Single Session Therapies: Why and How One-At-A-Time Mindsets Are Effective edited by Flavio Cannistrà and Michael F Hoyt
Routledge, 2025, 422 pages, ISBN 978-1032696935 (pbk), £33.99 (Kindle edition available)
This doorstopper of a book emerged from the fourth International Symposium on single session therapies (SST) convened by the Italian Center for Singe Session Therapy in Rome in November 2023. It comprises 27 chapters, each written by presenters at the event. While there is inevitably some duplication with so many authors covering broadly similar ground, the book is an excellent display of the state-of-the-art of SST a quarter of the way into the 21st century.
The editors have been leading lights in the brief therapy field for decades. It can be easy to forget that Solution Focused Brief Therapy emerged from the broader brief therapy field in the late 1980s and early 1990s, and that SFBT founders Steve de Shazer and Insoo Kim Berg were quick to see the potential of SST back in the day. Indeed, in their Introduction, Cannistrà and Hoyt quote Moshe Talmon (seen as the modern originator of SST):
When we started the project I was quite intrigued by the simple elegance of solution-focused therapy developed by de Shazer, Berg, et al. (de Shazer, 1985, 1988) in Milwaukee. I met them shortly before our project started and they were a main force in spreading the word about our initial findings long before we published anything. (Talmon, 2014)
This fits well with my recollection of Insoo Kim Berg speaking at the SOLWorld 2006 conference in Vienna not long before her death; she said that Brief Family Therapy Center (BFTC)'s broad ambition was to dismantle the prevailing assumption that effective therapy had to be long-term. Talmon’s seminal book appeared in 1990, giving a coherent timeline to these events.
What makes this book essential for anyone involved (or just interested) in SST is that it is not simply a how-to guide. The authors dig into the philosophy and rationale of SST work, or One-At-A-Time (OAAT, as it is becoming known). The shift in nomenclature reflects developing understanding of how this approach can and does work. While change from the (single) session is the aim, this does not preclude further sessions – but these are the choice of the client and not an expectation of the practitioner. Again, this is coherent with recent thinking about SFBT, handing over power concerning future sessions to the client (McKergow, 2021).
The editors are clear that SST is a model of service delivery rather than a single theoretical approach. This opens up many ‘roads to Rome’, which are covered in detail in the body of the book. Jeff Young’s chapter draws attention to the importance of the client sharing the SST mindset, at least at some level. They have to think that useful progress will be possible from the hour. Young notes that this isn’t a problem very often, particularly if the option for further work in future sessions is clear; clients are generally keen for progress. He notes that other reasons why SST can falter include overwhelming documentation (taking up the whole time), safety concerns (a topic for development) and involuntary clients (who may see the whole enterprise as against their interests).
There is not space here to list and comment on all the chapters. The six chapters exploring SST mindsets, theories and epistemologies are outstanding, well worth the price of admission. There are 10 chapters describing specific SST services around the world, including the UK, Canada, Sweden, the Netherlands, Italy and Australia, as well as online working. I was delighted to see Martin Söderquist, an old friend of SFBT from Sweden, reporting his OAAT work with couples.
The final section on SST Techniques and Practices offers a fine selection of ways to operationalise SST working. Scot Cooper’s chapter on Brief Narrative Practice offers some lessons from the work of Michael White, quite aligned in many ways with SFBT. Several authors note that the miracle question can offer a useful way to explore better futures as part of the conversation.
Why is there so little explicitly about SFBT in the book? Maybe we have our own conferences and channels, so do not join in the swim with Cannistrà, Hoyt and colleagues? Maybe we are working in services where a few sessions rather than one are regarded as a normal good outcome?
There seems to be a good overlap in practice, and the OAAT service model fits well with the priorities and pragmatics of SFBT. For now, this book offers a comprehensive and detailed look at this (still) quite novel and ethical stance.
Full details of all the chapters are on the publisher’s website.