Cost-effectiveness analysis of single-session walk-in counselling. J Ment Health 2017;27:560-566. [PMID: 28675324 DOI: 10.1080/09638237.2017.1340619]

Therapeutic Improvement in Single-Session Therapy: Innovative Moments as Change Markers

The growing demand for mental health services, exacerbated by long waiting lists and high psychotherapy dropout rates, highlights the urgent need for brief and effective approaches. The aim of this study was to analyse the presence and impact of change markers in online narrative single-session therapy (NSST) and a change interview 1 month later. The change markers were coded in the NSST and the interview via the innovative moments (IMs) coding system. This coding system allows the identification of IMs (i.e., change markers), differentiating them into three levels of complexity (from lower complexity, Level 1, to the highest complexity, Level 3). Good and poor outcomes were categorized on the basis of the change in presession distress to the distress reported 1 month later at the change interview. Previous research has associated IMs with therapy outcomes, mostly with Level 2 and 3 IMs. In this study, more IMs emerged in the NSSTs of clients with good outcomes. The Level 3 IMs did not emerge in the NSST and only emerged in the change interview. There was a positive correlation between the decrease in distress and the emergence of Level 3 IMs in the change interview. The pattern of the relationship between the IMs in NSST and those in the change interview suggests that, in good outcome cases, there is a positive evolution in the emergence of change markers. These results demonstrate that IMs are produced in NSST, as occurs in regular psychotherapy, and suggest that the change initiated in a single session is expanded until the change interview for good outcome cases. The clinical implications of this study are discussed.

Understanding parent engagement in advanced allied health single session therapy for children with developmental and behavioural disabilities

BACKGROUND

Increasingly, health services are adopting short-term consultative therapy models, such as single session therapy, to cope with increased service demands, finite budgets and changing consumer expectations. Within the paediatric sub-specialty of child development and behaviour, allied health clinicians are central to supporting families to understand their children, provide therapeutic interventions and help achieve optimal developmental and health outcomes. This study aimed to describe parents'/caregivers' engagement during advanced allied health consultations utilizing a single session therapy framework for managing neurodevelopmental and behavioural concerns in children.

METHODS

Between March to June 2021, 14 parents participated in a qualitative study involving focus groups. Reflexive thematic analysis was used to code and interpret the data to understand and explore families' engagement in single session therapy.

RESULTS

Three overarching themes relating to parents' engagement during consultations emerged from the data: connection with the clinician, parental attributes and organizational influences. Clinician connection was the prominent construct that enhanced parent attributes and the positive perception of the organization in an ongoing manner. There was a complex interplay between the behavioural and affective components of the clinician, parents and the organization to create mutual presence, valued time, understanding and action.

CONCLUSIONS

This study demonstrates the importance of clinician connection, parental attributes and organizational influences to enhance engagement in therapeutic consultations. These factors are interrelated and are a complex blend of behaviour and internal states and highly individualized for each family. Understanding how services can continue to engage families is integral to ongoing sustainability and overall health and well-being.

Single session work: Implementing brief intervention as routine practice in an acute care mental health assessment service

OBJECTIVES:

The study describes the implementation and adaptation of a brief intervention model as routine clinical practice in an acute care service.

METHODS:

An action research process informed the evaluation and design of the intervention.

RESULTS:

The model's theoretical framework enhanced clinical practice and benefited consumers, though it was too rigid to be implemented in an acute care setting, so was adapted to suit this environment.

CONCLUSIONS:

This paper highlights the value in realigning practice with fundamental engagement principles to improve practice outcomes.