Getting the Most Out of Every Session: Accelerating Therapy with TEAM-CBT

A Webinar Summary for Therapists

Hey everyone,

What a treat this webinar was! Angela and Kevin shared practical wisdom about making therapy more effective—whether in traditional 50-minute sessions or intensive formats. The heart of both approaches? Using TEAM-CBT with structure, skill, and intentionality so clients recover faster and more fully.

Let me walk you through what they covered, and I think you'll find some gems here that could transform your practice.

Making Every Minute Count in Traditional Sessions

Presented by Dr. Angela Krumm

Angela started with a reality check that might sting a little: The 50-minute therapy hour wasn't designed based on what works best for clients. Freud basically invented it for his own convenience. We've been following that tradition ever since, often without questioning whether it serves our clients well.

But here's the thing—Angela isn't saying we need to abandon the 50-minute session. Instead, she's saying: Let's use it brilliantly.

Before the First Session: Being a Good Party Host.

Angela shared this wonderful metaphor about being invited to a dinner party where you have no idea what to expect. Remember that uncomfortable feeling? That's exactly how our clients feel when they don't know what therapy will be like with us.

Key TEAM-CBT Principle: Set Clear Expectations

She emphasized that we need to be explicit about:

• Client roles and responsibilities: Arriving ready to work, doing homework, completing symptom measures, helping balance supportive talk with active work.
• Therapist roles and responsibilities: Creating treatment plans collaboratively, staying on track, assigning meaningful homework, balancing empathy with action.

This isn't about being rigid—it's about being respectful. When clients know what to expect, they can make informed choices about whether this approach is right for them.

The Beginning of Each Session: Structure Creates Freedom

Angela recommends covering three things in the first 5-10 minutes:

1. Review testing data / measures (T in TEAM)

This isn't cold or clinical—it's actually a beautiful empathy tool.

• When you review their scores, you get a complete emotional snapshot.
• You can connect deeply around what they're experiencing.

2. Review homework

If you don't check homework, expect near-zero compliance.

• We're all busy people—why would clients do work that nobody reviews?

3. Issue an invitation to work

• Example: "Last time we planned to work on X. Do you feel ready to jump in, or do you need more support?"
• This honors their autonomy while moving toward productive work.

TEAM-CBT Technique Alert: The Invitation Step This is one of the five steps of Agenda Setting. You're not pushing—you're genuinely asking if they're ready to work, while also making it clear that supportive talk alone won't create lasting change.

During the Session: Focused Intentionality

1. Stay Organized

• Have clients track their learning in writing.
• List methods that work for them.
• Long-term success depends on clients knowing what helped and being able to repeat it.

2. Focus on One Problem at a Time

• Humans naturally jump around topics.
• Your job: gently, empathically bring them back.
• Real skill-building requires depth, not breadth.
   

3. Think Ahead About Homework

• Keep a sidebar of notes during session.
• Jot down possible homework as ideas emerge.
• This prepares you for a smooth ending.

Pearl of Wisdom: When we let clients jump from topic to topic, we're actually doing them a disservice. They leave feeling heard but without tools. When we lovingly help them stay focused, they learn skills they can use for life.

Ending the Session: The Power of Planning

Angela recommends 2-10 minutes for wrapping up, focusing on:

Meaningful Homework (Two Types):

1. Practice what we learned

• Example: After teaching the Daily Mood Log, assign seven more—one per day.
• Master the skill through repetition.

2. Bridge to next session

• Prepare for the next step in treatment.
• Example: "Finish these self-control rebuttals so next session we can practice them in role play."

State a Tentative Plan for Next Session

• This is a gift to your client.
• Takes 30 seconds.
• Helps them feel held and know there's a path forward.
• Yes, plans can change—that's okay!
• Homework: Reading and finishing methods work.

The Power of Intensive Therapy

Presented by Kevin Cornelius, LMFT

Kevin opened with vulnerability—sharing his own initial fears about doing intensive therapy. Even with great training, the idea of someone flying in from another country to work with him for just one week felt terrifying. But you know what? His fear was in his head. Once he focused on the client, the fear disappeared.
 

What Is Intensive Therapy?

Intensive therapy is longer, more frequent sessions over a short period to accelerate recovery.

The Research Backs It Up: Studies show that condensed, intensive treatment produces stronger outcomes than spreading the same content over many weeks. It's not just anecdotal—it's evidence-based.

Kevin's Results: The Numbers Don't Lie

Kevin shared data from his 10 most recent intensive clients:

• Average 65% reduction in depression.
• Average 64% reduction in anxiety.
• 100% of clients reached subclinical levels (scores below 5 on 0-20 scale).

These aren't just statistically significant—they're life-changing.

Why Intensives Work So Well

1. Momentum

• No "three steps forward, two steps back" pattern.
• The ball keeps rolling downhill.
• Quick relief from painful symptoms.

2. Empowerment Through Skills

• Like "mini graduate school" to become your own therapist.
• Tools for life, not dependency on the therapist.
• Kevin's goal: Make himself unnecessary.

3. Perfect for Specific Situations

• Students on break.
• Medical leave from work.
• Stepping down from hospitalization/PHP.
• Living far from qualified therapists.
• Using vacation time to make major progress.

Pitfall to Avoid: Don't assume intensive therapy is just "more of the same" crammed into less time. It requires specific skills in managing resistance and maintaining focus. Without proper training, longer sessions might just mean more unfocused conversation.

Who's a Great Fit for Intensives?

Green Lights:

• Stable (not in crisis).
• Can set specific goals.
• Willing to work on one problem at a time.
• Enthusiastic about homework.
• Can handle longer sessions.
• Available for intensive schedule.

Red Lights:

• Active suicidal crisis without safety commitment.
• Prefers long-term supportive counseling.
• Being dragged in by family (not their idea).
• Active substance use needing detox.
• Can't tolerate session length due to stamina/disability.

Cultural Sensitivity Note: Kevin emphasized flexibility. Not all cultures value goal-oriented treatment the same way. Adjust the goals, respect individual needs, and never force a cookie-cutter approach.

The Intensive Process

Before Starting:

1. Initial consultation - Assess fit, explain model, check motivation.
2. Goal setting session (50 min) - Set 1-3 specific, achievable goals.
3. Pre-intensive homework - Usually reading (Feeling Great, When Panic Attacks, etc.)

During Treatment:

• First session often includes: 30-45 min empathy, 45 min resistance work, 30 min methods, 15 min homework/testing.
• Use T-E-A-M structure throughout.
• Testing before/after every session.
• Empathy is constant, not just a phase.
• Melting resistance is essential for rapid change.
• Focus on one goal at a time (even more critical than in weekly therapy).
• Homework between intensive sessions.

Ending Treatment:

• Relapse Prevention Training (critical!).
• Treatment summary document.
• Recommended ongoing homework.
• Usually 2 weekly follow-up sessions to maintain gains.

Looking to experience this approach firsthand?

Find a CBT Therapist

Case Example: Cynthia's Breakthrough

Cynthia was a successful TV writer whose anxiety about money increased with her income—a painful paradox. She had an "anxiety spiral" around buying a new car, followed by guilt and depression.

Goals Set:

1. Learn skills for managing anxiety more healthily (lower avoidance, increase tolerance).
2. Learn skills for lowering depression.

Pre-intensive homework: Reading When Panic Attacks 20-30 min daily.

Schedule: 12 hours over 2 weeks (later extended to 14 hours due to travel).

First Session Results (2 hours):

• 30 min pure empathy.
• 45 min melting resistance (TEAM Agenda Setting).
• 30 min cognitive methods.
• 15 min homework assignment and post-testing.
• Result: 50% reduction in depression, 46% reduction in anxiety.

Final Results:

• 67% reduction in depression.
• 77% reduction in anxiety.
• Symptoms in healthy range (0-5 on scale).

Key Takeaways: The Essential Principles

1. Experience Alone Doesn't Make Us Better Therapists
 

Research shows therapists actually get slightly less effective over time without deliberate practice and feedback. What works? Learning skills → practicing → getting feedback → practicing more.

2. Structure Liberates, It Doesn't Constrain

• Clear expectations help clients feel safe.
• T-E-A-M provides a roadmap.
• Organization during session enables depth.
• Planning creates momentum.

3. Homework Is Non-Negotiable

• Most learning happens between sessions.
• Without homework, clients may actually get worse.
• Check homework or expect zero compliance.
• Make it meaningful: practice what was learned OR bridge to next session.

4. The Invitation Step Changes Everything

Instead of just talking endlessly, we respectfully ask: "Are you ready to work on this, or do you need more support?" This honors their autonomy while maintaining therapeutic focus.

5. One Problem at a Time

This might be the hardest skill to master, but it's essential. When we help clients stay focused, they actually learn tools. When we let them jump around, they feel heard but leave without skills.

6. Tell Them the Plan

End every session with a tentative plan for next time. It takes 30 seconds and helps clients feel held and hopeful.

7. Intensive Therapy Isn't Just Longer Sessions

It requires:

• Excellent skills in melting resistance.
• Ability to maintain focus under time pressure.
• Strong case conceptualization.
• Confidence in your own skills.
• Willingness to make yourself unnecessary.

8. Testing Isn't Cold—It's Connection

When you review mood scores, you're getting a complete emotional picture. It's one of the most empathic things you can do.

Ready to strengthen your clinical work?

Training & Consultation Groups

Your Practice Assignment

Here's your homework (yes, you!):

This Week:

1. Before your next client session, write down:

• 3 client role expectations you want to make explicit.
• 3 therapist role expectations you'll commit to.
• Share these in your intake or next session.

2. At the start of your next 3 sessions, practice the three-part opening:

• Review testing (even if brief).
• Check homework (even if just asking).
• State the plan/issue invitation to work.

3. At the end of your next 3 sessions, state a tentative plan for next time (even if it's just one sentence).

4. Reflection question: How often do you let clients go off-topic because YOU feel anxious about redirecting them? Write about this. Be honest. We all do it.

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 & 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!

Final Thoughts

What Angela and Kevin demonstrated isn't just about technique—it's about respect. Respect for clients' time, their suffering, and their potential to change. When we bring structure, intentionality, and evidence-based methods to our work, we're saying: "Your time matters. Your growth matters. I'm going to do everything I can to help you get better."

And here's the beautiful paradox: When we're more directive and structured, we're actually more empathic. We're not wasting clients' time. We're not letting them spin in circles. We're partnering with them to build real, lasting skills.

Whether you do this in 50-minute sessions or intensive formats, the principles remain the same:

• Test to know where you're going.
• Empathize deeply to build trust.
• Honor resistance before methods.
• Teach skills clients can use without you.
• Assign meaningful homework.
• Stay focused on one problem at a time.
• End with a plan.

Now go practice. Stumble. Learn. Try again. That's how we all get better.

Getting the Most Out of Every Session—watch the full webinar and elevate your clinical work.

With warmth and high standards,

Jill Levitt, Ph.D., and the Feeling Good Institute team.