One- to three-session therapy with children and families

Individuals or families occasionally "leave therapy" after only one or several sessions, claiming to have gotten what they needed. Although such experiences are often considered treatment failures, there is growing evidence that such brief contacts can in fact produce changes as thorough and meaningful as those seen in long-term treatment. The few studies exploring such brief encounters suggest the long-range effectiveness of one-session treatment across diagnostic categories. Examples of one- to three-session treatment in the individual and family therapy literature are cited. Three of the author's cases are described, illustrating one style of intervention. Is such treatment merely palliative, or can it deal with "underlying" causal issues? How can significant change occur within the structure of one to three hours? These issues are discussed within the framework of psychoanalytic and family systems theories of symptom formation and symptom maintenance.