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.
10 Essential Soft Skills for Nurses
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.
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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.
Cultural, Religious, and Socioeconomic Influences
The influence of culture, religion, and socioeconomic factors on a patient’s perception of psychotherapy is substantial. Patients’ views on health and rehabilitation are greatly shaped by these aspects. Cultural differences can lead to varying attitudes towards psychotherapy. For example, some cultures stigmatize therapy, causing patients to resist it out of fear of being labeled as “crazy.” This cultural barrier often leads to premature termination of services, particularly among low-income patients and minorities. Furthermore, compared to their demographic representation, Asian Americans are less likely to seek mental health treatment and tend to hold more negative views on psychotherapy than European Americans. Encouraging a shared understanding of the underlying issues is crucial in making therapy more acceptable to Asian Americans (Nagayama et al., 2019).
Religion also exerts a significant influence on psychotherapy. Certain religious groups integrate prayer and religious practices alongside or in conjunction with counseling services. Many religious patients prefer therapists and medical professionals who share their religious beliefs because they seek therapy approaches that align with their core values (Charzyńska and Heszen-Celińska, 2020).
Socioeconomic factors, unfortunately, can have a detrimental impact on psychotherapy. Financial constraints, lack of transportation, and limited social networks deter many patients from seeking treatment, leading to poor treatment outcomes. For example, in Finland, where universal healthcare is available to all, access to psychotherapy is still partly dependent on one’s financial situation (Leppänen et al., 2022). Low socioeconomic status also affects the willingness to seek treatment. Even when there is a greater need, individuals with lower socioeconomic status, especially those with lower education levels, tend to use mental health services less frequently compared to those with higher socioeconomic status (Leppänen et al., 2022).
Legal and Ethical Considerations
Legal and ethical issues hold significant sway in determining a person’s access to and the overall outcome of their treatment. In the context of individual, family, and group therapy, obtaining informed consent is a common and crucial factor. In family and group settings, patients may hesitate to disclose pertinent information to therapists, potentially negatively affecting their treatment plans. The principle of self-determination, closely aligned with the moral principles of beneficence and non-maleficence, dictates that every patient has the right to make their own decisions (Trachsel and Grosse, 2019). In group or family sessions, therapists often adopt a more generalized approach, while they can be more specific and precise in one-on-one sessions, all while maintaining professionalism. The age of patients is another significant legal and ethical concern, as younger patients often have their parents present in therapy sessions. This dynamic can risk younger patients withholding crucial information or being reluctant to engage with the therapist. While legal requirements in most states mandate parental consent for minors to receive services, ethical considerations lead some therapists to have parents sign forms authorizing treatment without the presence of an adult. However, decisions about treatment are typically discussed with parents.
Scholarly Sources
All the resources referenced in this discussion are scholarly in nature. Each source is peer-reviewed and evidence-based, as demonstrated by the inclusion of research findings, tools, measures, and author contributions in each article. These articles were retrieved from reputable sources such as The National Institute of Health and PubMed Central, which are well-known for providing access to scholarly literature. Additionally, each article includes references to previous research findings and is supported by relevant data. The PDFs for each article are provided following the reference section.
The importance of psychotherapy is increasingly recognized, and over the past decade, multiple meta-analyses have demonstrated its effectiveness in addressing various mental and behavioral issues across different life stages (Kamenov et al., 2017). Despite this knowledge that psychotherapy is equally effective as psychopharmacology, its utilization has declined in the last ten years, even as more patients seek psychopharmacological treatments (APA, 2012). In response to the proven efficacy of psychotherapy, the American Psychological Association’s Council of Representatives adopted a resolution citing more than 50 peer-reviewed studies that highlight its effectiveness in treating mental health conditions across the lifespan (APA, 2012). Psychotherapy thrives on the therapeutic alliance between the therapist and the patient, as well as a shared understanding of therapy goals (APA, 2012).
Psychotherapy is a personalized and comprehensive biological treatment that doesn’t specifically target a single neurotransmitter but influences various biological processes in the brain (Javanbakht & Alberini, 2019). The outcome of psychotherapy leads individuals to adapt through new learning experiences, resulting in changes in cognitive, emotional, and internal regulation (Javenbakht & Alberini, 2019). Neuroscientific research has unveiled the genetic, epigenetic, anatomical, and functional basis of human behavior (Javenbakht & Alberini, 2019). Post-traumatic stress disorder (PTSD) is increasingly acknowledged as a public health concern, particularly among military service members (Stojek et al., 2018). Trauma-focused therapies like cognitive processing therapy (CPT) and prolonged exposure (PE) have proven successful in treating individuals with PTSD (Stojek et al., 2018). PE aims to facilitate emotional processing by deliberately addressing traumatic experiences, grounded in the Emotional Processing Theory (Stojek et al., 2018). Early studies utilizing exposure therapy observed increased hippocampal activation during the recall of traumatic memories, possibly due to the extinction of cognitive-emotional connections resulting from the cessation of learning (Stojek et al., 2018).
Religious beliefs can significantly influence individuals seeking cognitive psychotherapy. These beliefs are integral to a patient’s culture, and religious individuals often prioritize moral judgment over participation and understanding of psychological processes (Carone & Barone, 2001). As a therapist, it is crucial to avoid bias against a patient’s religion, respecting their beliefs, and recognizing how faith can complicate various aspects of life. Additionally, culture can shape one’s perspective on psychotherapy treatment, and the importance of culturally competent services for ethnic minorities has been emphasized for decades (Sue et al., 2009). Cultural and ethnic concepts may clash with the traditional values underpinning conventional psychotherapies, necessitating therapists’ competence in addressing culturally-based concerns of their clients.
In group and family therapy, therapists confront more ethical and legal challenges compared to individual therapy, mainly related to maintaining confidentiality within a group setting. Consequently, clients may choose to withhold information that might be pertinent in a group session. Informed consent is a crucial element of any psychotherapy, empowering clients to decide their participation (Grover et al., 2022). Therapists, as healthcare professionals, must uphold client confidentiality except when it conflicts with the law, in which case, legal consultation becomes necessary. Clients should also be aware that confidentiality is not absolute and that certain situations, such as abuse, the protection of potential victims, or self-defense against inappropriate or threatening client behavior, may require therapist reporting (Grover et al., 2022).
Peer-reviewed, evidence-based articles play a pivotal role as they represent scholarly literature where research undergoes evaluation for quality, relevance, and accuracy by experts in the same field. Several scholarly articles have been referenced in this discussion. For example, the article “Ethical and Legal Issues in Psychotherapy” authored by Grover et al. in 2022, is considered an academic article, published in the Indian Journal of Psychiatry, and presents scientifically valid and reasonable conclusions. Another peer-reviewed article referenced in this discussion is “The Efficacy of Psychotherapy, Pharmacotherapy, and Their Combination on Functioning and Quality of Life in Depression: A Meta-Analysis” by Kamenov et al. in 2017. This article is scholarly as it is a meta-analysis and has undergone rigorous peer review before publication. Similarly, “Neuroscience Informed Prolonged Exposure Practice: Increasing Efficiency and Efficacy Through Mechanisms” by Stojek et al. in 2018 is a scholarly article, having undergone peer review by experts in the field.