Single-Session Consultations Delivered in a Gender-Responsive Clinic: A Case Series on Implementation and Lessons Learned

Abstract

Single-session consultation (SSC) interventions are a promising approach for increasing access to timely evidence-based mental health care. This manuscript describes the early implementation, including feasibility and acceptability, of an SSC intervention delivered in a community-based gender-responsive mental health program at an academic medical center in the United States. Six clients completed a 45–60-minute SSC intervention that identified individualized goals, action steps, internal and external supports, and coping strategies. Pre- and post-session measures assessed psychological symptoms, hopelessness, agency, and satisfaction with care. Illustrative case studies are presented for two transition-aged youth. In both cases, the young women collaboratively completed the SSC and their post-session feedback indicated that they found the intervention helpful and aligned with their goals. Clinicians found the service easy to be trained in, viable to implement, and effective. Initial/preliminary results suggest the SSC intervention is feasible and acceptable for use in a free, community-based outpatient clinic serving young women and gender expansive youth. Findings highlighted increases in hopefulness mirroring findings from previous SSC studies. Implementation challenges included lower-than-expected uptake, including difficulty re-engaging youth who did not attend their SSC appointment. Lessons learned included the importance of flexible delivery, structured action planning, and intentional engagement strategies for successful implementation.

Plain Language Summary

In this article, the authors describe using a type of single-session intervention called single-session consultation (SSC) with girls and young adult women who were on a waitlist for a community-based, gender-responsive therapy clinic at an academic medical center in the United States. The SSC was either facilitated by a trainee (who was under the supervision of a licensed provider) or a licensed provider. A total of 6 clients completed the SSC over the course of the 5-month period. The SSC lasted around 45–60-minute and during the intervention, the provider and client identified a singular problem to work on for that session. Together, they created an individualized goal, action steps, identified internal and external support, and coping strategies that the young person could use to cope with their identified problem. This paper presents two examples of the SSC and highlights the young person’s identified problem, action steps, supports, and coping skills. In addition, the young person’s psychological symptoms, self-reported hopelessness, agency, and satisfaction with care are also detailed. Findings suggest that SSCs are feasible to implement in a community clinic, acceptable to use from the viewpoint of providers and trainees, and young people find this intervention acceptable. This paper also details lessons learned to help future providers and clinics implement this intervention.