Purpose: This systematic review provides a summary of the available evidence of the efficacy of single-session therapy (SST) on anxiety disorders in both youth and adults.Methods: PubMed, Scopus, Medline, and Google Scholar databases were search for relevant articles, and the Cochrane Collaboration's tool for assessing the risk of bias in randomized trials was used for transparent reporting of the methodological quality of each selected study.Results: The search of electronic databases identified 18 reports based on rigorous inclusion criteria. Single-session therapy was found superior to no treatment in reducing anxiety symptoms, and similar results were observed while comparing SST to multi-treatment sessions.Discussion: The findings support the benefits of SST in enhancing cognitive, behavioral, and psychological outcomes in both youth and adults suffering from anxiety disorders across treatment conditions and approaches, SST thus appears to be a promising way of providing access to both private and public therapeutic services efficiently and cost-effectively.Conclusions: Single-session therapy is effective in treating anxiety disorders. Further research is required to quantify its cost-effectiveness and deepen the knowledge of effective treatment ingredients for both young people and the adult population suffering from diverse anxiety disorders.Systematic Review Registration: PROSPERO, identifier [CRD42021232024].

Single session therapy (SST) postulates that one session can be sufficient for a client to take charge of the process and work toward their own solutions. Research has been conducted worldwide corroborating SST assumptions with several mental health conditions, but not in Italy. For the first time in Italy, this paper aims to explore: (1) if the most frequent number of sessions in traditional psychotherapy (not SST) is one (Study 1); and (2) the satisfaction of clients who attend SST services and the number who consider one session sufficient to address their presenting problem (Study 2). In Study 1, the records of 476 voluntary clients referred to three different traditional (not SST) psychological services in the west-central region of Latium, Italy, were retrospectively screened, and the number of sessions attended by each client recorded. In Study 2, 85 consecutive clients who voluntarily asked for SST with seven mental health professionals across Italy received a link to an online ad hoc survey, 1-3 weeks after the consultation, evaluating their experience. Study 1 found that the most frequent number of traditional psychotherapeutic (not intentionally SST) sessions was one (124 out of 476 clients (26%). Study 2 found that 44 out of 85 clients (52%) considered one session to be enough, as they felt better or much better and chose not to attend further sessions. Of those who asked for a second session (41 clients), 33 clients (80.5%) indicated that the first session was not enough and 8 clients (19.5%) wanted to address a new problem. These results converge with previous international studies and provide encouragement for the use of SST in both private and public psychological services to address the demand for timely mental health services in Italy. Further research is needed to support the efficacy of SST and to evaluate its cost-effectiveness.

Single-session thinking and practice are being increasingly recognized as an important component in the landscape of mental health service delivery. At the same time, however, there are some common misunderstandings that may impede applications and further developments. Inspired by Jay Haley's (1969) ironic “The Art of Being a Failure as a Therapist” and others of his articles, the authors describe some ways to avoid successful single-session therapy (SST), including insisting that therapy be only one session; disbelieving that therapy could be only one session; lowering hopeful expectations; avoiding clarifying a specific goal for the session; disregarding real-life issues; insisting on one model of therapy; ignoring context and working against the client's culture; thinking that the only single-session goal should be total resolution of whatever problems have brought the client to therapy; and neglecting implementation, supervision, and administrative support.

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