Focused Therapy for Anxiety: When One Session Can Help.

There is a common assumption that therapy must unfold slowly over months or years, with insight accumulating gradually until change becomes possible. That is often true, but not always. Sometimes people come to therapy with a very specific difficulty, a clear sense of what is troubling them, and a readiness to look at it directly. In those situations, meaningful change can happen far more quickly than people expect.

This is the idea behind what is sometimes called one-session therapy, an approach strongly associated with the work of Wendy Dryden, who has written extensively about the possibility of helping clients make useful psychological shifts within a single, focused meeting. The emphasis is not on rushing therapy or pretending complex problems can be solved instantly, but on recognising that therapy does not always need to be open-ended to be effective.

This fits naturally with the principles of Rational Emotive Behaviour Therapy (REBT). REBT has always been practical and direct, focusing on the relationship between thoughts, beliefs, emotions, and behaviour. Rather than spending long periods exploring history, REBT often asks a simpler question: what are you telling yourself right now that is creating unnecessary distress?

Anxiety provides a good example. Many forms of anxiety are sustained not only by situations themselves, but by rigid or catastrophic beliefs about those situations. Thoughts such as needing to perform perfectly, fearing mistakes, or believing one could not cope if something went wrong can intensify fear and maintain avoidance. When these beliefs are examined and challenged — something REBT is particularly suited to — people often find their emotional response begins to shift.

This does not mean anxiety disappears entirely, or that deeper work is never needed. It means that sometimes a person needs clarity rather than a long process. A single, structured conversation can help them understand what is maintaining their distress and what they can begin doing differently.

Dryden often describes one-session therapy as working with the assumption that the session should be as useful as possible in case it is the only one. That mindset encourages focus, collaboration, and practical movement rather than waiting for change to emerge gradually over time. When therapy is approached this way, people often leave with a stronger sense of agency and direction.

One-session therapy is not suitable for every difficulty. Long-standing trauma, complex relational patterns, or deeply rooted emotional problems usually require more time. But for specific, well-defined issues — particularly certain forms of anxiety — a single session can sometimes be enough to shift perspective and reduce distress.

For some people, therapy is a longer conversation. For others, it can be a timely one.

If you are struggling with a specific anxiety-related issue and would like to explore it in a focused, practical way, one-session therapy may be worth considering.