The second case study demonstrates the use of schema therapy with a chronically depressed patient. We shifted to schema therapy because Barbara’s depression was not lifting with stan- dard cognitive therapy. Although Barbara had learned how to challenge automatic thoughts with rational responses and had followed through on graded behavioral assignments to test her thoughts, she never believed the ratio- nal responses. Barbara had remained con- vinced that she was worthless, useless, and hopeless. Additionally, many of the behavioral assignments presented “catch-22” scenarios within her current life situation. It was neces- sary to add various emotive and experiential techniques that are part of schema therapy to access Barbara’s core beliefs. Core beliefs are the cognitive components of schemas. Schemas are deeply held emotionally based beliefs or EMSs that are unquestioningly experienced.
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