Psychotherapy Biological Basis
Peer-reviewed articles such as the one by Jokinen & Hartshorne (2022) have established that medication management cannot assist many clients alone; psychotherapy, which is a biological treatment that changes the client’s brain, is critical in the healing process. Psychotherapy is biological as it helps the client to develop healthy coping measures, address the mental illness, and foster new adaptations from trauma or other traumatic life events. (Moreira, Inman, & Cloninger, 2020) Clinicians utilizing a biopsychosocial holistic approach assist in healing clients in an individual, group, or family setting. This practice will assist the client whose biological or genetic components have been altered through experiences from trauma or another experienced life event, as established and discussed in the peer-reviewed article by Jokinen and Hartshorne (2022).
Culture, Religion, Socioeconomic
To assist clients of all cultures, religions, and socioeconomic considerations, psychotherapy often is combined with medication management to target the client’s mental illness specifically. When working with clients, where they come from, where they work, who is in the household, their neighborhoods, and their religious practices are just the surface of the information needed to be gathered to begin the healing psychotherapy journey. A client’s religious and cultural beliefs can and do influence their health and perspective toward therapy and medication management. Beliefs and cultural practices sometimes prevent the client from treatment, hindering their progress. The practitioner must be aware of their convictions to assist with exploration and assignments, not to be contractionary to their religious or cultural practices. Prayer may help a client; for others, this may bring further trauma, and a thorough assessment of these areas is required by the clinician to assist the client and/or family. A specific example would be culture and grief, as dealing with grief varies with age, culture, and the client’s religious belief and promotes or hinders the therapy process, as presented and discussed in the peer-reviewed article by Smid et al. (2018)
A client or family with a struggling socioeconomic status can be challenged to attend therapy sessions or purchase supplies and medications. Lower socioeconomic status is associated with higher mental health struggles, although recovery can be achieved equally to other socioeconomic levels. Transportation and finding childcare for adult clients when finances are limited can require assistance from the clinician to find alternative means and should be a priority early in the therapeutic relationship to prevent this from hindering their progress.
Legal and ethical for groups and families
Confidentiality is critical in healthcare and essential in rapport building in therapy and with families and groups; this can present a challenge. Protecting all clients, families, and members’ privacy while utilizing the group and family therapeutic environment is an educational process. With therapy becoming increasingly telemed, the importance of informed consent and protection of the client’s rights has emerged, been established, and discussed in the peer-reviewed article by Avasthi, Grover, & Nischal (2022). Permission must be signed, and all involved must be educated, but each client and family know that complete privacy cannot be guaranteed in a telemed, family, or group setting. The clinician must take all precautions, inform clients about the process, and obtain signed consent before the sessions or groups.
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.
I enjoyed reading your post. I do agree with you in that psychotherapy does have a biological basis to it. According to Malhotra and Sahoo (2017), “the brain is built during development and rebuilt during psychotherapy. With psychotherapy affecting one’s mind and mental processes it can be argue that it has a biological basis (Malhotra & Sahoo, 2017). Religion, culture, and socioeconomic status are all important factors that does play a part in whether a patient will participate in psychotherapy. In some cultures, mental health is just as important as one’s physical health. Talking about mental health is welcoming and persons are encouraged to seek treatment. One the other hand, in some culture it is totally unacceptable to have any form of mental illness and thus affecting treatment. As provider its importance to consider a person culture and religion when caring for the patient. A person from a lower socioeconomic status may have difficulties attending psychotherapy session. They may have difficulties as finding the payment, transportation or may not consider it important at the need. Legal and ethical issues will arise as provider treats client daily. In group session confidentially is important and informed consent must be obtained from all participants. Legal issues such as dealing with minors and client with guardianship. As provider client might share information that might not pose a direct danger to self or others but might be important if parents are aware. The ethical and legal issues will arise in that even though we might think it’s important and pose an ethical issue, legally we are not allowed to. Parents have the right to make informed decision about hre care of their child even if the child rejects it (Jesus et al, 2022).
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.
I enjoyed reading your post. I was going to submit mine first, but I’m happy you took the reins. The article you referenced by Jokinen and Hartshorne (2022) also really caught my attention. The manifestation of psychopathological disease process in the context of environmental and biological factors is the paradigm that attracted me to the field of psychiatry in the first place. What’s more, the temporal relationships between medical disease processes and psychopathological disease processes intrigue me as well. It has been widely accepted that medical disease processes take precedent over mental health disease processes, and I am excited to be a part of the mental healthcare workforce during this hopeful and much needed time of transformative services. Jokinen and Hartshorne (2022) discussed prior research regarding the impact of environment and biology on mental health disease processes, I appreciated how they summarized how neither genetics or biology are more important than the other, and what really matters is how an individual uses what they have to inform cognizant behaviors.
In the second portion of your post, you share that beliefs and cultural practices sometimes prevent the client from treatment, hindering their progress. In these circumstances, I feel that it is important for the provider to thoroughly understand exactly what “believes” or “cultural” practices are presenting barriers to care to best serve the patient. Not to sound too brash, but healthcare is a business with providers that offer products. The cool thing about these products is that they are intended to improve health, wellness, improve executive function, and in some specialties, actual happiness and joy in the setting of mood improvement. Just like any salesperson, I believe a provider should be thoughtful and use critical thinking skills to communicate with patients why treatment is important. According to Sunderani and Moodley’s (2020) research, cultural similarities is a primary sub theme of reasons therapist may use self-disclosure to build rapport with clients. Conversely, cultural differences are a primary sub theme of reasons a therapist would use nondisclosure during a client interaction. In my future practice, I hope to use self-disclosure when indicated to highlight cultural similarities and build rapport. This way, if there is a belief or cultural variable that compromises care, I will have more footing to forge patient-centered care plan update that will hopefully keep the patient engaged in treatment.
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