The Systemic Way
The Systemic Way Podcast is a therapy and mental health podcast featuring conversations with experts, practitioners, researchers, and people with lived experience from the worlds of systemic psychotherapy, family therapy, psychology, social work, and community practice. Hosted by Sezer and Julie, two systemic and family psychotherapists, the podcast explores mental health, relationships, trauma, resilience, social justice, culture, and change. Through engaging discussions on theory, practice, and real-world experiences, listeners gain a deeper understanding of how systemic and relational approaches can support individuals, families, organisations, and communities.
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The Systemic Way
Making Every Session Count: The Philosophy and Practice of Single Session Therapy with Katy Stephenson, Flavio Cannistra and Jeff Young
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In this episode we talk with Flavio Cannistra, Jeff Young and Katy Stephenson all about Single Session Therapy (SST). They share their professional experience and lived examples of the approach in action. We are introduced to the philosophy, key principles, benefits, challenges and ethics of SST and get an insight to how it can transform practice, systems and how services are delivered.
Guests:
Jeff Young (PhD) is Emeritus Professor, La Trobe University in Melbourne, Australia. He is a clinical psychologist and family therapist who has worked, published and presented in the area of Mental Health for over 38 years. He was Director of The Bouverie Centre, the world’s largest specialist family therapy centre between 2009 & 2022.
Katy Stephenson, Family and Systemic Psychotherapist working in a Child and Adolescent Mental Health Service community team in NHS, Dorset Healthcare Trust. She has worked predominately with children, young people, their families/carers and significant others for over 20 years.
Flavio Cannistrà, is co-founder and co-director of the Italian Center for Single Session Therapy and the ICNOS Institute, a school of Specialization in Brief Systemic Strategic Psychotherapy. He has published articles on Brief Therapy in international journals and has been a conference speaker in Europe, the United States, Australia and Japan.
His publications include “Terapia a Seduta SIngola. Principi e pratiche.” (2018, Giunti, translated into English and Japanese) and “Terapia breve centrata sulla soluzione. Principi e pratiche” (EPC).
Link to symposium:
https://www.singlesessiontherapies.com/single-session-therapy-symposium/
Welcome to the Systemic Way. In today's episode, we are talking all about single session therapies, which is a method practiced and known worldwide by an increasing number of mental health professionals. It is not a single approach, but a set of practices and mindsets all aimed at the same goal, to make every single encounter with our clients responsive, efficient, and effective. Today we have three very special guests with us, and that is Flavio Canistara, Katie Stevenson, and Jeffrey Young.
SPEAKER_04Flavio Canistra is co-founder and co-director of the Italian Centre for Single Session Therapy and the ICNOS Institute, a school of specialisation in brief systemic strategic psychotherapy. He has published articles on brief therapy in international journals and has been a conference speaker in Europe, the United States, Australia, and Japan.
SPEAKER_03Katie Stevenson is a family and systemic psychotherapist working in a CAMS team in the UK, Dorset. She has worked predominantly with children and young people and their families, carers, and significant others for over 20 years. She is incredibly passionate about offering services and treatment at the right time and preventing crisis intervention.
SPEAKER_04Jeff Young is Emeritus Professor at La Trobe University in Melbourne, Australia. He is a clinical psychologist and family therapist who has worked, published, and presented in the area of mental health for over 38 years. He was director of the Bouvery Centre, the world's largest specialist family therapy centre between 2009 and 2022. Jeff's interests include single session thinking, chronic conditions, blame, family grief and mental illness, indigenous health and well-being, contextually compassionate health services, and how to implement them. He has co-edited two seminal texts and two special editions of the ANZ JFT on single session therapy. With his colleague Pam Rycroft, Jeff created the first self-paced online learning suite for single session thinking.
SPEAKER_03What a privilege it is for us, Judy, to have these three esteemed members of the single session therapy community talking to us about their work. And yeah, I mean what stuck out for me was a kind of just bubbling enthusiasm and excitement about this way of working and the hope that this way of working is picked up not only by people who call themselves single session therapists, but anybody who's working therapeutically with people to be able to take some of these ideas and hold them in their work. Because any any session could end up being a single session, you know, and this idea that this might be the only time we might see this family and how I might maximize and make the best use of our time together. What was something that stuck out for you, Julie?
SPEAKER_04Thanks, Cesar. Uh I feel like for me it was the possibility of a single session um with a family, the invitation to sort of rethink your introduction with families and what could be possible, like you said, just like if you only have this moment of time with them, what does that do in terms of how it might inform you in in a session? Um and they really sort of break that down actually into a really helpful process at how to attend to that, because they're not saying that it will just be the session, but just the possibilities. I think that's that's one of the things that really stood out for me, as well as their sort of passion for it, because you absolutely can um see, feel, hear what is possible with with having that type of mindset going into work and what that might mean in terms of transforming services going forward. So I'm sure and I hope people will get a lot out of listening. Is there anything else you wanted to add, Cecil?
SPEAKER_03Yeah, uh we should um highlight that there is a fourth international symposium about to take place, and that starts on the 10th of November this year, and that's in Rome in Italy. Um, so it's not too late for people to join. I think it it's a hybrid um symposium they're doing this year. So some people online and and some people on face-to-face. So we will put a link in the chat, and that symposium is called single session therapies. What, why, and how single session mindset and practices are effective, efficient, and excellent. So do check it out and do check out their work, and we hope you all enjoy the conversation today.
SPEAKER_04Welcome to the Systemic Way. We've got Jeff, Lavio, and Katie. It's and of course you Cesar. So it's great to have you all here. Um, I guess what might be good and a nice place to start, because we've got three guests today, is just to hear from the three of you about how how you know each other, how you met, what brings you together with us.
SPEAKER_05Yeah, so I initially met Jeff when I was training. Um, so I'm British, but um, I lived in Australia and um worked in Australia, and I was fortunate enough to do be sponsored and do my training and family therapy at the Bouvery Centre for La Trobe University, and Jeff was the director um at the Bouvery Centre, and he introduced single session um in my as part of my training. Um and Flavio I I met briefly um at the single session symposium in 2019 that was held in Melbourne, Australia.
SPEAKER_02And uh I met uh Katie obviously then when she was a student at Bouvery, and also Flavio came and visited the Bouvery Centre. So we had some one-on-one time together, which was great. And then in the uh the symposium in 2019, which was the third international single session and walk-in services uh international symposium that was run was back in Melbourne. We did the original one in 2012. I think the second one was in Banff. Uh, and now Flavio is uh hosting the fourth international single session conference.
SPEAKER_00Yeah, thank you, Jeff. And uh well, we know the first two angles, so I'm the last Hangle of the triangle, and we know exactly where I am. Uh I've been training with Jeff at the Blue Risk Center, um, after we trained with Michael Hoyt in California. I'm from Italy. And um I met Katie in uh in Australia at first, and then I invited her, and of course, Jeff to the symposium.
SPEAKER_03Thank you. Thank you for introducing yourselves. Um we today's episode is talking about single session therapy, and we're really interested in hearing the different approaches you all may have, or also your journey into working in this way, and and then us having the opportunity to really dig into some of the core ideas and principles of single session therapy. I think it would be useful for us um and maybe for our listeners to get a bit of an understanding of what is meant by by single session therapy. And we could probably do a whole episode on the definition, it seems, from from from my reading around the subject. But yeah, it would be really useful to have a bit of an overview of what what how how might you define or describe what a single session therapy means?
SPEAKER_02I might start, it's Jeff. Um I wrote a chapter in 2015, which and in that what I said was that uh trying to define it, it's a tricky thing to define, but uh I suggested that it's everything clinically that comes from accepting three research findings, and also what comes organizationally from accepting those three same research findings. And the three research findings is the first is that uh the most common number of sessions that clients have in psychotherapy, all forms of psychotherapy, um, no matter the severity or complexity of the presentation, or the modality of the therapy is one, followed by two, followed by three. So it's the mode, not the average. The second research finding, and these research findings to the uninitiated are really quite shocking and challenging, um, which is what I think I love about single session therapy. It's simple, simple idea in some ways, but incredibly and profoundly challenging to the way we work and thought about uh psychotherapy. The second research finding is that around 75% of clients who have one session and drop out after that session, when they followed up, report that that one session was sufficient and they're happy with that one session. The third research finding, which sometimes is the almost the hardest for people to get or professionals to get their head around, is that you cannot tell, you cannot predict who's gonna come once and who's gonna come back for more sessions. And so if you accept those three research findings, it'll mean different things for different people depending on their clinical approach. But clinically it essentially means that you're going to approach that first session as if, and that's really important little phrase, as if it's the only session that you're going to have together. You make that overt with the client, you take that sort of thinking or mindset into the session, and it has a whole ramification where you basically find out what people want to work on in that time. You make the most of that time. Um, usually, well, you make the most of that time by seeing what people want to achieve by the end of the session, even if it's a good start in a complex process, and you respond to trying to get them what they want. Um organizationally, then it means that you don't put up a whole range of steps before having a therapeutic session where you're going to try if clinicians are going to try and get the most out of that session. And then importantly, you have no impediments for people finishing up after that one session if they're happy, but also continuing on if they feel that they need more. So that's my long-winded um simple explanation.
SPEAKER_00Uh I, Flavio, I like um to uh the finish hands of single session therapy. One is uh from Jeff actually. Uh so Jeff, please help me if I uh don't quote you exactly. Um Jeff said in a chapter um that single session therapy is a service delivery model, yeah, which is a great definition because it's a way in which you can deliver psychotherapy, deliver uh mental health care. And it's very different to say that it's an approach. Um, and the second is by Michael Hoyt, with um another chapter, I think in the book of uh 2021, say that uh single session therapy is basically a mindset, a way to uh an attitude, um a set of beliefs and behaviors that help you, the therapist, to create an interaction with your client or clients that helps to maximize that encounter, which means, as Jeff said, um helps to realize the chance that one session can be enough for the client. Enough for the client, it's important because that's not means that in one session you help the client to solve the problem. It can happen sometimes, sometimes it's just impossible because if you have, I don't know, we are a flight with airplanes, well, you have to take a plane to uh a flight, an airplane to see if the problem is solved. But for the client, that session could be enough. You can say, Well, I think that now I have the resources, the strategies, the confidence to take a flight to try. And so the mindset is something that helps you to create that with the client.
SPEAKER_05Yeah, and I mean, as Flavio and Jeff have both said, there in terms of um, and and Jeff's paper is um really good at explaining single session in terms of the approach, the philosophy. And as as both Flavio and Jeff were speaking, I was just thinking about you know the the work that I've done in the UK as well, and and it's really about the culture as well, in terms of how we work with um individuals and families, um, particularly in child and adolescent mental health um settings at the moment, um, which is quite different. It's a bit of a shift in terms of mindset as well, um, in how we offer single session. Um, and it is about being person-centered, so client-led. Um, there are you know goals that you collaborate with the person, with the family. Um, and it's rather than having the experts dance, it's more around doing it with the family as opposed to to. Um yeah.
SPEAKER_04Yeah. Thank well, thank you, all of you. And I'm sort of drawn in my head. I wanted to ask some questions about the mindset because I think you were talking about that. But I wondered before we get there, um I'd love to hear just from each of you about what is your sort of why you were drawn to single session therapy, why you know, obviously you're here today to talk about it. What about it sort of resonates so strongly with you?
SPEAKER_02Yeah, for me, um it was back in the uh about 1994. Um and just finding these this research was sort of so back then it was sort of so confronting. Um and when we were started sh um doing the work, it just led to a sense where we were felt like we were in a session, we were rolling up our sleeves, leaning forward, and saying, what is it that you want to get achieved by the end of today? And that that created a real energy, um, but it also created a real um transparency and uh uh openness, one that clients would say what they want and that we would work on it, and that we could um rather than just build the relationship, the therapy which was sort of standard in those prior to single session, build the relationship in order to do the work the next or the third or the fourth session, we actually did that very quickly, compressed it really quickly, and started the work immediately. And clients interestingly uh whilst our colleagues were really uh uh reacted quite intensely and often really angrily, thinking that we were suggesting that we should provide less services to clients, but clients never complained. They were actually relieved that the therapist was getting down to business after being friendly initially and engaging in the business and consulting them at every stage about what they wanted to work on, how they wanted to work on it, what would they want to walk away with at the end of the day? Is this what they hoped for? Is this helpful? Have I got it right? And over time, what I particular I I really love that checking in. So rather than thinking that you had to do all the work in your head to think what the client needs, all of a sudden we did a very simple thing and started to say, is this helpful? Are we on track? Um, and we found clients started to be very uh so much more active in co-designing the direction of the of the work. And then towards after a while, what we what I really loved was this um framework in which as a therapist I could share what I thought in an open and direct and uh way rather than trying to hold back and build a persuasive argument over a series of sessions, I would share what I really thought um in a tentative way, and I'd also be able to um provide any thoughts and advice really upfront and directly. And what we sort of started to realize when we asked clients they've had counseling before, and if it was helpful or not, and when it wasn't helpful, around that time, the mid-90s, um, when family therapy felt like the solutions should come from the client, it shouldn't come from the therapist. The most co one of the most common complaints about previous work that wasn't that helpful was almost verbatim. The therapist asked lots of questions, but they didn't give me any advice. And so this actually opened up uh a sort of a mix of postmodern and modernist thinking in some ways, where the postmodernist was, what is it that you want? What do you want to walk away with? And the modernist was look, can I be really upfront and and share what I really think? Um and clients loved that interplay. Um and if you ask, most clients actually really wonder what their therapists really think of them, and think what and really wonder what they think you should do. And it's not this is the solution or this is the right way, it's like guided guided by the single session thinking that if I'm never going to see this client again, what would I want to share with them? Then you share everything, um, and because it's early on, it's like co-developing a hypothesis and a solution, they can say, yeah, and you especially say, Tell me if this sounds right, or if this would be useful. It invites them to say, no, that doesn't actually fit. Whereas if you use three sessions to build a hypothesis, you're so attached to it, and you've worked so hard, if the client sort of rejects it, all of a sudden you feel they're being defensive, and you criticize and you're quite and and work as therapists, we're really quite narky because our therap our hypothesis and our solution wasn't enacted immediately. Sorry, I've gone on a bit, but um you can say I was quite passionate about it.
SPEAKER_05Great to hear, Jeff, like your passion, and you know, I think you've really inspired so many in terms of the work that you've done in lots of areas. And for me personally, in terms of the mindset, I think as you're speaking, I'm I'm just you know reflecting and thinking about um you know, as when you actually are live in a session and you witness it for yourself, is it then that you realise how effective it is? And and hearing that feedback from families, like you say, empowering them. Collaborating with them, you know, we're giving them the agency and autonomy, which for a lot of people they've not had. They've sometimes been defeated by the system, disempowered by the system, often let down by the system. And I think this gives them a real opportunity to feel more in control and able to kind of um you know acquire the tools and resources within and externally that can assist them in that moment, which I think is incredibly powerful and it's amazing to witness. Um also I guess in terms of reflection, so often when we've carried out sessions, we've done we've had a reflective team in the in those particular sessions. And Jeff, you mentioned about people, um the clients often feeling quite um a lot, a lot of the comments and feedbacks we've received is around us going there, go going to the problem immediately or being able to be transparent about what it is, like almost giving permission, which people really value. And they say, you know, we've sometimes been in been involved with services for so long and we've still never really talked about what the problem is, whereas this allows us to be really open and transparent. Um, and by checking in as well, we're being really sensitive, we're modelling that sensitivity about them being really important and part of the solution. Um, and also I think, you know, with the feedback we've got as well, is that parents, families, children, they love they love this. They feel really you know, they walk away and they genuinely feel empowered to make a difference at the therapeutic kind of um tools and resources that you know the the tangible ideas they can go um forward with in in their lives and they feel quite comfortable about you know um doing that.
SPEAKER_00Yeah, uh I found very interesting and amazing Jess and Katia's answer. Um I I started to be involved in single session therapy in a period of my life in which I was very interesting, very interested in uh realized how to help people uh pick care in a very brief way. I was trained in um strategic therapy, the uh evolution of the Hemerized model. And uh so uh I really I uh in that period I was searching for brief therapies uh approaches uh outside uh of Italy and brief therapies experience after Italy. I was involved in I I've read the at the time the Talmud's book, Single Session Therapy. Uh there was an Italian translation, but I took that um uh everything was just died with that book. Uh in Italy, nobody knows something about single session therapy uh after that book. And um so I um I strengthened a contact with Michael Hoyt, and I realized that single session therapy was uh everything but die, it was still sound and alive, and um my what helped me to fall in love with single session therapy was the idea that it's something very as Jeff said, something very easy. For easy, I mean that there is not a complicated structure that try to organize the experience of the client and uh that try to uh give um psychopathological explanation of how problems work, of how humans work, of how change works. Uh in our book, we say it's a method, it's not an approach, it's a series of um, let's say, guidelines that shows that help to create that interaction. I said before. It's it's easy, it's a framework, another framework, a framework. Um, and this is very important to me because sometimes I have the feeling that we still at this in the present, we still uh being stuck in theories like truths, but that's the truth, that's the theory that works. Even now that constructivism and constructionism are epistemologies that are um let's say English uh shared from many approaches. Um single session thropy is one of this framework, another of this framework, but it's can we say the the simplest, the first step? As just say, let's share some talks, let's share some feedback, let's ask to the client is her feedbacks about what he her thinks, not uh without leading her to a path that my theory previously uh built, and let's see what's happened. And if she said, uh, if she says, um, yeah, one session could be enough, let's assume, as Jeff said, uh, that uh could be enough. The worst thing that can happen is that after one, two, three weeks, one month, six months, she calls you back and say, Oh no, it wasn't enough. The good thing could be that as we um surprisingly um find in our research of uh 2020, that uh some will call you back for another problem. Oh, that's problem, it's not more a problem. I solved that. Oh, I see that in uh another way, but now I know how psychotherapy works. I didn't, and this is important. There is um uh a thing, sorry for my English, called uh unexpressed help seek, which is every everywhere in the world. And you have to know that around 60 to 90 percent of people which can uh have a benefit, some kind of benefit from uh psychotherapy, from mental health care, uh will never arrive to a psychologist or a psychotherapist or social worker. And one of the reasons is that they think it costs too much, it lasts too much, uh, or my problem is not a psychotherapy problem. But with a single session therapy, they can say uh I tried just one session, and they can see that it's simple, it's easy, it's not uh um I think this is the way that this is the reason uh why in a step at the care single session therapy often is the first step. Let's try to see what we can do in the easiest way possible in the easiest way possible. And uh yeah, those are the main topics that um involved me in uh approaching the single session therapy.
SPEAKER_03Thank you. It's it's generating so many questions.
SPEAKER_04I know it's hard to know where to go, isn't it, Cesar? There's so many places. I'm gonna hand it back to you though. You're sure you'll take us somewhere good.
SPEAKER_03Um I'm really interested in understanding the mindset. Uh uh where my head's at is kind of thinking about the service delivery uh uh single session therapy, the service delivery model, which we could come back to because I'm really interested in a different context actually with Australia, Italy, UK. Um but I think really um talking about the mindset and what are some of these kind of core ideas, core principles that's needed in this in this kind of mindset shift or within the psychotherapist to hold in mind when they're working in this way.
SPEAKER_02Flavio and uh Michael Hoyt have done a lot of work um uh and sort of introduced the idea of the single session mindset. Um I I think it's in a simple way, it's how would you approach a session? One, if you knew that one session could be helpful and maybe sufficient in itself, and two if you and you shared this with the client assumed that this was going to be your last session, how could you how would you approach it to be as helpful as you could in that one session? And again, organizationally and and you you need to be able to offer, as Flavio suggested, another session if people need it. But yeah, I think that leads and Flavio, I'm sure, take it uh further in terms of what he's thinking about.
SPEAKER_00I did um I did uh I write an article for a journal and about uh single session therapy mindset. Um it was very challenging. So um I uh I uh I find a trick to write that article that was to uh go to study what other people, other authors like Jeff, Hattie, and other others um think about uh single session therapy mindset, and then um put together all these tools and uh and write the article. So that's my article, but that's that is uh their the their tools, that are their tools. And um I found um of course I found 14 principles. I I don't want to uh tell all the 40 principles, I don't want to be boring. Um, of course, those are my interpretation of um the helpers' talks about mindset, but it's nice to see that um different authors shares uh very similar ideas about um principle of single session therapy mindset, about what is needed to make a single session therapy possible before any techniques. Uh, during um our workshop, uh, and I probably could say also during uh Bury's workshop and also during Michael Hoy's um workshop, um, I say and I saw that um to the participants that um it's not very difficult to learn how to do single session therapy, uh talking about techniques or uh practical guidelines, especially if you are an experienced um um practitioners, even if there is um a but, but I will tell about the but later. Uh, it's what is difficult is to put yourself in the right mindset, and in fact, the but is that the most experienced clinicians um have more difficult to put themselves in a single session mindset because maybe they think, oh, but this is um, I don't know, uh uh anorexia, a single session can be uh useful, yeah. But that's because you are thinking in terms of anorexia or in terms of uh long-term therapy. You are not thinking in terms of let's see what the client wants. As I say before previously, um a thing that we can do is to help the client solve the problem. Another thing is give to the client um a space in which it can be listen, um, a strategy, uh first steps. Uh, so some more of those principles is that of course, one encounter can be enough. You approach with this idea, as Jeff said, that's let's work as if this encounter, this session would be enough. Another very interesting is that the therapist can have an active role. And as Jeff said, an example is you therapists that share your ideas. Don't limitate yourself to listen to the client. Another, of course, as Katie says, single session therapy is that is a person-centered metered approach mindset. So um, a very important principle is that people have resources useful to uh stay better, to solve the problem. Uh Michael Hoyt loved to say that the most common number of um sessions in psychotherapy is not one, it's zero. And it means that uh we basically solve our problem just by ourselves most of the time. So let's look in the client, with the client, in the person, with the person. What are um his resources? Let's talk about let's talk about how those resources can be useful. In fact, another principle is that the client is the expert of his life. You are therapists, you are the expert of the process because it's not like a chat with a friend, it's a structured um interview, a structured talk. So you are the expert of how to structure this talk, but you are not the expert of the client life. Yesterday I was talking with uh a friend, and I was saying, and I was saying uh all the diets, we're talking about diets, all the diets works. The problem is when the the physician uh gives you a diet that don't work for you, and uh another um uh principle, and then I stop because we are one-third of the journey. Um, the five is that you can use different metals. This is very interesting. You can find research on single session therapy based on uh I can say uh every kind of uh I found a research about single session psychodrama therapy, or with uh he hemd here, or with strategic therapy or solution therapy, CBT, of course, um, and so on. So you can use your clothes, just put it on a structure that helps your clothes to better fit to the purpose that one session can be enough.
SPEAKER_02Yeah, the other thing that just listening to you, Flavio, that um I was reflecting and sort of changed in our sort of mindset over the time, um, in addition, is almost generate creating a Buddhist-like non-attachment to an outcome that you might have someone with incredibly severe and complex problems, and uh and a traditional mindset would be, oh, that's tricky. That's going to we're really going to have to have lots of sessions to be helpful. And sometimes that's correct, and then sometimes that person, you start, you know, the first of you know and imagine 20 sessions, and they don't show up for the second session. And you think, oh god, I had a great plan for the 20 sessions, and then they didn't show up. Um and then you can have a session in a single session with someone with really complex problems, you ring them up um wondering what will happen, or thinking you know that they'll need another session. And they say, Oh, look, actually, we've really addressed our drinking problem, and you know, that was really helpful. And you can and it initially it blows you out of the water. Um, but the other happens too. You sort of say, Oh, that was a fantastic single session. It wasn't a very serious problem. Um, um, I'm really looking forward to this phone call because they'll say, Look, that was great, we don't need your help. And they'll say, Oh, look, we're wondering if we can make another appointment next Thursday. So it made us over time just go in with a total open mind and non-attachment to an outcome. And certainly, and this is really hard to do for and for especially the senior experienced therapists, to break the nexus between severity equals long more sessions. There's some research to show that if anything, it's the an inverse relationship. Now, I I sort of in my workshop say we've all probably got client uh friends who are in psychotherapy, you know, weekly psychotherapy, and you think of the level of problems that they have, and then we've got people that are homeless and got a huge range of complex problems, and that they're not going to be interested in long-term therapy. So severity and number of sessions is is just yeah, the the research and experience, especially experience, has shown that um uh it's an inverse relationship, if any. And that change, and then hence change and the role of the therapists in and clients change is can be um somehow there's lots of other factors like the common factors research have shown that lead to change.
SPEAKER_04Thanks, Jeff. Katie, I I don't know if there's something that you wanted to add.
SPEAKER_05I mean, there's so many things I'd I'd love to add. Um, in terms of I'm just thinking of uh the UK's position right now and and the demand on services and um the lack of resources and how a lot of clinicians are feeling quite deflated and defeated by um how to to attend to some of the difficulties that you know we're presenting and and how do we get through um waiting lists and people being on waiting lists for a long period of time. And I guess um in terms of and sometimes that can affect mindset because it can make people feel like you know there isn't any other kind of ulterior kind of um method or approach, and single session can the title, as I've had many conversations with Jeff before, um, can sometimes evoke uh negative connotations about what it actually means and what it stands for. And I actually interestingly, you know, even writing an article, sometimes people can still misinterpret what single session is. Um and I think it's just really important that we hold on to the idea that it is possible that there are possibilities that if we intervene at the right stage, that we can make a difference. Um, and actually a lot of the clinicians who I've worked with and introduced this way have been re-energized and it's given people a lot more um yeah you know, energy and uh and it's kind of ignited some of the clinicians' um passion and interest in in the work. And and I think that's really important because right now, um, you know, as I've mentioned, it is quite a difficult time for many in the public sector, um, and for families, you know, ultimately with that mindset um shift, we are seeing a lot of positive outcomes as a result, and that's not coming from us, that's coming from them. Um so I just wanted to mention that because I think it's really important from a UK perspective, how absolutely beneficial single session can be. Um, and I think if we begin to kind of try and help. understand what single session philosophy is and how it does align with our values and our principles in our training, whatever discipline we're in, it could really be useful for many reasons for many factors in it in the work that we do.
SPEAKER_04Thanks.
SPEAKER_02I think the the the great work that um Katie's doing in child and adolescent work really shows the value of single session or why single session is starting to be really picked up now because um with the aging population and the effects of COVID, the uh demand on mental health services and psychotherapy services have grown uh so extensively that then they're now overwhelming. And I'd even say that the a community is becoming less stigmatized about mental health problems so they are more likely to seek help. And they're also so so you've got more people like at least 30% through COVID greater demand because there's less public money because of the aging population we can't just keep expanding services. So there's got to be a change. And we've also got an educated population that wants services when and where they want it and high quality. So what do you do? And single session can provide some options and there are options that managers like because you get greater throughput and clients like because they get more responsive immediate sort of help. And the research is showing that for when an immediate therapeutic active therapeutic encounter is done really early on like I think Katie was just telling me the other day you know sort of 80 odd percent of clients are finding that one session enough. We've got an online walk-in service so it's done online as families uh a one-off session they can come back if they want it's like 82% of the clients are finding one session is enough. And so that then is starting to relieve and address that over that demand. I've got a colleague in um Murray Bridge in us in Australia who introduced Susan Fuzzard who introduced walk-in single sessions and uh had a a long waiting list and after about six months was looking for clients so um I think it's come of its age because of people are struggling and wondering what to do with this you know demand that can't be addressed.
SPEAKER_03What's sticking out for me is this this hearing the kind of um stories of this mindset shift and it's kind of um some of the pushback you might have got or some professionals have in in saying oh this this is not for them or doesn't fit within their approach and that's that's one thing there and I I I get that. I'm also interested in how some of the kind of how this can demystify psychotherapy for clients and there the discourses that people have around being a you know being a patient in the psychotherapy and the idea that psychotherapy is a longer term piece of work or or even these like I mean I Julie and I also both work in CAMs and in England and it is very much you get six sessions and you re-review and you know we kind of as professionals get we can get stuck in that but also clients might internalize some of these ideas of how psychotherapy is supposed to be so I'm just wondering from your experience in how some of this work helps demystify and break some of those narratives around psychotherapy.
SPEAKER_05I think it's isomorphic isn't it like we we're in a very traditional kind of um setup and arrangement that's been you know um embedded for years. So naturally as uh you know in the UK naturally as um patients we do kind of expect what um has been provided over time. I think it's only a matter of um us maybe being more open to different ideas and solutions to how we can meet these growing needs that we will start to maybe make a difference in an in in how um services offer um treatment? Does that make sense?
SPEAKER_02Sorry yeah yeah I I think um therapy is a socially ambiguous process for for uh clients you know for example can clients ask about the therapist background can they ask questions can they direct it can they sort of say I don't agree with you can can they reject the hypothesis or like it's really unclear. And when you try and explain therapy in a more traditional way we tend to go in very vague euphemisms like sort of saying oh therapy's a process you have to sort of wait and see and people say can you can you help my partner stop gambling oh well we can't quite do you know we have to sort of understand like we get very vague um like George Orwell lovely you know a great uh English writer sort of said when the politics um don't fit uh with the consumers that um our language becomes very vague and woolly and I think that happens for with us therapists when we're put on the spot about change and but single session actually does allow you to explain the process quite clearly for example you say well we're going to try and get as much done as we can in today's session I'll ask you a lot of questions I want to know what you want and I'll check in from time to time and then I'll share my thoughts with you and you can tell me what fits or not. And then if you want more sessions or you know 50% of clients find one session enough 50% want more either's fine. If you um will but we'll see how you go and you can put things into practice after the session and I'll give you a call in a couple of weeks or whatever suits and see where you want to go from there. More sessions is fine. But some families find uh ones are not you can actually I found I could actually explain the complexity of therapy more clearly than I could before I knew about single session.
SPEAKER_04And I I guess for me the strand that I've been picking up on from listening to this part of the conversation has been around power um and how the role of power I suppose or how single session therapy addresses power. But before I get to that question I wanted to say I suppose there's an element I think Jeff you mentioned like Buddhist non-attachment but also sort of um there's something about this being the only session that for me is sort of being really present in the moment which also connects I suppose to a Buddhist philosophy I'm not saying that single session therapy is completely connected to that but you know that's all you've got you've you've only got this moment. But and also a non-attachment to our ideas of six sessions or what therapy should be of trying to take a a stance really of putting the the client the family first what do they actually need rather than what what do we need as as therapists and I suppose that's what led me on to thinking um about power um and that was some of my thoughts but then I was also thinking about it in in terms of single session therapy as like a a decolonizing approach as well. So those were a couple of my thoughts around power but I did I'd be interested for you to speak to how you see single session therapy in in regards to thinking about power.
SPEAKER_02Interesting um Mosha Tolman and Robert Rosenbaum talk about at one point started using present therapy as a as a name for it because exactly saying what you were reflecting on Julie that you're in the moment and you're making the most of that moment. You're not thinking about the history or necessarily the the future.
SPEAKER_00He talks about embodiment doesn't he as well interestingly we've we've at Bouvery we had a uh a team that's uh very interested in trauma work and gradually they've initially a bit reluctant but gradually really embraced single session uh therapy and thinking and trauma informed practice which really has responded to the powerless sense that a lot of um clients who've been traumatized often experience in in in the world and including in therapy um single session actually fits with a lot of the core principles of trauma informed practice which is about transparency so explaining exactly like I sort of said how a session will unfold so they know what to expect choice on what to work on and how to work on it and openness about what the therapist thinks because one strong element uh if you're suspicious of the therapist is that you're assuming that they're thinking critical negative assumptions about you and if the therapist says nothing that fests whether it's true or not but if the therapist says exactly what they think including what they think the client maybe should do in a tentative way with an option to actually criticize and disagree all fits with the um some of the core principles of trauma informed practice I'd say in a way it trans it makes the it you know there's always a power you know because therapists are socially you know in a high status position to a client but it does make power issues not that it might talk about it but if things are more transparent and where people have a choice and it's a uh encouragement for a collaboration a true practical collaboration not just a ethical or a philosophical wish to be collaborative I think that's quite powerful sorry um yeah thank you uh there is um a practical uh guideline you can call that um that I saw in different methods in different ways to of applying of um doing single session therapy i seen that from uh Michael Hoyt's workshop Moshe Talman's book um of course we raised training and others that is the guidelines of um asking feedback to the client um just mentioned this before which is I can tell it's my favorite um uh my favorite guideline my favorite um intervention during the session is sometimes it seems um almost an obsession you know a compulsion you know because um during during those training sometimes some uh participants say you're asking constantly maybe seeing the a video or a live demonstration you you're asking constantly what do you think what do you think about this how do you see this what are your talks about that to client and I think that this is probably the most powerful intervention you can use during the the session for many reasons one is that it's an active way to use client to discover and use client resources it's also uh a way to change the power as you say Julie um I asked the question uh you give the answer during uh um a congress in uh sofia i uh I saw an interesting intervention interesting wash by um Plamen Panayatov I think is the surname um and it's say it was talking about uh solution focused brief therapy and it was talking how um that approach changed the dynamic of psychotherapy because the traditional dynamic is that the client does the question and the therapist give the answer and solution focused brief therapy give out the possibility with the um the therapist do the question the client give the answer and uh you can do single session solution focused therapy or single session cbt therapy but the use of feedback helps you to help the client to have uh it in a in a more superficial way to produce uh her answer in a more deep way to give her the feeling that is in charge in her life um sometimes the client says I don't know and uh we teach to our students to say to answer suppose you do know or take some seconds and think about that why because I don't know often means I never thought about that and so if with my questions I help you to talk to something maybe in a different way to talk to something to think to something maybe you can see you can attribute meanings different meanings to the same situation which I think is one of the results the big results of every successful psychotherapy hence with two results one is a change in behaviors one is a change in belief in how the the client attributes mean meanings to the things the difference is how you help the client to achieve this um this changement there is uh a a quick case a quick session I want to report it's not a single session therapy session but it's still very interesting um with a client I write down basically everything she said I I wrote uh a sentence and then ask a question and she gave me another answer and I wrote that answer and then another session and so on. And at the end of the session I simply read what I whatever you say that and this means that for you because you say that this means that and so on and you say this and that and so on. And she's at the end she said oh what she said is amazing you completely changed my point of view and I say oh but I I I didn't say anything because you know I've written I you you you saw me I've written what you say and she said of course we're in front of me but when I was saying those things I feel um judgment by my by myself and I feel uh anxiety when you repeat the same identical things and I can assure you that I repeat with this tone of voice not that suggested tone of voice I start to think that I don't need to judge myself and I don't need to feel anxiety. That's a great example for me so how feedback how other clients to see to say their point of view their way to give meaning to the word is a powerful way to act.
SPEAKER_05I just wanted to add if that's all right thank you Flavio just to kind of um yeah talk about exactly what you're referring to there is with the single session approach as well is that it there are like some tangible resources to kind of help implement single session. So you do like a pre-single session questionnaire which is a bit like a tool in therapy we use it as part of therapy so we can like be guided by that. So it gives them some power again in terms of you know how the session is conducted and it is a it is a process. And then at the end we often complete a takeaway now that takeaway is like a therapeutic kind of you can call it a therapeutic ending if they're not going to have any further sessions. But what it does enable what I found with the young people I've been working with in their families is that often they say they've put it on their fridge that they refer back to some of the you know things that we've discussed in therapy that we've noticed the the things that um you know they want to work on so the actions and stuff like that. I actually do mine at the end. I like to think and reflect about what has been discussed so that it does act as like a therapeutic tool almost um and that they can refer back to and often that's something that um the clients um love they love that it's like a therapeutic letter that they can refer to it's not like one of our traditional kind of canned letters um but it's something with meaning and power and it's it's it's really I've found um and I'm sure others have too is um it's quite um it's it's made a noticeable shift and change in terms of how they view things and what they've want that what they've taken away from these sessions too.
SPEAKER_03And are those summaries um co-created with the family or do they do it? Because what I've noticed is when I summarize a session it's very different to what the young person or the family what how they might summarize it. So I've kind of shifted in my practice of letting them lead really and then I might add whereas previously I would probably try to summarize a session and just time's running out I need to kind of pull it all together kind of angst that I I used to have or probably still have but now I've I've shifted to asking them to summarize and I'm wondering if that fits with yeah it it definitely does Cesar and I think that that's you know a really lovely idea as well is reflecting back what they've said.
SPEAKER_05But as Jeff has mentioned with the single session model is it does give you permission as well to give you give them some leave them with some food for thought as well. So I'm I'm just thinking of one example so how do you as a family make time to um have difficult um conversations or express difficult emotions so it's just it's also leaving them with some kind of things to think about as well.
SPEAKER_02So yeah absolutely it's it comes in two parts it's like the reflective part and then also the actions so yeah definitely we've we've uh started doing some um uh a a model called walk in together which is uh families can have a one-off session um online and uh we have a a therapist watching sort of um as a reflecting team and whilst they're you know they just have their camera off they do a summary of the session and then when it comes to do a reflection that person comes on and reflects with the therapist online about what what the family said and what's happened and puts it in written form um in the you know shares their screen and then gets the family to say whether that's accurate or not and change it and add it. And another component is with the takeaways and I'm so pleased you're using the takeaways Katie we we develop them like a little doctor's script um and use them uh but in online they actually list down what the the what the clients said that they'd do and then they would um edit it. And so they and that's sent off to them the same day including any um resources that might be helpful. So you can imagine that families are able to get into this straight away and they leave with all those resources on the same day. And so the satisfaction rate is extraordinary partly because of that responsivity.
SPEAKER_03That's some really good examples. And um I'm I'm thinking about one of it's one of the principles in Flavio in your paper about um single session therapy is suitable for different contexts and needs. And as I'm hearing you all talk, I'm thinking about my own practice. And when I I I work in a school on on one of my days, and we get these referrals from the school saying this kid needs therapy, you know, and it's the school really pushing it. And the kids always quite ambivalent. They might see me around the school or in the football pitch, so they've kind of seen my face and have a bit of comfort of who I am and maybe some curiosity, but really not interested in therapy. So I'm always kind of encouraging them in this spirit. I mean, I've not had these words to it, but this kind of idea of a single session. Come see what it's like. Um, let's have a kind of chat about things, and you can decide from there. Um, but I've always had this sense of failure in a way if they don't come back, you know, because I I felt like my task was to get them to come back for further sessions. Um, and maybe I've missed a trick in thinking, how can I maximize this? So I I could see it working in that context. I I'm wondering in a family context where there's a lot of conflicts, and families might be quite sensitive about bringing it all out, you know, in one session, or um, really get into a place of safety where they can say what they want to say about their feelings around whatever's going on in their family. So I'm I'm wondering, in terms of the different contexts and the different difficulties or issues that you you've worked with in working this way, where where you see it to be more to be really effective, maybe more challenging, um, in what kind of context and issues it's being used in.
SPEAKER_05I might answer to this if that's okay. So um what I've been as a bit of a pattern and theme that I've noticed in the work that I've been doing in Dorset and in Hampshire too. So we're seeing a lot of young people um and where it's been positioned is where there's been often a spontaneous overdose. Um, and what it's enabled us to do is kind of you know gather everybody together that's you know, the important people in that young person's life. So really working systemically, um, identifying and communicating exactly what the concerns are right from the onset rather than you know leaving it for a few weeks. Um and it's what I was going to say in terms of so working, you know, with the family, often what it does as well, if it is potentially only one session, is it it allows people who might not be able to get there to attend. So, you know, as we know, life is very busy these days. Some parents work um, you know, long hours and they're not able to attend, or the idea of having to attend for a number of sessions, is it often puts people off. So, what it does do though is it it, as I said, it enables everybody in that young person's life to be present. And I've noticed how incredibly effective that has been for everybody to kind of collaborate um and communicate on what the concerns are. And as we've mentioned before, you know, walking away with um some ideas, some um maybe new information that they may not have been aware of. Um and it helps to kind of, you know, often people say, what about risk? Well, this this tends to risk immediately because you're openly communicating with everybody involved, um, and you're being able to kind of think about it collectively about what to do hereafter, what sort of strategies, what you might notice, what would be really helpful for that young person going forward and the family. And I have involved schools in that too, particularly when a young person is really struggling in various areas of their life. So, you know, as we mentioned, single session doesn't necessarily mean just a single session. It can be a process and it can involve the whole system as well as the family.
SPEAKER_02I I think building on that, um, we found early on, not so much now, but in Australia, the most common asked question in our workshops was who is it appropriate for and who isn't it? And we really struggled because and so did all of the people in the field, they had their lists originally of what who was suitable for a single session and who weren't. And then in practice, they started screwing up these lists because they didn't fit. And we came out with this uh uh an answer which was make sure you don't have to ask that question. And by that I mean um offer ideally everyone a single session and embed it in your service system. So after that single session, everything that your service can provide might be group work, ongoing therapy, referral to a specialist, a referral for a thorough assessment, a diagnostic assessment, whatever, make sure that that's available after that first session. And so then you don't have to try and predict, because we were hopeless at it, uh trying to predict who's gonna sort of find one session sufficient and who wasn't. I think in a practical sense, the the sort of I was thinking, what when doesn't it work? And one is when there's so many legal papers that you, you know, you you've sort of got to read and prepare, and it's like it's it can be really tricky just to get anywhere in one session. Um, the other is when some clients, not many, just have a totally strong belief that one session's not enough. You know, they'll they'll it's sort of come in and you know, you sort of give the stats and all that, and that's not convinced, and so you know, why fight it? Go with um further sessions. And then the other, it's sort of a partly a good approach, but a lot of the single session techniques don't work when people are mandated or forced to attend therapy. So the single session questions, which are lovely, which is you know, what brought you along and what would you like to get out of today, and what would you want to walk away with? And what's what do you think we should start first? And is this on track? And how do you want to work? And is this what you want? For someone who's forced or mandated to attend, if they were to be honest, they'd say, Oh, we should piss off and just leave me alone. Um, so those and those sort of single session questions, which are lovely, don't work. Um, and I've developed an approach called no bullshit therapy for for those people, which is very much about sort of being more upfront and direct and saying how you are going to work and see if that fits with them. But yeah, that's another podcast. But they're the they're the practical times when I felt uh it's sort of best to um yeah, the single session doesn't work.
SPEAKER_05I guess as you mentioned there, Jeff, as well, is um like what we've noticed it obviously wouldn't work is when there's um obvious safeguarding concerns. So yeah, that that's when we we don't feel that single session is appropriate.
SPEAKER_03Thinking about family therapy and how um some of these ideas can get integrated into the kind of core uh principles of thinking in in family therapy, how how might how might family therapy sessions be kind of adapted to include single session approaches?
SPEAKER_02Look, look, in some ways we'd sort of say take the same approach that we would with any therapist uh with a therapist with any model, which is how would you conduct this session if you thought that it was going to be the last? Um and what happens then that just every modality finds sort of similar sort of core concepts, like we've talked about the mindset. But in family therapy, uh being a family therapist myself, a dedicated family therapist, um you sort of slow down and and don't you sort of because you've got multiple people in the room and you've got to ask each person what brought them along and what they'd like to walk away with, that takes quite a while. But just in doing that and thinking about what might help each ask each person what do you think might help achieve what they want, and trying to come to some agreement is actually incredibly effective because they all hear each other what they actually want to walk away with by the end of the session, and they can negotiate that and work out which they should start with and prioritize it, and checking in to see if it's um uh helpful, and then the therapist sharing their advice to everyone, and including if you've got the family therapy expertise, you're pretty good at being able to realize there's not one uh truth, each family member has a different perspective, there's multi perspectives and holding them in equal sort of space in some ways, there's so much information sharing um between the family members that it can be incredibly therapeutic, even though you haven't necessarily gone down you know in detail with you know each one of those possibilities.
SPEAKER_05I also think that you know being a family therapist myself, um that single session is really beneficial in the work that we're doing in CAMS because it enables, as maybe Flavio and and Jeff don't know this, but it enables family therapists, systemic thinking to be at the front line, the front door, as opposed to being referred to us when they're in crisis. So it's really an and and sorry, allowing um family therapists to intervene early on to help us work as we know children aren't they they're not um indiscriminate, they're part of a whole um system, and it's really important that we acknowledge that um sometimes if we intervene systemically at the beginning, how effective that can truly be, and that therefore we might not necessarily warrant further ongoing sessions. Um and that's been my experience with doing this work, um, and that's why I'm so passionate about it because I really believe that family therapists aren't being used or utilized in the way the best way we could, and that's being right at the beginning of services.
SPEAKER_02And that's a lovely point, um, Katie. And I I've just come across uh uh some work um written up by uh a woman called Julie Green, uh Krim, and they've developed single session uh advanced uh allied health practitioners for uh children that have developmental and behavioral problems, um, and they have a family approach so that they have a session really early on. It's led to the gap between a GP and a referral being accepted from 169 days to 48 days, and a referral when it's required uh to diagnosis from 37 weeks, you know, 57 weeks down to 30 weeks. So having a family approach, which I think us family therapists always feel that it reduces the number of sessions that you have to have them rather than working just individually without that family context. And then a single session approach as well starts to reduce the the time and and the as well as the number of sessions, um, which again is is much needed at the current demand that can't be satisfied.
SPEAKER_00Single session therapy gives you uh a structure. You really don't have to change many practical things. Um if you do family therapy uh with this on that theory, uh, you can continue to do that. Uh just have to, you just have to um adapt those things that allow you and the client to uh maximize that session to don't give you the um resource that you will need another session. Um if you set that session with the idea, with a mindset, you and the client, that there will be a second session, that's a great way to fail a single session uh therapy. Um a great way to not have a single session uh therapy to not give you the chance to have um a single session therapy.
SPEAKER_02Um I think Flavio, that's why one of the um you mentioned the the definition, my definition of single session as a service delivery model rather than a therapeutic model. One of the real advantages of that is that you can go into a service where you've got therapists from different modes working in different modalities. You know, you've got a family therapist, a CBT therapist, a psychodynamic therapist, and there's so many, so many, so much energy is uh used arguing which model is best, and they can't work together very easily. If you say, and this is why single session therapy is easier, you know, always a bit tricky, but easier to implement than a new model of therapy, because you don't have to give up your um core modality that you've put so much time, so much effort, so much identity into being. Everyone can hold this is what Flavio is saying, everyone can hold on to their and still embrace their core therapeutic modality, but all practice in a single session way. So it can be potentially incredibly good for morale and building communication between across a service system with different types and not only therapists, and this is where we've started to um sort of use single session thinking just to really complicate things, um, to say that people, even managers, and you can run and uh you can run a um a meeting or uh an executive meeting using single session thinking, which is what would we do if if this was our last session, or or what would we want to achieve by the end of today's meeting? Um how can we help clients in the quickest way, knowing that one session may be enough? So it just expands the sort of the mindset, if you like, to outside of the therapy room. I love that.
SPEAKER_05Sorry, I should say it also can be used in supervision too, the whole the framework. Um, I know that I've been sharing it with um fellow colleagues um and utilizing it in supervision, so it's really helpful when we, you know, when we don't have a lot of time and we really want to maximize that time um that we've got. So yeah, it's great to use then too. Sorry, Flavio.
SPEAKER_00Thank you. Um I love to quote often um uh uh Jeff Young's work. Um Jeff Young is here, so you can correct me if I it's it's very nice, it's very um mind-blowing. Um Jeff, I try to remember all the correct things, and Jeff goes to this uh public mental health care, I think, a public mental health service, and which have uh um very high rate of dropout and just discover that they start with like remind three sessions uh doing tests, tests or diagnosis and things like that, and just say, okay, let's try to start with single session therapy, and then if the client wants uh a long-term therapy, continue with the three session of test and then with the other session of uh psychotherapy. And this very simple shift, starting with with a single session of uh actual therapy, effective therapy, and then continue if needed with test, um help to reduce in a very great way the dropouts. And if I remind well, uh many people then continue uh after the three sessions, complete the three test session, because you start with a session that gives them what they want, just set the ground to continue for a long-term therapy if they want of a long term therapy. Jeff, do I remind the this example uh correctly?
SPEAKER_02Yeah, well, certainly um the CAMS, the child and adolescent mental health services in Australia used to have a four-session assessment. And it was very, very thorough. And it makes sense in some ways that if you've got really kids with really complex issues, that a thorough assessment is sort of would be the best way to getting really good service until you find out, as one of my um research students found out, that 34% of the clients never reach the therapy. And so then you've got to think, well, actually, that's not terribly, that's not an ideal service. And so then by doing what Flavio's saying is doing the treatment as soon as possible and finding out what clients want, and then doing the assessment required in order to get them what they want, rather than doing a Rolls-Royce general assessment for four sessions that covers everything, of which you would only use a very small amount in the actual treatment. You change that around so that um um you find out what clients want, you still do an assessment, but it's targeted to exactly that particular client in that context with what they want.
SPEAKER_04Yeah, well, I guess, you know, sadly, we've got the time that we've got. And I just I wish I'd mentioned at the beginning, it's amazing. We've got, like you said, Cesar, we've got Australia, Italy, UK here, which has been incredible. And I know that you've all, like you said, you've met, you work together. It'd be really lovely, I suppose, to to hear just what your future hopes are or what your hopes are for the direction of single session therapy.
SPEAKER_05I represent the UK. I think for me personally, um, I'm incredibly passionate about how we are responding to the needs of people in the UK currently, particularly our child and adolescents and the current climate, you know, post-pandemic, even pre-pandemic. Um, and the, as we know, services were disbanded 15 years ago. A lot of early intervention, sorry, services were disbanded 15 years ago, which has had such a detrimental impact on our young people. Um, and I think in terms of accessing supports and services, so for me personally, I think I'd like to see single session implemented and adopted as the first step of care in CAM services, and not necessarily just in CAM services, but in early intervention services, so that young people, families have the opportunity, um, even if it's once, maybe twice, or maybe ongoing, but at least they've getting that opportunity to sit down with somebody and think about their situation and come out with some tangible resources and ideas that um may help them in the future.
SPEAKER_00Um I'm very excited for the symposium, the upcoming symposium, of course, because it's uh the first one in Europe. And um it's it's important for me because um recently I was looking for uh research in syncation therapy uh was going through a lot of research and most of the research are from uh uh canada usa australia we need a growing we have a growing interest in europe but we still need to uh uh set a more solid ground uh even if we have great helpers here in um in uh uh europe like windy dryden in uk or martin solar coeus and sound um for this symposium i wanted to do something that help um europe and the international community to have an idea on where we are and where we are going uh so we will have 15 guests uh where that are old names like um jeff young michael hoyt even mosche talman uh wendy dryden uh monte bobbel harm's leiden um catty stephenson and uh also new names that give um a future direction the three days will be uh we'll cover we'll try to cover uh theoretical um issues uh practical issues and also uh implementation research issues and um and there are also there is also space for many uh external presentation uh we we will have around 24 25 people from all around the world that present their work and um it's it's very i i think we did something very interesting i hope that we can uh do not say uh in english uh to respect what um has been the great work that has been uh done uh in the two symposium the two previous symposium in australia and the one in uh in Canada um uh and it will be I think it's the first time that it's uh a symposium a single session therapy symposium is done both in presence and online correct me if I'm wrong Jeff yeah yeah that's right love you okay and um I I just close with um uh something I've read in a uh systematic review of 10 years ago I think it's Campbell's systematic review right I'm not sure in which the outer uh said that um there are many research not very rigorous but still important and he said that uh single session therapy was uh exiting from his uh infancy uh and now I think that 10 years uh later we can tell that single session therapy with um many RCTs with many systematic reviews with the first meta-analysis and with the fourth uh international symposium uh is entered in the head of that's great thank you flavio we we'll share a link as well to the symposium for people that want to want to join that and Jeff um and I'm yeah really looking forward to this uh international symposium that Flavio's uh kindly organizing um and it sort of links with my sort of uh dream is that if we keep thinking of it as a service delivery model people from all different approaches can embrace that service delivery rather than argue which model therapeutic model is better and it'll um expand to uh help a broader range of people and this may be a way of simplifying it or summarizing it as saying it I hope that it helps us um make therapy fit clients rather than expect or demand that clients fit our models of therapy.
SPEAKER_02You know people don't want to go through four sessions of assessment before they get to the the the treatment they don't want to have to wait on a waiting list for six months or one year. They want help straight away and they want to be in the driver's seat of what's going to actually help improve their lives and they want to be collaborators on that process and they want the therapist to give them all that they've got not not hide not hold back anything for maybe a potential next session which may never happen.
SPEAKER_04Thanks Jeff I mean there's so many things aren't there Cesar I mean maybe we need to have it would be great to meet with to meet with you again and it's been wonderful to sort of talk with you now and to learn more about single session therapy. I know I've been really holding it in mind whilst I've been doing the reading um to prepare for this in all the sessions that that I've been doing so um I'm definitely hoping to to to utilize it more going forward. So thank you so much for your time and all of your knowledge.
SPEAKER_02Can I just make an observation that um something Cesar said earlier where he'd been working really hard to try and make sure clients come back maybe he would change and actually just make the most of that first session that that is the shift to a single session mindset.
SPEAKER_03Yeah in a really practical sort of way it was you too thank you bye bye bye bye