6 Keys to get WAY MORE out of Therapy

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Feb 26, 2026

Barry Fell, therapist and author with 20 years of clinical experience and trainer of over 100 therapists. He talks about making therapy goal-driven and measurable. They cover the power of a strong therapeutic relationship, using evidence-based frameworks, balancing insight with action, and practical steps like journaling and choosing the right modality.

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ADVICE

Use The Three C's To Structure Therapy

Work with your therapist to set a clear destination, concrete steps, and keep sessions concise so each visit moves you toward that goal.
Barry Fell calls this the three C's: Clear landing point, Concrete measurable steps, and Concise talking points aligned to the goal.

INSIGHT

Therapeutic Relationship Drives Outcomes

The therapeutic relationship explains far more outcome variance than techniques; fit and trust matter for effectiveness.
Emma McAdam: from therapist-controlled factors, 30% of outcome comes from relationship, 15% from hope, 15% from techniques.

INSIGHT

Safe But Challenging Therapy Produces Change

Therapy must balance safety with challenge; too much comfort can mean little progress while the right discomfort drives change.
Barry: therapeutic tension involves leaning into avoided situations so clients build new adaptive responses.

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In this conversation, Emma McAdam and Barry Fell discuss how to maximize the benefits of therapy. They share practical tips, including the importance of setting clear goals, the therapeutic relationship, and the balance between insight and action. They emphasize the need for clients to be proactive, such as bringing a journal to sessions, and the significance of discomfort as a sign of growth. The discussion also highlights the importance of evidence-based frameworks in therapy and how to measure progress effectively.

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Therapy in a Nutshell and the information provided by Emma McAdam are solely intended for informational and entertainment purposes and are not a substitute for advice, diagnosis, or treatment regarding medical or mental health conditions. Although Emma McAdam is a licensed marriage and family therapist, the views expressed on this site or any related content should not be taken for medical or psychiatric advice. Always consult your physician before making any decisions related to your physical or mental health. In therapy I use a combination of Acceptance and Commitment Therapy, Systems Theory, positive psychology, and a bio-psycho-social approach to treating mental illness and other challenges we all face in life. The ideas from my videos are frequently adapted from multiple sources. Many of them come from Acceptance and Commitment Therapy, especially the work of Steven Hayes, Jason Luoma, and Russ Harris. The sections on stress and the mind-body connection derive from the work of Stephen Porges (the Polyvagal theory), Peter Levine (Somatic Experiencing) Francine Shapiro (EMDR), and Bessel Van Der Kolk. I also rely heavily on the work of the Arbinger Institute for my overall understanding of our ability to choose our life's direction.

And deeper than all of that, the Gospel of Jesus Christ orients my personal worldview and sense of security, peace, hope, and love https://www.churchofjesuschrist.org/comeuntochrist/believe

If you are in crisis, please contact the National Suicide Prevention Hotline at https://suicidepreventionlifeline.org or 1-800-273-TALK (8255) or your local emergency services.