et al. (2025) concluded that SSIs will be useful to individuals with numerous psychological well being issues. Importantly, they don’t recommend that SSIs ought to substitute multi-session remedy; relatively, they suggest that SSIs needs 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’ll complement what’s already on provide.
Strengths and limitations
That is the primary umbrella evaluation bringing collectively systematic critiques 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 critiques, to make sure the searches are as updated as attainable. They assessed the standard of particular person critiques and commented on their transparency and strengths and limitations, rising the transparency of the umbrella evaluation itself. Nevertheless, the authors do level out that many particular person systematic critiques 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 critiques, they didn’t touch upon any limitations of the umbrella evaluation itself. Nevertheless, there are some limitations, together with the truth that not all of the critiques included simply randomised managed trials, that are thought of the ‘gold normal’ for measuring the effectiveness of psychosocial interventions. As some critiques contained non-randomised trials, it’s not 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, equivalent to motivation or psychological well being signs. This could make it tough to attract conclusions about the effectiveness of the intervention itself versus different shared elements among the many contributors.
SSI period assorted drastically between research and subsequently assessing them collectively means we can not 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 power of this umbrella evaluation is in its thorough and clear reporting. Nevertheless, the inclusion of non-randomised trials may introduce bias to the findings.
Implications for follow
This umbrella evaluation considerably contributes to the literature on SSIs by being the primary to synthesise obtainable systematic critiques assessing their advantages. As proven on this umbrella evaluation, the variety of developed and examined SSIs has been constantly rising, and there may be hope that they’ll complement present psychological well being service provision (Loades & Schleider, 2023). As such, it’s necessary for clinicians and researchers to have the ability to evaluation and draw on evidence-based suggestions and potential advantages of SSIs, significantly these from meta-analyses as they’re thought of the strongest sort of proof for intervention effectiveness within the analysis world.
I perceive that there will be scepticism round SSIs, e.g.:
- How can a one-off intervention probably assist somebody in want?
- Will this substitute 12-week programs of remedy and the onerous work of therapists?
- What about managing threat?
I feel this umbrella evaluation is clear about what it could inform us about SSIs. Whereas the proof right here does present their potential medical advantages, significantly as a few of the particular person critiques discovered that multi-session therapies didn’t outperform SSIs, the authors additionally spotlight many areas that also should be investigated to be able to enhance the implementation and advantages of SSIs. Comply with-up occasions range drastically, making it tough to attract conclusions on how long-lasting the results are. Even when the SSIs are helpful, with out understanding how and to what extent they are often carried out in actual life, their advantages can be restricted, so extra analysis is required on this.
Personally, once I consider the promise of SSIs, I consider a teen who’s coping with a selected phobia and who receives a one-off session whereas on a ready checklist for multi-session remedy. The one-off session teaches them some primary expertise 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 gentle 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 expertise. 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 workout routines as they discover psychological well being assist of their space.
Regardless of my optimism, I might echo what the authors stated – SSIs are probably to enhance, relatively 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 beneath 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 approach, SSIs look like a helpful 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
Main 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 evaluation of systematic critiques and meta-analyses. Annual Assessment 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). Know-how Issues: On-line, self‐assist single session interventions may broaden present provision, bettering 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).
