Discussion: Does Psychotherapy Have A Biological Basis?

Mental health processes and disorders originate from mechanisms within the brain. There has been the question within the psychiatric field as to whether plastic changes in the brain that can occur with the use of  pharmacological interventions for mental health disorders could also occur with the use of psychotherapy. Psychotherapy is extremely beneficial in treating several mental health issues (Laureate Education, 2016).There is compounding evidence that psychotherapy does have a biological basis and can have a positive impact in brain recovery from the stress response. According to Wheeler (2014), psychotherapy mediates the reintegration and connection of neural networks that have become maladaptively linked due to adverse life events facilitating healing of the brain. Psychotherapy has been found to be an effective treatment method for a variety of mental health disorders such as anxiety, major depression, and post-traumatic stress disorder. According to Fournier (2014), activity in regions associated with negative emotion, emotion regulation, fear, and reward are associated with respones to psychotherapy, and psychotherapy appears to alter the functioning of these regions.

While proven to be an effective treatment modality for mental health disorders, there are factors such as culture, religion, and socioeconomic background that can affect the client and their perspective on the use of psychotherapy. Psychotherapy within itself can bring conflicting emotions for the client and the clinician must be aware of how religion, culture, and socioeconomics can alter how the client perceives psychotherapy and its efficacy in their treatment. According to Wheeler (2014), the powerful influence of culture permeates all dimensions of out life in a way that is often unconscious. For example, if a client comes from a culture where emotions are not to be discusssed or if one discusses there past traumas or fears then the client could be resistant to the role of psychotherapy in their treatment plan. The clinician must be aware of the importance of culture in medical or psychological treatments. Religion also plays an instrumental role in how psychotherapy will be perceived by a client. Many clients may come from a religious background where one only speaks of negative emotions with someone from their clergy or a religious figure. According to Kim, Chen & Brachfeld (2018), religion and spirituality are important issues to consider and address in psychotherapy. Communication could become stagnant if the clinician is not aware of the role religion plays in the psychotherapy framework. Socioeconomic background can also be a variable in one‘s perspective of the value of psychotherapy. Certain traumatic events that a person can suffer throughout their lifetime can be directly correlated to socioeconomic standing. For example, poverty can be associated with depression, anxiety, substance abuse, and mood disorders. Patients from this type of background can experience barriers in both seeking and receiving mental health services. According to Bernal et al. (2017), vulnerable populations such as those low in social status face additional barriers to mental health treatment and experience unique barriers to receiving optimal care.

References

Bernal, D.R., Herbst, R.B., Lewis, B.L., & Feibelman, J. (2017). Ethical care for vulnerable populations receiving psychotropic treatment. Ethics & Behavior, 27(7), 582-598. doi:10.1080/10508422.2016.1224187

Fournier, J.C., & Price, R.B. (2014). Psychotherapy and neuroimaging. Psychotherapy: New Evidence and New Approaches, 12(3), 290-298. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4207360

Kim, E.E., Chen, E.C., & Brachfeld, C. (2018). Patients’ experience of spirituality and change in individual psychotherapy at a Christian counseling clinic: A grounded theory analysis. Spirituality in Clinical Practice, doi:10.1037/scp0000176

Laureate Education (Producer). (2016). Introduction to psychotherapy with individuals [Video file]. Baltimore, MD: Author.

Wheeler, K. (Eds.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

POST 2

Psychotherapy is just as controversial as mental health as a whole is. Some believe it is helpful, others believe it is a waste of time. One question still remains unanswered for many, can talking about feelings help change behavior and therefore sure whatever condition a person is suffering from? I believe psychotherapy has a biological basis. Lyrakos, Spinaris, and Spyropoulos (2017) clearly stated as results of a research that “the use of psychotherapy plays a significant role in achieving optimal health outcomes of psychiatric patients” (p. s753). Pairing psychopharmacology with psychotherapy can make a positive impact towards recovery compared to treatment with just psychopharmacology.

Many different reasons can influence the belief that psychotherapy might or might not work. For example, Adams et al. (2017) concluded in an article that “findings suggest that patients’ attachment characteristics play a role in their views and choices regarding treatments” (p. 194). Other factors that can impact the belief that therapy is a waste of time are culture, religion, and socioeconomic status. A person’s upbringing can be one to avoid talking about feelings with a stranger, or even with a loved one. Religion can also play a role in not receiving this type of treatment as faith in a spiritual belief might be the perceived as the cure to an ailment. Economical status and education level can also negatively impact the decision to avoid this type of treatment as the importance of it might not be completely comprehended or there are no means to afford the treatment. In another study that correlates the importance of psychotherapy, data showed “that children/adolescents with not only behavioral and emotional disorders, but also affective (mood) disorders had a higher chance for nondrug psychiatric/psychotherapeutic treatment compared to children with other psychiatric disorders” (Abbas et al., 2017, p. 442).

References

Lyrakos, G., Spinaris, V., & Spyropoulos, I. (2017). The introduction of psychotherapy in

psychiatric outpatients as part of the treatment in the last four years in a Greek

hospital. European Neuropsychopharmacology, 27(4).

Adams, G. C., McWilliams, L. A., Wrath, A. J., Adams, S., & Souza, D. D. (2017).

Relationships between patients’ attachment characteristics and views and use of

psychiatric treatment. Psychiatry Research, 256:194-201.

Abbas, S., Ihle, P., Adler, J., Engel, S., Günster, C., Holtmann, M., & …Schubert, I. (2017).

Predictors of non-drug psychiatric/psychotherapeutic treatment in children and

adolescents with mental or behavioral disorders. European Child & Adolescent

            Psychiatry, 26(4).

Learning Resources
Required Readings
American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.

Standard 1 “Assessment” (pages 44 & 45)
Note: Throughout the program you will be reading excerpts from the ANA’s Scope & Standards of Practice for Psychiatric-Mental Health Nursing. It is essential to your success on the ANCC board certification exam for Psychiatric/Mental Health Nurse Practitioners that you know the scope of practice of the advanced practice psychiatric/mental health nurse. You should also be able to differentiate between the generalist RN role in psychiatric/mental health nursing and the advanced practice nurse role.
Wheeler, K. (Eds.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

Chapter 1, “The Nurse Psychotherapist and a Framework for Practice” (pp. 3–52)
Fournier, J. C., & Price, R. B. (2014). Psychotherapy and neuroimaging. Psychotherapy: New Evidence and New Approaches, 12(3), 290–298. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4207360/
Holttum, S. (2014). When bad things happen our brains change but psychotherapy and support can help the recovery of our brains and our lives. Mental Health and Social Inclusion, 18(2), 52–58. doi:10.1108/MHSI-02-2014-0006
Petiprin, A. (2016). Psychiatric and mental health nursing. Nursing Theory. Retrieved from http://www.nursing-theory.org/theories-and-models/psychiatric-and-mental-health-nursing.php
Fisher, M. A. (2016). Introduction. In Confidentiality limits in psychotherapy: Ethics checklists for mental health professionals (pp. 3–12). Washington, DC: American Psychological Association. doi:10.1037/14860-001
Document: Midterm Exam Study Guide (Word document)
Document: Final Exam Study Guide (Word document)
Required Media
Laureate Education (Producer). (2016). Introduction to psychotherapy with individuals [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 2 minutes.

Laureate Education (Producer). (2015e). Therapies are helpful: Dodo bird conjecture [Video file]. Baltimore, MD: Author.

Provided courtesy of the Laureate International Network of Universities.

Note: The approximate length of this media piece is 2 minutes.
Credit: Provided courtesy of the Laureate International Network of Universities.
Laureate Education (Producer). (2015f). Therapies change and integrate different approaches over time [Video file]. Baltimore, MD: Author.

Provided courtesy of the Laureate International Network of Universities.

Note: The approximate length of this media piece is 1 minute.
Credit: Provided courtesy of the Laureate International Network of Universities.
Sommers-Flanagan, J., & Sommers-Flanagan, R. (2012). Clinical interview: Intake, assessment, & therapeutic alliance [Video file]. Mill Valley, CA: Psychotherapy.net.
Sommers-Flanagan, J., & Sommers-Flanagan, R. (2013). Counseling and psychotherapy theories in context and practice [Video file]. Mill Valley, CA: Psychotherapy.n