response 121

BIOLOGICAL BASIS AND ETHICAL/LEGAL CONSIDERATIONS OF PSYCHOTHERAPY

Many studies have found that psychotherapy is as effective as psychopharmacology in terms of influencing changes in behaviors, symptoms of anxiety, and changes in mental state. Changes influenced by psychopharmacology can be explained by the biological basis of treatments. But how does psychotherapy achieve these changes? Does psychotherapy share common neuronal pathways with psychopharmacology?

Psychotherapy is used with individuals as well as in groups or families. The idea of discussing confidential information with a patient in front of an audience is probably quite foreign to you. However, in group and family therapy, this is precisely what the psychiatric-mental health nurse practitioner does. In your role, learning how to provide this type of therapy within the limits of confidentiality is essential.

For this Discussion, you will consider whether psychotherapy also has a biological basis and analyze the ways in which legal and ethical considerations differ in the individual, family, and group therapy settings.

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. 

COLLEAGUE 1

For this week's discussion post, it is necessary to discuss the following: explain 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 individual therapy differ from those for family and group therapy; and explain how these differences might impact your therapeutic approaches for clients in individual, family, and group therapy. First, according to Javanbakht and Alberini (2019), "Psychotherapy is an individualized yet comprehensive biological treatment: it does not target one receptor, one or two neurotransmitters, or single modulators; it taps into all the biological regulations underlying complex brain responses. The end result of this type of intervention is a reelaboration of the whole sense of self and others, through new learning and new experiences that encompass cognitive, emotional, and internal regulation processes" (para. 2). For psychotherapy to be effective, healthcare providers trained in this practice must provide guided direction and support to their clients so they can develop healthy relationships, repair valued relationships experiencing periods of conflict, and/or end unhealthy relationships. We as human beings require social connection to live healthy and happy lives (Martino et al., 2017). There is a tremendous amount of evidence that links social connectedness to positive physical and mental health outcomes (Martino et al, 2017). Second, it is well known that culture, religion, and socioeconomics collectively influence the perspective of all people around the world regarding psychotherapy itself and whether it is a viable and valuable treatment (Moleiro, 2018). Third, before a healthcare provider trained in psychotherapy can begin sessions with a client or group of clients, there must be a discussion concerning informed consent (Darby & Weinstock, 2018). A client or group of clients must be educated about their rights to autonomy and confidentiality (can be bypassed if a client or group of clients are a danger to themselves or others, which must be made clear during this discussion) (Darby & Weinstock, 2018). Clearly, this discussion would be easier between a healthcare provider and an individual client. Once multiple clients are involved (family/group psychotherapy) or if a minor requires mental healthcare which usually involves their parent or legal guardian then this is where informed consent becomes complicated. At this point, a healthcare provider would need to have a serious discussion with all parties involved to determine their needs, goals, and understanding of how psychotherapy will be carried out (Darby & Weinstock, 2018). There would also need to be an additional discussion concerning respecting everyone's right to share their experiences, that personal information that a client wants to keep private cannot be provided by the healthcare provider to others in the minor/family/group setting, and that the healthcare provider must maintain professional boundaries (Darby & Weinstock, 2018). In summary, healthcare providers trained in providing psychotherapy must be cognizant of their legal and ethical obligations before agreeing to commence individual, family, and/or group psychotherapy (Darby & Weinstock, 2018). Each article in my reference list below is a scholarly source as they all are featured in academic journals which serve as permanent and transparent forums for the presentation, scrutiny, and discussion of research.  

Colleague two

Biological Basis and Ethical/Legal Considerations of Psychotherapy

Psychotherapy just like psychopharmacology ignites changes in the brain that support healing and recovery from mental illnesses. Psychotherapy has a biological basis because it follows the principles of evolutionary adaptions of the brain (Glannon, 2020). The brain records people’s experiences following adaptation to the environment and the experiences can be positive or negative. The negative experiences lead to defective mappings on the brain that results in distorted thinking and problematic behaviors in people with mental conditions such as depression. The function of psychotherapy is to target the maladaptive mappings to disengage and repair them, transforming them into adaptive mappings (Krause et al., 2021). The best technique that demonstrates this biological basis of psychotherapy is cognitive behavioral therapy. The therapy works by identifying the distorted thinking patterns caused by maladaptive mappings and turning them into positive thoughts. Studies have shown that CBT reduces glucose metabolism levels in patients who present with obsessive-compulsive disorder.  

Ethical and legal principles that apply in psychotherapy impact all modes of therapy including individual, group, and family sessions. One of the ethical issues is confidentiality. In a group and family setting, it might be a bit challenging to establish confidentiality because the therapist may not have control over what a person might be inside the group (Wrape & McGinn, 2019). However, all members should sign an informed consent and agree to maintain the privacy of information shared in the group. Similarly, in family sessions, they should all sign a form to establish their commitment to the privacy and confidentiality of the family members. Furthermore, information acquired through individual private sessions cannot be shared by the rest of the family members. In individual therapy, confidentiality and privacy are still established between the psychotherapist and the client. This, however, differs from group therapy confidentiality because there is limited potential for disclosing the information from therapy