Imagine the frustration of needing urgent medical care, only to find appointments booked weeks or months in advance. For physical ailments, most of us would find that unacceptable. Yet, in the realm of mental health, this is the everyday reality. So, why does this disparity persist? A prevailing misconception is that mental wellbeing necessitates prolonged, drawn-out therapy.

Now, picture this: a walk-in clinic for mental health support or therapists offering daily or weekly slots for immediate services at the point of need rather than at the point of availability. This concept aligns with Single Session Therapy (SST), a structured servicemodel where each session is treated as a potentially singular opportunity for change while remaining open to further support (Young et al., 2012). 

SST is not about arbitrarily limiting therapy to one session; it's about making every interaction count (Lee & Tratner, 2020). It is about the mindset of delivering support in a single session every time. Decades of research, beginning with the seminal work by Talmon (1990) and reinforced by the studies cited in the umbrella review by Schleider et al. (2025), have demonstrated the efficacy of single interventions across diverse client populations and therapeutic settings. Given its potential, the question remains: if SST can be so effective, what systemic and attitudinal barriers impede SST's wider adoption?

The landscape of mental health is undergoing a global transformation, demanding innovative and accessible solutions. This articleoffers a collaborative exploration of SST through the perspectives of four mental health practitioners from UK, Japan, Poland, and India, each driven by a shared conviction in the potential of SST. But first, let's look in a bit more detail at the methodology of Single Session Therapy.

A distinctive mindset

The core principles of SST are best understood through the concept of a therapist's 'mindset', which is defined as the therapist's series of beliefs that influence their actions and decisions during therapy. Flavio Cannistrà (2022) analyses the literature to identify 14 principles that constitute the typical mindset of a single session therapist. These principles highlight the therapist's active role, the client's inherent resources and expertise, and the flexibility of using various therapeutic methods. SST acknowledges that further sessions may be needed and is suitable for diverse contexts and needs. Therapists aim for small interventions, adopt a 'not-knowing' stance, focus on the present, and recognize that change primarily occurs outside the session. They use structured sessions, establish rapid client-therapist relationships, and avoid assumptions about the client's resources or self-awareness.

The Bouverie Centre, Australia, lists ten core elements of a single session as part of their training program to implement single session thinking: 

1. Negotiating a client-led outcome for the session, making overt that it may be the only session. 

2. Establishing the client's priorities; being clear about your priorities; making space for both – but privileging the client's 

3. Talking about the most important things – cutting to the chase 

4. Checking in at regular intervals throughout the session 

5. Interrupting respectfully, to help a client get what they want 

6. Making time your friend – Manage time efficiently but not officiously 

7. Sharing thoughts openly with the client 

8. Preparing to end well – Ensure all necessary information is discussed 

9. Leaving the door open – Let the client know that they can seek further help when needed 

10. Listening to client voices – Create a client-informed service using pre- and post-session questionnaires, In-session questioning, Takeaways.

Furthermore, Lee and Tratner (2020) highlight that the core of SST is to treat each session as if it could be the last, which reorients the therapeutic process to condense assessment, intervention, and evaluation into a single encounter. Young et al. (2012) suggest that SST is more of an approach to service delivery than a therapeutic model, allowing practitioners to use their own style whileadapting to the principles of SST. In their article, they describe the massive SST implementation project in Australia and suggest practical ideas for translating SST into mainstream clinical practice.

On top of these underlying principles that guide the approach, SST can also be understood in terms of the typical flow or phases of the session (pre-session, session, and post-session). Windy Dryden (2020) describes the distinct characteristics of each of thesephases, especially when compared to traditional, longer-term therapy approaches. The pre-session phase involves the optional use of a pre-session form/questionnaire primarily designed to help clients prepare for their session and get the most out of it. The design of the form is the beginning of a solution-focused intervention and can be tailored by each therapist. The focus of the session is on the person and their situation, rather than a diagnostic label or interpretation of statements through pre-existing psychological theories (Porter et al., 2025). Establishing a rapid client-therapist relationship is considered possible and vital in SST. SST session typically requires a structure with a beginning (agreement on purpose, contract, session goal, focus, problem assessment), middle (finding solutions by exploring past attempts, strengths, resources, and rehearsing solutions), and end (summarising, identifying takeaways, action planning, and offering further help options). Therapists are mindful that different methods can be used with differentclients based on their needs and preferences. The post-session phase in SST emphasises the client's autonomy and self-reliance – it is the client who often decides how much therapy they want, with the therapist presenting options for future help only after the client has had a chance to implement what they learned in the session. 

In summary, SST distinguishes itself from traditional therapy by its intentional focus on the immediate therapeutic encounter, itsbelief in the potential for change within a single session, its emphasis on client autonomy, and a streamlined approach across the pre-session, session, and post-session phases.

Now, let's turn to our collective experiences, and how they highlight the ways SST addresses accessibility challenges, reshaping traditional therapeutic models to better serve individuals in need.

We start with system-focused examples from UK and Japan, and then move to individual and cultural contexts of Poland and India. We explore our personal journeys with SST, analyse the real-world challenges of help-seeking in our diverse regions, and advocatefor the broader adoption of SST to bridge the growing gap in mental health support. Through our collective experiences and insights, we aim to contribute meaningfully to the evolving global dialogue on SST and inspire its wider implementation.

Sarah Lewis (UK)

I am a mental health nurse with over 20 years of experience in child and adolescent mental health care. I currently serve as the Chief Executive Officer of Normal Magic Personal Wellbeing, Training, and Consultation Service in England.

My engagement with SST began while I clinically and operationally led the Early Help for Mental Health Service (EH4MH) project inDevon, between 2016 and 2019. As part of this initiative, we provided one-time supervision and consultation to educators in primaryand secondary schools. The objective was to create a supportive space for school staff to address their own wellbeing while also discussing concerns about students' mental health. Due to the structure of the program, school staff often had access to only asingle session, necessitating an impactful and efficient approach to intervention. In response, the Normal Magic model was developed as a mindset framework aimed at equipping both clinicians and help-seekers with tools to maximise the effectiveness of a single session. This model focuses on the help-seeker's goals, leveraging their existing strengths and resources, while also acknowledging contextual factors and potential obstacles to resolution.

Over the past eight years, Normal Magic has continually refined its SST model, with a focus on empowering both mental health providers and the broader systems that deliver care. Our work is driven by a commitment to transforming the accessibility of mental health services, drawing inspiration from the contrasting structure of general health care in the UK. In the UK, individuals are registered with a General Practitioner (GP) and can seek care without the need for a referral, symptom-based thresholds, or open/discharge statuses. GPs offer immediate support, including medical guidance, symptom education, self-help strategies, monitoring, and referrals to specialists when necessary. In contrast, mental health care is often less accessible, with barrierssuch as high referral thresholds, open-and-closed care models, and lengthy waiting lists. Additionally, GPs are not always trainedto provide mental health care in the same capacity as physical health care. This system structure often leaves help seekers without effective mental health support. This disparity raises a crucial question: Can SST be integrated within primary care settings toenhance mental health accessibility in a manner similar to the GP model?

For the past two years, Normal Magic has been implementing this vision by delivering SST to children, young people, and theirfamilies within health centres. Our collaborative model between Normal Magic and the Primary Care Networks eliminates access barriers by removing referral requirements, symptom thresholds, and the need for open or discharge care, directly mirroring the GP approach to bring total health care in the GP surgery.

Our findings demonstrate significant improvements in access to timely and effective mental health care. Notably, health centres have reported a decline in GP appointments related to mental health concerns, a reduction in referrals to specialist mental health services and a reduction in emergency mental health interventions. These outcomes highlight the potential of the Normal Magic Single Session Therapy model to enhance mental health service delivery, improve timely access, and alleviate pressures on primarycare systems, specialist services and emergency services.

Keigo Asai (Japan)

I am a clinical psychologist and an associate professor at a Japanese teacher training university. I am also a school counsellor atprimary and junior high schools. My university focuses on education in remote areas and small-scale schools. Several depopulatedareas near the university often lack consistent psychological services, with some schools only receiving a counsellor visit annually.While researching how to make the most of my limited opportunities as a school counsellor in such schools and exploring support methods suited to these regions, I came across SST. 

Although SST is not yet widely practiced in Japan, its principles of maximising impact within limited timeframes resonated strongly.Fortunately, in 2021 I had the opportunity to invite Dr Flavio Cannistrà, a renowned researcher and practitioner of SST, to a Japanese academic conference. Unfortunately, due to the impact of Covid-19, the workshop ended up being an on-demand format. However, the Japanese practitioners and researchers who participated began to recognise the potential of SST. I now actively promote SST in Japan by translating books on SST written in English into Japanese, in order to raise awareness of its potential among more professionals.

I am currently researching whether the core principles of SST can be applied by school teachers to provide psychological supportfor students and their parents. In Japanese public schools, teachers have traditionally played a dual role – both educating students and providing psychological support to students and parents. Now that the role of school counsellors has been formally recognised, every public elementary and junior high school has a school counsellor. However, in reality, some schools only have a counsellor visit once a year, and in certain areas, there are no qualified psychologists available, leading to retired teachers taking on the role of school counsellor. Given the difficulty of increasing the number of school counsellors at this time, I would like to equip teachers with support methods that incorporate the essence of SST so they can provide some level of assistance to children andtheir parents.

Additionally, I believe that adopting the core principles of SST can significantly alleviate the burden on teachers, enabling them to provide effective support within limited timeframes. If one assumes that more complex problems require significantly more time, then support efforts can indeed become time-consuming, leading to exhaustion among teachers. However, adopting a mindset that enables adequate support within limited timeframes can help alleviate the psychological strain on supporting teachers.

I hope that, through continuing research and practice of SST in Japan, SST will soon become a viable option for many support professionals across the country.

Magdalena Turek (Poland)

I am a practising psychologist with a special interest in Single Session Therapy (SST), having trained with Professor Windy Dryden in the UK. Currently, I am focused on bringing the SST approach to mental health practice in Poland. My mission is to challenge the traditional mindset in Polish mental health services and demonstrate that a single, focused conversation can make a real difference to a patient's mental health. I  also lead a team that has created the AI-powered app Therapy&Go that is supporting people in need around the world 24/7. In 2025, I founded the Mind&Soul Club, a network that connects mental health professionals from all over the world.

I want to share a recent experience that illustrates the power of SST. A woman in her mid-thirties came to me feeling overwhelmed.She was torn between staying in a job that provided her with financial security but drained her emotionally or leaving it to pursue a long-held dream of running her own business. For months, she had been stuck, paralysed by the fear of making the wrong choice. During our SST session, I asked her the miracle question from the SFBT toolkit, 'If you woke up tomorrow and the decision hadalready been made for you, which option would bring you relief?' She immediately responded, 'Leaving'. That moment of clarity gave her the confidence she needed. By the end of the session, she had developed a concrete plan to transition out of her job and take the first steps toward her business.

In recent years, Poland's mental health system faces significant accessibility challenges. Long waiting times for therapy and limited resources often mean that people either suffer in silence or seek alternatives outside the mental health system. SST provides amore viable solution offering immediate, focused help when patients need it most. While some professionals in Poland are hesitant about SST, believing that meaningful change requires long-term therapy, research and practical application demonstrate the efficacy of SST in facilitating meaningful progress within shorter timeframes. SST does not replace traditional therapy but expands the options available, ensuring that people don't have to wait months to get support.

Promoting SST in Poland involves changing the conversation around mental health care. I am advocating for SST to be recognized as a valuable and effective approach. By integrating SST into existing services, we can increase accessibility, reduce waiting lists, and empower people to take meaningful steps forward in their lives. Bringing SST to Poland is not just about introducing a new technique – it's about shifting the mindset of both professionals and clients. It is about showing that meaningful change can occur almost instaneously. Sometimes, one conversation is enough.

Jasmine Joseph (India)

I am a researcher and a psychologist offering support services exclusively in SST format. For my PhD research, I created and empirically evaluated an online self-guided training program on Udemy, designed to improve Indian mental health practitioners'beliefs, attitudes, mindset, and self-efficacy in providing SST services. Although my recruitment efforts raised awareness of SST among thousands of Indian practitioners, the enrollment of the 150 required participants for the training program presented a significant challenge. The wider adoption of SST, even in contexts where it holds immense potential, necessitates a fundamental shift in mindset that begins with service providers.

The transformative potential of this mindset has been evident in both my personal life and clinical practice. I recall a period of profound indecision, paralysed by the weight of a life-altering choice: marriage to my partner of 14 years. For weeks, I was trapped, unable to move forward. Then, a simple, direct question from a colleague – 'You've known him for two years, what are youexpecting, and is that what you know about him?' – shattered my paralysis. At that moment, clarity emerged, and we married thenext day. This experience underscored a fundamental truth for me: people often crave an escape from suffering, a moment of clarity that can be self-generated, supported by others, or triggered by circumstance – what we recognise as pivotal 'Ah-ha' moments. If you reflect, you might have had them in your life too. 

These moments are not mere luck in SST. They are the result of a structured, goal-oriented approach that distinguishes SST from simply aiming for a quick resolution. Now that I am aware of the structured flow of an SST session, I have witnessed these momentsunfold regularly in my SST sessions, demonstrating that they are a predictable, rather than random outcome of the method.

In India, the urgency for accessible mental health support is stark. Help-seeking is often hindered by stigma and cultural beliefs prioritising self-reliance, family support, and spiritual remedies. With an increased demand for Western therapies in urban areas, SST remains relevant due to its brief, solution-focused nature, which reduces the stigma of engaging in long-term support. The emphasis on empowerment and existing resources in SST resonates with Indian values of self-sufficiency whilealso acknowledging the importance of family and community support. In a country with geographical and financial barriers, the accessibility of a single session can be a crucial first step, providing immediate solutions and potentially opening pathways for further support.

However, the widespread adoption of SST in India faces challenges as many professionals encounter SST only outside their formal training, leading to resistance and skepticism. To bridge this gap, I attempt to integrate SST into academic curricula and continuing education. Workshops, conferences, and online resources can facilitate learning and case discussions. Fostering open dialogue and creating platforms for professionals to share experiences and address concerns will build trust and encourage wideracceptance. By embracing SST, Indian practitioners can expand their service offerings, enhance efficiency, and better serve a diverse population in need.

The power of the present moment

Together, we illustrate the adaptability and effectiveness of SST in diverse contexts. Whether addressing systemic barriers in the UK,bridging service gaps in Japan, challenging traditional perspectives in Poland, or countering stigma in India, SST is proving to be a valuable tool for making mental health care more accessible, immediate, and impactful worldwide. Through continued advocacy,research, and training, we aim to pave the way for SST to become a recognised and integrated component of global mental health services.

A shared theme across our work is the fundamental role of mindset in the effectiveness of SST. We believe that both help-givers and help-seekers benefit from adopting a mindset that embraces the potential for change within a single encounter. SST is not just atechnique; it is a way of thinking – one that emphasises strengths, existing resources, and immediate action. By fostering a mindset that values the power of the present moment, we can create significant shifts in perception, unlocking solutions that may have previously seemed out of reach.

References

Cannistrà, F. (2022). The Single Session Therapy Mindset: Fourteen Principles Gained Through an Analysis of the Literature. International Journal of Brief Therapy and Family Science, 12(1), 1–26.

Dryden, W. (2020). Single‐Session One‐At‐A‐Time Therapy: a Personal approach. Australian and New Zealand Journal of Family Therapy, 41(3), 283–301. 

Lee, E., & Tratner, M. (2020). Make every session count for clients! Rethinking clinical social work practice from Single Session Therapy (SST): A case illustration of Emotion-Focused Therapy (EFT). Journal of Social Work Practice, 35(4), 447–467. 

Schleider, J. L., Zapata, J. P., Rapoport, A., Wescott, A., Ghosh, A., Kaveladze, B., Szkody, E., & Ahuvia, I.L. (2025). Single-Session Interventions for Mental Health Problems and Service Engagement: Umbrella Review of Systematic Reviews and Meta-Analyses. Annual Review of Clinical Psychology. 

Talmon, M. (1990). Single-session therapy: Maximizing the effect of the first (and often only) therapeutic encounter. Jossey-Bass.

Porter, S., Pitt, T., Eubank, M., Butt, J., & Thomas, O. (2025). An expert understanding of the Single-Session mindset. Journal ofSystemic Therapies, 1–25. 

Young, J., Weir, S., & Rycroft, P. (2012). Implementing single session therapy. Australian and New Zealand Journal of Family Therapy, 33(1), 84-97.