NRNP 6645 WK 1 RESPONSES

Running Head: MEMORANDUM 1

MEMORANDUM 3

Adedamola Adefioye Week1 Main Discussion Post COLLAPSE

Introduction

Psychotherapy is an interpersonal interaction between clinician and client that focuses on exploring thoughts, feelings, attitudes, cognition, and behaviors to solve client problems or achieve higher functioning levels. Issues such as difficulties coping with daily life stress, death of the family member, the impact of trauma, medical illness, and mental disorders (American Psychological Association, 2016). Effective psychotherapy can alleviate individual suffering, decrease healthcare expenses, and improve mental health. This essay will explore psychotherapy dynamics, ethical and legal issues.

Psychopathology and Biological basis

Psychotherapy has a biological basis because psychotherapy changes the way the brain functions. Psychotherapy can deactivate maladaptive behaviors and foster new constructive pathways thus, altering structures and functions of different regions and networks in the brain and improving mental health disorders. Psychotherapy has been shown to improve emotions and behaviors and to be linked with positive changes in the brain and body. With the use of brain imaging techniques researchers have been able to see changes in the brain after a person has undergone psychotherapy. Numerous studies have identified brain changes in people with mental illness (including depression, panic disorder, PTSD, and other conditions) because of undergoing psychotherapy. In most cases, the brain changes resulting from psychotherapy were similar to changes resulting from medication (Karlsson, 2011).

For example, cognitive-behavioral techniques can increase insight and emotional processing, the psychodynamic technique can change maladaptive cognitions, and experiential techniques can provide exposure to opportunities (Eubanks and Hunter, 2020). Therefore, psychotherapy indirectly targets certain brain regions that are imbalanced and improves the function of those brain regions through different modalities. For instance, the amygdala and hippocampus are associated with emotions and memories; thus, any injuries or stress to these regions can cause a negative impact on a person's life.

Impact of Culture, Religion, and Socioeconomic on Psychotherapy

Culture plays a significant role in how a person interacts with others, perceives illness and health, and engages in the treatment and healing process. Psychotherapy can be impacted by culture, religion, and socioeconomic status. For example, certain cultures do not believe in mental disorders; therefore, they do not believe in talking to a therapist. According to Lefevor et al. (2020), several predictors such as individual attitude, societal stigma, structural barriers, and the degree to which the individual feels capable of seeking treatment may explain why specific individuals refuse to seek care even when they have opportunities and resources. Clinicians need to be culturally sensitive, congruent, competent, and understand different cultural backgrounds to treat them effectively.

Religious individuals primarily seek spiritual and mental health from their church leaders instead of professionals. Because specific religious communities have their subjective norms, those who seek psychotherapy treatment may be criticized or ostracized because they may be seen as less faithful (Lefevor et al., 2020). Clinicians can use prayers and biblical quotes to reinforce healthy mental and emotional habits and help with the healing process.

Furthermore, Individuals with formal education are more likely to seek psychotherapy sessions than those with less education. Individuals who have jobs and are well established are more likely to have insurance coverage, transportation, access to quality care, and money to pay for treatment (Lefevor et al., 2020).

Ethical and Legal Consideration

Clinicians must be professional when conducting therapy sessions, maintain client autonomy, confidentiality, avoid causing harm, fidelity, and maintain a therapeutic relationship and boundaries. Several ethical dilemmas can arise especially when therapy session involves family members or couples. Psychotherapy is mostly conducted between a therapist and a client; however, sometimes, families and couples are involved in group therapy. Ethical issues such as informed consent can impact the way the sessions are conducted. Thus, the therapist should inform everyone involved on the treatment's risks and benefits and consent before the session starts. Informed consent for couples and families differs from those of individuals' therapy because the couples' family members have less control over the therapy outcome, leading to undesirable outcomes by one of the participants (Knauss and Knauss, 2012). Everyone in the group should be given enough information to make a clinical decision and maintain appropriate boundaries, limits, set goals, and expected behavior.

Privacy and confidentiality can be hard to maintain in group or family therapy sessions since an individual must share the information with everyone in the room. Everyone in the group should be encouraged to maintain client information and privacy. In group therapy, participants may be resistant to sharing information due to the fear of being judged or ridiculed. Confidentiality is a basic requirement of psychotherapy. Also, although patients share personal feelings and thoughts, intimate physical contact with a therapist is never appropriate, acceptable, or useful. The clinician should be competent in treating families or couples and offering effective treatment using appropriate treatment modalities.

References

American Psychological Association. Understanding psychotherapy and how it works. 2016.  http://www.apa.org/helpcenter/understanding-psychotherapy.aspx

Eubanks, C. F., & Hunter, E. B. (2020). HiTOP and psychotherapy integration: Promising potential. Journal of Psychotherapy Integration, 30(4), 498–505. https://doiorg.ezp.waldenulibrary.org/10.1037/int0000254 .

Karlsson, H. How Psychotherapy changes the Brain. Psychiatric Times. 2011.

Knauss, L. K., & Knauss, J. W. (2012). Ethical issues in multiperson therapy. In S. J. Knapp, M. C. Gottlieb, M. M. Handelsman, & L. D. VandeCreek (Eds.), APA handbook of ethics in psychology, Vol 2: Practice, teaching, and research. (pp. 29–43). American Psychological Association. https://doi-org.ezp.waldenulibrary.org/10.1037/13272-003 .

 Lefevor, G. T., Paiz, J. Y., Virk, H. E., & Smack, A. C. P. (2020). The influence of individual and congregational religiousness on seeking psychotherapy: A multilevel analysis. Practice Innovations, 5(4), 257–274. https://doi-org.ezp.waldenulibrary.org/10.1037/pri0000113.

Matthew Aaron Wk1 Main Post   COLLAPSE

The Biological Basis for Psychotherapy

     Psychotherapy does indeed have a firm basis in biological/neurological functions and adaptations. Until relatively recently, it was thought that once a brain had matured, the connections and damage developed until that point were, more or less, set in stone. However, with newer studies, science has shown that the brain is significantly more plastic than was previously theorized, and could adapt to new changes and induced behaviors, such as those presented to the patient by their therapeutic provider in an appropriately set up therapeutic environment (Sikorski, 2016). Indeed, these findings have shown that with appropriate psychotherapeutic treatment, patients may experience measurable changes in activity in brain regions responsible for behavioral/symptomatic change comparable to patients treated with psychopharmacological methods, and that the combination of psychotherapy with psychopharmacology can have significant synergistic effects upon the patient and their underlying disorder (Sikorski, 2016).

The Effects of Culture and Religion on Psychotherapy

     Culture, religion, and even a patient’s socioeconomic standing can have both negative or positive effects upon not only the patient’s choice to pursue psychotherapy, but also their overall outcomes and persistence with treatment. Studies performed since the 1980’s have shown that patients from racial/ethnic minorities often have a significantly lower rate of treatment in psychotherapy, and that those who do seek treatment, have a significantly lower level of social support to continue their treatment/therapeutic regimens, and therefore suffer much higher rates of relapse for many different psychopathologies compared to other patient groups (Watkins et al., 2019). These studies have shown that it is imperative to take into account a patient’s belief  structure, social supports, and overall cultural origin when devising a treatment plan, in order for the provider/clinician to avoid producing “cultural ruptures” or inadvertent cultural microaggressions that can negatively affect treatment/therapeutic outcomes (Watkins et al., 2019). In fact, many cultures, especially with a strong Patriarchal basis/machismo, can actively turn patient’s away from seeking therapy as it can be seen as “weak”, “feminine”, or otherwise suspect/untrustworthy (Hankerson et al., 2015).

     Furthermore, it is important for the clinician to keep in mind how a patient’s overall socioeconomic status can also have a profound impact on their viewpoints and behavioral habits as well. Studies have also shown that lower-working-class people, while having statistically lower chances of seeking therapy, also have significantly higher scores for empathy and typically have much greater resources for social/family support than many other socioeconomic classes, and therefore have a better support structure for treatment adherence/good treatment outcomes than many other patient populations (Manstead, 2018).

Legal and Ethical Considerations

     When transitioning between individual to group therapies, it is important for the clinician to keep in mind that there are various ethical and legal considerations to keep in mind. Most notably, with privileged communication with an individual patient, the patient may not be comfortable discussing the same level of private or emotionally charged information in front of a group setting as they do in a private setting. As such it is imperative to have the patient’s consent prior to discussing anything they may feel to be overly private or sensitive in a group setting, and to work continuously to maintain privacy for both the individual and the group at large with regards to the shared information to the extent the provider is able (Dever Fitzgerald et al., 2010).

     In conclusion, as an advanced care provider/clinician, it is important to keep in mind a patient’s changing needs with regards to consent and privacy of communication when changing between group and private/individual settings. This will aid in preventing not only a rupture in the therapeutic relationships, but also possible legal fall out should the patients feel their privacy was incorrectly compromised. Not only should these ethical and legal considerations be taken into account prior to any therapeutic conversation, but also there should be an examination of the patient’s underlying belief structures, culture, socioeconomic standing, and the clinician’s own view points that might color or shape the conversation or therapy in order to have a clear understanding of possible obstacles to therapeutic communication. Attached will be found the PDF forms as requested of all the references contained herein. These supporting sources are considered scholarly in that they are representative of peer-reviewed, published scholarly articles dealing intimately with the subject matter in an objective and scientifically verifiable manner.

References

Ethical and Legal Considerations for Internet Based Psychotherapy.pdf Multicultural Orientation in Psychotherapy Supervision 2019.pdf THE MECHANISM OF NEUROPLASTICITY AND ITS SIGNIFICANCe1111.pdf The psychology of social class How socioeconomicstatus impacts thought, feelings, and behaviour.pdf Treatment Disparities among African American Men with.pdf Ethical and Legal Considerations for Internet Based Psychotherapy.pdf Multicultural Orientation in Psychotherapy Supervision 2019.pdf THE MECHANISM OF NEUROPLASTICITY AND ITS SIGNIFICANCe1111.pdf The psychology of social class How socioeconomicstatus impacts thought, feelings, and behaviour.pdf Treatment Disparities among African American Men with.pdf  

Dever Fitzgerald, T., Hunter, P. V., Hadjistavropoulos, T., & Koocher, G. P. (2010). Ethical and legal considerations for internet-based psychotherapy. Cognitive Behaviour Therapy, 39(3), 173–187. https://doi.org/10.1080/16506071003636046

Hankerson, S. H., Suite, D., & Bailey, R. K. (2015). Treatment disparities among african american men with depression: Implications for clinical practice. Journal of Health Care for the Poor and Underserved, 26(1), 21–34. https://doi.org/10.1353/hpu.2015.0012

Manstead, A. R. (2018). The psychology of social class: How socioeconomic status impacts thought, feelings, and behaviour. British Journal of Social Psychology, 57(2), 267–291. https://doi.org/10.1111/bjso.12251

Sikorski, W. (2016). THE MECHANISM OF NEUROPLASTICITY AND ITS SIGNIFICANCE FOR PSYCHOTHERAPY AND THE EVALUATION OF THERAPEUTIC EFFECTIVENESS. Psychoterapia, 2(177), 43–56. http://psychoterapiaptp.pl/uploads/PT_2_2016/ENGver43Sikorski_Psychoterapia_2_2016.pdf

Watkins, C., Hook, J. N., Owen, J., DeBlaere, C., Davis, D. E., & Van Tongeren, D. R. (2019). Multicultural orientation in psychotherapy supervision: Cultural humility, cultural comfort, and cultural opportunities. American Journal of Psychotherapy, 72(2), 38–46. https://doi.org/10.1176/appi.psychotherapy.20180040

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