Question 112 marks
Question
(a) Explain what is meant by ‘bipolar’ disorder. [2] (b) Describe cognitive restructuring (Beck, 1979) as a treatment for depression. [4] (c) Explain one strength and one weakness of cognitive restructuring as a treatment for depression. [6]
Mark scheme
1(a) Explain what is meant by ‘bipolar’ disorder. 2 Award 1 mark for a basic explanation of the term/concept. Award 2 marks for a detailed explanation of the term/concept. For example, Two strongly contrasting phases of mood. (1) Periods of severely elevated mood followed by periods of very low mood lasting for several weeks or months. (2) Other appropriate responses should also be credited. 1(b) Describe cognitive restructuring (Beck, 1979) as a treatment for 4 depression. Award 1–2 marks for a basic answer with some understanding of the topic area. Award 3–4 marks for a detailed answer with clear understanding of the topic area. For example, This is where the patient participates in a number of therapy sessions over weeks and/or months to alleviate their symptoms of depression. (1) As it is believed the depressive symptoms are due to faulty thinking the therapist will help the patient to identify their faulty thinking and then correct these thinking patterns to more helpful ways of viewing themselves, the world and the future.(1) Initially the patient and therapist will identify what the thinking patterns are and the patient will be helped to come up with alternative thoughts. (1) The patient then goes away between sessions and practices these alternative thoughts which should then lead to more helpful behaviours which will lead the patient to feel more hopeful and positive.(1) Other appropriate responses should also be credited. 1(c) Explain one strength and one weakness of cognitive restructuring as a 6 treatment for depression. Likely strengths include – • Effectiveness of treatments – shown to be as effective as SSRIs for treating depression and give a toolkit for patients to use in the future if the depressive symptoms return. • Treatment does not have any side effects like medication and the patient has learned techniques to help with depression should they relapse in the future. • Can be inexpensive for the patient as could be offered for free in some countries • Fairly quick compared to other therapies as around 6–8 sessions. Psychotherapy can take over a year. • Empowering the patient – their free will is acknowledged and the patient is actively involved in their treatment. Likely weaknesses include – • Appropriateness of treatments as some patients will not want to discuss their personal problems with a therapist. OR some patients may be so severely depressed they cannot engage with the therapy. • Cost of treatment. Therapist’s time must be paid for either by the patient or by the health service. Therapists can charge £50–100 for a 50 minute session. This could lead to the patient feeling more depressed if they suffer financial hardship paying for the treatment. • Time consuming. Takes 6–8 sessions but can be offered up to 12. Some therapists will have two weeks between treatments so it could take almost six months to finish the therapy. For someone who is very depressed and might engage in self-injurious behaviour waiting for the therapy to get to the point where it is helpful might be dangerous. • Lots of effort/motivation required from the patient. • Patients may feel uncomfortable discussing their problems and may not be completely honest about their thoughts and experiences. Mark according to the levels of response criteria below: Level 3 (5–6 marks) • Candidates will show a clear understanding of the question and will explain one strength and one weakness. • Candidates will provide a good explanation with clear detail. Level 2 (3–4 marks) • Candidates will show an understanding of the question and will explain one appropriate weakness in detail or one appropriate strength in detail. OR one weakness and one strength in less detail. 1(c) Level 1 (1–2 marks) • Candidates will show a basic understanding of the question and will attempt an explanation of either a strength or a weakness. They could include both but just as an attempt. • Candidates will provide a limited explanation. Level 0 (0 marks) No response worthy of credit. Other appropriate responses should also be credited.