Psychotherapy Biological Basis
Peer-reviewed articles, exemplified by Jokinen & Hartshorne (2022), have affirmed that medication management alone may not be sufficient for many clients. Psychotherapy, a biological treatment that brings about changes in the client’s brain, plays a crucial role in the healing process. Psychotherapy is considered a biological intervention because it empowers the client to develop healthy coping mechanisms, address their mental health issues, and cultivate new adaptations following trauma or other significant life events, as highlighted in the scholarly work by Moreira, Inman, & Cloninger (2020). Clinicians who adopt a biopsychosocial holistic approach contribute to healing clients in individual, group, or family settings. This approach proves especially beneficial for clients whose biological or genetic components have been altered due to traumatic experiences or other life events, a concept substantiated and discussed in the peer-reviewed article by Jokinen and Hartshorne (2022).
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Culture, Religion, Socioeconomic Factors
In supporting clients from diverse cultural, religious, and socioeconomic backgrounds, psychotherapy is often combined with medication management to address their specific mental health needs. When working with clients, it’s essential to gather comprehensive information about their cultural backgrounds, employment, household composition, neighborhoods, and religious practices as a starting point for the therapeutic journey. A client’s religious and cultural beliefs can significantly influence their approach to therapy and medication management. Sometimes, these beliefs act as barriers to treatment, impeding progress. Practitioners should be sensitive to these convictions, guiding clients through exploration and assignments that align with their religious or cultural practices. While prayer might be therapeutic for some, it could trigger further trauma in others, necessitating a thorough assessment by the clinician. For instance, the impact of culture and religious beliefs on grief varies with age and culture, as elucidated in the peer-reviewed article by Smid et al. (2018).
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Clients or families facing socioeconomic challenges may find it difficult to attend therapy sessions or afford necessary supplies and medications. Lower socioeconomic status is often linked to higher mental health struggles, but achieving recovery is possible, irrespective of economic circumstances. Addressing practical issues, such as transportation and childcare for adult clients, particularly when finances are limited, should be a priority early in the therapeutic relationship to ensure these challenges do not hinder progress.
Legal and Ethical Considerations in Group and Family Therapy
Maintaining confidentiality is paramount in healthcare and essential for building rapport in therapy, especially in group and family settings, where it can present unique challenges. Safeguarding the privacy of all clients, family members, and group participants within a therapeutic environment is an ongoing educational process. In the context of an increasingly telemedicine-oriented world, the significance of informed consent and protecting clients’ rights has been established and discussed, as exemplified in the peer-reviewed article by Avasthi, Grover, & Nischal (2022). Obtaining signed consent and educating all involved parties is crucial, with the understanding that complete privacy cannot be guaranteed in telemedicine, family, or group settings. Clinicians must take all necessary precautions, inform clients about the process, and obtain signed consent before conducting sessions or group meetings.
References
Avasthi A, Grover S, Nischal A. Ethical and Legal Issues in Psychotherapy. Indian J Psychiatry. 2022 Mar;64(Suppl 1): S47- S61. DOI: 10.4103/Indian psychiatry. indianjpsychiatry_50_21. Epub 2022 Mar 22. PMID: 35599651; PMCID: PMC9122134.
Jokinen, R. R., & Hartshorne, T. S. (2022). Anxiety Disorders: A Biopsychosocial Model and an Adlerian Approach for Conceptualization and Treatment. Journal of Individual Psychology, 78(2), 155–174. https://doi.org/10.1353/jip.2022.0022Links to an external site.
Moreira, P., Inman, R., & Cloninger, C. (2022). Reactance and personality: Assessing psychological reactance using a biopsychosocial and person-centered approach. Current Psychology: A Journal for Diverse Perspectives on Diverse Psychological Issues, 41(11), 7666-7680.
Smid, G. E., Groen, S., de la Rie, S. M., Kooper, S., & Boelen, P. A. (2018). Toward Cultural Assessment of Grief and Grief- Related Psychopathology. Psychiatric services (Washington, DC), 69(10), 1050–1052. https://doi.org/10.1176/appi.ps.201700422Links to an external site.
Response 1:
I found your post quite engaging and I concur with your perspective on the biological basis of psychotherapy. As indicated by Malhotra and Sahoo (2017), the brain undergoes development and reconstruction during psychotherapy. Given that psychotherapy has a tangible impact on one’s mental processes, it can be argued that it possesses a biological foundation (Malhotra & Sahoo, 2017). Furthermore, religion, culture, and socioeconomic status are pivotal factors that influence a patient’s willingness to engage in psychotherapy. In certain cultures, mental health holds equal importance as physical health, fostering open discussions and encouraging individuals to seek treatment. Conversely, in other cultures, the acceptance of mental illness is nonexistent, which can impede the treatment process. As providers, it is essential to consider a person’s cultural and religious background when delivering care to the patient. Additionally, individuals from lower socioeconomic backgrounds may encounter challenges in attending psychotherapy sessions, such as financial constraints, transportation issues, or a lack of perceived importance.
The realm of legal and ethical concerns frequently arises as providers interact with clients on a daily basis. In group sessions, confidentiality stands as a paramount principle, and informed consent must be obtained from all participants. Legal matters extend to situations involving minors and clients with guardianships, requiring careful consideration. Providers may find themselves in situations where clients share information that, although not directly endangering themselves or others, could be significant if parents or guardians are made aware. This poses ethical and legal dilemmas as the importance of the information may clash with legal restrictions. Parents maintain the right to make informed decisions about their child’s care, even if the child rejects it (Jesus et al., 2022).
References
Jesus, V., Liem, A., Borra, D., & Appel, J. (2022). Who’s the Boss? Ethical Dilemmas in the treatment of children and adolescents. Focus, 2(20), 215-219. https://doi.org/10.1176/appi.focus.20210037Links to an external site.
Malhotra, S., & Sahoo, A. (2017). Rebuilding the brain with psychotherapy. Indian Journal of Psychiatry, 59(4), 411-419. Http://doi.org/104103/0019-5545.217299Links to an external site.
Response 2:
I thoroughly enjoyed reading your post, and I wholeheartedly agree with your perspective on the biological basis of psychotherapy. It’s evident that psychotherapy directly affects the brain, as virtually all mental processes are intricately linked to this complex organ. As Marwood et al. (2018) have indicated, psychotherapy can both activate and reduce activities in specific regions of the brain. The field of neuroscience is rapidly evolving, particularly in the context of mental health, and its integration into psychotherapy holds the potential for generating new hypotheses that could prove invaluable in addressing a myriad of mental health issues.
Psychotherapists must remain acutely aware of various factors that could potentially impede the successful implementation of psychotherapy. These encompass elements such as culture, religion, and socioeconomic considerations. Notably, individuals with a lower socioeconomic status often face barriers when seeking mental health services. Paradoxically, even when the need is more pressing, individuals with lower educational and socioeconomic levels tend to utilize mental health services less frequently than those from higher socioeconomic backgrounds, as emphasized by Leppänen et al. (2022). Moreover, psychotherapists must take into account the beliefs and values of patients with diverse cultural and religious backgrounds. Tailoring therapy to an individual’s socioeconomic status is equally vital. For instance, psychotherapists should approach patients while considering their financial circumstances and available resources.
Confidentiality stands as a cornerstone of ethical practice in group and family therapy. Psychotherapists are expected to uphold strict confidentiality in all psychiatric settings. However, group and family therapy settings introduce unique challenges, given that multiple patients are involved. To address this, one approach is to document pertinent information from individual patients before the sessions commence, thereby ensuring confidentiality for all parties involved. This proactive measure helps strike a balance between the need for therapy in a group context and the preservation of individual privacy.
References.
Marwood, L., Wise, T., Perkins, A. M., & Cleare, A. J. (2018). Meta-analyses of the neural mechanisms and predictors of response to psychotherapy in depression and anxiety. Neuroscience and Biobehavioral Reviews, 95, 61– https://doi.org/10.1016/j.neubiorev.2018.09.022Links to an external site.
Leppänen, H., Kampman, O., Autio, R., Karolaakso, T., Näppilä, T., Rissanen, P., & Pirkola, S. (2022). Socioeconomic factors and use of psychotherapy in common mental disorders predisposing to disability pension. BMC health services research, 22(1), 983. https://doi.org/10.1186/s12913-022-08389-1Links to an external site.
I truly enjoyed reading your post and appreciate your insights. It’s wonderful that you brought up the article by Jokinen and Hartshorne (2022) as it seems to have resonated with both of us. The interplay between psychopathological disease processes and the influence of environmental and biological factors is a core paradigm that drew me into the field of psychiatry initially. Additionally, I share your fascination with the temporal relationships between medical and psychopathological disease processes. It’s indeed a compelling area of study, and it’s widely acknowledged that medical disease processes often take precedence over mental health concerns. Being part of the mental healthcare workforce during this transformative time is both exciting and essential.
The discussion by Jokinen and Hartshorne (2022) regarding the impact of environment and biology on mental health disease processes is indeed noteworthy. Their emphasis on the idea that neither genetics nor biology alone holds primacy, but rather, it’s how individuals utilize these factors to inform their cognitive behaviors that truly matters, is insightful. This perspective underscores the importance of individual agency in managing one’s mental health.
In the second part of your post, you rightly highlight how beliefs and cultural practices can sometimes act as barriers to treatment, hindering a patient’s progress. It’s crucial for healthcare providers to have a deep understanding of the specific cultural and belief-related obstacles that patients encounter to effectively cater to their needs. You make a valuable point about healthcare being akin to a business with providers offering products aimed at enhancing health, well-being, executive function, and, in some cases, happiness and joy through mood improvement. Just like salespeople, healthcare providers should skillfully employ critical thinking and communication to convey the importance of treatment. Sunderani and Moodley’s (2020) research points out the significance of cultural similarities and differences in therapist-patient interactions. Using self-disclosure to highlight cultural similarities can help build rapport, while understanding cultural differences might necessitate non-disclosure during certain client interactions. In your future practice, your approach of using self-disclosure when appropriate to underscore cultural commonalities and foster rapport is commendable. This strategy could provide you with a strong foundation to address any belief or cultural variables that may impede care, ultimately facilitating the development of patient-centered care plans that keep patients engaged in their treatment journey.
References
Jokinen, R. R., & Hartshorne, T. S. (2022). Anxiety Disorders: A Biopsychosocial Model and an Adlerian Approach for Conceptualization and Treatment. Journal of Individual Psychology, 78(2), 155–174. https://doi.org/10.1353/jip.2022.0022Links to an external site.
Sunderani, S., & Moodley, R. (2020). Therapists’ perceptions of their use of self-disclosure (and nondisclosure) during cross-cultural exchanges. British Journal of Guidance & Counselling, 48(6), 741–756. https://doi.org/10.1080/03069885.2020.1754333
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