As the waiting lists continue to grow, mental health services are embracing innovative approaches to support. One example is Single Session Therapy (SST) or ‘one at a time’ therapy - a structured intervention that provides meaningful support in just one session.
Although single sessions are not a new phenomenon, demand for responsive ‘in-the-moment’ support via one-off sessions has seen a marked increase on Kooth in recent years, driven particularly by young people.
What is single session therapy?
SST is designed to deliver support within one session, focusing on an individual’s stated wants and needs. Unlike traditional therapy, which often involves multiple sessions, SST operates on the principle that one well-structured session can be impactful, supporting individuals to address challenges in a way that is focused and may be orientated around goals.
What we see on Kooth is that a young person may choose a single one-to-one session, perhaps for exam stress or to discuss an issue around friendships or anxiety. They may then use what they learnt in their session and process what they discussed - then return for another session, perhaps a few weeks or months later when it suits them.
The NHS has recognised the potential of SST as a way to improve access to mental health services, particularly for children and young people (CYP). Close to half of mental health conditions develop by age 14 and 75% by age 24. Evidence from Children and Adolescent Mental Health Services (CAMHS) shows that a single session is the most common way CYP engage with therapy.
A strengths-based approach
SST is centred around the individual, with goals and outcomes led by them rather than predefined therapeutic objectives. This approach allows people to take control of their mental health journey, choosing what they want to focus on during the session. It is particularly appealing to those who prefer flexibility and autonomy when seeking support.
Therapists use their expertise to address concerns within the session, operating under the assumption that additional support may not be necessary. However, if further sessions are needed, SST can be integrated into broader mental health care plans.
Developing the first ever measure for online single session support
Kooth has taken SST a step further. Observing the rise in demand for single sessions, we have spent more than three years developing the first ever measure for online support to determine its effectiveness. The ‘Session Wants and Needs Outcome Measure’ (SWAN-OM) is a validated tool measuring the effectiveness of a single online session, capturing immediate impact rather than tracking long-term symptom changes.
It’s unique in that it allows users to define their session goals in advance, ensuring that the session is focused and purposeful.
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Pre-session: our service users select areas they want to address, choosing from predefined categories or adding their own
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Post-session: They then assess their progress, reflecting on whether their objectives were met
This structured yet flexible framework enables Kooth practitioners to tailor interventions in real time, enhancing the overall effectiveness of SST.
How effective are single sessions?
Our outcomes measure, SWAN-OM, shows SSTs are overwhelmingly effective:
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Following their SST, young people experienced a significant improvement in positive affect (increased feelings of happiness, joy, and contentment) as represented by changes in the scores before and after the session
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Negative affect (feelings of sadness, anxiety, and anger) was also significantly reduced after SST when comparing pre- and post-scores
A scalable answer to a growing question
Single sessions are shown to be effective and popular and represent a significant leap forward in terms of providing help when it’s needed and, importantly, in a way that suits the young person. Being able to flex to changing demands is imperative, as is ensuring that whatever support is offered is evidence-based and demonstrably effective.