Nearly half of people with mental health needs do not or are unable to seek treatment, according to the National Alliance on Mental Illness, and among those that do, many only access mental health services once, according to recent work.
Now, a first-of-its-kind review conducted by Northwestern Medicine investigators has confirmed that single-session interventions – a structured program that intentionally involves one single visit or encounter with a clinic, healthcare professional or program – can significantly improve mental health outcomes in both youth and adults, according to findings published in the Annual Review of Clinical Psychology.
“I don’t believe that single-session interventions should replace any other kinds of support that already exist in our mental healthcare ecosystem. But I do think that single-session interventions, because of how scalable they are, especially digital, self-guided single-session interventions, are really poised to fill these untouched gaps in the mental healthcare system that high-intensity treatments like weekly psychotherapy delivered by professionals were never built to address,” said Jessica Schleider, PhD, associate professor of Medical Social Sciences in the Divisions of Intervention Science and Implementation Science, who was the lead and corresponding author of the review.
A previous meta-analysis led by Schleider found that across 50 randomized-controlled trials evaluating 10,000 youth, single-session interventions significantly reduced mental health problems including depression and anxiety.
“This was really surprising to me, because I’m trained as a psychotherapist to give treatments that are weeks or months or even years long. But ever since that meta-analysis, I’ve been dead set on figuring out how we can optimize and make the most of the first, and often last, clinical encounter that someone might have access to,” said Schleider, who is also an associate professor of Pediatrics and director of the Lab for Scalable Mental Health at Northwestern.
Encouraged by these findings, Schleider and her team aimed to determine if a single-session intervention could not only reduce mental health problems but also increase engagement in other types of mental health services.
To do this, they conducted an umbrella review, synthesizing all available research on single-session interventions for mental health problems and service engagement in both youth and adults.
The scientists identified 24 systematic reviews of single-session mental health and behavioral health interventions, which included 415 clinical trials. Of the 24 systematic reviews identified, they found that 83 percent reported positive effects from single-session interventions for one or more of the following outcomes anxiety, depression, externalizing problems, eating problems, substance use, and treatment engagement or uptake.
Schleider said she hopes these findings will push the mental health field forward in making single-session interventions a core part of mental healthcare and inform the creation and implementation of new public policy measures.
“If you’re spending your first session with somebody exclusively diagnosing them, you’ve lost your opportunity to take advantage of the first and potentially last encounter to actually do something that helps them,” Schleider said. “One example of a policy direction we’re hoping to pursue is creating new reimbursement codes so that single-session interventions can be sustainably offered by clinics that accept insurance so that they can more flexibly support people outside of this traditional workflow of clinical services.”
Co-authors include Juan Zapata, PhD, research assistant professor of Medical Social Sciences in the Division of Intervention Science, and Erica Szkody, PhD, research assistant professor of Medical Social Sciences.
This work was supported by the National Institutes of Health Office of the Director grant DP5OD02812, the National Institute of Mental Health grant R43MH128075, the Upswing Fund for Adolescent Mental Health, the National Science Foundation grant 2141710, the Health Research and Services Administration grant U3NHP45406-01-00, the Society of Clinical Child and Adolescent Psychology, Hopelab, the Child Mind Institute, Alongside, Kooth and the Klingenstein Third Generation Foundation.
