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Little Treatments, Big Effects: How to Build Meaningful Moments that Can Transform Your Mental Health
If you've ever wanted mental health support but haven't been able to get it, you are not alone.
In fact, you're part of the more than 50% of adults and more than 75% of young people worldwide with unmet psychological needs. Maybe you've faced months-long waiting lists, or you're not sure if your problems are 'bad enough' to merit treatment? Maybe you tried therapy but stopped due to costs or time constraints? Perhaps you just don't know where to start looking? The fact is, there are infinite reasons why mental health treatment is hard to get. There's an urgent need for new ideas and pathways to help people heal.
Little Treatments, Big Effects integrates cutting-edge psychological science, lived experience narratives and practical self-help activities to introduce a new type of therapeutic experience to audiences single-session interventions. Its chapters unpack why systemic change in mental healthcare is necessary; the science behind how single-session interventions make it possible; how others have created 'meaningful moments' in their recovery journeys (and how you can, too); and how single-session interventions could transform the mental healthcare system into one that's accessible to all.
In fact, you're part of the more than 50% of adults and more than 75% of young people worldwide with unmet psychological needs. Maybe you've faced months-long waiting lists, or you're not sure if your problems are 'bad enough' to merit treatment? Maybe you tried therapy but stopped due to costs or time constraints? Perhaps you just don't know where to start looking? The fact is, there are infinite reasons why mental health treatment is hard to get. There's an urgent need for new ideas and pathways to help people heal.
Little Treatments, Big Effects integrates cutting-edge psychological science, lived experience narratives and practical self-help activities to introduce a new type of therapeutic experience to audiences single-session interventions. Its chapters unpack why systemic change in mental healthcare is necessary; the science behind how single-session interventions make it possible; how others have created 'meaningful moments' in their recovery journeys (and how you can, too); and how single-session interventions could transform the mental healthcare system into one that's accessible to all.
256 pages, Paperback
Published January 30, 2024
10 people are currently reading
661 people want to read
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Displaying 1 - 7 of 7 reviews
February 15, 2024
I cannot stress enough the importance of Dr. Jessica Schleider's work in developing evidence-based, scalable, and open-source single session interventions (SSIs) for tackling mental health issues. Those familiar with the mental healthcare systems in Canada or the US know all too well the challenges of accessibility, ranging from the difficulty of finding appropriate care when needed, to financial constraints, among many other obstacles. While SSIs are not a panacea, they offer considerable promise in assisting the vast majority who fall within the grey space between stable mental health and debilitating mental illness.
When reflecting on the experience of reading the book, it's evident why Dr. Schleider is such a prolific researcher. Not only is she a logical and prudent thinker, but she also embodies deep compassion and is a beautiful writer. The only reason I had to put the book down was due to other commitments.
My sole piece of constructive criticism concerns the chapter on meaningful moments in action, which relied on a very small convenience sample recruited through social media for the purposes of the book. This approach seemed to deviate from the spirit of the rest of the book, which is grounded in Dr. Schleider's comprehensive and commendable research program. However, this is a minor critique of something Dr. Schleider is transparent about and handles with rigour nonetheless.
I highly recommend this book to anyone interested in mental health, as it offers insightful perspectives and innovative solutions.
When reflecting on the experience of reading the book, it's evident why Dr. Schleider is such a prolific researcher. Not only is she a logical and prudent thinker, but she also embodies deep compassion and is a beautiful writer. The only reason I had to put the book down was due to other commitments.
My sole piece of constructive criticism concerns the chapter on meaningful moments in action, which relied on a very small convenience sample recruited through social media for the purposes of the book. This approach seemed to deviate from the spirit of the rest of the book, which is grounded in Dr. Schleider's comprehensive and commendable research program. However, this is a minor critique of something Dr. Schleider is transparent about and handles with rigour nonetheless.
I highly recommend this book to anyone interested in mental health, as it offers insightful perspectives and innovative solutions.
January 4, 2026
A smart, concise book based on one key point that should be understood by every mental health provider: make the first session count, as that’s enough to meet (many) clients needs.
The book should be on every clinician’s shelf and yet the author’s willingness to make single session intervention (SSI) content free at https://osf.io/xnz2t/ is remarkable.
SSI is not a panacea or a cure for serious MH issues— there are still people/clients who are ready for deeper treatment and need more than this intervention. The author is realistic about that. Yet SSI is a fundamental skill that should be incorporated into every clinical toolbox.
I appreciated that the author gave clear, research based direction to measure the impact of SSI both in terms of clinical effectiveness/clinically relevant change (using the PHQ-9, the GAD-7, Hope scale, perceived agency subscale, and/or the 1 item readiness ruler) and the acceptability feedback items. So simple and meaningful to demonstrate the value of this atheoretical intervention.
My lingering questions:
1. Access as the primary rationale for SSI
The book frames Single Session Interventions (SSI) as a response to limited access to mental health care. That argument made sense in 2019, when provider shortages and long waitlists were the dominant barriers. But the care landscape has shifted dramatically. The growth of telehealth and large insurance-accepting platforms (e.g., Grow Therapy, Headway, Alma) has expanded provider availability and reduced friction in accessing care. Access is still inequitable, but it’s not the same core problem it was five years ago. This raises an important question: Would the research findings supporting SSI look the same in 2026 as they did in 2019, given this seismic shift in access models and care delivery infrastructure?
2. Who benefits from SSI and what that signals clinically
As a clinician, I’ve never subscribed to the idea that “therapy is for everyone.” The research cited in the book showing that 40–50% of people get what they need from a single session may reflect something important: that many of these individuals likely did not present with a diagnosable condition warranting ongoing treatment. This reality sits in tension with reimbursement structures, where clinicians are only paid when a billable diagnosis exists. The author briefly references the use of SSI within intake processes, and I believe this is an under-developed but promising area. SSI could be intentionally embedded into the required initial assessment as a structured, outcomes-informed intervention that educates clients, normalizes not entering care when it isn’t clinically indicated, and reduces stigma around choosing not to continue.
3. The structural misalignment between SSI and provider incentives
Even with strong evidence and philosophical alignment, SSI faces a major structural challenge: profitability. Insurers benefit when SSI contains costs and helps ensure that ongoing treatment is reserved for those who truly need it. Clients benefit when they receive exactly the level of care appropriate to their readiness and needs, which is sometimes/often a single session, nothing more. But providers do not benefit financially from the successful use of SSI. In most care delivery models, they are explicitly incentivized and often evaluated by employers on retention from session one to session two, with retention treated as a proxy for quality and therapeutic alliance. Value-based arrangements frequently reinforce this by targeting 70%+ first-to-second-session retention. These business norms create a direct tension: doing what is clinically appropriate may conflict with what is operationally rewarded.
This leads to a broader systems-level question: If SSI represents a clinically valid and ethically sound pathway for many clients, how do we reshape incentives, metrics, and cultural expectations so that providers are not penalized financially or professionally for using it?
I have more questions and this book really gets me thinking, which is always a sign of a great read!
The book should be on every clinician’s shelf and yet the author’s willingness to make single session intervention (SSI) content free at https://osf.io/xnz2t/ is remarkable.
SSI is not a panacea or a cure for serious MH issues— there are still people/clients who are ready for deeper treatment and need more than this intervention. The author is realistic about that. Yet SSI is a fundamental skill that should be incorporated into every clinical toolbox.
I appreciated that the author gave clear, research based direction to measure the impact of SSI both in terms of clinical effectiveness/clinically relevant change (using the PHQ-9, the GAD-7, Hope scale, perceived agency subscale, and/or the 1 item readiness ruler) and the acceptability feedback items. So simple and meaningful to demonstrate the value of this atheoretical intervention.
My lingering questions:
1. Access as the primary rationale for SSI
The book frames Single Session Interventions (SSI) as a response to limited access to mental health care. That argument made sense in 2019, when provider shortages and long waitlists were the dominant barriers. But the care landscape has shifted dramatically. The growth of telehealth and large insurance-accepting platforms (e.g., Grow Therapy, Headway, Alma) has expanded provider availability and reduced friction in accessing care. Access is still inequitable, but it’s not the same core problem it was five years ago. This raises an important question: Would the research findings supporting SSI look the same in 2026 as they did in 2019, given this seismic shift in access models and care delivery infrastructure?
2. Who benefits from SSI and what that signals clinically
As a clinician, I’ve never subscribed to the idea that “therapy is for everyone.” The research cited in the book showing that 40–50% of people get what they need from a single session may reflect something important: that many of these individuals likely did not present with a diagnosable condition warranting ongoing treatment. This reality sits in tension with reimbursement structures, where clinicians are only paid when a billable diagnosis exists. The author briefly references the use of SSI within intake processes, and I believe this is an under-developed but promising area. SSI could be intentionally embedded into the required initial assessment as a structured, outcomes-informed intervention that educates clients, normalizes not entering care when it isn’t clinically indicated, and reduces stigma around choosing not to continue.
3. The structural misalignment between SSI and provider incentives
Even with strong evidence and philosophical alignment, SSI faces a major structural challenge: profitability. Insurers benefit when SSI contains costs and helps ensure that ongoing treatment is reserved for those who truly need it. Clients benefit when they receive exactly the level of care appropriate to their readiness and needs, which is sometimes/often a single session, nothing more. But providers do not benefit financially from the successful use of SSI. In most care delivery models, they are explicitly incentivized and often evaluated by employers on retention from session one to session two, with retention treated as a proxy for quality and therapeutic alliance. Value-based arrangements frequently reinforce this by targeting 70%+ first-to-second-session retention. These business norms create a direct tension: doing what is clinically appropriate may conflict with what is operationally rewarded.
This leads to a broader systems-level question: If SSI represents a clinically valid and ethically sound pathway for many clients, how do we reshape incentives, metrics, and cultural expectations so that providers are not penalized financially or professionally for using it?
I have more questions and this book really gets me thinking, which is always a sign of a great read!
May 31, 2024
Super informative, great read. Schleider did really well balancing history with current research and tangible actions to take in a way that was accessible to a broad audience. It’s so important that books like this exist to normalize and encourage change for the better in mental health spaces 🤍. Will be coming back to this often for sure!!
want-to-read-nonfiction
January 18, 2024Adam Grant rec
July 9, 2025
Good read. Interesting ideas but not sure how feasible they are. Need to change post secondary schools, government, and practitioners to make this happen.
There’s a reason that there are private practitioners. They control their schedule and client base. This makes the author’s idea more difficult to implement. To change post secondary curriculum is almost impossible as they prefer the way it’s always been done. On second thought maybe government will be the easiest change.
There’s a reason that there are private practitioners. They control their schedule and client base. This makes the author’s idea more difficult to implement. To change post secondary curriculum is almost impossible as they prefer the way it’s always been done. On second thought maybe government will be the easiest change.
December 26, 2023
Must read book for anyone who wants to understand the history and future of mental health care. Fluidly written with a depth of expertise and authority from this Harvard PhD and Forbes 30 under 30 alum. More to come from Professor Schleider, but this is a great distillation of her mission and message.
April 20, 2024
I love the ideas. But the book repeats itself several times when it is confirming that her research helps people. And it does. And the ideas are AWESOME. Using her Schleider Lab website is more useful than the book to me though.
Displaying 1 - 7 of 7 reviews