Future Directions in Single-Session Youth Mental Health Interventions

Abstract

The United States spends more money on mental health services than any other country, yet access to effective psychological services remains strikingly low. The need-to-access gap is especially wide among children and adolescents, with up to 80% of youths with mental health needs going without services, and the remainder often receiving insufficient or untested care. Single-session interventions (SSIs) may offer a promising path toward improving accessibility, cost-effectiveness, and completion rates for youth mental health services. SSIs are structured programs that intentionally involve only one visit or encounter with a clinic, provider, or program; they may serve as stand-alone or adjunctive clinical services. A growing body of evidence supports the capacity of SSIs to reduce and prevent youth psychopathology of multiple types. Here, we provide a working definition of SSIs for use in future research and practice; summarize the literature to date on SSIs for child and adolescent mental health; and propose recommendations for the future design, evaluation, and implementation of SSIs across a variety of settings and contexts. We hope that this paper will serve as an actionable research agenda for gauging the full potential of SSIs as a force for youth mental health.

Mental health and clinical psychological science in the time of COVID-19: Challenges, opportunities, and a call to action.

“…Brief and low-intensity interventions must become a research and clinical practice priority. This includes, as one well-studied example, single-session interventions (SSIs): structured, evidence-based interventions that require just one encounter with a provider or program (Schleider et al, 2020). Evidence suggests that SSIs can reduce or prevent psychopathology in youths and adults (e.g., Schleider et al, 2020;Schleider & Weisz, 2017), and are effective in treating self-harm (Lamprecht et al, 2007), depressive symptoms (Schleider et al, 2020), and conduct problems (Mejia, Calam, & Sanders, 2015).…”

“…This includes, as one well-studied example, single-session interventions (SSIs): structured, evidence-based interventions that require just one encounter with a provider or program (Schleider et al, 2020). Evidence suggests that SSIs can reduce or prevent psychopathology in youths and adults (e.g., Schleider et al, 2020;Schleider & Weisz, 2017), and are effective in treating self-harm (Lamprecht et al, 2007), depressive symptoms (Schleider et al, 2020), and conduct problems (Mejia, Calam, & Sanders, 2015). Importantly, clinically significant, positive SSI effects emerge even for programs that are selfadministered (e.g., web-based SSIs), without therapist guidance (Schleider & Weisz, 2017;Schleider et al, 2020).…”

“…Evidence suggests that SSIs can reduce or prevent psychopathology in youths and adults (e.g., Schleider et al, 2020;Schleider & Weisz, 2017), and are effective in treating self-harm (Lamprecht et al, 2007), depressive symptoms (Schleider et al, 2020), and conduct problems (Mejia, Calam, & Sanders, 2015). Importantly, clinically significant, positive SSI effects emerge even for programs that are selfadministered (e.g., web-based SSIs), without therapist guidance (Schleider & Weisz, 2017;Schleider et al, 2020). SSIs' overall effects are slightly smaller than those observed for multisession psychotherapy, but their brevity and accessibility magnify their potential public health impact, especially in the case of digital, self-administered SSIs, which are often accessible freeof-charge from any location (e.g., Schleider et al, 2020).…”

“…Importantly, clinically significant, positive SSI effects emerge even for programs that are selfadministered (e.g., web-based SSIs), without therapist guidance (Schleider & Weisz, 2017;Schleider et al, 2020). SSIs' overall effects are slightly smaller than those observed for multisession psychotherapy, but their brevity and accessibility magnify their potential public health impact, especially in the case of digital, self-administered SSIs, which are often accessible freeof-charge from any location (e.g., Schleider et al, 2020). Moving ahead, it will be critical to integrate SSIs and other low-intensity interventions into service delivery ecosystems.…”

Acceptability and Utility of an Open-Access, Online Single-Session Intervention Platform for Adolescent Mental Health

“…Overall, SSI effects on youth psychopathology are slightly smaller than those observed for youth treatments lasting an average of 16 sessions ( g =0.32 for single-session interventions [ 17 ], versus g =0.46 for multi-session interventions [ 17 , 18 ]. However, their brevity and flexible format magnify their potential public health impact [ 19 ]. Additionally, across placebo-controlled trials, self-administered online SSIs have reduced youth depression across 4-9 months in high-symptom and community youth samples [ 20 - 22 ].…”