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1.1 Understand the history of ideas about mental illness, their treatment and the debates around these issues


The assignment

Cut-off date: 24 May 2022

Important These pages provide guidance on how to write your assignment. Please ensure you read all of this information right through until the checklist at the end.

Before you start work on this assignment, please ensure that you have read the Assessment guidance specific to this module and are familiar with the advice in the Social Sciences Assessment Information. These sources contain support and guidance that you may need in writing your EMA, including, for example, advice on plagiarism and the marking system. Guidance on referencing is available on the Library’s Referencing and plagiarism page. You will be following the Cite them Right (CTR) Harvard style. Note that you will likely do better in this assessment if you follow this guidance.

There are two parts to this EMA. Please note that you must complete both Part 1 (Report) and Part 2 (Reflexive review). On the following pages you will find guidance on how to complete this assignment.

The task: Report and reflexive review

This EMA contributes 40% towards your overall module result.

Please be aware that the regulations on word limits and deadlines for EMAs are different to those for TMAs. Check the EMA guidance below, and in the module Assessment guidance, carefully.

Part 1 Report (worth 80% of the EMA)

Write a report that provides a justification for the mental health interventions to be delivered by an organisation that seeks to improve the levels of mental health within a community (as described in the hypothetical scenario provided in the next section). Your report should be suitable for reading by a non-academic audience.

Word limit: 2400 words

Part 2 Reflexive review (worth 20% of the EMA)

  • Discuss the meaning of ‘reflexivity’ and how counsellors might make ‘therapeutic use of the self’ in their work with clients.
  • Explain which of the three therapeutic modalities addressed on the module (psychodynamic, person-centred and cognitive behavioural) you are most drawn to and least drawn to.
  • Reflect on your preferences with reference to your own process of self-reflection over the course of the module.

Word limit: 600 words

In the following pages you will find:

  • learning outcomes addressed by this assignment
  • student notes for this assignment that will help you with the focus of the task, the structure, tips for writing and pointers to relevant material
  • pointers to the relevant material
  • a checklist to ensure you have done everything required for this assignment.

Scenario for Part 1 Report

The scenario you should base your Part 1 Report on is:

This exercise requires that you put yourself in the position of someone who works for an organisation that has experience of providing mental health services to the town of ‘Middleton’. A national charity has identified Middleton as an area that suffers from high levels of mental health distress; it has been noted that there are significant rates of depression and anxiety. The town is ethnically diverse and has also recently witnessed increases in unemployment, as it has been badly hit economically by Covid-19 disruption. The national charity is willing to fund local organisations such as yours to provide new services that will ameliorate the problems.

You are asked to provide a justification for receiving funding for the services that you would like to provide. Your organisation takes a service user-led, collaborative approach, meaning that all services are co-produced by professionals and people who have experience of using mental health services. Both professionals and service users are represented in the leadership of the service.

Your service seeks funding to provide interventions at two levels:

1. Individual psychotherapy where clients can self-refer or they might be referred by another agency.

2. Activism and campaigning within the community. This might involve campaigning and working with the local community on issues that have been identified as significant to mental health, such as social cohesion, inequality and racism.

You are required to deliver a report that presents an outline of the interventions that you would like to provide and a justification for their provision.

You have been informed that the people reading and assessing the report are not experts in mental health or psychology. They want to understand the reasons behind each of these interventions, and the evidence that exists to support the approach.

Learning outcomes

1 Knowledge and understanding

  • 1.1 Understand the history of ideas about mental illness, their treatment and the debates around these issues.
  • 1.2 Sound knowledge and critical understanding of key concepts, theories, research and practices relevant to counselling.
  • 1.3 Awareness of the importance of social and political factors with respect to diversity and difference in mental health and counselling.
  • 1.4 Understanding of the importance of ethical issues in researching and practicing in mental health and counselling.
  • 1.5 Awareness of the links between issues of mental disorder and the criminal justice system.
  • 1.6 Understanding of critical debates on the role that mental health and counselling services play in society.

2 Cognitive skills

  • 2.1 Construct arguments with appropriate use of evidence, concepts and theories.
  • 2.2 Identify, select and critically evaluate different theories/arguments and types of evidence.
  • 2.3 Consider and compare the strengths and weaknesses of different methods of practice and research used in mental health and counselling.

3 Key skills

  • 3.1 Apply knowledge, understanding and skills to critically evaluate and formulate evidence-based arguments.
  • 3.2 Comprehend and produce written and spoken texts in appropriate academic language, and appropriately referenced, for the discipline of mental health and counselling, including primary texts and secondary sources.
  • 3.3 Use a range of digital practices (including tools and resources) to find, use, create and share information and knowledge relevant to mental health and counselling practice and research.

4 Practical and/or professional skills

  • 4.1 Understand the significance of reflexivity in terms of your own learning and your responses to issues of mental health and counselling.
  • 4.2 Critically identify and plan appropriate professional responses to mental health problems.

Student notes for Part 1

The following notes provide guidance on how to write Part 1 of your assignment and explain how it will be marked.

In addition to these notes, the module team have provided you with the Assessment marking grid which sets out how your work will be assessed for all assignments. Marking grids are used by the emarker to grade your EMA. They are therefore useful tools for you to use as they clearly explain what the marker will be looking for.

You should use this feedback to help you improve your work when you complete any future assignments.

If you feel at all uncertain about how to work with any part of these notes, consult your own tutor for advice.

Focus of the task

This task will assess your understanding of some of the ethical dilemmas encountered in the field of mental health and the importance of ‘service-user’ perspectives. It will assess your skills in evaluating evidence about mental health issues and research about the usefulness of the interventions available. You will also need to demonstrate your knowledge of how mental health issues can be understood to be embedded in social conditions and that interventions might be planned to operate at that level.

You will need to demonstrate that you are able to select and present relevant arguments and evidence from a range of sources gathered across the module.

Writing your assignment

This section provides guidance on how to approach your assignment – what the assignment is asking you to do and what you need to consider in order to provide a good answer.

Process and content words

You are being asked to write a report that provides a justification for the planned mental health services. The key process word here is therefore ‘justification’ – or ‘justify’. This means that you need to provide evidence and arguments that support the claims you make about the interventions that your service wishes to provide.

The important content words are ‘mental health distress’ and the ‘interventions’ that are designed to improve ‘mental health’. You are told that levels of depression and anxiety are particularly high. So you will need to demonstrate some awareness of the debates about the nature of these difficulties and what relieving them might mean. Remember there might be different perspectives on this – there might be differences between the point of view of the people who may be seen as having difficulties and those of the community.

You will need to write in a balanced way that demonstrates your ability to evaluate evidence and arguments, and show awareness of counter-evidence and counter-arguments.


The report should have the following structure (the word lengths should be used as a guide):

Introduction: (200 words).

This should briefly explain the background to the report, and summarise its important points, including a brief rationale and purpose of the interventions that would be provided.

A service user-led approach: (600 words).

This section should provide a justification for why your organisation seeks to take a service user-led approach and what can be gained from this way of working. A good answer will show critical awareness of the significance of the service-user movement and some of the key criticisms that have been made of mental health service delivery. It will include awareness of the ethical and practical advantages of service-user involvement alongside some of the potential obstacles and difficulties that can be encountered.

Individual therapy: justifying using the individual modality (700 words).

Here you need to briefly describe the nature of the first intervention which is a form of individual psychotherapy. You should choose one of the treatment modalities that you have focused on in the module. You should select either a CBT, OR a psychodynamic, OR a person-centred/humanistic approach.

You should justify the use of the approach by referring to relevant literature. You will need to demonstrate critical engagement with relevant theory and research evidence to back up the claims that you are making. You should avoid spending too much time describing the intervention as higher marks will be awarded for explaining concepts and using research evidence to back up your claims.

Community activism/campaigning: an intervention that supports community campaigning or a community-based mental health initiative and the justification for this (750 words).

You need to briefly describe the intervention – what it is and what it aims to do. You will need to use relevant literature and research evidence to justify the approach. You need to explain the rationale of a community-level intervention and why you believe that it would work, and the expected impact of taking this approach on mental health. You might want to focus on a particular issue, such as social cohesion, inequality or racism. As in the earlier section on the individual intervention, you should avoid spending too much time describing the intervention as higher marks will be awarded for provision of theory and evidence that provide the rationale for the intervention. The rationale might include the positive impact on the mental health of individuals suffering from distress, but might also include the benefits to the community (such as a reduction in crime, for example).

An example of an intervention that supports community-level campaigning would be provision of support, advice, facilities and resources for a peer-led group campaigning to improve a particular issue in the area (such as poor employment prospects for young people locally or the lack of support for families with young children).

An example of a community-led mental health initiative would be a weekly ‘coffee morning’ peer-led group with a crèche supporting parents of under-fives where the parent is experiencing depression.

Examples of campaigns that are aimed at the wider community might be those that aimed to: draw attention to the impact of poverty and sought to reduce poverty in the area, or strengthen social cohesion, or enhance the capacity of the community itself to provide support for its members, or reduce levels of stigma.

Conclusion: summarise the main arguments for the approaches that you have adopted (150 words).

Approaching the task

An important element of writing this part of the EMA is to remember your audience and write appropriately for them. Your audience has been identified as non-academic, so you should not assume familiarity with psychological concepts, theories or terminology. If you use specialist terminology you should define the term first. You should also use a format that is appropriate for a report, presenting your material in an appropriate style and using the structure outlined above so that it is clear and concise.

You may use sub-headings. You can use non-textual elements if they help to convey your points, such as tables, graphs, figures or diagrams. However, words associated with figures will count towards the word count, so do make sure that any such elements serve a useful function in your report: do not include them just for the sake of it. The highest marks will still be possible for reports which don’t use them. If you use non-textual elements, make sure you put them in the main body of your report (not in an appendix) and explain and reference them sufficiently in the text.

For good marks you should draw on material from across the module, so when selecting which material to cover make sure you demonstrate a breadth of knowledge (e.g. don’t draw exclusively, or very heavily, on just one topic, no matter how interesting you find it).

You should also draw on at least two additional sources of material that you have found through independent study to help illustrate your points. These might be recent research papers that you might have found through the Open University Library, for example. However, you should make sure that you use these to support points that are based on examples from within the module, rather than introducing entirely new topics or areas.

Relevant material

There is relevant material across the module for use in this EMA. This is a brief guide to where you can find relevant material pertinent to different aspects of the question.

The significance of the service-user involvement

In Block 1 you will find important material that introduces some of the debates about the mental health system and some of the difficulties encountered by service users.

Week 2 presents some of the key contrasting claims made about the mental health services and the extent to which they have developed in order to support and/or control people. Week 2 and Chapter 1 present some of the ethical dilemmas of mental health service delivery – notably those concerning issues of liberty and confinement.

Week 3 looks at some of the major criticisms of psychiatry; by academics, from within the professions and by service users. Chapter 2 looks directly at the service-user movement. Week 5 looks at some of the negative experiences that people can have of being diagnosed. This might also be useful to your answer.

Presenting problems

Block 2 introduces sadness and worry in Week 7 and Chapter 5. Also Week 4, Section 3.3 (and Chapter 9, p. 263) describes Freud’s work on depression.

Chapter 11 (p. 324) describes the humanistic approach to depression. It might also be helpful to remember Fariha’s experiences of depression and the psychodynamic understanding of her problems presented in Week 12. Gosia had experiences of anxiety, and the CBT approach to this is explored in Week 13.

Treatment modality

There is an introduction to the three main treatment modalities in Block 1, Week 4.

Each modality is discussed in detail in Block 3:

  • Week 12 psychodynamic
  • Week 13 CBT
  • Week 14 humanistic and person-centred approaches.

Issues of research and evidence are discussed throughout the module. Particular attention to some of the complexities of evidence are discussed in Block 5, Week 22 and in Chapter 17.

It will also be useful to refer to material on the importance of the therapeutic relationship (Block 4, Week 17) and on the ethics of practice (Block 4, Week 20).

Activism and the significance of community

You should demonstrate that you have a good understanding of the issues that are raised in Block 5. You are being asked here not to think about treatments that are aimed at individuals but to consider the social context of mental health. This means thinking about not only how social conditions might cause mental distress (Week 24 and Chapter 19), but the reciprocal relationship between good mental health and social conditions.

The relationship between matters of criminal justice and mental health (Week 23 and Chapter 18) might be a particular example of mental distress that can have wider impact on the community, but also you might want to think about strategies that prevent mental distress (the significance of early childhood might be a matter to consider). Week 25 and Chapter 20 look at how society itself might have been shaped by some of the ideas we have about the nature of mental health – some of the pros and cons of this impact might be considered here.

Student notes for Part 2

Focus of the task

Part 2 of this EMA is designed to assess your understanding of the topic of reflexivity, and to apply this understanding to its potential significance for counselling and psychotherapeutic work with clients. You need to demonstrate the capacity to reflect on your own thinking and preferences.

Writing your assignment

This section provides guidance on how to approach this part of your assignment – what the assignment is asking you to do and what you need to consider in order to provide a good answer.


This is a short assignment and needs to directly address the three requirements:

  • Discuss the meaning of ‘reflexivity’ and how counsellors might make ‘therapeutic use of the self’ in their work with clients.
  • Explain which of the three therapeutic modalities addressed on the module (psychodynamic, person-centred and cognitive behavioural) you are most drawn to and least drawn to.
  • Reflect on your preferences with reference to your own process of self-reflection over the course of the module.

Tips for writing

The module has stressed the importance of reflexivity from the beginning. You were encouraged to keep a journal and so it is likely that you will be able to review your own writing and this will help inform your reflections. You will not have space to include extracts from your journal but you can use the entries to help review your thoughts and feelings as you have progressed through the module. Given the nature of the assessment, it is certainly acceptable to use the first person and indeed that is likely to make for greater clarity.

Remember to reference as appropriate – when you are referring to theories, or ways of approaching reflexivity, for example.

It is important that you address each of the points requested.

Relevant material

Week 1 introduces and defines reflexivity and outlines the professional requirement for it. You are also introduced to the journal task here.

The significance of personal experience and reflexivity in the field of mental health and counselling is discussed in Week 3 (Sections 1 and 2). There was also more here on the importance of personal reflection in your journal.

In Block 2, Week 7 and Week 9 you are asked to use your journal to think about how your mood might impact on your study, and to reflect on your own relationships.

In Block 4, Week 17 there is discussion about the importance of the therapeutic relationship and you are asked to think about your own experiences of empathy. Week 18 asked you to be culturally reflexive and to draw your own cultural genogram.

The importance of personal experience is also addressed in Block 4, Week 20 (particularly Section 4.1).

Block 5, Week 25, Section 8.1 directly introduced this task and presented an exercise (using a Johari window) that should help you reflect on yourself and on the approaches to which you have been introduced.

Final note for both Parts 1 and 2

As with all assignments, it is very likely that you will need to complete a ‘good draft’ well ahead of the submission date. This will give you plenty of time to redraft and strengthen your report. It is important to make sure that you have time to reread the report before the submission date. This will allow you to pick up on spelling and grammatical errors, while also helping you to check that your arguments are coming through clearly.

If you are still unsure whether you have responded directly to the question, it is worth challenging yourself to consider whether you would be able to guess the task for the report simply from what you have written – it should be clear from your introduction. You could perhaps ask a friend or family member to test this for you.

As this report is written as an assignment in an academic context it should be referenced as usual. Citations should be appear in the body of the report and in the references section at the end. If you are unsure about how to cite please check Cite them Right (CTR) Harvard referencing.

Remember to state the word count at the end of each part of your EMA. For D241, both the assignment title, which you should include at the start, and the reference list are excluded from the word count.

Marking criteria

Please note that the Assessment marking grid is being used to mark your work on this module. These criteria will be used to mark your report.

Study skills

The following specific study skills have been covered in the block:

  • Week 2, Section 5.2, ‘Finding and handling information’
  • Week 3, Section 2, ‘Reflexivity – keeping a journal’
  • Week 4, Section 7, ‘Essay writing and “the talking cure”’
  • Week 5, Section 4, ‘Quality of sources’
  • Week 7, Section 7.3, ‘Using the WWW framework to evaluate sources on worrying’
  • Week 8, Section 5.1, ‘Searching the literature and using the library’
  • Week 22, Section 2, ‘Critical reading’
  • Week 23, Section 7, ‘Accurately reporting evidence’
  • Week 24, Section 4.4, ‘Structuring a report’
  • Week 25, Section 7.1, ‘Preparing for the EMA – drawing on reports’
  • Week 25, Section 8, ‘Preparing for the EMA – reflexive reviewing’.


Use this checklist to make sure that you have completed everything before you submit your assignment.

Have I made sure I understand the question? Look at Getting started in ‘Social Sciences Assessment Information’. See also Understanding the question in ‘Skills for OU Study’. Have I read all of the guidance notes for this assignment? Carefully read through the student notes that accompany your assignment to check that you have followed all the advice and instructions.

Have I actively studied the relevant module material and anything else to which I’ve been directed? See the booklets Reading and taking notes and Thinking critically. Have I reflected on my learning, including feedback received on earlier assignments, in order to improve my skills? See section 2, ‘Active learning’ and section 4, ‘Being reflective’ of the booklet Developing effective study strategies . See also Learning from feedback in ‘Skills for OU Study’.

Have I thought about how best to structure my answer and questions of style and language? Further advice on structuring answers is available in the relevant sections in ‘Social Sciences Assessment Information’; see, for example, Skill: Essay writing. For questions relating to style and language, see the section Presentation and language in ‘Social Sciences Assessment Information’. See also Developing academic English and Writing for University in ‘Skills for OU Study’; and section 7 ‘Choosing a writing style’ and section 8 ‘Improving your written English’ of the booklet Preparing assignments.

Have I written in my own words? Guidance on writing in your own words is available in the sections on Understanding plagiarism and Writing in your own words in ‘Social Sciences Assessment Information’.

Have I, where necessary, used evidence to back up my arguments, and referenced correctly? Advice on using evidence to support your arguments is available in the section on Selecting your examples in ‘Social Sciences Assessment Information’. See also Gathering your materials in ‘Skills for OU Study’. Guidance on referencing is available on the Library’s Referencing and plagiarism page.

Have I checked my word count? The assignment tells you the word limit for the EMA. An answer that is shorter than the word limit by more than 10% is likely to be too short to have fully answered the question. An answer that exceeds the word limit by more than 10% may be penalised. For further information see the section on Word limit in ‘Social Sciences Assessment Information’.

Have I written the word count at the end of my EMA? Check the word count and write that figure clearly at the end of each part of the EMA.

Have I set out my assignment properly? See Section 3.3 ‘Conventions for presenting written work’ in your module’s ‘Assessment Guidance’, which you will find under ‘Assessment’ on the module website. Have I completed each part of the EMA? Read through the assignment notes carefully to check that you have completed all the necessary tasks.

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