Discussion Response

Response to Jocelyn Glessing

This is a great post. Your discussion highlights essential aspects of psychotherapy’s biological basis and the importance of culturally competent care. Incorporating epigenetics into the conversation is particularly compelling, emphasizing how maternal stress can predispose future generations to heightened stress responses: Discussion Response.

This underscores the critical role of early intervention and psychotherapy in breaking such cycles (Smeeth, 2021). It might be beneficial to delve deeper into how specific therapeutic modalities, like cognitive-behavioural therapy, actively reprogram stress-related gene expressions and whether these effects are equally observed across various demographics.

The emphasis on culturally competent care aligns with (Day et al., 2023), yet the challenge remains in adapting psychotherapy frameworks to diverse cultural paradigms. For instance, how might a collectivist cultural perspective alter the therapist-client dynamic? Additionally, socioeconomic barriers are a profound concern. Expanding on Bulthuis et al.’s (2019) findings, one could explore potential policies or programs aimed at improving access for underserved populations, such as sliding-scale fees or community-based therapy initiatives. What are your thoughts on these potential solutions?

References

Bulthuis, S. E., Kok, M. C., Raven, J., & Dieleman, M. A. (2019). Factors influencing the scale-up of public health interventions in low- and middle-income countries: a qualitative systematic literature review. Health Policy and Planning, 35(2). https://doi.org/10.1093/heapol/czz140

Day, S., Laver, K., Jeon, Y., Radford, K., & Low, L. (2023). Frameworks for cultural adaptation of psychosocial interventions: A systematic review with narrative synthesis. Dementia, 22(8). https://doi.org/10.1177/14713012231192360

Smeeth, D. (2021). The role of epigenetics in psychological resilience. The Lancet Psychiatry, 8(7), 620–629. https://doi.org/10.1016/S2215-0366(20)30515-0

Response to Adam George Perez

Your post effectively connects psychotherapy’s biological basis to its practical applications, particularly the lasting behavioural and neurological changes facilitated by cognitive-behavioural therapy (CBT). The mention of therapy’s influence on the prefrontal cortex and amygdala adds depth, but expanding on how these changes differ from those induced by pharmacological treatments could enhance the discussion (Nakao et al., 2021). For example, what are the comparative durations of these effects, and how might they influence long-term treatment planning?

You also thoughtfully analysed cultural, religious, and socioeconomic influences. (Knifton & Inglis, 2020) Exploring poverty and mental health is crucial; however, integrating examples of how therapists address such barriers could add practical relevance. For instance, community-based programs or integrating mental health services into primary care might offer feasible solutions (Cammisuli & Castelnuovo, 2023). Have you encountered evidence on how these approaches affect treatment outcomes for low-income populations?

References

Cammisuli, D. M., & Castelnuovo, G. (2023). Neuroscience-based psychotherapy: A position paper. Frontiers in Psychology, 14(14). https://doi.org/10.3389/fpsyg.2023.1101044

Knifton, L., & Inglis, G. (2020). Poverty and mental health: policy, practice and research implications. BJPsych Bulletin, 44(5), 193–196. https://doi.org/10.1192/bjb.2020.78

Nakao, M., Shirotsuki, K., & Sugaya, N. (2021). Cognitive–Cognitive-behavioural therapy for Management of Mental Health and stress-related disorders: Recent Advances in Techniques and Technologies. BioPsychoSocial Medicine, 15(1), 1–4. https://doi.org/10.1186/s13030-021-00219-w

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Jocelyn Glessing

Nov 27 10:25pm

Manage Discussion by Jocelyn Glessing

Reply from Jocelyn Glessing

Discussion week 1 Nurs 6645, Glessing, J.

            In life individuals and families will often go through struggles and even crisis, if the stressful event outweighs the existing individual’s available coping mechanisms.  During the struggle or crisis, if help is needed outside of the capacity for the individual or family to handle the situation, outside help may be needed either from a medical model that offers help in the form of medications for individuals, or in the form of psychotherapy for individuals or families.  Therapist Matthew Bambling (Neurobiology of Behavior Change, 2013,) mentions how normal biology changes genes and proteins to function in our brains, and if that doesn’t happen to success then stressors outweigh our capacity to function normally.

         Research has shown that psychotherapy can act on the problem genes as effectively as medication can, essentially given individuals and families new skills and knowledge that they can use later when similar or new stressors threaten to disrupt.  This shows that psychotherapy does have a biological process. When our brains are programmed to function a certain way and that can be changed as we learn a new process, this is a biological construct.  Another proof to this frame of thought is epigenetics and stress. 

       DeSocio (2018) demonstrated how infants with mothers that experienced stress could be essentially programmed to have more stress when still in utero. This stress gene can be passed down essentially through generations unless it is stopped, and new skills are learned and taught to future offspring through psychotherapy.  In a future study by Diez, et al. (2023,) DeSocio (2018) demonstrated how infants with mothers that experienced stress could be essentially programmed to have more stress when still in utero. This stress gene can be passed down essentially through generations and less it is stopped, and new skills are learned and taught to future offspring through psychotherapy.

       Another important avenue is the importance of culturally competent care.  While providing culturally competent care is important in psychotherapy, Lo & Fung (2023,) mention that current psychotherapy practices in the United States, do not line up with many other cultures. Future practices need to take that into consideration as culturally competent care is important in psychotherapy to make sure that the therapeutic alliance stays intact, and patients get care that is appropriate to their personal needs.  Additionally, those of low financial, educational, and occupational background tend to have higher incidences of mental illness, compared to their higher socioeconomic status peers, yet they are also least likely to obtain psychotherapy (Niemeyer & Knaevelsrud, 2023.)

    The above studies show the importance of psychotherapy to healing mental health issues, not only for the current individual but helping generations down the line with the help of Epigenetics and the changing of the biology of the brain to have more resilience and better coping skills; however, people of different, cultural backgrounds, and lower socioeconomic status are not currently getting that benefit. Future efforts need to be made in ensuring people can equally get the benefits that psychotherapy can offer.

   Nurse practitioners offering psychotherapy need to offer the same legal and ethical protection to their psychotherapy clients that they offer to any other patient and that is honoring HIPAA for the health information. Patient portability act (Avasthi, Grover, & Nischal, 2022,) which protects patient rights to privacy and confidentiality. This is even more important in mental health because of the sensitivity of many of the issues being discussed.

   While there are some places where confidentiality is mandated to be overwritten such as if somebody is going to harm themselves or others or if there’s any case of child abuse then patient confidentiality does not take effect, however, and all other cases confidentiality between patient and mental health worker is vital to be able to help patience. In psychotherapy it’s possible to not only have individual patients, but it is possible to have complete families be under the nurse practitioner’s care. The legal and ethical liability is the same, and that everybody will sign the informed consent contract, except in the case of minor for a family, but everyone that is able to consent will sign a consent form.

   The difference is if everybody is an adult and even though one individual might be present during Family sessions, what occurs in private sessions with that patient cannot be disclosed to other parties that are present for group sessions without written consent. Mental health practitioners must be cautious to not break confidentiality even when parties they know our present for family meetings are involved. Patients that have private care have the right for their personal treatment plan to remain private.        

********I was only able to attach one PDF but all of the below articles have links*****

References

Avasthi, A., Grover, S., & Nischal, A. (2022). Ethical and Legal Issues in Psychotherapy. Indian journal of psychiatry, 64(Suppl 1), S47–S61. https://doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_50_21Links to an external site.

Diez GG, Martin-Subero I, Zangri RM, Kulis M, Andreu C, Blanco I, Roca P, Cuesta P, Garcia C, Garzon J, Herradon C, Riutort M, Baliyan S, Venero C, & Vazquez C. (2023). Epigenetic, psychological, and EEG changes after a 1-week retreat based on mindfulness and compassion for stress reduction in healthy adults: study protocol of a cross-over randomized controlled trial. PloS One, 18(11), e0283169. https://doi.org/10.1371/journal.pone.0283169Links to an external site.

DeSocio, J. E. (2018). Epigenetics, maternal prenatal psychosocial stress, and infant mental health. ARCHIVES OF PSYCHIATRIC NURSING, 32(6), 901–906. https://doi.org/10.1016/j.apnu.2018.09.001Links to an external site.

Neurobiology of Behavior Change. (2013).  [Video/DVD.] Mental Health Academy.  https://video.alexandersgreet.com/watch/neurobiologyLinks to an external site.

Lo, H. T., & Fung, K. P. (2003). Culturally competent psychotherapy. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 48(3), 161–170. https://doi.org/10.1177/070674370304800304Links to an external site.

Niemeyer, H., & Knaevelsrud, C. (2023). Socioeconomic status and access to psychotherapy. Journal of clinical psychology, 79(4), 937–953. https://doi.org/10.1002/jclp.2344Links to an external site.

Epigenetic, psychological, and EEG changes after a 1-week retreat based on …_ @ Walden University Library-1.pdf

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Adam George Perez

Nov 27 10:22pm

Manage Discussion by Adam George Perez

Reply from Adam George Perez

Biological Basis of Psychotherapy

Psychotherapy has a biological foundation that has its benefits due to its psychological benefits. In some cases, it can change the way the brain functions ultimately affecting the behavior, like how medications work. For instance, cognitive-behavioral therapy (CBT) has the ability to have an effect on the prefrontal cortex and the amygdala (Bertolín, et al., 2023). resulting in altered decision making.

If these changes are made through psychotherapy, then it can lead to improved mental health and reduced symptoms in disorder like anxiety and depression. Therapy can have lasting benefits even after the sessions are over. Unlike medications, psychotherapy is more focused on behavioral patterns but also targets the biological issues. As a result, the benefits from psychotherapy are deeply connected to the brain’s functioning.

Cultural, Religious, and Socioeconomic Influences on Psychotherapy

Culture, religion, and socioeconomic status have a tremendous effect on how psychotherapy is perceived. Cultural values shape whether someone is willing to believe therapy as an option for positive change. Individualistic cultures focus on personal growth (Sun, et al., 2024). Religious beliefs impact people’s beliefs on whether someone will seek therapy.

Some individuals will seek prayer or spiritual guidance over psychotherapy. Socioeconomic factors are much different because it can act as a solid barrier limiting access to therapy because of its affordability and availability (Marbin, et al., 2022). Individuals who are qualified as low-income may stick to Maslow’s hierarchy of needs because basic needs or physiological needs are going to be more important than anything else.

There is a lot of stigmas around the idea of mental health which can influence some people to not even seek therapy. This is why it is important for therapist to consider all the factors when considering types of effective treatment plans for diverse populations.

Legal and Ethical Considerations in Group vs. Individual Therapy

Between group, family, and individual therapy, it is common for legal and ethical issues to vary. It is more obvious that confidentiality can be more difficult because more people are going to be involved during the therapy. This is why therapist must make sure that all members agree to participate with respect. Family therapies can involve more complexities because therapist will have to attempt to navigate through all the different issues and perspectives among close family members.

It is important to consider when involving minors, parental consent and selective vocabulary are going to have to be utilized during sessions. Individual therapy will focus more on gaining trust and making sure confidentiality between the two member and the licensed therapist stays confidential. Ensuring consent and maintain boundaries will be a couple ethical concerns to include. Each therapy requires different types of demands among members to facilitate positive outcomes for the clients.

References

Bertolín, S., Alonso, P., Martínez-Zalacaín, I., Menchón, J. M., Jimenez-Murcia, S., Baker, J. T., Bargalló, N., Batistuzzo, M. C., Boedhoe, P. S. W., Brennan, B. P., Feusner, J. D., Fitzgerald, K. D., Fontaine, M., Hansen, B., Hirano, Y., Hoexter, M. Q., Huyser, C., Jahanshad, N., Jaspers-Fayer, F., Kuno, M., … Soriano-Mas, C. (2023). Right Prefrontal Cortical Thickness Is Associated With Response to Cognitive-Behavioral Therapy in Children With Obsessive-Compulsive Disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 62(4), 403–414. https://doi.org/10.1016/j.jaac.2022.07.865Links to an external site.

Marbin, D., Gutwinski, S., Schreiter, S., & Heinz, A. (2022). Perspectives in poverty and mental health. Frontiers in public health, 10, 975482. https://doi.org/10.3389/fpubh.2022.975482Links to an external site.

Sun, Y., Kinsella, E. L., & Igou, E. R. (2024). On Cultural Differences of Heroes: Evidence From Individualistic and Collectivistic Cultures. Personality & social psychology bulletin, 50(6), 841–8