Everyone is curious about online therapy, and many of those who haven’t yet participated are very close to giving it a try. But as with many things that may require their time, financial, and emotional commitment, they are only ready to pledge themselves to a single session. That in itself is an admirable first step, although there is one obstacle that gets in the way of booking an appointment. It’s the question: “Is one therapy session enough?”.
Prospective participants generally understand that enough doesn’t mean complete healing from trauma or recovery from some behavioral issue. What they really want to know, is if one therapy session is enough to make a difference. If they feel confident that they will leave the session feeling better, having accessed tools to identify triggers and effectively cope with negative feelings and emotions, then whatever they “pay” in time and money will be worthwhile.
As someone who is among the group being discussed here today, we can tell you here and now, that yes – one online therapy session is enough to make a difference. But this assertion is certainly not true for everyone, as the proverbial stage needs to be set for a successful outcome. Whether it will only be one session as initially intended, or the beginning of a journey in online therapy, we want you to enter this new chapter with optimal opportunity for favorable outcomes. Please keep reading.
Paving the Way for Success When Trying Out Online Therapy with One Session
Understand that Engagement is Associated with Improved Outcomes
Before we get into what to do, or not do, when trying out therapy with one session, we must draw your attention to documented treatment outcomes.
Industry-wide reports, published through the decades, do show that one therapy session is enough to have a positive and sustainable impact on the wellbeing of participants. This recent summary from the National Institutes of Health (NIH) speaks to successes:
“Accordingly, single-session interventions (SSIs) may help bridge the treatment gap. We conducted the first umbrella review synthesizing research on SSIs for mental health problems and service engagement in youth and adults. Our search yielded 24 systematic reviews of SSIs, which included 415 unique trials. Twenty reviews (83.33%) reported significant, positive effects of SSIs for one or more outcomes (anxiety, depression, externalizing problems, eating problems, substance use, treatment engagement or uptake). Across 12 reviews that meta-analytically examined SSIs’ effectiveness relative to controls, SSIs showed a positive effect across outcomes and age groups […] Overall, findings support the clinical utility of SSIs for certain psychological problems and populations.” (NIH)
As a leading provider of online therapy in the United States, we have also seen the positive impact that a single session – and early sessions – can have on participants from all walks of life. There is a caveat, however. To increase the odds of a participant experiencing a positive outcome from one session (all else equal) they must be willing to commit to engagement with their therapist. This is why we look to engagement rates/scores when assessing the success of therapy for various mental and behavioral health issues.
In mental health, engagement rates, in part, describe a client’s active involvement, commitment, and emotional connection to the therapeutic process, which involves more than just attendance. It is a strong predictor of positive outcomes. Engagement in therapy can be understood in dimensions, including behavioral engagement, cognitive engagement, and affective engagement. Behavioral engagement refers to a participant’s adherence to treatment, such as following through on session attendance (although it’s just one session, in this case), completing homework, or using digital modules as intended. It also includes the active effort a participant makes within treatment, such as communicating openly and be willing to make real-life changes. Cognitive engagement references a participant’s belief in the treatment rationale, perceiving it as appropriate for reaching their goals, and actively using their thinking skills. Meanwhile, affective engagement relates to a participant’s emotional experience, including their interest in the content provided by a therapist, the attention they focus towards it, and their overall feelings while interacting with it.
Our virtual therapy platform uses Texas Christian University (TCU) Treatment Engagement Data as a key component of measuring client/participant outcomes. A corresponding self-report assessment known as the TCU Treatment Engagement Form measures client/participant engagement in addictive behavior treatment by looking at three-dozen items across four scales. These scales include the following:
- Treatment Participation: Assesses and tracks how actively an individual is participating and engaging in their treatment.
- Treatment Satisfaction: This is one, among other indicators, that provide a complete picture of a individual’s progress, and the effectiveness of care.
- Counselor Rapport: This refers to the therapeutic relationship and/or emotional connection a counselor builds with a participating individual, characterized by agreement, mutual understanding, and a harmonious relationship.
- Peer Support: This refers to engagement in a supportive environment (i.e. group therapy) where clients connect with peers regarding shared behavioral/mental health issues.
To provide an example of this “in action”, we refer you to a recently published Treatment Report on Client Engagement for those struggling with problematic gambling behavior and cooccurring mental health issues. While the full report (view here) encompassed multiple assessments occurring over multiple sessions, we extracted the results for after just one assessment to show how the scores instantly increased after initial sessions:
| SCALE | Score Before Therapy | Score After 1st Assessment |
| Counselor Rapport | 39 | 46 |
| Peer Support | 34 | 38 |
| Treatment Participation | 39 | 43 |
| Treatment Satisfaction | 39 | 45 |
*Scores are rounded up or down to the nearest whole value.
Average scores improved significantly with the first assessment. This highlights not only symptom reduction but also the restoration of overall positive mental health and resilience.
Similar results were also found for those in therapy for problematic use of pornography and cooccurring mental health issues (view here).
It’s important to note that a single session is designed differently when compared to when someone commits to ongoing therapy (this is discussed further below). However, the intent in sharing the data above is to show that even when an individual participates in one (or few) sessions, they experience positive outcomes. These positive outcomes are tethered to a participant’s willingness to engage at a behavioral, cognitive, and affective level. We encourage you to be mindful of this when trying out single session therapy for yourself.
Opt for Open-Minded vs Prove-Me-Wrong
Commitment to engagement (as per above) is a great place to start. However, it’s also important to be open minded. This is where some people fall short.
It is not uncommon for those who “try on” therapy with one session to do so with a mindset that it probably won’t work. Sure, they are willing to give it a shot, but they approach it with a “prove me wrong” mentality that ultimately sets the stage for a therapeutic flop.
Entering therapy with a prove-me-wrong mentality can be counterproductive because it often transforms a collaborative (with your therapist) healing process into a confrontational debate. Therapy is most effective when built on trust and openness, whereas a confrontational mindset can sabotage progress, reinforce negative patterns, and waste one’s valuable time and resources.
Instead, we encourage you to be truly open-minded when preparing to enter your single therapy session. Approach the process with curiosity and willingness to change, rather than coming in with skepticism or fixed expectations. Be prepared to honestly explore emotions and accept potential discomfort. Carry this open-minded mindset with you after closing the laptop or online browser, adopting new perspectives and employing new coping strategies, even when they feel unfamiliar and challenge previous beliefs.
What to Expect from a Single Session
By confirming with an intake / care coordinator that you’re engaging with a single appointment, your therapist will be prepared to design an empowering 60-minute session that is tailored specifically to your goals.
The one-hour session is designed to be a complete, self-contained intervention rather than a cursory intake for ongoing treatment. Expect a focused, solution-oriented approach that leaves you with immediate insights, practical coping tools and strategies, and importantly – a greater sense of hope.
Rather than attempting to “cure” long-term issues, a successful single session helps you get “unstuck,” providing a clear action plan to manage a specific, current difficulty. In some cases, you will have the opportunity to download self-help guides (here is one example) which are great takeaways for helping manage responses to triggers.
*Please note that care coordinators for single session bookings still have an obligation to screen for risk of self-harm. While this may not apply to you, it does inform how a therapist will proceed.
NEXT STEP TO BOOKING YOUR SESSION
Confirm Insurance Coverage and Direct Billing
We’re not concluding this article with an attempt to convince you to try more than a single therapy session. However, we’d be remiss if we did not address a common motivation for commitment to just one. If it’s solely because of perceived cost (which is totally fair) then it’s important to know that you may have overlooked an opportunity. Many virtual therapy platforms, including Kindbridge Behavioral Health, accept insurance and offer direct billing for the treatment of anger, anxiety, chronic stress, and depression in addition to a variety of behavioral health issues such as problem gambling, unhealthy gaming, excessive consumption of pornography, problematic smartphone use, and so much more. There is a good likelihood that a significant portion of, or all, therapy sessions will be covered by your private or corporate insurance plan. Again, if cost is all that is keeping you to one single therapy session, you are more than welcome to book as many as you desire once your level of coverage has been confirmed by a care coordinator.
Take Advantage of Flexible Online Scheduling
Ready to try online therapy with curiosity, an open-mind, and willingness to make meaningful change? You’ll be pleased to know that we offer flexible scheduling for virtual therapy that works around YOUR schedule. Click or call for a FREE assessment and to book a single session at a day / evening and time that is convenient for YOU.
