Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-24T22:55:37.750Z Has data issue: false hasContentIssue false

When Less is More: Lessons from 25 Years of Attempting to Maximize the Effect of Each (and Often Only) Therapeutic Encounter

Published online by Cambridge University Press:  12 June 2012

Moshe Talmon*
Affiliation:
The Academic College of Tel Aviv-Yaffo and the International Center for SST
*
Address for correspondence: The Academic College of Tel Aviv Yaffo, P.O. Box 8401, Yaffo 61083, Israel. Email: [email protected]
Get access

Abstract

The three main findings of studies conducted by Hoyt, Rosenbaum, and myself during the years 1986–1990 at the Kaiser Permanente Medical Group, were:

  1. 1. Single session is the most common length of psychotherapy.

  2. 2. The first session in psychotherapy is potentially the most therapeutic and often has the greatest influence on the outcome of therapy.

  3. 3. Single session therapy (SST) is the most cost-effective mode of therapy.

The fact that less is very often better in psychotherapy is by now one of the most validated and consistent findings in evidence-based psychotherapy research. We now think of it as a very common, very useful way of conducting therapy, employing many different approaches and methods to address a wide range of presenting problems. In retrospect, 25 years later, I believe that the essence of single session therapy is still about being present in each and every session as a whole. The goal has always been to make the most of every therapeutic session, whether seeing a client only once or over a long period of time. In a personal communication in 1978, Haley (in Talmon, 1990) predicted that a ‘single interview could become the standard for estimating how long and how successful therapy should be.’ This article explains why it didn't happen.

Type
Articles
Copyright
Copyright © The Authors 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Baer, J. S., Marlatt, G. A., Kivlahan, D. R., Fromme, K., Larimer, M. E., & Williams, E. (1992). An experimental test of three methods of alcohol risk reductions with young adults. Journal of Consulting and Clinical Psychology, 60, 974979.Google Scholar
Barlow, D. H., et al. (2009). Development of a transdiagnostic unified psychosocial treatment for emotional disorders. Psychiatric Times, 26 (7).Google Scholar
Berg, I. K. (1994). Family-Based Services: A Solution-Focused Approach. New York: Norton.Google Scholar
Bloom, B. L. (1981). Focused Single-Session Therapy: Initial Development and Evaluations. In Budman, S. H. (ed.), Forms of Brief Therapy. New York: Guilford Press.Google Scholar
Bloom, B. L. (2001). Focused single-session psychotherapy: A review of the clinical and research literature. Brief Treatment and Crisis Intervention, 1, 7586.Google Scholar
Cummings, N. A. (2000). The single-session misunderstanding. In Cummings, N. A., The collected papers of Nicholas A. Cummings. Vol. 1. The value of psychological treatment. Phoenix, AZ: Zeig, Tucker, & Theisen.Google Scholar
De Shazer, S. (1985). Keys to Solutions in Brief Therapy. New York: Norton.Google Scholar
Erickson, M. H. (1980). Collected Papers (vol. 1-4). New York: Irvington.Google Scholar
Goleman, D. (2009). Ecological intelligence. London: Penguin.Google Scholar
Goulding, M. C., & Goulding, R. L. (1979). Changing lives through redecision therapy. New York: Grove Press.Google Scholar
Gergen, K. J. (1985). The social constructionist movement in modern psychology. American Psychologist, 40, 266275.Google Scholar
Gustafson, J. P. (1986). The complex secret of brief psychotherapy. New York: Norton.Google Scholar
Hoyt, M. F. (Ed.). (1994). Constructive therapies. New York: Guilford Press.Google Scholar
Hoyt, M. F. (Ed.). (1996). Constructive therapies, Vol. 2. New York: Guilford Press.Google Scholar
Hoyt, M. F. (Ed.). (1998). The handbook of constructive therapies. San Francisco: Jossey-Bass.Google Scholar
Hoyt, M. F. (2009). Psychotherapy in organized healthcare. In Hoyt, M. F. (Ed.), Brief psychotherapies: Principles and practices. Phoenix, AZ: Zeig, Tucker, & Theisen.Google Scholar
Hoyt, M. F. (2000). Likely future trends and attendant ethical concerns regarding managed mental health care. In Hoyt, M. F. (Ed.), Some stories are better than others: Doing what works in brief therapy and managed care. Philadelphia: Brunner/Mazel.Google Scholar
Hoyt, M., Rosenbaum, R., & Talmon, M. (1992). Planned single session therapy. In Budman, S. H., Hoyt, M. F., & Friedman, S. (Eds.), The first session in brief therapy. New York: Guilford Press.Google Scholar
Littlepage, G. (1976). The problem of early outpatient terminations from community health centres: A problem for whom? Journal of Community Psychology, 4, 164167.Google Scholar
Malan, D. H., Bacal, H. A., Heath, E. S., & Balfour, F. H. G. (1968). Psychodynamic changes in untreated neurotic patients: I. Improvements that are questionable on dynamic criteria. British Journal of Psychiatry, 114, 525551.CrossRefGoogle ScholarPubMed
Malan, D., Heath, E., Bacal, H., & Balfour, H. (1975). Psychodynamic changes in untreated neurotic patients: II. Apparently genuine improvements. Archives of General Psychiatry, 32, 110126.Google Scholar
Miller, S. D., & Duncan, B. L. (2000). Paradigm lost: From model-driven to client-directed, outcome-informed clinical work. Journal of Systemic Therapies, 19, 2034.Google Scholar
Minuchin, S. (1974). Families and Family Therapy. Cambridge, MA: Harvard University Press.Google Scholar
Pekarik, G. (1996). Psychotherapy abbreviation: A practical guide. New York: Haworth Press.Google Scholar
Perkins, R. (2006). The effectiveness of one session of therapy using a single-session therapy approach for children and adolescents with mental health problems. Psychology and Psychotherapy: Theory, Research and Practice, 79, 215227.CrossRefGoogle ScholarPubMed
Prochaska, J. O. (1999). How do people change, and how can we change to help many more people? In Hubble, M. A., Duncan, B. L., & Miller, S. D. (Eds.), The heart and soul of change: What works in therapy (pp. 227258). Washington, DC: APA Press.Google Scholar
Rosenbaum, R. (1992). Single-session therapy: The time being. Paper presented at the annual meeting of the American Psychological Association, Washington, DC.Google Scholar
Rosenbaum, R. (1999). Zen and the heart of psychotherapy. Philadelphia: Brunner/Mazel.Google Scholar
Rosenbaum, R., Talmon, M., & Hoyt, M. (1993). Heavy ideals: A strategic single-session intervention for achieving weight loss through increasing autonomy. In Wells, R. & Gianetti, V. (Eds.), Casebook of the brief psychotherapies. New York: Plenum.Google Scholar
Silverman, W. H., & Beech, R. P. (1979). Are dropouts, dropouts? Journal of Community Psychology, 7, 236242.Google Scholar
Talmon, M. (1990). Single session therapy: Maximizing the effect of the first (and often only) therapeutic encounter. San Francisco: Jossey-Bass.Google Scholar
Talmon, M. (1993). Single-session solutions: A guide to practical, effective, and affordable therapy. New York: Addison-Wesley Publishing Company.Google Scholar
Talmon, M. (1996). (Hebrew). .Google Scholar
Yalom, I. D. (2002). The gift of therapy. New York: HarperCollins.Google Scholar
Young, J., & Rycroft, P. (1997). Single-session therapy: Capturing the moment. Psychotherapy in Australia, 4 (1), 1823.Google Scholar