CBT and Exposure Techniques That Work: A TEAM-CBT Training Summary

Training Summary for Therapists

Overview: What We Covered

Hey everyone! So we just wrapped up an incredible two-hour webinar on CBT and exposure techniques, and wow, did we go deep. David Burns and I took you on quite a journey - from watching Terry overcome 10 years of panic attacks in just six minutes (yes, you read that right!) to Sarah conquering her decades-long OCD by sticking her hands in a garbage can.

If you missed it, or if you were there but your head is still spinning from all the content, let me break down what we covered and why it matters for your practice.

The Main Event: Four Models of Anxiety (But We Focused on Two)

We started by introducing the four powerful models for understanding and treating anxiety in TEAM-CBT:

1. The Motivational Model - All about resistance (which we expect 100% of the time!).
2. The Cognitive Model - Those pesky distorted thoughts causing all the trouble.
3. The Exposure Model - Avoidance maintains anxiety; exposure cures it.
4. The Hidden Emotion Model - Niceness as the surprising culprit.

Today's focus was primarily on the exposure and cognitive models, though David couldn't resist sharing some beautiful examples that touched on all four.

The Terry Video: When Everything Changes in Six Minutes

Let me paint you a picture. Terry had been suffering from panic attacks five times a week for TEN YEARS. She'd been to countless doctors, tried every medication, spent years in therapy. She was convinced she was dying every time she had a panic attack.

Key TEAM-CBT Techniques Used:

• Testing (T): David had been tracking her scores weekly.
• Empathy (E): Building trust over several sessions with perfect empathy scores.
• Assessment of Resistance (A): Helping her see what is good and great about anxiety, and commit to doing exposure, and the work it takes to overcome it. 
• Methods (M): David had used many techniques that were not helpful and then he turned to the Experimental Technique - inducing a panic attack in the room and testing her beliefs.

Here's what happened: David deliberately induced a panic attack (yes, on purpose!), and then - this is the kicker - he had her do jumping jacks. JUMPING JACKS! While she thought she was dying!

The cognitive distortions at play:

• Fortune Telling: "I'm about to die."
• Mind Reading: "Everyone can see I'm falling apart."
• Magnification: "My heart is going to explode."
• Emotional Reasoning: "I feel like I'm dying, therefore I must be dying."

The transformation? She went from sobbing uncontrollably to laughing hysterically when she realized, "Wait, people having heart attacks don't do jumping jacks in the ER!"

The Counterintuitive Truth: David didn't try to calm her down. He actually tried to make her MORE anxious. That's the opposite of what most therapists do, and that's exactly why it worked.

Sarah and the Garbage Can: Flooding at Its Finest

Then there was Sarah from our Tuesday training group. Twenty-five years of contamination OCD. Elaborate washing rituals. Couldn't touch doorknobs without tissue paper.

The TEAM-CBT Process:

1. Testing: Tracking her contamination fears.
2. Empathy: Building rapport in the group setting.
3. Assessment of Resistance:

• Outcome resistance: The benefits of OCD/Anxiety "What if I really do get sick?"
• Process resistance: The work involved in overcoming it: "I can't possibly touch that toilet seat!

4. Methods: In Vivo Exposure. David took the entire training group (30 people!) into the women's bathroom and had Sarah touch the toilet seat, then the inside of the toilet, then - get this - stick her hands in a garbage can and rub that black grime all over them.

Five years later? She is still OCD-free.

The Attorney Who Never Lost (Except Once)

This story gets me every time. Jeffrey, the top courtroom attorney in America, had won every case but one in his entire career. But he'd never experienced a moment of happiness. Ever.

Techniques Used:

• The What-If Technique (uncovering the core fear)
• Interpersonal Exposure (the survey technique)

His core fear? Ending up homeless, begging on the streets of Philadelphia while the attorneys he'd beaten kicked sand at him. Seriously.

The cure? David had him tell 10 colleagues he'd lost a case. The result? Half didn't even hear him (too busy bragging about themselves), and the other half opened up about their own failures and thanked him for being vulnerable. He felt joy for the first time in 60 years.

Safety Behaviors: The Hidden Saboteurs

Here's something crucial we covered - safety behaviors. These are the sneaky little things patients (and maybe you!) do to feel better in the moment:

• Carrying medication "just in case."
• Opening windows to "breathe better."
• Saying mantras or prayers.
• Distracting with phones or music.
• Carrying water bottles for dry mouth.

Why they're problematic: They prevent new learning. The patient never learns they're actually safe without the crutch.

Gradual vs. Flooding: Both Work!

We showed you both approaches:

Gradual Exposure (The driving phobia example):

• Start small (drive to the end of the street).
• Build up gradually.
• Move to the next level when anxiety drops to about 20/100.

Flooding (Terry, Sarah, David's own fear of heights):

• Hit the worst fear all at once.
• Stay with it until anxiety drops to zero.
• Often produces faster results but requires more courage.

Cognitive Exposure Techniques

For fears you can't face in reality (like fear of losing your mind), we use:

Cognitive Flooding:

• Write out the worst-case scenario script.
• Record yourself reading it.
• Listen for 30 minutes daily until it's boring.

Memory Rescripting:

• Relive traumatic memories.
• Change the script to gain control.

The Bottom Line: What Makes This Work

1. Empathy is mandatory but not curative - You need that A+ on the empathy scale before you can push.
2. Resistance is expected - There are always benefits to your anxiety.
3. Persistence is key - If you back off, you confirm their fears.
4. More anxiety = better outcomes - We're not trying to calm anyone down.
5. Safety behaviors must go - No crutches allowed.

If you or someone you know is struggling with panic, OCD, or anxiety and would benefit from structured, evidence-based care, you can find a certified TEAM-CBT therapist here.

Practice Assignment for You

Here's your homework (yes, therapists get homework too!):

1. Identify one fear in your own life - What are you avoiding?
2. Create a fear hierarchy - List situations from least to most scary.
3. Pick one item from your list - Start with something manageable.
4. Do it without safety behaviors - No phone, no mantras, no escape routes.
5. Stay with it until your anxiety drops by half.

If you're not willing to do this yourself, how can you ask your patients to do it?

If you're ready to strengthen your skills and gain hands-on guidance, explore our TEAM-CBT training and consultation groups for therapists.

Now get out there and help someone face their fears. Just maybe bring some jumping jacks into your next session!

With warmth and a gentle push toward the scary stuff, Jill (and David).

P.S. - If you found yourself thinking "I could never do that with my patients," congratulations! You've just identified your next growth edge. Time to sign up for supervision!

Appendix: TEAM‑CBT Roadmap

TEAM is an acronym for Testing, Empathy, Assessment of Resistance, and Methods—but more than just a checklist, it’s a structured roadmap that integrates the strongest predictors of successful outcomes into every session. It’s flexible and effective across anxiety, depression, OCD, trauma, habits, addictions—and more.

Core Components

• T — Testing: Use brief, validated measures (e.g., a daily mood log) at the beginning and end of every session to track progress, spotlight alliance ruptures, and pinpoint exactly where to focus your next move.
• E — Empathy: Before introducing any techniques, deeply understand the client’s experience by using the Five Secrets of Effective Communication—listening for emotions, reflecting accurately, validating feelings, asking gentle questions, and summarizing succinctly. These refined skills build trust, repair ruptures, and create a safe container so your client feels truly heard.
• A — Assessment of Resistance: This phase uncovers outcome resistance (good reasons NOT to change) and process resistance (good reasons NOT to do the work required for change). By surfacing the hidden “benefits” of a problem—using paradoxical invitations, cost–benefit analyses, and “magic button” questions—you transform resistance into genuine client‑driven motivation and collaboration.
• M — Methods: This phase taps into over 100 powerful cognitive, behavioral, and interpersonal interventions.. From cognitive restructuring and role‑plays to behavioral experiments and exposure therapy, each technique is tailored to your client’s unique needs, translating insight into targeted action for rapid symptom relief and lasting change 

Each method builds on the previous ones, creating a powerful sequence that honors resistance before attempting change—the heart of what makes TEAM-CBT so effective!

Biggest takeaway: TEAM‑CBT gives you a repeatable process you can use with every client, every session, for faster, deeper results.

Watch the full webinar here: CBT + Exposure Techniques That Work.