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 applications 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 seemingly because of the attraction 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).
As a result of improve 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 evaluate (i.e., a scientific evaluate of systematic evaluations).
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 way of the literature to seek out systematic evaluations (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 way of medical trials for a variety of psychological well being issues, substance use, or engagement with psychological well being companies. They adopted the usual process for umbrella evaluations, and systematically searched well-known databases (e.g., MEDLINE, PsycINFO) and thesis platforms, in addition to hand-searching for any ongoing evaluations.
The inclusion of meta-analyses (a statistical means of mixing findings from totally different research) was optionally available, however narrative evaluations (those who solely described the findings with out combining them in a standardised means) have been excluded. Different exclusion standards included SSIs concentrating on motivation or readiness to hunt therapy, 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 evaluate, and ended up together with 24 systematic evaluations that matched all standards they have been searching for.
Lastly, a generally used instrument (AMSTAR 2) to measure the accuracy and transparency of every included systematic evaluate was used, to evaluate the scientific rigour with which every evaluate was carried out.
Outcomes
Research traits and total results
- 24 systematic evaluations containing 415 particular person medical trials have been included within the umbrella evaluate. These trials concerned roughly 40,629 contributors with ages starting from 5 to 90 years outdated.
- 62% of the systematic evaluations have been printed between 2019 and 2024, displaying a pointy improve in newly printed medical trials evaluating the advantages of SSIs lately.
- Of the 24 included systematic evaluations, 20 discovered total advantages of SSIs on a spread of medical outcomes. Solely two systematic evaluations targeted on SSIs to enhance engagement with psychological well being companies, highlighting a scarcity of proof on this space.
- 12 of those evaluations included a meta-analysis. Based mostly on these, the authors discovered a small, optimistic total impact of SSIs throughout varied 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 evaluations 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 evaluations 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 evaluations specializing in nervousness discovered total advantages. SSIs focused particular phobias and generalised nervousness utilizing cognitive behaviour remedy (CBT) methods, graded publicity for particular phobias, and even train comparable to yoga because the ‘energetic ingredient’.
- 5 of six systematic evaluations specializing in melancholy discovered total advantages, with SSIs utilizing CBT parts or behavioural activation (serving to individuals do extra of what they get pleasure from).
- One among two systematic evaluations assessing SSIs for consuming issues, together with weight-reduction plan, physique mass, skinny splendid internalisation, and physique dissatisfaction, discovered total advantages.
Does mode of supply have an effect?
- Every of the 4 systematic evaluations on self-guided SSIs for younger individuals reported total advantages for at the very 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 evaluations discovering total advantages of any such SSI in comparison with management teams.
How lengthy do the advantages final?
- It’s troublesome to inform as a result of the follow-up occasions various significantly amongst particular person research within the included systematic evaluations. 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 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 evaluate recognized 24 eligible systematic evaluations, combining information from 415 particular person trials. General, 83% of the evaluations discovered helpful results of single-session interventions for at the very least one medical end result.
Conclusions
Based mostly on the 24 included systematic evaluations, this umbrella evaluate discovered an total small-to-moderate impact of SSIs on a spread of psychological well being issues, together with substance use, melancholy, nervousness, and engagement with psychological well being companies. This impact is barely decrease that the consequences normally discovered for conventional, multi-session psychotherapies.
Regardless of the smaller impact, provided that SSIs are a low-cost possibility with the potential to achieve extra individuals at a faster fee, Schleider et al. (2025) concluded that SSIs will be useful to individuals with varied psychological well being issues. Importantly, they don’t recommend that SSIs ought to exchange multi-session remedy; quite, they advocate that SSIs must be a complementary supply to conventional or extra high-intensity types of assist.
Single-session interventions shouldn’t exchange conventional, multi-session assist; as a substitute, they’ll complement what’s already on supply.
Strengths and limitations
That is the primary umbrella evaluate bringing collectively systematic evaluations evaluating SSIs for psychological well being issues, which means it fills an important hole within the literature and aids medical suggestions to be made on the implementation of SSIs. The authors totally searched the literature, together with unpublished evaluations, to make sure the searches are as updated as attainable. They assessed the standard of particular person evaluations and commented on their transparency and strengths and limitations, rising the transparency of the umbrella evaluate itself. Nevertheless, the authors do level out that many particular person systematic evaluations didn’t report pre-registration, which means it’s attainable that among the outcomes have been selectively or not transparently reported.
Whereas the authors mentioned the constraints of the included evaluations, they didn’t touch upon any limitations of the umbrella evaluate itself. Nevertheless, there are some limitations, together with the truth that not all of the evaluations included simply randomised managed trials, that are thought of the ‘gold commonplace’ for measuring the effectiveness of psychosocial interventions. As some evaluations 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 prone to share some traits, comparable to motivation or psychological well being signs. This will make it troublesome to attract conclusions about the effectiveness of the intervention itself versus different shared elements among the many contributors.
SSI length various significantly 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 varied timepoints after the intervention, so it’s not clear how long-lasting the advantages are.
The principle power of this umbrella evaluate 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 evaluate considerably contributes to the literature on SSIs by being the primary to synthesise out there systematic evaluations assessing their advantages. As proven on this umbrella evaluate, the variety of developed and examined SSIs has been repeatedly rising, and there’s 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 evaluate and draw on evidence-based suggestions and potential advantages of SSIs, significantly these from meta-analyses as they’re thought of the strongest kind 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 exchange 12-week programs of remedy and the laborious work of therapists?
- What about managing danger?
I believe this umbrella evaluate is clear about what it might inform us about SSIs. Whereas the proof right here does present their potential medical advantages, significantly as among the particular person evaluations discovered that multi-session therapies didn’t outperform SSIs, the authors additionally spotlight many areas that also should be investigated in an effort to enhance the implementation and advantages of SSIs. Comply with-up occasions differ significantly, making it troublesome to attract conclusions on how long-lasting the consequences are. Even when the SSIs are helpful, with out realizing how and to what extent they are often applied in actual life, their advantages shall 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 particular phobia and who receives a one-off session whereas on a ready checklist for multi-session remedy. The one-off session teaches them some fundamental 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 delicate low temper signs, however who isn’t fairly positive 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 workouts as they discover psychological well being assist of their space.
Regardless of my optimism, I might echo what the authors mentioned – SSIs are probably to enhance, quite than exchange 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’ll want additional assist. However at a time when persons are struggling to entry any kind of psychological well being assist or assist, SSIs could also be a further instrument below the belt of psychological well being assist programs.
For some individuals, SSIs might be able to present them with the assist that they want; for others, SSIs could present a stepping stone to additional assist. Both means, SSIs appear to be a helpful instrument within the toolbox.
Assertion of pursuits
NK was not concerned within the examine summarised above, however she is a PhD researcher creating a single-session intervention. Her analysis group collaborates with among the authors of the examine on this weblog on creating 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 evaluate of systematic evaluations 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 melancholy. The Psychological Elf.
Loades, M. E., & Schleider, J. L. (2023). Expertise Issues: On-line, self‐assist single session interventions may increase present provision, bettering early entry to assist for younger individuals with melancholy 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).
