Structuring Safety in SST
Structuring Safety
The structured safety of a robin’s nest amongst the foliage and support of the branches of an evergreen liken to how we intentionally structure safety throughout single session therapy.
Unique to the context of single session therapy, people arrive to participate in a therapeutic encounter who are unknown to the service provider. There is very little pre-session information. We’re meeting people for the first time at what might be their first experience with therapy. We can never underestimate how big of a step that is for many people. Structuring safety for these conversations is of upmost importance.
As I’ve previously noted (Cooper, 2024), Michael White (co-founder of narrative therapy) used to facilitate live sessions during his training intensives. These were often recorded allowing review and study. Although we may not have thought about it at the time, Michael was teaching us about how to do single session therapy. One aspect seemingly rarely talked about was how Michael structured safety into these one off sessions. Beginning these conversations, he would spend significant time engaging in conversation about how the time together was typically spent. He would ask permission to ask his questions and to take notes along the way as there were sentiments that might catch his interest that he had hoped to return to. He shared how he would do his best to archive their words not his. He would locate himself, sharing about where he was from, his style of practice, and asked if they had any questions about him or the process. Humour often showed up early too, setting folks at ease and disrupting the stress of the context. We learned a great deal from watching Michael.
In 2008 Karen Young and I co-wrote, Toward Co-composing an evidence base: The narrative therapy re-visiting project. The project involved an approach developed to learn from therapy participants what is meaningful and significant in narrative therapy conversations. For me, feedback from participants highlighted practices that structure safety in single sessions. Participants noted how accepting if they didn’t want to answer a question, summarizing back what was said, and checking in about our understanding, or archiving people’s own words helped shape trust, comfort and a sense of collaboration.
These practices, while subtle, serve to structure safety in single session therapy. Structuring safety is not simply about ensuring confidentiality or informed consent- it is an active, ongoing process that helps people feel a sense of agency, dignity, and trust within the conversation.
The ways Michael White engaged with participants- clarifying the process, asking permission, inviting questions, using humour, and making it clear that their words would be honoured, are all intentional acts that contribute to this structure. Similarly, the feedback Karen and I received through the Narrative Therapy Re-visiting Project reinforced that these small but deliberate actions can profoundly shape how safe, seen, and heard someone experiences a brief encounter.
Cathy Richardson and Vikki Reynolds (2014) foreground and detail the process of structuring safety in their article Structuring Safety in Therapeutic Work alongside Indigenous Survivors of Residential Schools. This article is an important read and highly relevant to single session therapy as well as all therapeutic practice, virtual or in-person. It has shaped my practice profoundly.
“Structuring safety refers to the practices of negotiating or co-constructing the conditions, structures and agreements that will make space for safe-enough work alongside [people].”
As a process, we are intentionally engaging in practices to assist people to experience comfort and safety throughout our time together. It means letting people know what is to come and inviting their permission to begin the conversation. So how do we intentionally structure safety in single session therapy?
In my book Brief Narrative Practice in Single-Session Therapy , I highlight several paths to structuring safety in single-session therapy. Those include:
The use of a pre-amble,
Locating myself personally and professionally,
Locating our practice within a culture,
Explaining our noting practices,
Asking permission to concurrently take notes, and
Asking if participants have any questions about the process.
As an example, a young adult was visiting the quick access (walk-in) clinic for the first time. She was greeted by her assigned therapist who accompanied her down the hallway toward the meeting room. As they approached the space, she paused awkwardly at the doorway in silence. Sensing discomfort, our therapist noted that this was the room they had intended to meet in today and wondered if it looked okay to her. The room was set to be comfortable with a couch, chairs, side tables and a few paintings hanging on the walls. The young person asked, “Is there another room?”
“Of course,” replied the therapist, and they moved to a room dedicated to play therapy with children. The setting in this room was more playful with fun colours, bean bag chairs, stuffed animals, and materials for expressive art activities. She appeared far more comfortable as she entered the room and settled into the bean bag chair.
The therapist asked, “Are you okay if I close the door for some privacy, or would you rather I leave it open?”
“Closed is fine,” she responded.
As the ensuing conversation unfolded, she shared that she had experienced physical abuse in relationship and the first meeting space had reminded her of the home in which this abuse most often took place. It was unsettling for her whereas the second room was experienced as different enough as not to evoke what she had been through.
Acts of Convening:
This is a small example of striving to structure safety in our acts of convening these conversations. Our general practice is to welcome people as though they are a houseguest, offering snacks and beverage and providing a brief tour of the venue. We ask if the room looks okay to meet within and if we can close the door. We want people to have an opportunity to alert us if the space is experienced as unsafe as in the young adult’s situation. We have had many first time visitors to the quick access clinic who had the past experience of having to provide testimony or had been interviewed by child protection in office-like settings, so we try to ensure our space is comforting and not distancing.
Although I place ‘structuring safety’ up front in the beginning phase of the single session therapy map, it is an on-going practice throughout the entire conversation. There are several ways that we continue to tend to safety, turn by turn, in conversation.
Negotiating Permissions:
“Structuring safety requires that therapists resist getting caught up in compelling stories of pain and suffering. Questions informed by a naive and intrusive curiosity pose great threats to safety. We can easily be seduced by the privileging idea that as therapists we have a right, and perhaps even a duty, to ask anything that captures our interest.”
In my pre-amble I note that I tend to ask a lot of questions and should I ask one they don’t want to answer or is to off topic, they can let me know. In follow-up to this disclaimer it is important to periodically ask permission to ask our questions. This doesn’t mean we ask permission to ask every question. Rather, when there is a change in focus or I hope to continue on a topic with further questioning I will check-in, seeking permission for further inquiry. It’s important for people to know that they can say no to our questions and that we can pause the conversation at any time if it is not useful or too unsettling. Is it okay if I ask some more about that? Often, in the spirit of transparency, I note why I hope to ask more. Would it be okay if I ask a bit more about that- the reason is I am interested in how you might have navigated such as difficult situation? This is a way to foreshadow the kinds of questions I’m thinking about so they can make a more informed decision about how to proceed.
Feedback Loops:
Feedback loops provide another way that we can continually engage in the process of structuring a safe-enough experience. Safety and permission are part of continuous negotiation and feedback loops along the way, interwoven throughout our conversation assist in the co-creation of safety.
“These practices allow for a co-creation of “enough-safety”, a negotiated and nurtured relationship with safety positioned outside of the binary constructions of complete safety and a complete lack of unsafety”
I may ask, How’s this conversation going for you? Are you okay to continue or should we take a break? Are we talking about what is most pressing to you or should we be focused on something else? This line of questioning enhances collaboration as we can pivot to alter the course of the conversation should it not be aligning with what people came for. Feedback loops also invite the experience of personal agency, choice and influence over the conversation.
Summary and re-tellings:
Again, in the Revisiting Project we learned from participants the importance of sharing back their words through the use of summary and re-tellings of what we have heard. Often, this can be a means to share what we have written down and to check in about accuracy or that we haven’t misunderstood too much. It seems to facilitate an openness (Young & Cooper, 2008).
“. . . the summarizing is really important . . . she’s quickly getting some information out of him
(son) and then going through it sort of with him. . . The effect of the moment again is more of that building trust with her. . .”
When words are shared back with people they are momentarily positioned differently in the conversation. Rather than being in a respondent position, they take on the role of an audience, allowing them to step back from the immediacy of their experience, reflect, and more thoughtfully consider their next steps.Think of those moments as momentary ‘safe perches’ along the meaning-making journey.
The image I have chosen to represent structuring safety is that of the robin’s nest. With great intention robins collect materials and craft the nests to protect their eggs from the wind, rain and predators. They utilize a cup like structure nestled within the branches and foliage. In the same way robins provide this structure for safety, our single session therapy is designed with intentionality and care to structure safety with participants.
Prior to your next single session consider:
How do you intentionally structure safety in therapeutic practice?
How do we have conversations with people in which they do not re-experience distress of the past?
How do we have conversations that assist people not to get stuck in the immediacy of their experience?
How do we set the scene for people to experience choice within our conversation?
References:
Cooper, S. (2024). Brief Narrative Practice in Single-Session Therapy. Routledge.
Cooper, S. (2024) Brief Narrative Practice in Single Session Therapy: Some lessons from Michael White and others. In Hoyt, M. and Cannistrá, F. (Eds), Single Session Therapy: Why and how one-at-a-time mindsets are effective. Routledge.
Peterson, J., (2021). Moving beyond the single story: using a double-storied assessment tool in narrative practice. International Journal of Narrative Therapy and Community Work, (1), p.70-81
Reynolds, V. (2002). Weaving threads of belonging: Cultural Witnessing Groups. Journal of Child and Youth Care, 15(3), 89-105.
Richardson, C., Ph.D., & Reynolds, V., Ph.D. (2014). Structuring safety in therapeutic work alongside indigenous survivors of residential schools. The Canadian Journal of Native Studies, 34(2), 147-164.
Young, K. & Cooper, S. (2008). Toward Co-composing an evidence base: The narrative therapy re-visiting project. Journal of Systemic Therapies, Volume 27, Number 1, p. 67-83.