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Biological basis and ethical/legal considerations of psychotherapy discussion essay

Biological basis and ethical/legal considerations of psychotherapy discussion essay
BY DAY 3

Post an explanation of whether psychotherapy has a biological basis. Explain how culture, religion, and socioeconomics might influence one’s perspective on the value of psychotherapy treatments. Describe how legal and ethical considerations for group and family therapy differ from those for individual therapy, and explain how these differences might impact your therapeutic approaches for clients in group, individual, and family therapy. Support your rationale with at least three peer-reviewed, evidence-based sources and explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources.
Read a selection of your colleagues’ responses.

BY DAY 6

Respond to at least two of your colleagues on 2 different days by providing an additional scholarly resource that supports or challenges their position, along with a brief explanation of the resource.

   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.
 
 

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Collapse SubdiscussionTessie Harris

Tessie Harris
Nov 30, 2022Nov 30, 2022 at 8:37pm

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great post Aisha, could you give an example of how knowledge about socioeconomic status helps in understanding how exposed the patient is to mental health conditions. 

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Collapse SubdiscussionAisha Adigun

Aisha Adigun
Dec 2, 2022Dec 2, 2022 at 1:06pm

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Thanks Dr. Harris.
An individual’s socioeconomic status is essential in understanding a patient’s exposure to mental health conditions. Individuals of lower economic status are more exposed to mental health conditions compared to those of higher socioeconomic status (Reiss et al., 2019). The higher rates of mental health conditions among individuals living in lower socioeconomic status are tied to their exposure to stress and life pressures. An individual living in poverty, for example, has to deal with stressful situations such as lack of food, unemployment, and homelessness, among other problems. The poverty situation creates a negative environment that leads to negative emotions (Kivimäki et al., 2020). The build-up of negative emotions puts such an individual at significant risk of a mental health condition. On the flip side, individuals of higher socioeconomic status do not have to deal with stressful situations related to living conditions. Their ability to meet daily needs limits stress, pressure, and negative emotions.
References
Kivimäki, M., Batty, G. D., Pentti, J., Shipley, M. J., Sipilä, P. N., Nyberg, S. T., … & Vahtera, J. (2020). Association between socioeconomic status and the development of mental and physical health conditions in adulthood: a multi-cohort study. The Lancet Public Health, 5(3), e140-e149.
Reiss, F., Meyrose, A. K., Otto, C., Lampert, T., Klasen, F., & Ravens-Sieberer, U. (2019). Socioeconomic status, stressful life situations and mental health problems in children and adolescents: Results of the German BELLA cohort-study. PloS One, 14(3), e0213700.
 

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Collapse SubdiscussionMaxine Fomunung

Maxine Fomunung
Dec 1, 2022Dec 1, 2022 at 3:56pm

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Hi Aisha
I agree with you that psychotherapy taps into the verbal interaction of the clinician and the patient. I however feel that psychotherapy could also entail activities such as relaxation techniques that help in some disorders such as generalized anxiety disorders. Some interventions such as exposure- exposure used in management of some phobias could also be considered a form of psychotherapy. I agree with you that psychotherapy taps into the emotional component of the patient and through helps in elevating the negative and positive symptoms of some disorders such as depression. This is through the modification of various neurotransmitters that are involved in major psychiatric disorders.
I agree with you on the concept of cultural influence in which every individual is unique in their approach to treatment as guided by their cultural beliefs. A clinician who understand the cultural practices of a patient will be more likely to gain the confidence and confidentiality of a patient compared to one who has bias or prejudice. For instance, understanding that some native communities do not find mental illnesses to be medical but rather spiritual warfare it would be important to first educate the patients and their families on the condition before forcing treatment on them without the required knowledge(Levi et al., 2018).
I agree with you that different religions have different approaches to mental illnesses. Some religions belief that mental illness is a form of haunting or possession by spirits that require spiritual intervention and these patients would be reluctant to engage in medical treatment. People who have a good religious base are more likely to have a good social support system and are more likely to recover faster in the community rather than in secluded places (Levi et al., 2018). Some religions such as the Hindu and other Asian also value therapies such as relaxation techniques and yoga.
I agree with you that group therapy abolishes the confidentiality in patient care and the clinician should make the patient aware of this to avoid legal litigations according to the HIPAA regulations (Stoll et al., 2020).
 
References
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.

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Collapse SubdiscussionBasirat Shomuyiwa

Basirat Shomuyiwa
Dec 3, 2022Dec 3, 2022 at 6:06pm

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Respond to Maxime
Discussion Response
Hello, following a review of your discussion post on the biological basis and ethical considerations of psychotherapy, I concur with you that psychotherapy has a biological basis. For instance, according to Carey et al. (2020), psychotherapy is a complex mode of treatment that targets an entire biological regulation underlying complex brain responses. Additionally, psychotherapy targets abnormalities in brain adaptation and substitutes this maladaptation with new neural circuits that enhance positive behavior and coping strategies. Finally, psychotherapy is bracketed with structural brain changes.
Similarly, I agree with you that culture, religion, and socioeconomic status influence psychotherapy. As discussed, the diverse nature of psychiatric patients necessities that PMHNPs develop cultural competency to practice competently. Cultural competency facilitates the accurate delivery of psychotherapy and enhances positive therapeutic alliance which improves health-seeking behaviors (Gopalkrishnan, 2018). Religion may undermine the value of psychotherapy as patients may opt for spiritual and divine intervention. Additionally, individuals from poverty-stricken areas less often seek psychotherapy due to cost considerations and limited knowledge of the benefits of psychotherapy (Fonagy & Luyten, 2021).
As with other modes of psychotherapy, ethical and legal considerations must be observed while delivering group and family therapy. Pertinent issues such as informed consent, privacy, confidentiality, and therapeutic alliance during the delivery of these therapies cannot be overstated. PMHNPs must practice according to their professional code of ethics and conduct. Finally, I agree with you that the references used are considered scholarly as they are peer-reviewed journal articles from recommended sources.
 
 
References
Carey, T. A., Griffiths, R., Dixon, J. E., & Hines, S. (2020). Identifying functional mechanisms in psychotherapy: A scoping systematic review. Frontiers in Psychiatry, 11, 291. https://doi.org/10.3389/fpsyt.2020.00291Links to an external site.
Fonagy, P., & Luyten, P. (2021). Socioeconomic and sociocultural factors affecting access to psychotherapies: the way forward. World Psychiatry: Official Journal of the World Psychiatric Association (WPA), 20(3), 315–316. https://doi.org/10.1002/wps.20911Links to an external site.
Gopalkrishnan, N. (2018). Cultural diversity and mental health: Considerations for policy and practice. Frontiers in Public Health, 6, 179. https://doi.org/10.3389/fpubh.2018.00179Links to an external site.
 
 

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Collapse SubdiscussionEsther Fakayode

Esther Fakayode
Dec 1, 2022Dec 1, 2022 at 6:30pm

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Hello Aisha,
Great, and well-put-together discussion post, It is very important as a PMHNP to understand how culture, religion, and socioeconomic status can impact clients’ perspectives about mental illness. To properly diagnose and treat each client, either with medication management, or psychotherapy, advanced practitioners must have a thorough understanding of their various cultures, religions, and socioeconomic status (Wheeler, 2014). Different cultures with the same disease or mental illness may not manifest symptoms the same as other cultures. Therefore, it is essential to have a good understanding and knowledge of different cultures to help provide quality and effective treatment (Wheeler, 2014). In most cases, cultures impact how some clients identify and report their physical and emotional symptoms. Some cultures may feel more comfortable talking to a therapist or clinicians and getting psychotherapy, but people from other cultures may turn to religious beliefs or conservative ways to improve their symptoms. It is important to remember that some clients may have more than one culture that impacts their lifestyle. The advanced practitioner should take the time to understand different cultures, even if that means directly asking the client about them. A cultural competence model is a good tool for practitioners to use. It has several questions that an NP can ask themselves to measure their level of competence (Wheeler, 2014).
Socioeconomic status can be defined by income, level of education, and occupation, to reflect a person’s social, material, and psychological resources. Low socioeconomic status is associated with poorer mental health and higher work disability rates due to mental disorders. In addition, people with lower socioeconomic status, especially those with lower education, tend to use mental health services less willingly or drop out of treatment due to poverty and poor education than those with higher socioeconomic status, even though the need may be greater (Leppänen, et al., 2022).
References
Finegan, M., Firth, N., Wojnarowski, C., & Delgadillo, J. (2018). Associations between
socioeconomic status and psychological therapy outcomes: A systematic review and
meta-analysis. Depression and anxiety, 35(6), 560–573. https://doi.org/10.1002/da.22765
Leppänen, H., Kampman, O., Autio, R., Karolaakso, T., Näppilä, T., Rissanen P., & Pirkola

(2022). Socioeconomic factors and use of psychotherapy in common mental disorders

predisposing to disability pension. meta-analysis. Depression and anxiety, 35(6), 560–

https://doi.org/10.1186/s12913-022-08389-1Links to an external site.

Wheeler, K. (Eds.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to
guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing
Company.

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Collapse SubdiscussionSherill A Broderick

Sherill A Broderick
Dec 2, 2022Dec 2, 2022 at 8:39pm

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        Aisha,
I agree that culture can have an impact on a patient’s perspective of psychotherapy treatment.  A study was carried out by Koduah et al., (2019), examining how sociocultural factors influence nurses’ health literacy practices. Here, it was noted that many Ghanaians firmly believe that mental illness is caused by the existence and manipulation of several demonic forces such as witches, ancestral spirits, sorcerers. As a result, in Sub-Sahara Africa, mental health issues are often too sensitive to discuss with patients and their families due to the shame and stigma associated with them. This context affects how health professionals deliver information and how patients and their relatives interpret it. In a study carried out by Huang et al., (2022), on caregivers’ burden, it was also noted that Asian-Americans are less likely to seek mental health services. The attitude of this population may potentially cause them to resist psychiatric treatment in general.
Huang, Y., Nagao, C. A., Santos, K. M. B., & Werchowsky, M. I. (2022). Impact of Culture,
Spirituality, and Mental Health Attitudes on Intergenerational Asian-American Caregivers: A
Pilot Study. American Journal of Occupational Therapy,&

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