The new science of single session interventions: Implications for mentoring

By Jean Rhodes

Here’s a sobering statistic. As many as 80% of young people in need of mental health services in the U.S. never receive it. And, even when they do, they typically don’t stick around long enough for the service to be delivered as designed.

Enter the incredibly prolific, Professor Jessica Schleider, of Northwestern University, who is on a mission to help fill this massive treatment gap through her innovative research on brief, accessible interventions. “The mean number of sessions that families and children actually access is one,” Schleider explained in a recent podcast. “For this reason, we think it’s very important to figure out what are the potential benefits of one very targeted session.”

The Power of Single Sessions

Single session interventions (SSIs) offer a promising new solution to expand the reach of mental health services. These brief, intentional programs can reduce young people’s distress, with effect sizes comparable to traditional, multi-session psychotherapies. And, crucially, SSIs are designed to be flexible, cost-effective, and rapidly scalable. They can be delivered in diverse settings, including online platforms like MentorPRO, eliminating geographical barriers and the need for transportation. Some SSIs can even be self-administered, reducing the reliance on trained providers. And, as we’ll discuss below, they can be an essential part of a mentor’s toolboxes.

Professor Schleider’s meta-analysis evaluating over 50 randomized trials found surprising evidence that single-session interventions can significantly reduce youth mental health symptoms like anxiety, depression, and behavioral issues – with effect sizes not far off from multi-session treatments averaging 16 sessions!

A key goal is identifying which brief intervention works best for whom based on targeted goals. Her team also targets parents, as their beliefs about treatment impact whether youth ever receive care. For example, teaching parents about neuroplasticity in a single session improved their perceived effectiveness of therapy for themselves and their children. If targeted to the right person at the right time, a single-session intervention could make a big difference. Her lab, Lab for Scalable Mental Health  develops online, self-administered single-session programs that teach skills like self-compassion, behavioral activation, and the belief that people can change.

And, to meet public demand, Schleider’s team launched Project YES (Youth Empowerment and Support) at schleiderlab.org/yes, allowing anyone (including mentees and mentors!) to anonymously access three of their online single-session programs for free. Early data show benefits like reduced hopelessness and increased perceived control across nearly 200 young participants, many from underrepresented backgrounds.

Professor Schleider and her team also test innovative ways to deliver these programs outside clinics. In one study, youth who screened positive for depression at pediatric primary care clinics immediately received free access to single-session online interventions for themselves and parents, with promising initial results.  Another study provided a single-session program to those waiting for outpatient psychotherapy, helping prevent deterioration. This highlights the importance of “just-in-time” interventions.

And then there’s mentors… In an important new paper, “Expanding the Reach of Psychosocial Services for Youth: Untapped Potential of Mentor-Delivered Single Session Interventions.” Professor Schleider and her colleagues propose leveraging the existing network of mentors to further enhance their accessibility and impact. As they note, previous research has shown that volunteer mentors can be effectively trained to deliver structured psychosocial programs. SSIs, which target specific mechanisms like cognitive restructuring, could provide mentors with the just-in-time evidence-based curricula they need to help their mentees.

Why mentors?

As they argue, there are a lot of good reasons for extending SSI’s to mentoring programs.

• Mentors have already established trusting relationships with their mentees. This bond is critical for overcoming stigma and increasing engagement with mental health content. A mentor can normalize struggles and provide a supportive space to learn new skills.
• Mentors are embedded within the community settings where youth already spend their time. Delivering SSIs through mentors increases access by meeting young people where they are, rather than requiring additional appointments.
• Mentors tend to be diverse paraprofessionals who can help mitigate inequities in the mental health workforce. With proper training, they could capably deliver high-quality interventions.
• Mentors are already accustomed to having structured, skill-building activities during their meetings with mentees. Incorporating an evidence-based SSI would be a relatively seamless extension of their current practice.

Beyond Mental Health

This past year, in partnership with with the Step Up Digital Community as well as the Career Opportunities Initiative, my colleagues and I have been exploring the possibility of extending SSI’s beyond a singular focus on mental health to academics and career outcomes. With Step Up, for example young women can use Flash Mentoring, to connect to interest-aligned mentors who can provide just-in-time guidance that can be life changing. Our evaluations are still underway, but we’ve seen preliminary evidence that a single session around setting SMART goals, building social capital, effective interview skills, etc., can make a difference .

For mentors to be able to deliver SSI’s, however, they do need training not just on delivering the core content of each SSI, but also on how to effectively reinforce the skills and help their mentees practice and apply them to real life problems. Ongoing coaching, observation, supervised practice, and supervision would likely be required, and platforms can help college-aged young people and their mentors in accessing, delivering, and practicing new skills.

Although mentors cannot replace treatment for higher-risk cases, they could provide a first line of prevention and early intervention, as well as extend the reach of care for underserved populations.

Combining the benefits of mentoring relationships with the effectiveness of SSIs could significantly increase the accessibility and impact of effective mental health care for underserved youth.