Biological basis and ethical/legal considerations of psychotherapy discussion essay

   Week 1 Discussion: Psychotherapy

Psychotherapy relates to a psychological procedure associated with verbal interaction between a mental health expert and a patient to understand the prognosis of the mental condition. Psychotherapy has a biological basis as it is associated with understanding the patient’s behavior following a particular healthcare condition. Through psychotherapy, a mental health expert taps into the patient’s receptors, modulators, and neurotransmitters (Javanbakht & Alberini, 2019). The three are critical biological regulations in brain response. Psychotherapy equally has a biological basis because it realigns an individual’s perception of the self by creating changes to a patient’s emotions and cognitive reasoning processes.

The concepts of culture, socioeconomics, and religion have a significant impact on a patient’s perspective of psychotherapy treatments. Culture is quite critical because every patient would want to be treated in a culturally competent manner (Levi et al., 2018). Thus, the attending mental health expert should understand the background of the patient to ensure that culturally competent care is provided. Providing culturally competent care also creates a good rapport between the patients and the mental health expert.

The concept of religion is equally critical in the treatment of mental health conditions. Some patients would prefer to be attended to by mental health experts who have similar religious beliefs as them. It is also critical for mental health experts to understand a patient’s religious beliefs because they are related to various beliefs that might impact treatment (Levi et al., 2018). The beliefs may impact religious practices such as meditation. The socioeconomic status of the patient is equally important because it is associated with social determinants of health. Knowledge about socioeconomic status helps in understanding how exposed the patient is to mental health conditions.

Legal and ethical considerations for group and family therapy differ from those of individual therapy. For individual therapies, the interaction is between the one patient and the attending and mental health expert (Stoll et al., 2020). Thus, the mental health expert guarantees the total confidentiality as per HIPAA regulations. In case the confidentiality of the patient is breached in individual therapy, the therapist is fully liable. When working attending to an individual client, I will have an understanding of the fact that it is my responsibility to keep the patient’s information confidential. On the other hand, the ethical considerations in group dynamics are quite different (Stoll et al., 2020). Ideally, all the group and family members are liable for the confidentiality of the provided information. While working with a family or a group, I will make them understand that confidentiality is not binding because of the third-party rule.

 

 

References

Javanbakht, A., & Alberini, C. M. (2019). Neurobiological models of psychotherapy. Frontiers in Behavioral Neuroscience, 13, 144.

Levi, U., Laslo-Roth, R., & Rosenstreich, E. (2018). Socioeconomic status and psychotherapy: A cognitive-affective view. J Psychiatry Behav Health Forecast. 2018; 1 (2), 1008.

Stoll, J., Müller, J. A., & Trachsel, M. (2020). Ethical issues in online psychotherapy: A narrative review. Frontiers in Psychiatry, 10, 993.

 

 

Biological basis of psychotherapy treatments

Neuroscience addresses the brain in the manner in which it truly develops, matures, and functions, which in essence, is the biological basis. Psychotherapy deactivates brain mappings that are maladaptive and stimulates the development of new pathways in the brain that are constructive. Psychiatric disorders are caused entirely by our temperaments’ reactions to stressful experiences as they are processed by our bodies. The problematic mappings that are brought up in therapy are deactivated, while the healthier ones are activated. The mappings of a traumatic experience are what produce the suffering that is associated with mental health conditions. Therefore, psychotherapy is a healing modality that accomplishes this by utilizing the biological processes of the brain (Jimenez et al., 2018).

It has also been demonstrated that psychotherapy can alter the amount of activity found in the prefrontal cortex. According to the findings of a study conducted on depression, patients diagnosed with this illness exhibited an unusually elevated level of activity in the prefrontal cortex. Researchers observed that patients who took part in interpersonal therapy had lower levels of activity in their prefrontal cortex than those who did not engage.

In addition, it has been demonstrated that psychotherapy has a biological basis that is analogous to the biological treatment that may be seen through the use of drugs. For instance, data has demonstrated that cognitive behavioral therapy (CBT) creates alterations in the brain that are similar to the changes that are caused in the brain by psychotropic medicines. This evidence was obtained through a study on brain imaging. As a consequence, this body of evidence demonstrates that psychological therapies are capable of bringing about changes in an individual’s symptoms. People who struggle with obsessive-compulsive disorder provide a good illustration of this phenomenon (OCD). Patients who suffer from OCD have been shown to have neuronal hyperactivity, which may be determined by an elevated rate of glucose metabolism. It has been demonstrated that psychotherapeutic treatments such as cognitive behavioral therapy (CBT) and psychotropic medicines such as Prozac can slow down the rate at which the body processes glucose and ameliorate OCD symptoms (Marano et al., 2012). Consequently, this gives the impression that cognitive behavioral therapy is as effective as other biological treatments, such as psychotropic drugs.

 

How religion, culture, and socioeconomics influence psychotherapy management

The mental health professional would need to consider the client’s culture, religion, and socioeconomic influences to determine how to deliver psychotherapy treatments to accurately identify and treat clients with mental illness. Because every culture has a unique perspective on numerous issues, a PMHNP should be familiar with the client’s history and culture. Hallucinations, for example, are viewed as a kind of divine contact in several civilizations. Instead of being stigmatized as mentally ill, people who have hallucinations are held in the highest regard. Therefore, in order to perform psychotherapy successfully, every PMHNP must possess cultural competency. As the therapeutic alliance and connection are strengthened, this will promote a positive client-practitioner relationship. Cultural influences on individuals’ healthcare-seeking behaviors will also come in handy when handling males who come in with mental illnesses. Some cultures would view men as being emotionally strong and will be expected to handle every situation in a strong manner. This, therefore, shows that few men would seek psychotherapy for their issues or come in with advanced mental illness with cognitive changes.

The opinions, conclusions, and perceptions of an individual are frequently influenced by their cultural background. Contrarily, compared to nonreligious people, persons who practice a particular religion tend to have better mental health, fulfilling relationships, and physical health. Thus, it is believed that their faith contributes to the stabilization of psychological health. People with mental health issues who identify as members of a certain faith typically prefer to consult a psychologist who shares their beliefs. However, some want to see nonreligious therapists or psychologists so that they can receive treatment that is impartial to their psychological condition.

In order to effectively address the client’s mental health during psychotherapy, there is an emphasis on the significance of recognizing socioeconomic disparity, the stress associated with poverty, and attending to the significant external and societal circumstances. In order to help clients understand the challenges they are facing with poverty-related stress, discussions about how to create coping mechanisms will be hard rather than how to make them happy about being poor. As a result, clients can learn how to make adjustments that will help them and their families advance. In addition, a lack of resources may prevent people from lower socioeconomic strata from accessing appropriate psychotherapy therapies. Living in poverty may psychologically impact some people, which may cause mental health problems.

Furthermore, a sizable portion of people who struggle with mental health disorders do not get the mental health services they require. For instance, the study found that fewer kids who require mental health care and live in poverty obtain it than 15% of the time (Hodkinson, Godoy, Beers, Lewin, 2017). Even fewer kids finish their treatment. Lack of insurance, long travel times, and parental worries that their kids would be taken away from them because of their low-income status are just a few of the obstacles that prevent people from receiving mental health care.

 

Ethical and legal considerations for group and family therapy

Mental health therapists are required to make ethical decisions regarding whether or not their personal knowledge or connection to a particular patient should be disclosed. The client may need to be referred to another therapist because of a role conflict, which is one of the biological bases and ethical, and legal considerations of psychotherapy. A mental health counselor, for instance, should not give advice to someone who lives next door to them, especially when working in a rural environment setup (Kim et al., 2016).

Various psychology bodies have approved the Ethics Code or other comparable ethical standards or rules for the professional conduct of clinicians. When providing services to more than one individual in a joint session, such as to a group of patients, couples, family, children, and caregivers, a clinician must begin the interaction by delineating the limits of confidentiality, so that information between the parties can be shared amongst themselves. This requirement applies to situations in which the clinician is providing services to a family or couple, for instance, or when the clinician is providing services to a family or couple, or when the clinician is providing services to In contrast to individual therapy, where clinicians are expected to adhere to HIPPA rules and regulations.

One of the legal considerations in this aspect of family or group therapy is the clinician’s duty to warn, which was influenced by the Tarasoff decision. During family therapy, the clinician is responsible for warning the family members or the group if the patient poses a danger to other people, such as the risk of homicide and suicide. This will influence the level of expressed emotion that the family will accord the patient and help them to recover from the psychological illness.

 

 

References

Jiménez, J. P., Botto, A., Herrera, L., Leighton, C., Rossi, J. L., Quevedo, Y., Silva, J. R., Martínez, F., Assar, R., Salazar, L. A., Ortiz, M., Ríos, U., Barros, P., Jaramillo, K., & Luyten, P. (2018). Psychotherapy and Genetic Neuroscience: An Emerging Dialog. Frontiers in genetics, 9, 257. https://doi.org/10.3389/fgene.2018.00257Links to an external site..

It is a scholarly article since it has been peer-reviewed, and the study findings have been supported by other studies and literature, as evidenced by the number of citations and references in the article. The information in the article is clear and precise and is written by research experts.

 

Marano, G., Traversi, G., Nannarelli, C., Pitrelli, S., Mazza, S., & Mazza, M. (2012). Functional neuroimaging: points of intersection between biology and psychotherapy. Clin Ter, 163(6), e445-456.

The article is considered scholarly as research experts did the research, and other experts have analyzed the results, and the research is based on the literature and findings of other studies found in the references. It was done to add information on the gaps that other studies have done on the subject matter.

 

Hodgkinson, S., Godoy, L., Beers, L. S., & Lewin, A. (2017). Improving Mental Health Access for Low-Income Children and Families in the Primary Care Setting. Pediatrics, 139(1), e20151175. https://doi.org/10.1542/peds.2015-1175Links to an external site..

The article is scholarly as it is based on the findings of other studies and information done on the same topic and has been reviewed by other research experts. The findings have also been shared and analyzed by other peers before publication.

 

Kim, N. S., Ahn, W. K., Johnson, S. G., & Knobe, J. (2016). The influence of framing on clinicians’ judgments of the biological basis of behaviors. Journal of experimental psychology. Applied, 22(1), 39–47. https://doi.org/10.1037/xap0000070Links to an external site..

The article is scholarly as it bases its objective and study questions on previous studies done in the field of psychology and aims at testing a hypothesis and supporting or refuting evidence and data from other articles. The article has been based on other literature, evidenced by the references and citations.

Week #1 Discussion #1  NRNP-6645C-9/NRNP-6645-9 11/29/2022  Ana Tattersall Cocke

 An explanation of whether psychotherapy has a biological basis.

Psychotherapy has a solid biological basis. Bambling (2013) explains how our brains adapt to environmental stimuli that can create pathways that can cause maladaptive behaviors, and psychotherapy has been proven to aid in restructuring brain mapping. PTSD is an excellent example of how one can rewire the brain with the physiological, primitive response to a certain. Neer et al. (2016) provided an example of a case study of a 31 y/o veteran who experienced PTSD with conversion disorder and could not eat solid food without alcohol.  He was provided with trauma management therapy (TMT) five times per week over three weeks that included daily exposure therapy (EXP) as well as daily social and emotion regulation (SER) group therapy to work on anger, depression, and social withdrawal. After the treatment Clinician-Administered PTSD Scale (CAPS) decreased from 63 at pre-treatment to 17 at posttreatment, noting that he no longer had PTSD symptomatology. The intensive exposure therapy allowed him to consume full meals without alcohol (Neer et al., 2016).

Explain how culture, religion, and socioeconomics might influence one’s perspective on the value of psychotherapy treatments.

Cultural elements of the Western world can promote confirmation bias because of the commonalities and similarities in our daily lives (Koch and Kafa, 2019). With the growth of non-Western migration, the assumptions that current psychotherapy models can be easily adapted need to be researched (Koch and Kara, 2019). Wheeler (2020) reports that mental health treatment needs to be patient-centered; secular psychotherapy may not be a good fit for some. Socioeconomic factors can impact how some of those with financial insecurity may have difficulty accessing psychotherapy (Nichols and Davis, 2020).

Describe how legal and ethical considerations for group and family therapy differ from those for individual treatment, and

In her presentation, Shuttlesworth (2013) states that informed consent is essential to move forward with any therapy process. Wheeler (2020) suggests that group therapy can be more economically affordable to some. In contrast, family and individual therapy may be more expensive if it must be afforded with out-of-pocket funds Biological basis and ethical/legal considerations of psychotherapy discussion essay.

Explain how these differences might impact your therapeutic approaches for clients in group, individual, and family therapy.

Nichols and Davis (2020) summarize the differences between individual and family therapy by focusing on where human behavior needs to be concentrated. Individual therapy focuses on internal personality forces that can impact the family dynamic, and this approach may make the individual feel most comfortable with confidentiality (Wheeler, 2020). By contrast, family therapy works on the external structure of the family because this may be needed to change the individual so that the dynamics will work. The differences between family and group therapy can be viewed through the lens of how some may feel more comfortable revealing themselves to strangers vs. a family member. Therapy groups have to promote an environment of cohesion and support, whereas family dynamics can still be pronounced (Nichols and Davis, 2020).

References

Bambling, M. (2013). Neurobiology of behavior change Links to an external site.Links to an external site.[Video/DVD] https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/watch/neurobiology-of-behavior-changeKoç, V., & Kafa, G. (2019). Cross-Cultural Research on Psychotherapy: The Need for a Change. Journal of Cross-Cultural Psychology, 50(1), 100–115. https://doi.org/10.1177/0022022118806577

Neer, S. M., Trachik, B., Munyan, B. G., & Beidel, D. C. (2016). Comprehensive Treatment: Intensive Exposure Therapy for Combat-Related PTSD and Comorbid Conversion Disorder. Clinical Case Studies, 15(5), 343–359. https://doi.org/10.1177/1534650116643401

Nichols, M., & Davis, S. D. (2020). The essentials of family therapy (7th ed.). Pearson.

Shuttlesworth, M. (2013, August 14). Ethical and legal issues in abnormal psychology Links to an external site.Links to an external site.[Video]. YouTube. https://www.youtube.com/watch?v=pRXibYiorQ0

Wheeler, K. (Ed.). (2020). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (3rd ed.). Springer Publishing.

     Main Post

 

Psychotherapy Nursing

Psychiatric mental health practitioners undertake recovery-focused practice where they work with the long-term goal of the final recovery. As such, they take their time to learn more about the clients and offer support to their client’s endeavors, goals, and recovery. The psychotherapy techniques they apply are as effective as psychopharmacology (Greenway et al., 2020). A common question asked is how psychotherapy achieves the changes and whether it shares common neuronal pathways with psychopharmacology. As such, it is important to explore whether psychotherapy has a biological basis and the ways in which legal and ethical considerations differ in individual, family, and group therapy settings. Psychotherapy has a biological basis since the strategy focuses on brain aspects such as how it operates, brain maturation, and brain development (Wheeler, 2020). Psychotherapy applies evolutionary adaptation ideologies, thus targeting the adaptation complexities and repairs such. The implication is that the strategies disengage and solve the maladaptive brain adaptations and replace them with positive pathways.

Culture religion and socioeconomics might influence one’s perspectives on the value of psychotherapy treatments. For instance, in some cultures, using psychotherapy to treat mental illnesses is stigmatized and regarded shameful, hindering individuals from using psychotherapy (Markin & Zilcha-Mano, 2018). Some believe that mental illness is a curse hence should be solved through divine strategies. In some religions, individuals believe that illnesses such as mental illnesses should be treated though prayers and divine healing, hence some individuals may frown at psychotherapy. Individuals with low socioeconomic status may find it difficult to seek for psychotherapy interventions due to cost issues

Various legal and ethical considerations as associated with individual, family, and group therapy settings. However, these legal and ethical considerations differ depending on the setting. However, ethical and legal considerations in all settings have to be upheld to avoid any ethical or legal consequences. While the issue of confidentiality is more straightforward in the case of individual therapy, it is more complex in group and family therapy as the psychotherapists need to inform every participant of why it is key to uphold confidentiality and some of the consequences of the breach (Ezhumalai et al.,2018). The legal privilege is not applicable to family/group discussion, except in cases where it is provided by the state statute. The provider during family or group therapy is no more dedicated to an individual client and does not function entirely as the client’s agent. The provider hence participates in activities that focus on the overall community. The rules and guideline of handling the psychotherapy sessions therefore differ in each case.  The published sources used in this assignment are scholarly because they are peer reviewed.

 

 

References

Ezhumalai, S., Muralidhar, D., Dhanasekarapandian, R., & Nikketha, B. S. (2018). Group interventions. Indian Journal of Psychiatry, 60(Suppl 4), S514. https://doi.org/10.4103%2Fpsychiatry.IndianJPsychiatry_42_18Links to an external site.

Greenway, K. T., Garel, N., Jerome, L., & Feduccia, A. A. (2020). Integrating psychotherapy and psychopharmacology: psychedelic-assisted psychotherapy and other combined treatments. Expert Review of Clinical Pharmacology, 13(6), 655–670. https://doi.org/10.1080/17512433.2020.1772054Links to an external site.

Markin, R. D., & Zilcha-Mano, S. (2018). Cultural processes in psychotherapy for perinatal loss: Breaking the cultural taboo against perinatal grief. Psychotherapy, 55(1), 20. https://psycnet.apa.org/doi/10.1037/pst0000122

Wheeler, K. (2020). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. Springer

 

According to American Psychological Association (2022), individuals in participating psychotherapy work closely with their therapist to address their mental health concerns. Based on the conversation, it creates a safe space for someone to share their thoughts and feelings with someone who is impartial and will not pass judgment. Together, the patient and the psychologist will determine what kinds of thoughts and actions are contributing to the patient’s less-than-optimal emotional state, and then try to alter those. The changes that occur in the brain and body because of psychotherapy are what improve emotional and behavioral health.

 Biological Basis of Psychotherapy

A large part of psychotherapy is devoted to understanding the neural bases of psychological phenomena. The human brain develops from a combination of genetic blueprints and environmental influences. Traumatic events, in contrast to good events, might alter one’s thinking, feeling, and controlling behaviors. Rather than focusing on just one or two receptors, neurotransmitters, or modulators, psychotherapy is an integrative biological treatment that activates all the systems responsible for regulating the brain’s complex reactions. The ultimate goal of this sort of intervention is to facilitate a re-elaboration of one’s holistic view of self and others through the acquisition of new knowledge and participation in novel experiences that engage one’s cognitive, emotional, and self-regulatory systems. Therapeutically effective interventions result in substantial, long-lasting, and quantitatively observable changes in the brain (Javanbakht & Alberini, 2019). Psychotherapy’s primary objective is to help people learn to adapt to their circumstances to foster healthier patterns of thought, feeling, and behavior.

Culture, Religion, and Socioeconomic Influences

Although it is essential to consider how the patient’s presenting problem and therapeutic interactions are influenced by the patient’s culture and cultural differences as part of diversity, it is equally crucial to analyze how institutional and economic influences shape these aspects. Distinct cultures’ members can and will have different points of view, leading to divergent accounts of how the human mind works and what constitutes acceptable behavior. Cultural background can influence the formation of mental illnesses as well as the reaction patterns that will eventually result in psychological disorders; thus, disorder symptoms, behavioral reaction levels, frequency with which illness occurs, perceptions and reactions toward illness, and willingness to receive psychotherapy can all be affected (Koç & Kafa, 2019). When comparing the understanding of psychotherapy in various nations, it is evident that their appreciation or worth varies considerably. Countries in the third world have very little effect in the field of psychotherapy, presenting a quite different picture. For example, some Muslims lack faith in the science of psychotherapy, in part due to psychotherapy’s image as a secular discipline that rejects the spiritual side of humanity; Muslims may fear that their beliefs will be studied and stripped away. Moreover, in Muslim psychology, the majority of errors in the field of psychology are attributed to faulty assumptions about human nature, spanning from the Darwinian perspective of human nature to the model of information processing units (Koç & Kafa, 2019).

Equally, cultures have various rules for what constitutes normal behavior and how people should act, so people from different cultures will have different viewpoints on the world and mental health taboos and/or expectations. Therefore, psychotherapy may be appreciated in one culture and less embedded in another culture.

Legal and Ethical Issues

Issues of law and ethics are present in all types of therapy, including family, group, and individual. Legal and ethical considerations include, but are not limited to, the patient’s right to privacy, protection from abuse, violation of personal space, autonomy, and therapy adherence.

A therapist’s ability to establish rapport with patients hinges on his or her empathy, openness, and willingness to listen. The therapist’s role in group and family therapy is to ensure that everyone has a chance to speak. Unless the patient poses an immediate threat to themselves or others, a therapist has a legal and ethical obligation to maintain the patient’s confidentiality.

Finally, in order to provide an effective psychotherapy treatment plan, it is also crucial to have a thorough understanding of the patient’s worldview, cultural background, socio-economic background, and medical history.

 

References

American Psychological Association (2022). Understanding psychotherapy and how it works. https://doi.org/10.1037/e502202022-001Links to an external site.

Javanbakht, A., & Alberini, C. M. (2019). Editorial: Neurobiological Models of Psychotherapy. Frontiers in behavioral neuroscience, 13, 144. https://doi.org/10.3389/fnbeh.2019.00144

Kim, N. S., Ahn, W., Johnson, S. G. B., & Knobe, J. (2016). The influence of framing on clinicians’ judgments of the biological basis of behaviors. Journal of Experimental Psychology: Applied, 22(1), 39–47. https://doi.org/10.1037/xap0000070Links to an external site.

Koç, V., & Kafa, G. (2019). Cross-cultural research on psychotherapy: The need for a change. Journal of Cross-Cultural Psychology, 50(1), 100–115. https://doi.org/10.1177/0022022118806577