If Therapy Is Too Expensive, Try One-Time Interventions.
What do you think of when you hear the word “therapy”? Weekly one-hour sessions with someone who takes notes and offers occasional advice so that months or years from now you can start to get your mental health in order? While this is how we’ve traditionally approached treating mental illness, it doesn’t have to be the only approach, according to clinical psychology professor and therapist Dr. Jessica Schleider.
Traditional mental health care is a long-term investment that many people do not have access to. Schleider’s research shows that finances, long waiting lists and stigma are among the most common barriers to accessing traditional mental health care. In her new book , Small Treatments, Big Effects, she writes about how effective “one-off interventions” can be if they are intentional.
What is a single session intervention?
Schleider defines single-session interventions (SSI) as “specific, structured programs that intentionally involve only one visit or meeting with a clinic, provider, or program” that include digital and self-directed activities. Think of one-time interventions as a kind of mental health emergency or first aid designed to solve your problem in the moment and get you on your way.
“Brief, one-time mental health interventions are backed by decades of international research and practice , including work from my own laboratory,” Schleider wrote in her book. “These interventions are intentionally short and designed to last a single therapeutic meeting; that is, they recognize the dual reality that any therapeutic experience may well be someone’s last, and that it can be truly beneficial either way.”
Single-session interventions may look like a single therapy session with a licensed professional, contact with a peer support specialist, or an online self-guided activity.
“ Regardless of format, all SSIs aim to instill in the recipient a “context of competence”—the idea that they already have the tools, strengths, and capabilities needed to make meaningful changes in their lives—while instilling the belief that that it is possible to take a step toward meaningful change at any moment, no matter how short the moment,” Schleider said. “This structure helps optimize people’s willingness and ability to get the most out of what they learn over the next 10 to 90 minutes.”
In a mental health emergency where someone is at risk of harming themselves or others, you can call a crisis hotline, but that’s different from SSI, Schleider explains.
“ Crisis care focuses on emotional de-escalation and physical safety, while SSI can help people deal with a variety of problems, from relationship stress to low mood and anxiety about school or work. SSIs help people determine the “best next step” toward a future that is meaningful to them, regardless of their emotional starting point,” Schleider said.
Times when a one-time intervention may be helpful
Honestly, anyone can use mental health support, and that extends to SSI. Schleider said SSIs have been tested on people experiencing anxiety and depression , but there is also evidence that they may be helpful for traumatic stress, suicidal ideation and eating disorders .
“Interestingly, the impact of SSI does not seem to depend on the severity of the mental health problems you face; that is, SSI promises to help whether you have experienced severe hardship for years or moderate hardship for just a few weeks,” Schleider said. “This is probably because, regardless of your emotional “baseline,” everyone can take a small but meaningful step in the direction that is important to them. What SSI is most helpful in changing—such as feelings of hope, self-confidence, or motivation to take steps forward—can help people cope in a wide range of circumstances.”
In other words, no matter what type of mental health problem you’re dealing with, one dose of therapy or therapeutic intervention can prepare you to take the next step toward feeling better.
How to get one-time mental health help
Right now in the United States, seeking mental health care can drain your finances, your time, and, surprisingly, your mental health. Once you get to the point where you are ready to continue therapy, you will likely have to wait a while for an appointment and have multiple sessions.
“Unfortunately, there aren’t many options for people to seek in-person, one-time intervention at the moment—at least not in the United States,” Schleider said. “I hope my book will help spark change in this department, but therapist training models must change for SSI access to improve in the long term.”
However, there are online resources that you can access to perform a one-time intervention yourself:
-
Project YES (Youth Empowerment): Designed for Schleider’s study of adolescents, but useful for everyone. Choose from four online sessions on working with difficult emotions, including a one-time (self) consultation.
-
Project EMPOWER : This online activity is for anyone who works with or cares for children to teach skills for developing courage and reducing anxiety in children and adolescents. (But again, this can be helpful for anyone dealing with anxiety.)
-
More resources for therapists who want to offer one-time interventions.
Additionally, there are many other ways to work on your mental health outside of therapy, such as learning self-soothing techniques and other evidence-based mental health practices .
If you want to reap the benefits of growth and relief that you can experience from a single therapy session, tell potential therapists that you would like to try “one-session solution-focused therapy.” While it may not be widely practiced at this time, the more people who ask for it, the more doctors can work to meet their needs. And while therapists may be accustomed to approaching therapy as a long-term process, they must know how to provide help to people who may only have access to therapy once.
If you are thinking about suicide or are worried about a friend or loved one, call or text the Suicide & Crisis Lifeline at 988 (or chat to 988lifeline.org ); Lifeline is a national network of local crisis centers that provides free and confidential emotional support to people experiencing suicidal crisis or emotional distress 24 hours a day, 7 days a week in the United States.