NRNP 6645 BIOLOGICAL BASIS AND ETHICAL/LEGAL CONSIDERATIONS OF PSYCHOTHERAPY
The Biological Underpinnings of Psychotherapy
Psychotherapy encompasses a therapeutic dialogue that emphasizes empathy, transference, exploration of unconscious thoughts, and cognitive restructuring. In this intricate process, various brain regions, such as the hippocampus, amygdala, temporal lobe, and frontal lobe, play pivotal roles in learning. Psychotherapy primarily focuses on facilitating patients in acquiring constructive insights, thereby mitigating destructive thought patterns that impair daily functioning. Different therapeutic modalities, such as dialectical behavior therapy (DBT), interpersonal psychotherapy, and cognitive-behavioral therapy (CBT), exert discernible effects on brain function for individuals grappling with conditions like social anxiety disorder, obsessive-compulsive disorder (OCD), major depressive disorder (MDD), borderline personality disorder (BPD), and post-traumatic stress disorder (PTSD).
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Research findings illustrate the impact of CBT in reducing limbic and para-limbic hyperactivity in phobic conditions and lowering metabolism in the right caudate nucleus in individuals with OCD (Hamann et al., 2022; Ojeda & Hurley, 2022). Furthermore, patients receiving psychotherapy for PTSD exhibit increased activity and connectivity in the lateral frontal cortex and ventromedial prefrontal cortex, leading to improvements in hyperarousal (Rooij et al., 2021). Additionally, psychotherapy contributes to the augmentation of serotonin production in the brain, a neurotransmitter often deficient in individuals with depression and anxiety (Harbi, 2021; Wu et al., 2022). These alterations underscore the biological foundation of mental health disorders and the role of psychotherapy in modulating the underlying processes responsible for the manifestation of these conditions.
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Cultural, Religious, and Socio-economic Influences on Psychotherapy
The practice of psychotherapy is significantly influenced by cultural, religious, and socio-economic factors. Cultural and religious beliefs can substantially impact individuals’ willingness to seek mental health care. In some cultures, the stigma surrounding mental health issues persists, making it challenging for individuals to access necessary care. Access to psychiatric treatment remains a significant concern for many (Della et al., 2020). In various societies, religious rituals are integral to the healing process (Alattar et al., 2021). Despite mixed empirical evidence, some individuals may be hesitant to seek professional therapy due to their religious beliefs, potentially leading to suboptimal outcomes. In 2020, of the 14.2 million adults in the United States with mental illnesses, only 9.1 million (64.5%) received mental health treatment (National Institute of Mental Health [NIMH], 2022). Moreover, an individual’s socio-economic circumstances can limit their access to psychotherapy. Socio-economic barriers include factors such as the absence of insurance coverage, lengthy waitlists at community mental health centers, inability to afford copayments, and ineligibility for financial assistance. Research by Foster and O’Mealey (2021) indicates that individuals with higher socio-economic status are more likely to access mental health treatment.
Legal and Ethical Considerations in Group and Individual Therapy
The legal and ethical considerations in group and family therapy differ from those in individual therapy. Firstly, maintaining confidentiality in group settings is more challenging, even when strongly encouraged. Secondly, obtaining informed consent in group and family therapy is a more intricate process than in individual therapy (Riva & Cornish, 2018). Group facilitators and therapists must establish a therapeutic rapport with each participant. Managing conflicts that arise within a group setting can be demanding. Therapists must possess a profound understanding of group dynamics and ethical dilemmas due to the unique nature of group therapy. They must remain vigilant to address any issues that could compromise the safety of group members or the group as a whole (Riva & Cornish, 2018). Before commencing group therapy, therapists should engage in individual conversations with each participant. Participants must agree to uphold the confidentiality of their own identities and any other information shared during group sessions. They should be educated on preserving the confidentiality of group discussions when outside the therapeutic environment. In individual therapy, obtaining informed consent is comparatively straightforward as there is only one client. Similarly, confidentiality in individual therapy is one-on-one and can be maintained more easily between the patient and the therapist.
As a psychiatric nurse practitioner, I am acutely aware of the legal and ethical considerations inherent to various forms of therapy sessions. It is my responsibility to ensure that these principles are meticulously integrated into my practice when working with patients.
References
Alattar, N., Felton, A., & Stickley, T. (2021). Mental health and stigma in Saudi Arabia: A scoping review. Mental Health Review Journal, 26(2), 180-196. https://doi.org/10.1108/mhrj-08-2020-0055
Della, C. D., Teo, D. C. L., Agiananda, F., & Nimnuan, C. (2020). Culturally informed psychotherapy in Asian consultation‐liaison psychiatry. Asia-Pacific Psychiatry, 13(1), 12431-12439. https://doi.org/10.1111/appy.12431
Foster, S., & O’Mealey, M. (2021). Socioeconomic status and mental illness stigma: The impact of mental illness controllability attributions and personal responsibility judgments. Journal of Mental Health, 31(1), 1-8. https://doi.org/10.1080/09638237.2021.1875416
Hamann, C. S., Bankmann, J., Mora Maza, H., Kornhuber, J., Zoicas, I., & Schmitt-Böhrer, A. (2022). Social fear affects limbic system neuronal activity and gene expression. International Journal of Molecular Sciences, 23(15), 8228-8245. https://doi.org/10.3390/ijms23158228
Harbi, V. (2021). The neuroplasticity of depression: How antidepressants and cognitive behavior therapy (CBT) can reverse depression. PCOM Capstone Projects, 30(1), 1-40. https://digitalcommons.pcom.edu/capstone_projects/30/
National Institute of Mental Health. (2022). Mental illness.U.S. Department of Health and Human Services. https://www.nimh.nih.gov/health/statistics/mental-illness
Nohr, L., Lorenzo Ruiz, A., Sandoval Ferrer, J. E., & Buhlmann, U. (2021). Mental health stigma and professional help-seeking attitudes a comparison between Cuba and Germany. Public Library of Science (PLoS) ONE, 16(2), 246501-246524. https://doi.org/10.1371/journal.pone.0246501
Ojeda, W. L., & Hurley, R. A. (2022). Kisspeptin in the limbic system: new insights into its neuromodulatory roles. The Journal of Neuropsychiatry and Clinical Neurosciences, 34(3), 190-195. https://doi.org/10.1176/appi.neuropsych.20220087
Riva, M. T., & Cornish, J. A. (2018). Ethical considerations in group psychotherapy. In M. M. Leach & E. R. Welfel (Eds.), The Cambridge handbook of applied psychological ethics (pp. 218–238). Cambridge University Press. https://doi.org/10.1017/9781316417287.012
Rooij, S. J. H., Sippel, L. M., McDonald, W. M., & Holtzheimer, P. E. (2021). Defining focal brain stimulation targets for PTSD using neuroimaging. Depression and Anxiety, 38(7), 768-785. https://doi.org/10.1002/da.23159
Wu, Z., Wang, C., Dai, Y., Xiao, C., Zhang, N., & Zhong, Y. (2022). The effect of early cognitive behavior therapy for first-episode treatment-naive major depressive disorder. Journal of Affective Disorders, 308(1), 31-38. https://doi.org/10.1016/j.jad.2022.04.008Links to an external site.
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.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
To prepare:
- Review this week’s Learning Resources, reflecting on foundational concepts of psychotherapy, biological and social impacts on psychotherapy, and legal and ethical issues across the modalities (individual, family, and group).
- Search the Walden Library databases for scholarly, peer-reviewed articles that inform and support your academic perspective on these topics.
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.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Reply button to complete your initial post. Remember, once you click on Post Reply, you cannot delete or edit your own posts and you cannot post anonymously. Please check your post carefully before clicking on Post Reply!
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. https://doi.org/10.3389/fgene.2018.00257
Trachsel, M., & Grosse Holtforth, M. (2019). How to strengthen patients’ meaning response by an ethical informed consent in psychotherapy. Frontiers in Psychology, 10. https://doi.org/10.3389/fpsyg.2019.01747
Wheeler, K. (Ed.). (2020). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (3rd ed.). Springer Publishing.
Week 1 Response to Dania
Hello Dania, I found your post to be both insightful and engaging. I concur with your perspective that psychotherapy encompasses various elements such as therapeutic exchange, empathy, transference, exploration of unconscious thoughts, and cognitive restructuring. It is indeed a powerful tool for facilitating behavioral change and addressing a range of psychological issues.
Psychotherapy is a practice that employs psychological techniques, often involving interpersonal interactions, to assist individuals in altering their behavior and addressing issues in a way that aligns with their goals. The primary objective of psychotherapy is to enhance an individual’s mental health and overall well-being by addressing and managing problematic behaviors, beliefs, thoughts, emotions, and compulsions. Furthermore, it seeks to improve interpersonal relationships and social skills (Jimenez et al., 2018). A fundamental aspect of psychotherapy is to empower clients and support them in taking control of their lives. This collaborative effort between the therapist and the client defines the essence of psychotherapy.
Individual therapy, as you pointed out, typically involves one person receiving therapy from a psychologist, counselor, therapist, or psychiatrist. In contrast, group therapy involves the treatment of multiple individuals in a structured therapeutic setting. Group therapy has the advantage of being a cost-effective option, particularly for patients without insurance coverage (Wheeler, 2020). It allows therapists to work with several individuals simultaneously, thus increasing access to treatment for clients (Wheeler, 2020). Individual psychotherapy often focuses on the client from intrapsychic, interpersonal, and cognitive-behavioral perspectives, while family therapy aims to understand the client within the context of a broader system (Wheeler, 2020).
In group and family therapy settings, information is shared not only with the therapist but also with fellow group members. Consequently, the legal and ethical considerations in these settings differ from those in individual therapy. Therapists bear the responsibility of clearly communicating the necessity of confidentiality to all group participants, outlining the potential consequences of breaching confidentiality, and emphasizing that legal privileges do not extend to group discussions.
Legal and ethical considerations are of paramount importance in the field of therapy, serving to safeguard patient privacy and ensure that therapeutic relationships are built on trust and respect. As practitioners, we are bound by a code of ethics that mandates adherence to these principles. Healthcare professionals, including psychotherapists, are both legally and ethically obligated to obtain informed consent from patients for the treatments they provide, encompassing details such as the type and duration of treatment, potential benefits, and possible risks, among other factors. Informed consent represents a critical legal and moral framework for various therapeutic interventions, including psychotherapy, regardless of the treatment setting, whether inpatient or outpatient, and whether the therapy is individual, couples, or group-based (Trachsel & Holtforth, 2019). It is through informed consent that patients actively engage in their treatment, understanding and participating in the therapeutic process.
Exploring the Biological Basis of Psychotherapy
The practice of psychotherapy is rooted in a patient-centered approach that hinges on consistency and the therapeutic relationship, offering healing and support to individuals grappling with various mental health issues and emotional challenges. Its fundamental goal is to empower individuals to eliminate or manage debilitating symptoms, thereby enhancing their overall well-being and the healing process (APA, 2013). What may come as a revelation to many is that psychotherapy, despite its predominantly psychological focus, has a profound biological basis.
The biological foundation of psychotherapy centers on the intricate workings of the brain. Tyron (2016) elucidates that psychotherapy specifically targets maladaptive brain processes, effectively mending unfavorable cognitive patterns by introducing positive pathways. The brain constructs its experiential maps through the intricate connections of neurons. Psychotherapy, in its essence, seeks to rectify any dysfunctional mappings that may have formed over time. As Linden et al. (2012) have discovered, cognitive-behavioral therapy (CBT), a prominent form of psychotherapy, induces substantial changes in the prefrontal cortex. This region of the brain is closely linked to the regulation of emotions and decision-making, and alterations in its activity have been associated with therapeutic progress.
The Intersection of Culture, Religion, and Socioeconomic Factors in Shaping Attitudes Toward Psychotherapy
Culture, religion, and socioeconomic status are potent influencers in shaping an individual’s perspective on the value of psychotherapy treatments. These factors are pivotal in determining one’s beliefs, attitudes, and expectations concerning mental health and psychological interventions.
Culture, a product of shared beliefs, values, and practices within a particular group, significantly colors attitudes toward mental health and help-seeking behaviors. Cultural backgrounds profoundly influence emotions, actions, judgments, and self-perceptions. Consequently, cultural beliefs can deeply influence one’s perspective on psychotherapy. For instance, some cultures may stigmatize mental illness, promoting a preference for pharmacological treatments while discouraging the pursuit of psychotherapy (Anglin et al., 2008). In contrast, other cultural backgrounds may view psychotherapy as a sign of strength. An illustrative example is the varying perspectives within the United States, where a substantial portion of the population still sees therapy as a sign of weakness, while others, such as African Americans, consider it a means to cope with stress and build resilience.
Religion, too, plays a pivotal role in shaping perceptions of psychotherapy. Religious beliefs can significantly impact how individuals view mental health issues. Some religious groups may attribute conditions like depression to a lack of faith, while others perceive them as medical conditions requiring treatment. Moreover, religious beliefs may sway an individual’s choice between seeking help from mental health professionals and turning to spiritual or religious practices for coping. For example, in a predominantly Catholic country like the Philippines, it’s not uncommon for people to recommend increased prayer as a solution to depression.
Socioeconomic status adds another layer of complexity to this interplay. Individuals from lower socioeconomic backgrounds may encounter financial barriers when attempting to access mental health services, potentially viewing therapy as an impractical expense. Furthermore, the stigma associated with mental health issues can be more pronounced for those in lower socioeconomic brackets, affecting their willingness to seek help.
Studies have corroborated the significant influence of cultural, religious, and socioeconomic factors on attitudes toward psychotherapy. Research by Pescosolido and colleagues (2008), for instance, has revealed that cultural beliefs and attitudes play a crucial role in determining whether individuals seek help from mental health professionals. Similarly, Blevins and colleagues (2018) found that religious beliefs and practices are associated with attitudes toward psychotherapy among individuals experiencing depression.
Divergent Legal and Ethical Considerations in Group and Family Therapy
The landscape of legal and ethical considerations in group and family therapy diverges significantly from that of individual therapy due to the unique dynamics inherent in these settings. Of paramount importance in group and family therapy is the matter of confidentiality. While confidentiality is always an ethical imperative in therapy, it becomes increasingly complex in group and family settings. Therapists must navigate the delicate balance between safeguarding individual clients’ privacy and preserving the integrity of the group or family dynamic.
In group and family therapy, group members may possess sensitive information about fellow participants that can potentially influence their perceptions and interactions. Maintaining confidentiality, therefore, requires careful handling. The American Counseling Association (ACA) Code of Ethics mandates that group and family therapists secure written consent from all participants prior to commencing therapy, along with establishing clear guidelines for preserving confidentiality within the group or family (ACA, 2014).
Informed consent represents another critical ethical consideration, and it takes on a heightened level of complexity in group and family therapy. In addition to obtaining informed consent from individual clients, therapists must also secure consent from the entire group or family unit. This stems from the fact that group therapy involves interactions between participants, and each individual must be aware of the implications of these interactions. Informed consent serves as a pivotal ethical safeguard, ensuring that participants make well-informed decisions about their involvement in therapy.
The differential legal and ethical considerations in group and family therapy significantly impact therapeutic approaches for clients in these settings. Group and family therapists must adeptly navigate these complexities to create a secure and effective therapeutic environment that respects individual privacy while promoting the group’s therapeutic objectives.
References:
American Counseling Association. (2014). ACA Code of Ethics. Retrieved from https://www.counseling.org/resources/aca-code-of-ethics.pdf
American Psychological Association. (2017). Ethical Principles of Psychologists and Code of Conduct. Retrieved from https://www.apa.org/ethics/code/ethical-principles-2017.pdf
Anglin, D. M., Alberti, P. M., Link, B. G., & Phelan, J. C. (2008). Racial Differences in Beliefs About the Effectiveness and Necessity of Mental Health Treatment. American Journal of Community Psychology, 42(1-2), 17-24. https://doi.org/10.1007/s10464-008-9189-5
Blevins, C. E., Weatherspoon, A., DeFife, J. A., McAdams, D. P., & Gubi, A. (2018). Religiousness, spirituality, and depression: A study of mental health treatment-seeking adults. Journal of Affective Disorders, 232, 109-116.
Ethical Challenges in Group and Personal Therapy | Psychology Paper Examples. (2022, January 14). PsychologyWriting.com. https://psychologywriting.com/ethical-challenges-in-group-and-personal-therapy/
Linden, D. E. J., Habes, I., Johnston, S. J., Linden, S., Tatineni, R., Subramanian, L., … & Goebel, R. (2012). Real-time self-regulation of emotion networks in patients with depression. PloS one, 7(6), e38115.
M, N. (2021, April 21). Biological Basis of Psychotherapy Treatments – Best Nursing Writing Services. Best Nursing Writing Services. https://www.bestnursingwritingservices.com/biological-basis-of-psychotherapy-treatments/
Pescosolido, B. A., Gardner, C. B., & Lubell, K. M. (1998). How people get into mental health services: Stories of choice, coercion, and “muddling through” from “first-timers.” Social Science & Medicine, 46(2), 275-286.
Tyron W. (2016). Psychotherapy Integration via Theoretical Unification. International Journal of Integrative Psychotherapy, 7(1),1-26.
Robinson, B., Ph.D. (2021, February 4). 47% Of Americans Believe Seeking Therapy Is A Sign Of Weakness. Forbes. https://www.forbes.com/sites/bryanrobinson/2021/02/04/47-of-americans-believe-seeking-therapy-is-a-sign-of-weakness/?sh=124a800d4413
Diving Deeper into the Foundations of Psychotherapy
Psychotherapy, at its core, encompasses a multifaceted approach characterized by therapeutic exchanges, the nurturing of empathy, the exploration of transference, the illumination of unconscious thoughts, and the restructuring of cognitive patterns. This intricate practice delves into the realms of neurobiology as it unfolds. Several key brain regions, including the hippocampus, amygdala, temporal lobe, and frontal lobe, play pivotal roles in learning processes. Psychotherapy, as a treatment modality, places its emphasis on facilitating patients in acquiring constructive insights that can counteract destructive thought patterns that hinder their everyday functioning. Variants of psychotherapy, such as Dialectical Behavior Therapy (DBT), Interpersonal Psychotherapy, and Cognitive-Behavioral Therapy (CBT), are engineered to bring about notable shifts in brain function. These therapies are particularly beneficial for individuals grappling with conditions like social anxiety disorder, obsessive-compulsive disorder (OCD), major depressive disorder (MDD), borderline personality disorder (BPD), and posttraumatic stress disorder (PTSD).
Emerging research findings have illuminated the transformative potential of psychotherapy at the neurological level. For instance, in the case of phobias, Cognitive-Behavioral Therapy (CBT) has been shown to reduce para-limbic and limbic hyperactivity, offering individuals relief from their irrational fears (Hamann et al., 2022; Ojeda & Hurley, 2022). When it comes to OCD, CBT contributes to a reduction in metabolic activity within the right caudate nucleus, ultimately alleviating the distressing symptoms associated with this disorder. Patients undergoing psychotherapy for PTSD exhibit augmented activity and enhanced connectivity in brain regions like the lateral front cortex and ventromedial prefrontal cortex (Rooij et al., 2021), thereby fostering the attenuation of hyperarousal. Furthermore, psychotherapy has been noted to bolster the production of serotonin in the brain, a neurotransmitter that is often deficient in individuals experiencing depression and anxiety (Harbi, 2021; Wu et al., 2022). These collective findings strongly suggest that the symptoms of mental health disorders have a tangible biological basis, and psychotherapy acts as a catalyst in modifying the underlying biological processes responsible for the manifestation of these symptoms.
Navigating the Interplay of Culture, Religion, and Socioeconomic Status in Psychotherapy
The journey of psychotherapy is profoundly influenced by the tapestry of culture, religion, and socioeconomic status. These three potent forces collectively shape an individual’s perception of the significance of psychotherapeutic interventions and profoundly impact their attitudes and behaviors toward mental health care.
Culture, steeped in shared beliefs, values, and practices, wields considerable power in shaping an individual’s stance on mental health and the utilization of psychotherapy. It plays a profound role in influencing emotions, behaviors, judgments, and self-perceptions. Cultural backgrounds significantly color one’s outlook on psychotherapy. For example, certain cultures stigmatize mental illness, often favoring pharmacological treatments while stigmatizing or discouraging psychotherapy (Anglin et al., 2008). In contrast, other cultures consider seeking psychotherapy a testament to one’s strength. This dichotomy is evident even within a diverse society like the United States, where seeking therapy is still viewed by a significant portion of the population as a sign of weakness, while other communities, like African Americans, perceive it as a tool to cope with stress and build resilience.
Religion, as another influential force, can significantly shape an individual’s perception of psychotherapy’s value. Religious beliefs can profoundly impact one’s understanding of mental health issues, dictating whether they view mental illness as a spiritual ailment or a medical condition. For example, some religious groups might attribute depression to a lack of faith, while others may recognize it as a medical condition necessitating professional treatment. Moreover, religious beliefs may guide an individual’s choice between mental health professionals and spiritual or religious practices as coping mechanisms.
Socioeconomic status introduces an additional layer of complexity to this intricate interplay. Individuals from lower socioeconomic backgrounds may face financial barriers to accessing mental health services, potentially viewing psychotherapy as an impractical expense. Moreover, the stigma surrounding mental health issues is often more pronounced in these socioeconomic strata, further affecting individuals’ willingness to seek help.
The profound impact of culture, religion, and socioeconomic status on attitudes toward psychotherapy has been substantiated through research. Studies have highlighted how these factors significantly influence people’s views on psychotherapy and their likelihood to seek mental health treatment (Pescosolido et al., 2008). For instance, cultural beliefs and attitudes have been identified as key predictors of individuals’ decisions to seek help from mental health professionals (Blevins et al., 2018).
Exploring the Nuances of Legal and Ethical Considerations in Different Forms of Therapy
The landscape of legal and ethical considerations within the realm of therapy is nuanced and distinct across various modalities, such as individual therapy, group therapy, and family therapy. As these therapeutic settings vary in structure and dynamics, the ethical and legal implications diverge accordingly.
In the context of group and family therapy, confidentiality, a fundamental ethical principle, is a complex matter. Although therapists strongly encourage confidentiality, it is not always feasible to maintain it completely within group settings. The presence of multiple participants in therapy introduces intricate dynamics that may challenge the preservation of individual privacy. In such scenarios, group facilitators and clinicians shoulder the responsibility of establishing a therapeutic bond with each participant, ensuring that conflicts within the group do not jeopardize the delicate balance of confidentiality. Therapists must possess a deep understanding of group dynamics and the ethical dilemmas inherent in group therapy. It is crucial for therapists to bear in mind these intricacies while developing therapeutic strategies. Providers of group therapy must remain vigilant for any issues that could compromise the safety and well-being of group members, addressing them promptly (Riva & Cornish, 2018).
Informed consent, another ethical cornerstone, is equally complex in group and family therapy. In addition to obtaining informed consent from individual clients, therapists must secure consent from the entire group or family, given the interdependent nature of these therapeutic contexts. Informed consent is pivotal as it empowers participants to make informed decisions regarding their involvement in therapy. Individual therapy, in contrast, simplifies the process of obtaining informed consent as there is only one client involved. Furthermore, the maintenance of confidentiality in individual therapy is relatively straightforward, as it primarily concerns the relationship between the therapist and the single client.
As a psychiatric nurse practitioner, I am acutely aware of the intricacies of ethical and legal considerations within different forms of therapy. I ensure that these principles are diligently incorporated into my practice, regardless of the therapeutic setting, to safeguard the rights and well-being of my patients.
References
Alattar, N., Felton, A., & Stickley, T. (2021). Mental health and stigma in Saudi Arabia: A scoping review. Mental Health Review Journal, 26(2), 180-196. https://doi.org/10.1108/mhrj-08-2020-0055
Della, C. D., Teo, D. C. L., Agiananda, F., & Nimnuan, C. (2020). Culturally informed psychotherapy in Asian consultation‐liaison psychiatry. Asia-Pacific Psychiatry, 13(1), 12431-12439. https://doi.org/10.1111/appy.12431
Foster, S., & O’Mealey, M. (2021). Socioeconomic status and mental illness stigma: The impact of mental illness controllability attributions and personal responsibility judgments. Journal of Mental Health, 31(1), 1-8. https://doi.org/10.1080/09638237.2021.1875416
Hamann, C. S., Bankmann, J., Mora Maza, H., Kornhuber, J., Zoicas, I., & Schmitt-Böhrer, A. (2022). Social fear affects limbic system neuronal activity and gene expression. International Journal of Molecular Sciences, 23(15), 8228-8245. https://doi.org/10.3390/ijms23158228
Harbi, V. (2021). The neuroplasticity of depression: How antidepressants and cognitive behavior therapy (CBT) can reverse depression. PCOM Capstone Projects, 30(1), 1-40. https://digitalcommons.pcom.edu/capstone_projects/30/
National Institute of Mental Health. (2022). Mental illness.U.S. Department of Health and Human Services. https://www.nimh.nih.gov/health/statistics/mental-illness
Nohr, L., Lorenzo Ruiz, A., Sandoval Ferrer, J. E., & Buhlmann, U. (2021). Mental health stigma and professional help-seeking attitudes a comparison between Cuba and Germany. Public Library of Science (PLoS) ONE, 16(2), 246501-246524. https://doi.org/10.1371/journal.pone.0246501
Ojeda, W. L., & Hurley, R. A. (2022). Kisspeptin in the limbic system: new insights into its neuromodulatory roles. The Journal of Neuropsychiatry and Clinical Neurosciences, 34(3), 190-195. https://doi.org/10.1176/appi.neuropsych.20220087
Riva, M. T., & Cornish, J. A. (2018). Ethical considerations in group psychotherapy. In M. M. Leach & E. R. Welfel (Eds.), The Cambridge handbook of applied psychological ethics (pp. 218–238). Cambridge University Press. https://doi.org/10.1017/9781316417287.012
Rooij, S. J. H., Sippel, L. M., McDonald, W. M., & Holtzheimer, P. E. (2021). Defining focal brain stimulation targets for PTSD using neuroimaging. Depression and Anxiety, 38(7), 768-785. https://doi.org/10.1002/da.23159
Wu, Z., Wang, C., Dai, Y., Xiao, C., Zhang, N., & Zhong, Y. (2022). The effect of early cognitive behavior therapy for first-episode treatment-naive major depressive disorder. Journal of Affective Disorders, 308(1), 31-38. https://doi.org/10.1016/j.jad.2022.04.008
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