This is only a DB reply to two different peers. I do not need a title page. I need a solid paragraph (or two) for each reply with a resource. Please attach a pdf of the resource so I can upload it to my assignment. Thank you!

First posting that needs a reply:

Suzanne Olesko (She/Her)

           Biological Basis of Psychotherapy

          The latter half of the 20th century saw theorists explaining the biological basis of mental illness and its associated behaviors. The field of neuroscience is now also examining the effect of behavior in altering gene expression (Jiménez et al., 2018). For example, research has shown that exposure to childhood trauma can lead to changes in the brain regions sensitive to stress. This includes changes to the amygdala, hippocampus, and pre-frontal cortex leading to differences in brain structure, function, and connectivity (Cross et al., 2017). The less control of a situation a person has, the more stress the person experiences, and subsequent pathophysiological changes occur (Wheeler, 2022).

            The question is, then, that if stress and mental illness can cause physical changes to the structure and function of the brain, can psychotherapy then correct some of these structural and functional changes. Newer methods of examining the neurobiology of the brain including ingle-pho-ton emission computed tomography (SPECT), positron emission tomography (PET]), and functional magnetic resonance imaging (fMRI) have allowed researches to see in detail the changes the occur in individuals with a variety of mental illnesses. For example, six weeks of interpersonal therapy in patients with major depressive disorder found on SPECT imaging that decreased depressive symptoms resulted in increased cerebral blood flow in the posterior cingulate cortex and right basal ganglia (Beauregard, 2014). Newer psychotherapy modalities such as psychedelic assisted psychotherapy like lysergic acid diethylamide (LSD) and psilocybin, especially useful in trauma therapy, shows that the brain is put into an open state in its plasticity, allowing for an altered level of consciousness. This alteration allows for psychotherapy such as cognitive behavior therapy or motivational interviewing to then change the neuroplasticity and subsequently enhance the correct functioning of neurons in areas of the brain like the prefrontal cortex (Lepow et al., 2021). As newer psychotherapy approaches emerge, functional imaging of the brain will allow for a more in-depth understanding of exactly what structural and functional changes psychotherapy has in the brain.

Personal Perspectives of Psychotherapy

            A wide body of research shows that significant sociocultural and socioeconomic differences exist related to psychotherapy. Many rural areas of the country lack psychotherapy providers. In many urban and suburban areas where patients access services at community mental health centers, services are often provided by college interns or new graduates under supervision (Fonagy & Luyten, 2021). Culturally, cross-cultural considerations can cause issues in developing therapeutic relationships. Research shows that most counselors are Caucasian or Western European in descent creating a disparity for social justice and diversity. Counseling training programs have begun to develop courses specifically designed to promote effective cross-cultural psychotherapeutic techniques for all counselors (Tanaka-Matsumi, 2022).

Ethical and Legal Issues in Psychotherapy

            At the most fundamental level, the provider is responsible for providing maximum benefit to the patient, avoiding exploitation or harm to the patient, promoting the patient’s independence over time, proving equal treatment to all patients, and committing to their own self care so that the provider is health and able to commit to the above (Grover et al., 2022). Informed consent is needed with all patients before engaging in psychotherapy. The provider needs to outline what is to be expected during the therapeutic process and create a safety plan including what the patient should do in the event that psychotherapy triggers suicidal thoughts needs to be in place. When in the context of family or group therapy, confidentiality of individual members of the group or family system is essential while also encouraging the sharing of dialogue that may be of sensitive nature with others. It is thus the provider’s job to moderate the sharing of information so that all parties are engaged, sharing appropriate information or experiences, and actively listening to other group or family members (Turlius & Candel, 2019). While the same therapeutic modalities are used in group and family therapies, such as cognitive behavior therapy or dialectical behavior therapy, the provider managing the session may need to prompt some patients to encourage sharing while simultaneously protecting the privacy and confidentiality of all patients. If a patient does not want to share, then that patient should not be forced to share. Informed consent allows for a patient to be part of a group and engage in active listening rather than sharing. Therapeutic techniques applied to each individual in the family system or group is necessary by the provider to ensure everyone gains as much positive experience from the group as possible.

            Personally, I thoroughly enjoy group therapy because the interplay between group members can often run the entire group. Additionally, it is interesting to watch the changes in the group dynamic depending on group members. I have had partial hospitalization program groups where patients are fully engaged, and I have had to do very little active facilitation and then one member is added to the group and suddenly the group becomes overall silent and requires a lot of active facilitation efforts on my part. At the same time, a minimally participatory group may have the addition of one patient and suddenly it turns into a group that virtually runs itself. The group process is dynamic and while not part of this assignment per se bears discussion because of how varied a group therapy experience can be.

References

Beauregard, M. (2014). Functional neuroimaging studies of the effects of psychotherapy. New Therapeutic Targets and the Pathobiology of Depression, 16(1), 75–81. https://doi.org/10.31887/dcns.2014.16.1/mbeauregard

Cross, D., Fani, N., Powers, A., & Bradley, B. (2017). Neurobiological development in the context of childhood trauma. Clinical Psychology: Science and Practice, 24(2), 111–124. https://doi.org/10.1111/cpsp.12198

Fonagy, P., & Luyten, P. (2021). Socioeconomic and sociocultural factors affecting access to psychotherapies: the way forward. World Psychiatry, 20(3), 315–316. https://doi.org/10.1002/wps.20911

Grover, S., Avasthi, A., & Nischal, A. (2022). Ethical and legal issues in psychotherapy. Indian Journal of Psychiatry, 64(7), 47–61. https://doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_50_21

Jiménez, J. P., Botto, A., Herrera, L., Leighton, C., Rossi, J. L., Quevedo, Y., Silva, J. R., Martínez, F., Assar, R., Salazar, L. A., Ortiz, M., Ríos, U., Barros, P., Jaramillo, K., & Luyten, P. (2018). Psychotherapy and genetic neuroscience: An emerging dialog. Frontiers in Genetics, 9. https://doi.org/10.3389/fgene.2018.00257

Lepow, L., Morishita, H., & Yehuda, R. (2021). Critical period plasticity as a framework for psychedelic-assisted psychotherapy. Frontiers in Neuroscience, 15. https://doi.org/10.3389/fnins.2021.710004

Tanaka-Matsumi, J. (2022). Counseling across cultures: A half-century assessment. Journal of Cross-Cultural Psychology, 53(7-8), 957–975. https://doi.org/10.1177/00220221221111810

Turliuc, M. N., & Candel, O. S. (2019). Ethical issues in couple and family research and therapy. Advances in Library and Information Science, 226–242. https://doi.org/10.4018/978-1-5225-6310-5.ch012

Wheeler, K. (2022). Psychotherapy for the Advanced Practice Psychiatric Nurse (3rd ed.). Springer Publishing Company.

The second posting that needs a reply:

Suzanne Olesko (She/Her)

           Biological Basis of Psychotherapy

          The latter half of the 20th century saw theorists explaining the biological basis of mental illness and its associated behaviors. The field of neuroscience is now also examining the effect of behavior in altering gene expression (Jiménez et al., 2018). For example, research has shown that exposure to childhood trauma can lead to changes in the brain regions sensitive to stress. This includes changes to the amygdala, hippocampus, and pre-frontal cortex leading to differences in brain structure, function, and connectivity (Cross et al., 2017). The less control of a situation a person has, the more stress the person experiences, and subsequent pathophysiological changes occur (Wheeler, 2022).

            The question is, then, that if stress and mental illness can cause physical changes to the structure and function of the brain, can psychotherapy then correct some of these structural and functional changes. Newer methods of examining the neurobiology of the brain including ingle-pho-ton emission computed tomography (SPECT), positron emission tomography (PET]), and functional magnetic resonance imaging (fMRI) have allowed researches to see in detail the changes the occur in individuals with a variety of mental illnesses. For example, six weeks of interpersonal therapy in patients with major depressive disorder found on SPECT imaging that decreased depressive symptoms resulted in increased cerebral blood flow in the posterior cingulate cortex and right basal ganglia (Beauregard, 2014). Newer psychotherapy modalities such as psychedelic assisted psychotherapy like lysergic acid diethylamide (LSD) and psilocybin, especially useful in trauma therapy, shows that the brain is put into an open state in its plasticity, allowing for an altered level of consciousness. This alteration allows for psychotherapy such as cognitive behavior therapy or motivational interviewing to then change the neuroplasticity and subsequently enhance the correct functioning of neurons in areas of the brain like the prefrontal cortex (Lepow et al., 2021). As newer psychotherapy approaches emerge, functional imaging of the brain will allow for a more in-depth understanding of exactly what structural and functional changes psychotherapy has in the brain.

Personal Perspectives of Psychotherapy

            A wide body of research shows that significant sociocultural and socioeconomic differences exist related to psychotherapy. Many rural areas of the country lack psychotherapy providers. In many urban and suburban areas where patients access services at community mental health centers, services are often provided by college interns or new graduates under supervision (Fonagy & Luyten, 2021). Culturally, cross-cultural considerations can cause issues in developing therapeutic relationships. Research shows that most counselors are Caucasian or Western European in descent creating a disparity for social justice and diversity. Counseling training programs have begun to develop courses specifically designed to promote effective cross-cultural psychotherapeutic techniques for all counselors (Tanaka-Matsumi, 2022).

Ethical and Legal Issues in Psychotherapy

            At the most fundamental level, the provider is responsible for providing maximum benefit to the patient, avoiding exploitation or harm to the patient, promoting the patient’s independence over time, proving equal treatment to all patients, and committing to their own self care so that the provider is health and able to commit to the above (Grover et al., 2022). Informed consent is needed with all patients before engaging in psychotherapy. The provider needs to outline what is to be expected during the therapeutic process and create a safety plan including what the patient should do in the event that psychotherapy triggers suicidal thoughts needs to be in place. When in the context of family or group therapy, confidentiality of individual members of the group or family system is essential while also encouraging the sharing of dialogue that may be of sensitive nature with others. It is thus the provider’s job to moderate the sharing of information so that all parties are engaged, sharing appropriate information or experiences, and actively listening to other group or family members (Turlius & Candel, 2019). While the same therapeutic modalities are used in group and family therapies, such as cognitive behavior therapy or dialectical behavior therapy, the provider managing the session may need to prompt some patients to encourage sharing while simultaneously protecting the privacy and confidentiality of all patients. If a patient does not want to share, then that patient should not be forced to share. Informed consent allows for a patient to be part of a group and engage in active listening rather than sharing. Therapeutic techniques applied to each individual in the family system or group is necessary by the provider to ensure everyone gains as much positive experience from the group as possible.

            Personally, I thoroughly enjoy group therapy because the interplay between group members can often run the entire group. Additionally, it is interesting to watch the changes in the group dynamic depending on group members. I have had partial hospitalization program groups where patients are fully engaged, and I have had to do very little active facilitation and then one member is added to the group and suddenly the group becomes overall silent and requires a lot of active facilitation efforts on my part. At the same time, a minimally participatory group may have the addition of one patient and suddenly it turns into a group that virtually runs itself. The group process is dynamic and while not part of this assignment per se bears discussion because of how varied a group therapy experience can be.

References

Beauregard, M. (2014). Functional neuroimaging studies of the effects of psychotherapy. New Therapeutic Targets and the Pathobiology of Depression, 16(1), 75–81. https://doi.org/10.31887/dcns.2014.16.1/mbeauregard

Cross, D., Fani, N., Powers, A., & Bradley, B. (2017). Neurobiological development in the context of childhood trauma. Clinical Psychology: Science and Practice, 24(2), 111–124. https://doi.org/10.1111/cpsp.12198

Fonagy, P., & Luyten, P. (2021). Socioeconomic and sociocultural factors affecting access to psychotherapies: the way forward. World Psychiatry, 20(3), 315–316. https://doi.org/10.1002/wps.20911

Grover, S., Avasthi, A., & Nischal, A. (2022). Ethical and legal issues in psychotherapy. Indian Journal of Psychiatry, 64(7), 47–61. https://doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_50_21

Jiménez, J. P., Botto, A., Herrera, L., Leighton, C., Rossi, J. L., Quevedo, Y., Silva, J. R., Martínez, F., Assar, R., Salazar, L. A., Ortiz, M., Ríos, U., Barros, P., Jaramillo, K., & Luyten, P. (2018). Psychotherapy and genetic neuroscience: An emerging dialog. Frontiers in Genetics, 9. https://doi.org/10.3389/fgene.2018.00257

Lepow, L., Morishita, H., & Yehuda, R. (2021). Critical period plasticity as a framework for psychedelic-assisted psychotherapy. Frontiers in Neuroscience, 15. https://doi.org/10.3389/fnins.2021.710004

Tanaka-Matsumi, J. (2022). Counseling across cultures: A half-century assessment. Journal of Cross-Cultural Psychology, 53(7-8), 957–975. https://doi.org/10.1177/00220221221111810

Turliuc, M. N., & Candel, O. S. (2019). Ethical issues in couple and family research and therapy. Advances in Library and Information Science, 226–242. https://doi.org/10.4018/978-1-5225-6310-5.ch012

Wheeler, K. (2022). Psychotherapy for the Advanced Practice Psychiatric Nurse (3rd ed.). Springer Publishing Company.