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Latest SSW Research: An Update
The cutting edge of single session research seems to be heading into two areas. The first involves more rigorous outcome studies that go beyond client self report. The second is the application of single session approaches to specific work contexts and specific client presentations. The following summaries represent work in each of the above directions. The process of selection is always a political activity, and the selection to follow reflects the views of SSW Team at The Bouverie Centre.
Rigorous outcome studies
Dr. Ruth Perkins, Senior Clinical Psychologist at the Royal Children's Hospital Child and Adolescent Mental Health Service, Melbourne, carried out a study of the effectiveness of a single session approach with 258 clients over a 14 month period. Clients were aged between 5 '“ 15 years old, and two-thirds were boys. This study used more rigorous methodology than had previously been used, and included standardised and multi-dimensional outcome measures, pre- and post- ratings, and random allocation of clients to a treatment group (SST) or to a delayed treatment group, which served as a control group. Diagnostic categories included: Parent-Child Relational Problems (27%), Oppositional Defiant Disorder (18%), Anxiety (9%), ADHD (8%), Adjustment Disorder (8%), Separation Anxiety Disorder (4%), Disruptive Behaviour Disorder (7%), and other disorders (19%).
Following a phone intake, an appointment was made for a questionnaire interview, during which the client's parent filled out 'pre-session' questionnaires. Questionnaires were also filled out by the client's teacher. Clients were then allocated to either a treatment group, who received treatment within two weeks of the Questionnaire interview, or a control group, where treatment was delayed for six weeks.
The SST session was two hours long and involved the client and family members.
At the end, the parent completed a client satisfaction questionnaire, and the clinician completed the HoNOSCA (a state-wide standardised evaluation scale). Six weeks from the intake call, the parent and the clinician (in both the treatment and control groups) completed a second set of questionnaires. Further sessions were provided at any time according to clinical need. Only clients at risk of immediate harm to self or others were excluded from the study.
Results showed that, of the clients who received treatment:
50% had SST and a follow-up session;
11% had one further session;
8% had two further sessions;
7% had three, and
the remaining 24% had more than three sessions after follow-up.
Both SST Treatment and Control groups showed a marked reduction in the frequency of the major presenting problem: however, the improvements made by the Treatment group were significantly greater than those made by the Control group.
SST treatment also resulted in a marked reduction of the major presenting problem in both groups, but again the improvements shown by the treatment group were significantly greater.
Parents' rating of psychopathy significantly changed from elevated to borderline/normal following the SSW. Teachers' ratings, which were low prior to the SST, did not change.
Client satisfaction following the SST session was very high, with 95% of clients being either "very satisfied" (51%) or "mostly satisfied" (45%).
At follow-up 88% of clients were either "very satisfied" (40%) or "mostly satisfied" (48%).
In summary, the beneficial effect of the single session approach with child and adolescent mental health service clients and their families has been well demonstrated in this important study. Many clinicians are now using SST as the first choice of treatment for the majority of clients. It is arguably the most cost-effective therapeutic approach. It allows intermittent and longer term therapy to be provided where necessary.
Ruth Perkins (2006) research is the most rigourous outcome study, to our knowledge, on SSW.
SSW & CAMHS Outcomes
Perkins (2006)
| Main Problem | SST Freq. Severity |
Control Freq. Severity |
| Improved | 73% | 50% |
| Got worse | 5% | 7% |
| Stayed same | 22% | 43% |
| Based on a 5 point likert scale | After 6 weeks | After 6 weeks |
Reduction in Deveraux Scale of Mental Disorders (Parents' Rating)
| 14%
in SST (64.2 to 56.5) |
Scale
key Normal = < 56 Borderline = 56-59 Elevated = 60-69 Very Elev. = > 70 |
| 6% in
Controls (63.4 to 60.2) |
psychopathology than teachers but parents scored
much greater change post SST.
Source: Perkins, R. (2006) Summarised with the kind permission of Dr. Ruth Perkins.
Research Results: USA and Australia, 1996
Local results have shown similar patterns across different Australian organisational contexts which are compatible with international studies.
One session attendees in agency's
period of review (Boyhan, 1996)
period of review (Boyhan, 1996)
| Agency | % SSW
clients attending once |
| Bouverie's Family Therapy Centre (Melbourne) |
53% |
| Dalmar Child and Family Care (Sydney) |
45% |
| ACT Child and Adolescent Mental Health (CAMHS) (Canberra) |
47% |
| Talmon (USA) | 58% |
SST clients' perceptions of
improvement post SST
4 studies (Boyhan, 1996)
improvement post SST
4 studies (Boyhan, 1996)
| Agency | Clients' perceptions | Total |
| Bouverie (Melbourne) |
Much improved, 56% A little better, 22% |
78% |
| Dalmar (Sydney) |
Much better A little better |
63% |
| CAMHS (Canberra) |
Improved | 71% |
| Talmon (USA) |
Much improvement Or improvement |
88% |
