Respond to at least two of your colleagues on by providing an additional scholarly resource that supports or challenges their position, along with a brief explanation of the resource.
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Whitney Kelley
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Biological Basis of Psychotherapy
Although it is widely known that changes in the brain contribute largely to the presence of psychiatric disorders, it is lesser known what the effects are on these brain structures in the presence of intervention. In examining this topic further, there is conflicting evidence on whether there is a biological basis to psychotherapy. According to Maffioletti et al. (2021), psychiatric conditions such as major depressive disorder are shown to have significant alterations in gene expression. Psychotherapy that focuses on trauma has proven to be effective in patients, specifically those with treatment resistant depression (Maffioletti et al., 2021). The expression of several genes was changed in patients who participated in psychotherapy, as well as a decreased inflammatory response (Maffioletti et al., 2021).
Influence and Perspective of Psychotherapy
As with many aspects of mental health, there are several factors that may influence one’s perspective of psychotherapy such as culture, religion, and socioeconomic status. It is vital to the relationship between client and therapist that each party is self-aware of their own beliefs and values. It is said that the therapeutic relationship relies heavily on factors involving culture and other beliefs and can heavily influence the process and outcome of the psychotherapy (Owen, 2018). Religion is said to have a significant influence on an individual’s overall well-being (Captari et al., 2018), making it an important topic to explore during a psychotherapy session. According to Captari et al. (2018), many providers of psychotherapy are hesitant to include religion and other spiritual beliefs into their sessions, leading them to elude the subject altogether. Discussing religion and spiritual considerations for each client can have a significant impact on the treatment plan, interventions that the client is willing to accept, and overall outcomes (Captari et al., 2018), further explaining the importance of this topic. Socioeconomic status and the presence of psychiatric disorders are said to have a significant correlation with one another (Blackshaw et al., 2018). Along with the presence of mental health conditions, lower socioeconomic status can have profound negative effects on physical health, access to treatment, and a higher incidence of life stressors (Blackshaw et al., 2018).
Legal and Ethical Considerations in Therapy Sessions
Ethical and legal considerations exist regardless of the type of therapy in discussion (individual, group, family), but the nature of these considerations will vary somewhat depending on the type of therapy. According to Avasthi et al. (2022), informed consent, confidentiality, and documentation are among the most important. Informed consent refers not only to agreeing to participate in the therapy, but also that the client is made aware of the risks, potential outcomes, and is agreeing to play a vital role in the therapy process (Avasthi et al., 2022). Confidentiality is arguably the most important, especially when group/family therapy sessions are involved. It would be important to relay to the client(s) that there are certain exceptions in confidentiality, such as abuse, self-harm, or cases that involve a minor (Avasthi et al., 2022). Confidentiality should be discussed thoroughly with each client, especially since it cannot always be maintained during group and family sessions. Lastly, documentation and confidentiality often overlap, causing ethical and legal dilemmas. Avasthi et al. (2022), states that documentation may be summoned in a court case and the therapist should use their own clinical judgement when determining the amount of detail provided in their therapy notes. It would be prudent to relay this fact to each client, as they may feel as though their confidentiality is being breached, which may subsequently damage the relationship between the client and the psychotherapist.
References
Avasthi, A., Grover, S., & Nischal, A. (2022). Ethical and legal issues in psychotherapy. Indian Journal of Psychiatry, 64, 47–61. Ethical and legal issues in psychotherapy_ EBSCOhost.pdf
Blackshaw, E., Evans, C., & Cooper, M. (2018). When life gets in the way: Systematic review of life events, socioeconomic deprivation, and their impact on counselling and psychotherapy with children and adolescents. Counselling & Psychotherapy Research, 18(2), 143–153. When life gets in the way_ Systematic review of life events, socioeconomic …_ EBSCOhost.pdf
Captari, L. E., Hook, J. N., Hoyt, W., Davis, D. E., McElroy-Heltzel, S. E., & Worthington, E. L., Jr. (2018). Integrating clients’ religion and spirituality within psychotherapy: A comprehensive meta-analysis. Journal of Clinical Psychology, 74(11), 1938–1951. Integrating clients’ religion and spirituality within psychotherapy_ A comp…_ EBSCOhost.pdf
Maffioletti, E., Bocchio-Chiavetto, L., Perusi, G., Carvalho Silva, R., Sacco, C., Bazzanella, R., Zampieri, E., Bortolomasi, M., Gennarelli, M., & Minelli, A. (2021). Inflammation-related microRNAs are involved in stressful life events exposure and in trauma-focused psychotherapy in treatment-resistant depressed patients. European Journal of Psychotraumatology, 12(1), 1987655. Inflammation-related microRNAs are involved in stressful life events exposu…_ EBSCOhost.pdf
Owen, J. (2018). Introduction to special issue: Cultural processes in psychotherapy. Psychotherapy (Chicago, Ill.), 55(1), 1–2. Introduction to special issue_ Cultural processes in psychotherapy_ EBSCOhost.pdf
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Hey Tyler, I am happy to hear from you
Biological Basis for Psychotherapy
I agree with your post that psychotherapy has a biological basis an opinion that is supported by nursing publications. Individuals that go through psychotherapy experience a change in the manner the brain works. It results in a change in the structure and functioning of the synaptic pathways in the brain. Studies also indicate that psychotherapy results in changes, which rely on epigenetic modifications (Jimenez et al., 2018). Psychotherapy allows for the reconfiguration of the neural systems, which allows for better adaptation among patients.
Impact of Culture, Religion, and Social-economic Factors on Psychotherapy
Culture, religion, and social-economic factors impact psychotherapy’s value on patients. Religion and culture define people’s beliefs, perceptions, attitudes, and way of life. Therefore, individuals that have been exposed to negative beliefs and perceptions about psychotherapy are not likely to seek the treatment or better still benefit from the sessions. Some cultural and religious beliefs may stigmatize mental health issues, therefore, discouraging patients from seeking treatment. Better still, due to impaired thoughts and opinions, patients and therapists may face communication issues attributed to poor interpretations and the inability to express themselves well. Patients from the low-income social classes may shy away from seeking psychotherapy due to financial constraints and the lack of medical insurance.
Ethical and Legal Issues
Ethical and legal issues affecting psychotherapy are likely to be distinct to the patients. Group therapy is likely to face issues touching on privacy and confidentiality while family therapy may face issues on communication and conflicts of interests among the family members. In individual therapy, the patient may only require assurance from the therapist on professionalism and the maintenance of privacy and confidentiality to safeguard the patient’s dignity and welfare (Darby & Weinstock, 2018). The therapist should put in place measures to curb ethical and legal issues, which could interfere with the achievement of the set goals and expectations. She/he should provide a safe environment for the patients and avail consent forms to bind the patients to maintain privacy and confidentiality.
References
Darby, W. C., & Weinstock, R. (2018). The Limits of Confidentiality: Informed Consent and Psychotherapy. Focus (American Psychiatric Publishing), 16(4), 395–401. https://doi.org/10.1176/appi.focus.20180020
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.2018.00257