Whether psychotherapy has a biological basis
According to the American Psychiatric Association (2016), psychotherapy is defined as the interaction between a healthcare professional and a patient to comprehensively explore their feelings, thoughts, and behaviors to attain higher functioning levels or solve problems. Psychotherapy aids in solving difficulties such as the effect of trauma, loss of loved ones, challenges in coping with activities of daily living, and mental disorders such as anxiety or depression (APA, 2016). Psychotherapy is indeed a biological treatment. According to Mancke et al. (2018), psychotherapy is comparable to learning a new task. In addition to that, teaching an individual’s brain to think or perceive things differently triggers certain portions of the brain to respond. In research conducted on women with borderline personality disorders, PET and MRI scans of the brain showed that after undergoing 12 weeks of dialectical behavioral therapy, they experienced an increase in grey matter volume compared to individuals who participated in usual treatments.
Furthermore, Schubert et al. (2019), clients presenting with post-traumatic stress disorder experienced an enhanced dysfunctional cognitive coping strategies, and improved blood pressure after undergoing psychotherapy. This implies that psychotherapy makes the brain learn, perceive, and incorporate new views and representations. This results in long-term noticeable physical changes in the brain.
Influence of culture.
Culture has a significant influence on the perspective of psychotherapy treatment. Different cultural groups have different communication mechanisms and preferences. For instance, research shows that African Americans prefer to utilize non-verbal communication and non-verbal cues. A psychotherapist who is not conversant with the culture may misunderstand the non-verbal cues given by an African-American (Wheeler, 2014). In addition to that, culture also influences how trust is built between the client and psychotherapist, and how quickly the client manifests help-seeking behavior. Lastly, culture generally influences the societal view of therapy. If an individual’s culture considers therapy shameful and stigmatizing with regards to how emotions are freely expressed, it may be difficult for certain people to go for psychotherapy or open up about their issues.
Religion
According to Kersting (2015), religion is one of the most fundamental factors influencing people’s lives. Religious beliefs govern most decisions in the lives of human beings. Integrating therapeutic tools such as prayer, spiritual journaling, biblical texts, and forgiveness protocols to reinforce emotional habits and mental wellbeing can help clients overcome abusive situations and unhealthy anger (Kersting, 2015). For religious patients, the therapist’s willingness to interact with the religiously results in the creation of trust and a positive relationship. This can improve therapy outcomes and foster positive mental wellbeing. Some individuals regard spiritually guided psychotherapy as experiencing a unique presence in a room of restoration by God’s power (Kersting, 2015). Therefore, it is fundamental for therapists to integrate the client’s spiritual beliefs into the plan. This creates a positive relationship between the client and the therapist.
The inability to pay for basic healthcare services due to poverty is a significant barrier to overcome. Hawley, Leibert, & Lane (2014) assert that an individual’s socioeconomic status significantly influenced their uptake of therapy and the outcomes. Research shows that access to higher education levels and healthcare insurance significantly enhanced participation in counseling and therapy outcomes. Additionally, Hawley et al. (2014) found out that individuals with lower socioeconomic status experienced greater dysfunction, less successful therapy outcomes, and greater goal disagreement. Such individuals also had a higher incidence of quitting the counseling sessions before completing the inferiority complex (Wheeler, 2014).
For mental health nurse practitioners to provide high-quality care with positive outcomes, it is important for them to carefully consider religion, ethnicity, race, culture, and social status. Cultural intelligence and competence is fundamental to create a conducive environment for positive relationships and improved wellbeing.
References
American Psychiatric Association (2016). https://www.psychiatry.org/patients-families/psychotherapy
Hawley. D. L., Leibert. T. W., & Lane. A. J. (2014). Relationship of social Economic status and counseling outcomes. Retrieved from https://pdxscholar.library.pdx.edu/coun_fac/34/
Kersting. K (2015). Religion and spirituality in the treatment room. American Psychological Association, 34 (11). PP40 Retrieved from http://www.apa.org/monitor/dec03/religion.aspx
Mancke, F., Schmitt, R., Winter, D., Niedtfeld, I., Herpertz, S. C., & Schmahl, C. (2018). Assessing the Marks of Change: How Psychotherapy Alters the Brain Structure in Women with Borderline Personality Disorder. Journal of Psychiatry and Neuroscience, (3), 171. https://doi-org.ezp.waldenulibrary.org/10.1503/jpn.170132
Schubert, C. F., Schreckenbach, M., Kirmeier, T. Gall-Kleebach, D. J., Wollweber, B., Buell, D. R., Manfred, U., Rosner, R. & Schmidt, U. (2019). PTSD Psychotherapy Improves Blood Pressure but Leaves HPA Axis Feedback Sensitivity Stable and Unaffected: First Evidence from A Pre-Post Treatment Study. Psychoneuroendocrinology. 2019;100:254-263. doi:10.1016/j.psyneuen.2018.10.013.
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.