By Mark Ryan, BACP Accredited Psychotherapist and NCPS Accredited Relationship Therapist
Is one therapy session enough? It is a fair question, and it is one that many people ask when the idea of weekly sessions feels like too much. Many people hold back because of the time, the cost, or the sense that therapy means signing up for something open ended. Others have one clear question on their mind and wonder whether a single good conversation could help. Single session therapy is designed for exactly that. It is one longer, carefully prepared session that is treated as complete in itself, for individuals and for couples. This article explains what it is, how it works, what the research can and cannot tell us, and who it may suit.
Article Summary
Single session therapy is one planned session, designed to be useful in its own right rather than a taster for something longer.
It is built around one question and careful preparation, with a workbook before the session and a written reflection and follow up workbook afterwards.
Some people find one session is enough and others decide to continue. Either choice is fine. In agency studies, most clients who attended a single session found it sufficient.
Research on single session therapy is encouraging, particularly for low mood, with more limited evidence for anxiety, and many of the studies have limitations.
I could not find controlled studies of single session therapy with couples, so for couples it is a considered offer and not a proven one.
It is not a crisis service, and it is not suitable where there is abuse, violence or coercive control in a relationship.
What Single Session Therapy Is
When people think about booking therapy, they often picture weekly sessions stretching ahead for months. That picture puts some people off before they begin. It can also leave others feeling that they should not ask for help until things are bad enough to justify it. Single session therapy starts from a different idea, which is that one conversation can be worth having in its own right.
In my practice it means a single 110 minute session, longer than the usual 50 minutes, so that there is time to settle, look closely at what is happening and plan what comes next. We choose one focus and give it our full attention, rather than trying to cover everything. You are the expert on your own life or your own relationship. I bring structure, questions and experience. Some people leave feeling that they have what they need. Others decide they would like more sessions, and that is a good outcome too.
It is not a rushed version of long term therapy, and it does not promise to solve everything in one go. It is a focused piece of work that sometimes stands alone and sometimes opens a door to more.
Is One Therapy Session Enough?
It depends on what you are bringing, and the answer is sometimes yes and sometimes no. I would rather say that than promise more than one session can do. When the question is specific, such as a decision you cannot make, a conversation you cannot start or a pattern you want to understand, one well prepared session can give you a clearer view and a first step. In studies of agencies that offered single sessions, most clients who attended one said it was sufficient and helpful (Hymmen et al., 2013, discussed below). That tells us about those clients and those services, and it cannot promise the same for you.
Other things are less likely to fit into one session. Long standing difficulties, trauma, ongoing low mood or anxiety, and situations that need regular support usually benefit from more time. Needing more is not a failure of the session or of you. A single session can also be a useful way to find out what kind of help you need, and I will tell you if I think longer term or specialist support would serve you better.
Here are some questions that can help you judge whether one session might be enough.
Do I have one question or decision to work on, or is it many things at once?
Would a clear next step be a good outcome for me, even if everything is not solved?
Am I safe, and am I able to look after myself in the days after a long conversation?
If I wanted more help afterwards, would I be comfortable saying so?
If you answer yes to most of these, a single session may be worth considering. If you are unsure, the free consultation is a good place to talk it through before you decide, and there is no obligation to book anything afterwards.
How It Works
Preparation does a lot of the work in single session therapy, so it begins well before the day. When you book, you receive a preparation workbook with questions about why you are coming now, what you want to focus on, what you have already tried and what is already working. You complete it and email it back to me at least 72 hours before the session, and I read it before we meet. If you are coming as a couple, each of you completes your own copy separately. I do not share one partner's workbook with the other, although I cannot hold information in confidence from a partner where it is relevant to the work we are doing together.
The workbook also asks some wellbeing and safety questions. If an answer suggests that this format may not be right for you, I will contact you before the session so that we can decide together what will help most.
On the day we meet for 110 minutes, with a short break in the middle. Sessions are in person in London or online by video anywhere in the UK. Couples join together from one place on one shared call.
During the session you set your own pace. You can pause, take a moment, or say that you would rather not go there, and I may sometimes slow things down or bring us back to your focus because our time is limited. People often feel lighter, tired, tender or all three afterwards, and all of that is normal.
Afterwards I send you a written reflection within five working days, along with a follow up workbook so that the work carries on in daily life. You can also choose a 50 minute follow up session, ideally four to six weeks later, once you have had time to try things out. Change after a single session can show up over days and weeks rather than on the day itself.
What the Research Says
If you are deciding whether one session can help, it is fair to want some evidence. The picture is encouraging and incomplete. Most studies involve individuals, and the research is stronger for some problems than for others.
A review of studies from community mental health and counselling agencies concluded that most clients who attended either a planned or a walk in single session found it sufficient and helpful. The studies pointed to perceived improvement in the problems people brought, and to improvement on measures of depression, anxiety and distress. The authors also noted that many of the studies had methodological limitations (Hymmen et al., 2013).
A systematic review of randomised trials with adults who had common mental health difficulties found six trials with 298 participants in total. Five of the six reported improvement in depression, and only one reported improvement in anxiety. The approaches tested included behavioural activation and solution focused therapy. Participants had symptoms that were not severe, and four of the six studies carried a high risk of bias. The reviewers concluded that single session therapy may be effective, particularly for depression, but that firm conclusions are not yet possible (Kim et al., 2023).
Another systematic review looked at single session therapy for anxiety disorders in young people and adults. It found that single session therapy was better than no treatment, and that results were similar to multiple session versions of the same treatment. Many of the included studies tested structured exposure treatments, some lasting about three hours, which is a different approach from the conversational format I offer (Bertuzzi et al., 2021). A 2012 review article described the field as lacking methodological rigour, although I could read only its abstract (Campbell, 2012).
Most of this research involves individuals, and much of it tests structured programmes that differ from one another and from the way I work. I could not find controlled studies of single session therapy with couples. That does not mean it cannot help couples. It does mean that I offer it to couples as a considered approach and not as a proven one, and I would rather say so plainly.
Single session therapy is one planned session, designed to be useful in its own right rather than a taster for something longer.
Who It May Suit
Not every problem fits into one session. A single session may suit people who arrive with a question or a decision, and who would value a structured and unhurried conversation about it.
It may suit you in these situations.
You have one clear question or decision and want to think it through with someone skilled in listening.
You would like to try therapy before committing to a longer course.
You have been going round in circles and want a fresh perspective.
You are a couple facing one specific issue, such as a decision about the future, a conversation you cannot start, or a change such as opening up the relationship. There is no research on this yet, so I offer it with that caveat.
You find weekly sessions hard to fit around work, travel or family.
It is for people of all kinds. I work with individuals and couples, including LGBTQ+ people and couples and those in consensually non monogamous relationships. Joint sessions are for two people.
It may not be the right format if you are in crisis or thinking about harming yourself. Single session therapy is not a crisis service. Samaritans are available on 116 123, free and open 24 hours a day, and in an emergency you should call 999.
It is also not suitable where there is abuse, violence or coercive control in a relationship. If you are afraid of a partner, please speak to a specialist service. The National Domestic Abuse Helpline is on 0808 2000 247 and is open 24 hours a day. Men's Advice Line is on 0808 8010327, Monday to Friday, 10am to 5pm. Galop supports LGBTQ+ people on 0800 999 5428, Monday to Friday, 10am to 5pm, with later hours on Wednesdays and Thursdays. If you are worried about how a partner would react to a workbook or an email, please keep your safety first. Do not write about abuse in a workbook that may be shared, and contact one of these services or ask me for a separate conversation before the session.
If it becomes clear that longer term or specialist support would serve you better, I will say so and help you find it. One practical point is that my individual work cannot later become couples therapy with the same person. If you are thinking about relationship therapy as a couple, it is worth asking me before you book an individual session.
Making the Most of It
A long session is easier when you arrive prepared and settled. These are suggestions and not rules.
Complete the workbook candidly. A few words are enough, and you can skip anything that does not fit.
Choose one focus. A useful way to start is to finish the sentence ‘if we could only talk about one thing, it would be…’
Eat a proper meal an hour or two before, bring water and a notebook, and put your phone on silent.
Leave some space afterwards, and avoid big decisions or difficult conversations on the same day.
After the session, the written reflection and follow up workbook are there to help you hold on to what mattered. If you would like to know what therapy involves more broadly, what to expect from relationship therapy and is couples therapy worth it are good places to start. If you are not sure whether to see someone together or alone, when to go to couples therapy and is therapy right for me may help you decide.
How Therapy Can Help
A conversation with someone trained to listen can slow things down, bring order to what feels tangled and help you find a next step that is yours. For some people one session does that. For others it shows that a longer piece of work would be useful, and a single session can be a way to find that out without committing in advance.
If you would like to talk about whether a single session is right for you, I offer a free 30 minute consultation, in person in London or online. I work with individuals and couples of all kinds, and you are welcome to ask any questions before you decide. For some people they don’t feel they need the consultation, and with single session therapy it’s an optional step. If you’d like to go ahead with a single session you can use the button below to book your session. After booking you’ll receive an email with information and a workbook for you to complete.
About the Author
Mark Ryan is a BACP Accredited Psychotherapist and NCPS Accredited Relationship Therapist, and the founder of Rise and Grow Therapy, a private practice offering couples and relationship therapy across Kensington, Pimlico, and Angel, Islington in London, as well as online consultations. His approach draws first on Imago Relationship Therapy, alongside integrative relational, attachment based, Gottman, and systemic approaches. Mark works with couples of all kinds, including LGBTQ+ couples and those in non traditional relationship structures such as consensual non monogamy, as well as with individuals working through relational issues.
References
Bertuzzi, V., Fratini, G., Tarquinio, C., Cannistraci, C., Andersson, G., Tarquinio, P., & Rosso, G. (2021). Single session therapy by appointment for the treatment of anxiety disorders in youth and adults: A systematic review of the literature. Frontiers in Psychology, 12, 721382. https://doi.org/10.3389/fpsyg.2021.721382
Campbell, A. (2012). Single session approaches to therapy: Time to review. Australian and New Zealand Journal of Family Therapy, 33(1), 15 to 26. https://doi.org/10.1017/aft.2012.3
Hymmen, P., Stalker, C. A., & Cait, C. A. (2013). The case for single session therapy: Does the empirical evidence support the increased prevalence of this service delivery model? Journal of Mental Health, 22(1), 60 to 71. https://doi.org/10.3109/09638237.2012.670880
Kim, J., Ryu, S., & Chibanda, D. (2023). The effectiveness of single session therapy for adults with common mental health problems: A systematic review. BMC Psychology, 11(1), 373. https://doi.org/10.1186/s40359-023-01410-0
