Single-Session Therapy in a Walk-in Counseling Clinic: A Pilot Study

Single-session therapy (SST) delivered in walk-in counseling clinics is dramatically increasing in Ontario; however, studies of the clinical effectiveness of SST are few, and those that exist are limited by weak research designs. The pilot study reported here had two objectives: 1) to learn more about the clinical effectiveness of SST as delivered in a walk-in counseling clinic and 2) to better understand how the quality of research on this model of service delivery can be improved. We measured psychological distress, stage of change as posited by the Transtheoretical Model of Change (TTM), recent use of health and social services, and recent ability to work and undertake normal activities in a sample of clients attending the KW Counselling Services walk-in counseling clinic in Kitchener-Waterloo, Ontario. Follow-up data, although limited by a low response rate, suggest that clients show a decrease in distress, improvement in general functioning, and decreased use of health services one month and four months after the walk-in visit. However, clients' use of other social service organizations tended to increase following the walk-in visit. The majority of clients were in the Contemplation stage of change; having a high score on either the Contemplation or Maintenance stages was significantly related to improvement at one month follow-up. However, contrary to what the TTM would predict, scoring highest on the Action stage was not significantly related to improvement. At four months follow-up, the correlation between being in the Contemplation stage at the walk-in visit and improvement was very close to statistical significance; being in the Precontemplation stage tended to predict a lack of improvement. Ideas about how to strengthen studies of the effectiveness of single-session therapy provided in walk-in counseling clinics are discussed.