How TEAM-CBT Helped a Client Feel Less Stuck in Depression: A Six-Session Case Study
By Gunjan Arya, Counselling Psychologist and Advanced TEAM-CBT Therapist
People with depression usually know what they’re supposed to do. Exercise, meet friends, think positive. Knowing doesn’t help, and the gap between knowing and doing often makes them feel worse.
That’s because depression isn’t only a thinking problem. It carries old emotional pain, a harsh inner critic, and a hopelessness that has often built up over years.
I use TEAM-CBT in my practice. Dr. David Burns developed it, and it builds on cognitive behavioural therapy with a strong focus on empathy, motivation, and measuring progress. Below is a case from my work, with details changed to protect the client’s identity, showing what six sessions looked like.
Who she was
She was 32, a working professional, and had been low for several months. She cried often, avoided social plans, criticized herself constantly, and felt like a failure. Nothing gave her joy. She was still doing her job, but she felt exhausted and cut off from her own life.
Her most frequent thoughts were:
- “I am not good enough.”
- “Everyone else is moving ahead.”
- “I always fail.”
- “Nothing is ever going to change.”
She believed these were facts, not interpretations. Most people with depression do.
How TEAM-CBT works
Many people expect therapy to start with challenging negative thoughts. TEAM-CBT starts somewhere else. TEAM stands for:
- Testing: we measure symptoms at every session, so progress is visible and not guessed.
- Empathy: I try to understand her experience fully before attempting to change anything.
- Assessment of resistance (agenda setting): instead of fighting the symptoms, we ask why they might make sense.
- Methods: only then do we use specific techniques.
The six sessions at a glance
| Session | Focus | What shifted |
|---|---|---|
| 1 | Listening | She felt understood |
| 2 | Daily Mood Log | She saw her thinking distortions |
| 3 | Positive reframing | Shame eased |
| 4 | Core belief | She doubted her inner critic |
| 5 | Behavioural experiments | She acted despite fear |
| 6 | Relapse prevention | She had tools of her own |
Session 1: feeling understood
Many clients arrive after months or years of feeling misunderstood, so I spent the whole first session on her experience. She talked about the breakup that set off the episode, how quickly she blamed herself, her fear of disappointing people, her perfectionism, and her loneliness.
I offered no reassurance and no solutions. Near the end she said, “I don’t think anyone has understood how difficult this has been for me.” That told me we could start.
Session 2: reading the depression story
We used a Daily Mood Log to look at one recent moment. A colleague had been recognized at work, and her mind went straight to “I am falling behind,” “Everyone is more successful than me,” and “There must be something wrong with me.”
Together we found four distortions in those thoughts:
- All-or-nothing thinking: success only counted if it was perfect.
- Discounting the positive: she brushed aside her own achievements.
- Mind reading: she assumed others saw her negatively.
- Emotional reasoning: she felt inadequate, so she concluded she was.
For the first time, she wondered whether her thoughts were entirely accurate.
Session 3: what the depression was protecting
In TEAM-CBT we don’t ask how to get rid of depression. We ask what it might be doing for the person. She found this odd at first.
Then the list appeared. Her depression reflected a wish to be responsible, a commitment to improving herself, deep care for her relationships, high standards, and a lot of empathy. None of those values were the problem. They had grown extreme and turned against her. Seeing that took some of the shame out of the room.
Session 4: testing “I am not enough”
One belief sat under almost everything: “I am not enough.” It showed up in her relationships, her career, her family’s expectations, and her own achievements. We looked at the evidence for and against it.
The exercise that landed hardest was simple. I asked how she would treat a close friend in her position, and how she treated herself. The difference was obvious to her right away. Friends got patience and compassion. She got blame. From there she started asking whether her inner critic was telling the truth.
Session 5: acting before feeling confident
Her mood had lifted, but she was still avoiding anything she might fail at. She skipped social invitations, hesitated over career opportunities, and put off decisions for fear of getting them wrong.
Avoidance feels safe, but it usually feeds depression. So we designed small behavioural experiments. She didn’t wait to feel confident. She acted while uncertain. She went to a gathering she had been dodging and told me afterwards, “I actually enjoyed myself more than I expected.”
Session 6: making it last
By the sixth session she reported better mood, more energy and motivation, more time with people, less self-criticism, and more hope about the future. [Add her before and after scores here, for example from the Burns Depression Checklist.]
We spent the rest of the time on relapse prevention: spotting early warning signs, continuing to track her mood, practising self-compassion, and using the tools without me. She summed it up this way: “I still have difficult days, but I no longer feel trapped by them.”
What made the difference
I don’t think any single technique did it. She felt understood first, which lowered her isolation and shame. Once she saw that her depression made sense, it was easier to question her thoughts. Action then gave her real evidence to work with, and measuring every session showed us what was helping and what wasn’t.
A note on results
This is one client’s story. Every person is different, and six sessions is not a promise. Some people need more time, and some need a different approach.
She didn’t become someone else. She changed how she related to her thoughts and to herself.
If you’re struggling with depression
Reaching out is a real first step, even when it feels too small to count. I see clients in Paschim Vihar and online. You can book a session through psychtherapy.in
Gunjan Arya
Counselling Psychologist, Founder of Psych Therapy
Advanced TEAM-CBT Therapist
