Creating and Maintaining a Focus in Single-Session Therapy

Introduction

Single-Session Therapy (SST) is an intentional endeavour in which the client and therapist agree to meet for a single session to help the client address their chosen concern, with the understanding that more help is available if needed. It is based on research that shows that the modal number of sessions that clients have internationally is ‘1’ and that 70-80% are happy with that session given their current circumstances (Talmon, 1990; Hoyt & Talmon, 2014).

One of my concerns as a trainer of single-session practitioners is that therapists in training are not taught how to help large numbers of clients who attend for a single counselling session.  To practise SST effectively, therapists need to adopt a single-session mindset and help clients identify a focus for the work and maintain it.

In this article, I will deal with the latter issue and refer the interested reader to Dryden (2026) for a discussion of the single-session mindset.

Helping the Client to Create a Focus for the Session

Once the client has given informed consent to participate in single-session therapy, the therapist’s primary goal is to help the client create a focus for the session, and once one has been established, the therapist needs to help the client maintain it.

There are several questions the single-session therapist can ask the client to create a focus. These questions can be problem-oriented, solution-focused or goal-focused. In SST, a solution helps the person address their problem effectively so that they can achieve their goal.

Questions that help create a problem focus for the session

• What concern can I help you address today?

• What one issue can I help you with today?

Questions that help create a solution focus for the session

• If I could help you today find an effective way to address your problem, what would your response be?

• If I could help you find a solution to your problem today that you could take forward to achieve your goal, would you be interested?

  
  

Questions that help create a goal focus for the session

• What would you realistically like to have achieved by the end of the session, which would make you glad that you came today?

• If, when you are at home this evening, and you reflect on our session today, what would you have realistically liked to have achieved?

After the therapist asks the client a focus-oriented question, the client’s response will indicate whether a focus can be created from it or whether the therapist needs to ask further clarificatory questions. It is also important to note that the therapist may begin by asking for a problem focus and then, depending on the client’s response, use that to agree on a solution or a goal focus. This also occurs in the following exchange.

Therapist: What one issue can I help you with today?

Client: I have been quite anxious lately.

Therapist: Anxious about what?

Client: Anxious about my son not getting into the school of his choice.

Therapist: What effect does your anxiety have on you?

Client: I am having sleepless nights, and I can’t concentrate on my work.

Therapist: How do you hope that I can help you with this problem today?

Client: Help me to get some sleep and help me to concentrate on my work.

Therapist: So, if I can help you address your anxiety about your son’s schooling

so that you can sleep and concentrate on your work, what would you

think of that?

Client: That would be great.

Therapist: So, shall we agree that this will be the focus of the session

Client: Yes.

Helping the Client to Maintain the Agreed Focus

Once the therapist and client have agreed on a focus, both must maintain it if they are going to use session time effectively. It is the therapist’s primary task to ensure that this focus is maintained. The therapist uses a variety of skills to do this.

Seeking and gaining permission to interrupt the client

When I received training as a therapist 50 years ago, interrupting the client was strictly forbidden. The therapist’s primary task was to encourage the client to explore their concerns and to follow them in their exploration, rather than to guide them in any direction, and to interrupt the client’s process to help them reach that direction. Apart from that, interrupting the client was considered rude. In single-session therapy, interrupting is regarded very differently. Once a session focus has been agreed, the therapist needs to take charge to ensure that it is maintained during the session. As interrupting the client may be seen by the latter as rude, the therapist first provides a rationale for doing so and then seeks permission from the client to do so. Here is an example: Therapist: So now we have agreed on a focus for the session, we both need to

maintain this focus. OK?

Client: OK.

Therapist: In any conversation between two people, it is easy for one or both to go

from topic to topic, and in a social conversation, that is perfectly fine, but in a therapeutic conversation, when we have agreed on a focus, that is problematic. So, if that happens with us, I would like to interrupt you to bring us back to the focus. I will strive to do that as sensitively as possible, but I will need to do this. Do I have your permission to do so?

Client: Yes, that is fine. I do tend to meander around sometimes.

Therapist: And feel free to interrupt me if I am going off topic, too.

Client: (laughing) I will.

Checking that both are maintaining the focus

Sometimes it is difficult for the therapist to know whether a client has strayed from an agreed focus. Thus, what appears, at first sight, to be a departure from the focus may be a vital elaboration on a topic that clarifies the focus.  Mutual dialogue is a critical feature of SST, so when this occurs, the therapist checks with the client that the focus is maintained.

Therapist: Can I just check something with you?

Client: OK.

Therapist: We agreed to focus on your anxiety about your son’s schooling, and I  am aware that we are now discussing your wife spending a lot of time with her sister. I am not sure how this latter issue fits with your anxiety about your son's schooling

Client: It doesn’t. I was going off track.

Therapist: So, shall we get back to your feelings of anxiety about your son not

getting into his preferred school?

Client: Yes.

In the exchange above, the client acknowledges that they had gone off track. The following is an example of how what seems to be a departure from the focus clarifies it.

Therapist:  Can I just check with you?

Client: OK.

Therapist:  We agreed to focus on your anxiety about your son’s schooling, , and I am aware that we are now discussing your daughter’s problems at ballet school. I am not sure how this issue fits with your anxiety about your son's schooling.

Client: The way I see it, they are both instances of my anxiety that my children may

be blocked in getting what they really want in life.

Therapist:  OK, I get that. They are linked. Would it make sense for us to maintain the focus on your son and then see if we can generalise to your daughter's situation?

Client: If we could do both today, that would be great.

Therapist:  OK, let’s do that.

In this latter exchange, the client’s seeming departure from the agreed focus (anxiety about the client’s son's schooling) turned out to be a clarification of the focus (anxiety about my client’s children not getting what they really want in life). The former is a specific example of the latter, and the client’s introduction of his daughter was another example of the broader focus. Note how the therapist acknowledged the link and suggested that they remain with the specific instance of the now broadened focus (anxiety about the client’s son’s schooling). The therapist then indicated that the client could generalise any learning to the other instance of the broadened focus (anxiety about the client’s daughter’s difficulties at ballet school).   This latter example shows how the single-session therapist works with both the specific and the general in SST, ensuring that both types of issues are connected.

Conclusion

Using time effectively in single-session therapy is a core skill in this form of service delivery. In this article, I have discussed the core skills for helping clients create and maintain an agreed focus so they can get the most from their time with the therapist.

References

Dryden, W. (2026). The Single-Session Therapy Mindset: What to Keep in Mind and Implications for Practice. Routledge.

Hoyt, M.F., & Talmon, M.F. (2014). What the literature says: An annotated bibliography. In M.F. Hoyt & M. Talmon (Eds.), Capturing the Moment: Single Session Therapy and Walk-In Services (pp. 487-516). Crown House Publishing.

Talmon, M. (1990). Single Session Therapy: Maximising the Effect of the First (and Often Only) Therapeutic Encounter. Jossey-Bass.