Creating a Single Session Clinic in Paediatric Health Care: Unearthing Client Strengths, Enhancing Inter-professional Communication and Promoting Mental Health

Co-Principal Investigators: S. J. Anthony, J. Mulligan; Co-Investigator: H. Olivieri

The SickKids Neurology Social Work Single Session Clinic (NSWSSC) is part of the Division of Neurology and the Centre for Brain and Mental Health. The neurology population is diverse and includes diagnoses such as epilepsy, stroke, headache, neuromuscular disease, inflammatory brain disorders and multiple sclerosis.

To increase accessibility to therapy and address the psychosocial needs of neurology patients and their families in a timely manner, the NSWSSC was piloted in November 2013.  The NSWSSC initiative began by offering single session therapy by appointment. Based on the positive feedback from patients, families and team members, the NSWSSC continues to operate within this mandate today. In 2015 over 300 patient and family members received therapeutic support within the clinic.

Background: This research seeks to understand the experiences of clients who received counselling through a Social Work Single Session Clinic (SWSSC) at a large paediatric tertiary care hospital and to assess the clinical effectiveness of this intervention that integrates brief and narrative models. The literature suggests that single session therapy has many benefits but there is a lack of strong empirical evidence in support of its effectiveness. This study addresses some of the gaps identified in the literature and contributes to the necessary empirical foundation to establish a SWSSC within a paediatric hospital setting.

Objective: The overarching purpose of this research is to understand the experiences and perceptions of clients who utilize the SWSSC and to assess the clinical effectiveness of the intervention.

Methods: A longitudinal study, using a nested, multiple method design was chosen to explore client perceptions of the SWSSC and assess intervention outcomes including self-efficacy, distress, anxiety, therapeutic alliance, and client satisfaction. Standardized questionnaires were completed by study participants at three time periods: (T1) immediately pre-single session appointment, (T2) immediately post-single session appointment and (T3) 5 – 7 weeks post-single session appointment. Semi-structured qualitative interviews were conducted to capture the client experience and perceptions of participating in the NSWSSC.

Results: A total of 135 participants completed standardized instruments and 12 semi-structured interviews were conducted with a subsample of 17 participants. Findings indicate high rates of client satisfaction and strong therapeutic alliance. Levels of distress and anxiety were found to be decrease from T1 to T2 and increase from T2 to T3. Levels of self-efficacy were found to increase from T1 to T2 and decrease from T2 to T3. However, change in levels were deemed clinically insignificant. Emerging qualitative themes reflect an overall positive experience with the SWSSC. While many participants report initial uncertainty surrounding the concept of the SWSSC, they express feelings of renewed hope, optimism and a stronger sense of self following the intervention.

Conclusion: This study addresses one of the profession’s most pressing needs: evidence about the effectiveness of interventions in social work practice. The credibility and effectiveness of our practice depends on the sufficiency of our knowledge about what works, under what circumstances, and for whom.

Funded by: Ontario Association of Social Workers