Single session therapy in pediatric healthcare: the value of adopting a strengths-based approach for families living with neurological disorders

Abstract

Background Pediatric patients with neurological disorders often require lifelong management of symptoms and behaviours that can result in enduring emotional burden, stress and impacted health-related quality of life. Single session therapy (SST) draws upon patients’ existing skills and knowledge and has emerged as a therapeutic approach to address pediatric patient and family needs in a timely manner. This study aimed to assess the clinical effectiveness of SST for pediatric patients with neurological disorders and their families, considering self-efficacy, distress, anxiety, therapeutic alliance and client satisfaction, as well as perceptions of whether SST met their pressing needs. Methods A convergent parallel mixed-methods design included quantitative data collection via five standardized questionnaires across three time points and qualitative data collection through semi-structured interviews. Quantitative and qualitative data were analyzed independently and then integrated. Results The study comprised of 135 participants, including patients, parents and siblings across diverse neurological conditions. Scores of self-efficacy and anxiety in children, and distress and anxiety in adults, improved significantly after the SST. Notably, changes in anxiety in adults remained significant five to seven weeks after the SST. Seventeen participants participated in 12 semi-structured interviews. Participants described that SST (1) was a missing piece in ongoing clinical care, (2) illuminated existing strengths and resilience, and (3) effected a lasting impact beyond the single session. Conclusions SST may be a promising initial, strengths-based treatment to support the short-term and potentially long-term needs of pediatric patients with neurological disorders and their families by emphasizing existing strengths, supporting therapeutic alliance and cultivating hope.

Understanding parent engagement in advanced allied health single session therapy for children with developmental and behavioural disabilities

“…Engaging during SST reduced parental stress and improved understanding of the child and diagnostic conditions. These parental outcomes are similar to other studies into SST, which identified that an improved understanding of a diagnosis reduced anxiety and stress and increased hope and the perceived ability to cope (Courtnage, 2020; Creen et al, 2023; John Westwater et al, 2020; Mulligan et al, 2022). Parental stress and anxiety frequently emerge in the literature, impacting families' trust in healthcare and the ability to engage in positive therapeutic actions (Kouo et al, 2022).…”

“…Through active engagement in SST, parents drew upon their internal characteristics and capabilities to cope and have hope. This ability to enhance internal parental attributes to engage in positive behaviours is a fundamental aspect of SST throughout the literature (Campbell, 2012; Mulligan et al, 2022). This study has highlighted that establishing meaningful engagement during SST impacts parental confidence, competence, thoughts and feelings toward taking ownership of their child and family needs.…”

“…Studies into SST have identified that parents' can feel less overwhelmed and more capable of managing their child's needs following SST therapeutic encounters (Boyle et al, 2017; John Westwater et al, 2020; Sommers‐Flanagan, 2007). In addition, recent research into paediatric hospital services has identified that SST consultations support families to improve understanding, adjust to a diagnosis, enhance confidence, provide hope and link with ongoing community support and resources (Courtnage, 2020; Mulligan et al, 2022).…”

“…The title ‘single session therapy’ is prone to misinterpretation, the most concerning being that clinicians and clients understand SST to be limited to ‘one session’ (Hoyt et al, 2020; Young, 2020). This limitation to one session is not the philosophy of SST, but rather, the approach is that each session is a ‘one at a time’ session that is complete in itself (Hoyt et al, 2020; Mulligan et al, 2022). Many clients can engage in multiple ‘single sessions’, if required, to help with the same or differing problems at differing time points of need (Hymmen et al, 2013; Talmon & Hoyt, 2015).…”

Case report: Dissociative neurological symptom disorder with gait disturbance: taking after the father?

“…The mother acquired more leisure time outside the family, the relationship between the mother and the younger daughter became appropriately distant, and the sibling bond between the patient and her sister deepened, contributing to the patient's acquisition of more emotional closeness, potentially replacing the mother-daughter relationship. In recent years, some studies have indicated that single-session therapy effectively treated mental disorders such as anxiety, depression, and eating disorders and physical diseases (19)(20)(21)(22). This approach is particularly beneficial for patients who may not be able to receive comprehensive psychotherapy due to limitations in their circumstances (19,20).…”