A single session with a psychiatrist to solve a problem

A single appointment with a psychologist to overcome an ordeal, e.g. B. a breakup. The ‘single session intervention’ is gaining traction in the Quebec health and social services network. The University Group for Family Medicine (GMF-U) Saint-Jean-sur-Richelieu offers it to its patients and the CISSS de la Montérégie-Ouest wants to start a pilot project. The Order of Psychologists of Quebec warns healthcare facilities against this “very attractive” approach.

Kathy Perreault, psychologist at GMF-U Saint-Jean-sur-Richelieu, introduced the “single session intervention” in 2018 to increase access to her services. At the time, the associate clinical professor at Université de Sherbrooke only had one day a week to see patients at the GMF-U (she has a teaching position). She offered her clients “conventional” follow-ups that could extend over several sessions.

“I realized I was treating 16 or 17 patients a year,” says Kathy Perreault. I felt it wasn’t enough for a front line service. His GMF-U has 9,000 registered patients.

To offer support to more people, Kathy Perreault is now using “single session intervention,” an approach that is primarily present in Ontario, England and Australia. She meets patients in difficult times, but not in crisis situations (e.g. suicidal thoughts).

“During the meeting we will focus on a problem in the ‘here and now’,” explains the psychologist. We will make a plan with this person to help her in her daily life to find ways that will allow her to cope with the situation that she finds difficult. If necessary, the patient can consult them again.

Geneviève Bruneau, interim medical director of the GMF-U Saint-Jean-sur-Richelieu, regularly sends patients to see Kathy Perreault. She cites the case of a woman in her 40s whose father is struggling with a major health problem. “She was penniless enough to “find her way” with her private life, her children and the sick relatives,” says the family doctor. Sometimes talking to the psychologist can help to defuse or air things out. »

According to DD Bruneau, GMF-U patients are satisfied with the service. “Sometimes they would have liked to have had more than one session,” she admits. But they understand that resources are limited. And they know they have the right to come back. » GMF-U social workers can provide longer follow-up visits.

A study

To measure the effectiveness of the one-on-one session, Kathy Perreault, in collaboration with University of Sherbrooke Professor Mylaine Breton, conducted a study in 2019 involving 114 adult patients.

According to Kathy Perreault, the mental state of the participants improved. “The intensity of the perceived problem decreased after the individual session and remained the same at follow-up four to six weeks later,” she says. The intensity of the psychological stress also decreased significantly and remained the same four to six weeks later. Well-being increased after the session and was maintained.

One in five patients in the study required more than one encounter. Almost 93% said they were satisfied with their meeting.

The CISSS de la Montérégie-Ouest is interested in this approach and intends to start a pilot project soon. Kathy Perreault has trained dozens of psychologists, social workers and human resources consultants in the healthcare sector. Others will soon be.

“If we manage to establish this form of intervention there and manage to offer it to our clientele at the right time, maybe a single session will be enough and it will prevent that [problèmes des] People become chronic,” says Sophie Poirier, Associate Director of Multidisciplinary Services, Research and Higher Education.

In her opinion, this approach could help reduce waiting times for mental health services. “It will free up space for people who have more complex needs, who may need a different approach or may not want that approach,” Poirier believes. There remains a choice. »

Gaëtan Roussy, president of the Association of Psychologists of Quebec, believes the one-on-one session “can help people” who have “situational problems.” But you have to properly assess the patient first, he emphasizes, to make sure this is the right path for them.

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Gaëtan Roussy fears that the one-on-one session will be “instrumentalized” by CISSS and CIUSSS managers in a hurry to shorten their waiting lists. “Given the lack of psychologists, we will take a bunch of them just to meet for one session to analyze a situation and say ‘thank you, good evening,'” he fears. It doesn’t have to rotate straight away. »

The President of the Order of Psychologists of Québec, Christine Grou, also expresses reservations about the only session. She points out that this is not psychotherapy or psychological treatment, but rather one advisory or at coaching

“This doesn’t apply to all types of customers,” she emphasizes. The one-on-one session requires someone who is motivated to change and who has the resources to change. This is not treating a major depressive episode. »

Christine Grou believes that “more research is needed” on this approach. “We know it’s not necessarily true in patients with mental disorders, and the literature says so,” she says.

She recalls that psychological treatments on the public network are already “very short”. “It is very dangerous to try to import this and think that it can solve the access problem [aux services en santé mentale] ‘ she concludes.

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