Biological basis and ethical/legal considerations of psychotherapy discussion essay

Biological basis and ethical/legal considerations of psychotherapy discussion essay

Biological basis and ethical/legal considerations of psychotherapy discussion essay
BY DAY 3

Post an explanation of whether psychotherapy has a biological basis. Explain how culture, religion, and socioeconomics might influence one’s perspective on the value of psychotherapy treatments. Describe how legal and ethical considerations for group and family therapy differ from those for individual therapy, and explain how these differences might impact your therapeutic approaches for clients in group, individual, and family therapy. Support your rationale with at least three peer-reviewed, evidence-based sources and explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources.
Read a selection of your colleagues’ responses.

BY DAY 6

Respond to at least two of your colleagues on 2 different days by providing an additional scholarly resource that supports or challenges their position, along with a brief explanation of the resource.

   Week 1 Discussion: Psychotherapy
Psychotherapy relates to a psychological procedure associated with verbal interaction between a mental health expert and a patient to understand the prognosis of the mental condition. Psychotherapy has a biological basis as it is associated with understanding the patient’s behavior following a particular healthcare condition. Through psychotherapy, a mental health expert taps into the patient’s receptors, modulators, and neurotransmitters (Javanbakht & Alberini, 2019). The three are critical biological regulations in brain response. Psychotherapy equally has a biological basis because it realigns an individual’s perception of the self by creating changes to a patient’s emotions and cognitive reasoning processes.
The concepts of culture, socioeconomics, and religion have a significant impact on a patient’s perspective of psychotherapy treatments. Culture is quite critical because every patient would want to be treated in a culturally competent manner (Levi et al., 2018). Thus, the attending mental health expert should understand the background of the patient to ensure that culturally competent care is provided. Providing culturally competent care also creates a good rapport between the patients and the mental health expert.
The concept of religion is equally critical in the treatment of mental health conditions. Some patients would prefer to be attended to by mental health experts who have similar religious beliefs as them. It is also critical for mental health experts to understand a patient’s religious beliefs because they are related to various beliefs that might impact treatment (Levi et al., 2018). The beliefs may impact religious practices such as meditation. The socioeconomic status of the patient is equally important because it is associated with social determinants of health. Knowledge about socioeconomic status helps in understanding how exposed the patient is to mental health conditions.
Legal and ethical considerations for group and family therapy differ from those of individual therapy. For individual therapies, the interaction is between the one patient and the attending and mental health expert (Stoll et al., 2020). Thus, the mental health expert guarantees the total confidentiality as per HIPAA regulations. In case the confidentiality of the patient is breached in individual therapy, the therapist is fully liable. When working attending to an individual client, I will have an understanding of the fact that it is my responsibility to keep the patient’s information confidential. On the other hand, the ethical considerations in group dynamics are quite different (Stoll et al., 2020). Ideally, all the group and family members are liable for the confidentiality of the provided information. While working with a family or a group, I will make them understand that confidentiality is not binding because of the third-party rule.
 
 
References
Javanbakht, A., & Alberini, C. M. (2019). Neurobiological models of psychotherapy. Frontiers in Behavioral Neuroscience, 13, 144.
Levi, U., Laslo-Roth, R., & Rosenstreich, E. (2018). Socioeconomic status and psychotherapy: A cognitive-affective view. J Psychiatry Behav Health Forecast. 2018; 1 (2), 1008.
Stoll, J., Müller, J. A., & Trachsel, M. (2020). Ethical issues in online psychotherapy: A narrative review. Frontiers in Psychiatry, 10, 993.
 
 

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Collapse SubdiscussionTessie Harris

Tessie Harris
Nov 30, 2022Nov 30, 2022 at 8:37pm

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great post Aisha, could you give an example of how knowledge about socioeconomic status helps in understanding how exposed the patient is to mental health conditions. 

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Collapse SubdiscussionAisha Adigun

Aisha Adigun
Dec 2, 2022Dec 2, 2022 at 1:06pm

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Thanks Dr. Harris.
An individual’s socioeconomic status is essential in understanding a patient’s exposure to mental health conditions. Individuals of lower economic status are more exposed to mental health conditions compared to those of higher socioeconomic status (Reiss et al., 2019). The higher rates of mental health conditions among individuals living in lower socioeconomic status are tied to their exposure to stress and life pressures. An individual living in poverty, for example, has to deal with stressful situations such as lack of food, unemployment, and homelessness, among other problems. The poverty situation creates a negative environment that leads to negative emotions (Kivimäki et al., 2020). The build-up of negative emotions puts such an individual at significant risk of a mental health condition. On the flip side, individuals of higher socioeconomic status do not have to deal with stressful situations related to living conditions. Their ability to meet daily needs limits stress, pressure, and negative emotions.
References
Kivimäki, M., Batty, G. D., Pentti, J., Shipley, M. J., Sipilä, P. N., Nyberg, S. T., … & Vahtera, J. (2020). Association between socioeconomic status and the development of mental and physical health conditions in adulthood: a multi-cohort study. The Lancet Public Health, 5(3), e140-e149.
Reiss, F., Meyrose, A. K., Otto, C., Lampert, T., Klasen, F., & Ravens-Sieberer, U. (2019). Socioeconomic status, stressful life situations and mental health problems in children and adolescents: Results of the German BELLA cohort-study. PloS One, 14(3), e0213700.
 

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Collapse SubdiscussionMaxine Fomunung

Maxine Fomunung
Dec 1, 2022Dec 1, 2022 at 3:56pm

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Hi Aisha
I agree with you that psychotherapy taps into the verbal interaction of the clinician and the patient. I however feel that psychotherapy could also entail activities such as relaxation techniques that help in some disorders such as generalized anxiety disorders. Some interventions such as exposure- exposure used in management of some phobias could also be considered a form of psychotherapy. I agree with you that psychotherapy taps into the emotional component of the patient and through helps in elevating the negative and positive symptoms of some disorders such as depression. This is through the modification of various neurotransmitters that are involved in major psychiatric disorders.
I agree with you on the concept of cultural influence in which every individual is unique in their approach to treatment as guided by their cultural beliefs. A clinician who understand the cultural practices of a patient will be more likely to gain the confidence and confidentiality of a patient compared to one who has bias or prejudice. For instance, understanding that some native communities do not find mental illnesses to be medical but rather spiritual warfare it would be important to first educate the patients and their families on the condition before forcing treatment on them without the required knowledge(Levi et al., 2018).
I agree with you that different religions have different approaches to mental illnesses. Some religions belief that mental illness is a form of haunting or possession by spirits that require spiritual intervention and these patients would be reluctant to engage in medical treatment. People who have a good religious base are more likely to have a good social support system and are more likely to recover faster in the community rather than in secluded places (Levi et al., 2018). Some religions such as the Hindu and other Asian also value therapies such as relaxation techniques and yoga.
I agree with you that group therapy abolishes the confidentiality in patient care and the clinician should make the patient aware of this to avoid legal litigations according to the HIPAA regulations (Stoll et al., 2020).
 
References
Levi, U., Laslo-Roth, R., & Rosenstreich, E. (2018). Socioeconomic status and psychotherapy: A cognitive-affective view. J Psychiatry Behav Health Forecast. 2018; 1 (2), 1008.
Stoll, J., Müller, J. A., & Trachsel, M. (2020). Ethical issues in online psychotherapy: A narrative review. Frontiers in Psychiatry, 10, 993.

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Collapse SubdiscussionBasirat Shomuyiwa

Basirat Shomuyiwa
Dec 3, 2022Dec 3, 2022 at 6:06pm

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Respond to Maxime
Discussion Response
Hello, following a review of your discussion post on the biological basis and ethical considerations of psychotherapy, I concur with you that psychotherapy has a biological basis. For instance, according to Carey et al. (2020), psychotherapy is a complex mode of treatment that targets an entire biological regulation underlying complex brain responses. Additionally, psychotherapy targets abnormalities in brain adaptation and substitutes this maladaptation with new neural circuits that enhance positive behavior and coping strategies. Finally, psychotherapy is bracketed with structural brain changes.
Similarly, I agree with you that culture, religion, and socioeconomic status influence psychotherapy. As discussed, the diverse nature of psychiatric patients necessities that PMHNPs develop cultural competency to practice competently. Cultural competency facilitates the accurate delivery of psychotherapy and enhances positive therapeutic alliance which improves health-seeking behaviors (Gopalkrishnan, 2018). Religion may undermine the value of psychotherapy as patients may opt for spiritual and divine intervention. Additionally, individuals from poverty-stricken areas less often seek psychotherapy due to cost considerations and limited knowledge of the benefits of psychotherapy (Fonagy & Luyten, 2021).
As with other modes of psychotherapy, ethical and legal considerations must be observed while delivering group and family therapy. Pertinent issues such as informed consent, privacy, confidentiality, and therapeutic alliance during the delivery of these therapies cannot be overstated. PMHNPs must practice according to their professional code of ethics and conduct. Finally, I agree with you that the references used are considered scholarly as they are peer-reviewed journal articles from recommended sources.
 
 
References
Carey, T. A., Griffiths, R., Dixon, J. E., & Hines, S. (2020). Identifying functional mechanisms in psychotherapy: A scoping systematic review. Frontiers in Psychiatry, 11, 291. https://doi.org/10.3389/fpsyt.2020.00291Links to an external site.
Fonagy, P., & Luyten, P. (2021). Socioeconomic and sociocultural factors affecting access to psychotherapies: the way forward. World Psychiatry: Official Journal of the World Psychiatric Association (WPA), 20(3), 315–316. https://doi.org/10.1002/wps.20911Links to an external site.
Gopalkrishnan, N. (2018). Cultural diversity and mental health: Considerations for policy and practice. Frontiers in Public Health, 6, 179. https://doi.org/10.3389/fpubh.2018.00179Links to an external site.
 
 

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Collapse SubdiscussionEsther Fakayode

Esther Fakayode
Dec 1, 2022Dec 1, 2022 at 6:30pm

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Hello Aisha,
Great, and well-put-together discussion post, It is very important as a PMHNP to understand how culture, religion, and socioeconomic status can impact clients’ perspectives about mental illness. To properly diagnose and treat each client, either with medication management, or psychotherapy, advanced practitioners must have a thorough understanding of their various cultures, religions, and socioeconomic status (Wheeler, 2014). Different cultures with the same disease or mental illness may not manifest symptoms the same as other cultures. Therefore, it is essential to have a good understanding and knowledge of different cultures to help provide quality and effective treatment (Wheeler, 2014). In most cases, cultures impact how some clients identify and report their physical and emotional symptoms. Some cultures may feel more comfortable talking to a therapist or clinicians and getting psychotherapy, but people from other cultures may turn to religious beliefs or conservative ways to improve their symptoms. It is important to remember that some clients may have more than one culture that impacts their lifestyle. The advanced practitioner should take the time to understand different cultures, even if that means directly asking the client about them. A cultural competence model is a good tool for practitioners to use. It has several questions that an NP can ask themselves to measure their level of competence (Wheeler, 2014).
Socioeconomic status can be defined by income, level of education, and occupation, to reflect a person’s social, material, and psychological resources. Low socioeconomic status is associated with poorer mental health and higher work disability rates due to mental disorders. In addition, people with lower socioeconomic status, especially those with lower education, tend to use mental health services less willingly or drop out of treatment due to poverty and poor education than those with higher socioeconomic status, even though the need may be greater (Leppänen, et al., 2022).
References
Finegan, M., Firth, N., Wojnarowski, C., & Delgadillo, J. (2018). Associations between
socioeconomic status and psychological therapy outcomes: A systematic review and
meta-analysis. Depression and anxiety, 35(6), 560–573. https://doi.org/10.1002/da.22765
Leppänen, H., Kampman, O., Autio, R., Karolaakso, T., Näppilä, T., Rissanen P., & Pirkola

(2022). Socioeconomic factors and use of psychotherapy in common mental disorders

predisposing to disability pension. meta-analysis. Depression and anxiety, 35(6), 560–

https://doi.org/10.1186/s12913-022-08389-1Links to an external site.

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.

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Collapse SubdiscussionSherill A Broderick

Sherill A Broderick
Dec 2, 2022Dec 2, 2022 at 8:39pm

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        Aisha,
I agree that culture can have an impact on a patient’s perspective of psychotherapy treatment.  A study was carried out by Koduah et al., (2019), examining how sociocultural factors influence nurses’ health literacy practices. Here, it was noted that many Ghanaians firmly believe that mental illness is caused by the existence and manipulation of several demonic forces such as witches, ancestral spirits, sorcerers. As a result, in Sub-Sahara Africa, mental health issues are often too sensitive to discuss with patients and their families due to the shame and stigma associated with them. This context affects how health professionals deliver information and how patients and their relatives interpret it. In a study carried out by Huang et al., (2022), on caregivers’ burden, it was also noted that Asian-Americans are less likely to seek mental health services. The attitude of this population may potentially cause them to resist psychiatric treatment in general.
Huang, Y., Nagao, C. A., Santos, K. M. B., & Werchowsky, M. I. (2022). Impact of Culture,
Spirituality, and Mental Health Attitudes on Intergenerational Asian-American Caregivers: A
Pilot Study. American Journal of Occupational Therapy, 76(2), 1–7.
https://doi.org/10.5014/ajot.2022.046912
Koduah, A. O., Leung, A. Y. M., Leung, D. Y. L., & Liu, J. Y. W. (2019). “I Sometimes Ask
Patients to Consider Spiritual Care”: Health Literacy and Culture in Mental Health Nursing
Practice. International Journal of Environmental Research and Public Health, 16(19).
https://doi.org/10.3390/ijerph16193589

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Collapse SubdiscussionNorma Jacquez

Norma Jacquez
Dec 3, 2022Dec 3, 2022 at 5:42pm

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Thank you for your post Aisha.  Your source content is interesting and highlights the focus of this assignment.  I agree with you about the biological basis of psychotherapy.  Much like pharmacological treatments, I agree that therapy influences the neurotransmitters and receptors that affect the central nervous system.  Wheeler supports this concept by stating that the mind and brain are both affected by medications and therapy (Wheeler, 2020).
It’s important to maintain cultural competence and I agree with your position.  It is essential for the mental health provider to be aware of different cultures, customs, and religions and also be sensitive to socioeconomic differences in patients.  It is so important to establish a trusting relationship with each patient in order to improve rapport, and adherence to treatment, and ultimately for the patient to feel comfortable and safe when sharing important personal information.  Cultural competency should focus on understanding the patient’s background, beliefs, and culture in order to provide the patient with a feeling of being heard and understood.  This will empower the patient and promote positive patient outcomes (Chu, et al, 2016).
Legal considerations are so important to protect the patient’s confidentiality at all times.  It’s important to always prioritize confidentiality and ensure the patient feels respected and safe.  Therefore, in considering individual versus group therapy, the patient must consent to information being shared.
References
Chu, J., Leino, A., Pflum, S., & Sue, S. (2016). A model for the theoretical basis of cultural competency to guide psychotherapy. Professional Psychology: Research and Practice, 47(1), 18. Retrieved from https://psycnet.apa.org/journals/pro/47/1/18.html?uid=2016-05588-002
National Institute of Mental Health (2022) https://www.nimh.nih.gov/health/topics/psychotherapiesLinks to an external site.
Nichols, M. P. & Davis, Sean, D. (2020).  The essentials of family therapy  (7th ed.).   Pearson.
Wheeler, K. (Ed.). (2020).  Psychotherapy for the advanced practice psychiatric nurse:  A how-to guide for evidence-based practice (3rd ed.). Springer Publishing.
 

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Collapse SubdiscussionMaxine Fomunung

Maxine Fomunung
Nov 29, 2022Nov 29, 2022 at 4:16pm

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Biological basis of psychotherapy treatments
Neuroscience addresses the brain in the manner in which it truly develops, matures, and functions, which in essence, is the biological basis. Psychotherapy deactivates brain mappings that are maladaptive and stimulates the development of new pathways in the brain that are constructive. Psychiatric disorders are caused entirely by our temperaments’ reactions to stressful experiences as they are processed by our bodies. The problematic mappings that are brought up in therapy are deactivated, while the healthier ones are activated. The mappings of a traumatic experience are what produce the suffering that is associated with mental health conditions. Therefore, psychotherapy is a healing modality that accomplishes this by utilizing the biological processes of the brain (Jimenez et al., 2018).
It has also been demonstrated that psychotherapy can alter the amount of activity found in the prefrontal cortex. According to the findings of a study conducted on depression, patients diagnosed with this illness exhibited an unusually elevated level of activity in the prefrontal cortex. Researchers observed that patients who took part in interpersonal therapy had lower levels of activity in their prefrontal cortex than those who did not engage.
In addition, it has been demonstrated that psychotherapy has a biological basis that is analogous to the biological treatment that may be seen through the use of drugs. For instance, data has demonstrated that cognitive behavioral therapy (CBT) creates alterations in the brain that are similar to the changes that are caused in the brain by psychotropic medicines. This evidence was obtained through a study on brain imaging. As a consequence, this body of evidence demonstrates that psychological therapies are capable of bringing about changes in an individual’s symptoms. People who struggle with obsessive-compulsive disorder provide a good illustration of this phenomenon (OCD). Patients who suffer from OCD have been shown to have neuronal hyperactivity, which may be determined by an elevated rate of glucose metabolism. It has been demonstrated that psychotherapeutic treatments such as cognitive behavioral therapy (CBT) and psychotropic medicines such as Prozac can slow down the rate at which the body processes glucose and ameliorate OCD symptoms (Marano et al., 2012). Consequently, this gives the impression that cognitive behavioral therapy is as effective as other biological treatments, such as psychotropic drugs.
 
How religion, culture, and socioeconomics influence psychotherapy management
The mental health professional would need to consider the client’s culture, religion, and socioeconomic influences to determine how to deliver psychotherapy treatments to accurately identify and treat clients with mental illness. Because every culture has a unique perspective on numerous issues, a PMHNP should be familiar with the client’s history and culture. Hallucinations, for example, are viewed as a kind of divine contact in several civilizations. Instead of being stigmatized as mentally ill, people who have hallucinations are held in the highest regard. Therefore, in order to perform psychotherapy successfully, every PMHNP must possess cultural competency. As the therapeutic alliance and connection are strengthened, this will promote a positive client-practitioner relationship. Cultural influences on individuals’ healthcare-seeking behaviors will also come in handy when handling males who come in with mental illnesses. Some cultures would view men as being emotionally strong and will be expected to handle every situation in a strong manner. This, therefore, shows that few men would seek psychotherapy for their issues or come in with advanced mental illness with cognitive changes.
The opinions, conclusions, and perceptions of an individual are frequently influenced by their cultural background. Contrarily, compared to nonreligious people, persons who practice a particular religion tend to have better mental health, fulfilling relationships, and physical health. Thus, it is believed that their faith contributes to the stabilization of psychological health. People with mental health issues who identify as members of a certain faith typically prefer to consult a psychologist who shares their beliefs. However, some want to see nonreligious therapists or psychologists so that they can receive treatment that is impartial to their psychological condition.
In order to effectively address the client’s mental health during psychotherapy, there is an emphasis on the significance of recognizing socioeconomic disparity, the stress associated with poverty, and attending to the significant external and societal circumstances. In order to help clients understand the challenges they are facing with poverty-related stress, discussions about how to create coping mechanisms will be hard rather than how to make them happy about being poor. As a result, clients can learn how to make adjustments that will help them and their families advance. In addition, a lack of resources may prevent people from lower socioeconomic strata from accessing appropriate psychotherapy therapies. Living in poverty may psychologically impact some people, which may cause mental health problems.
Furthermore, a sizable portion of people who struggle with mental health disorders do not get the mental health services they require. For instance, the study found that fewer kids who require mental health care and live in poverty obtain it than 15% of the time (Hodkinson, Godoy, Beers, Lewin, 2017). Even fewer kids finish their treatment. Lack of insurance, long travel times, and parental worries that their kids would be taken away from them because of their low-income status are just a few of the obstacles that prevent people from receiving mental health care.
 
Ethical and legal considerations for group and family therapy
Mental health therapists are required to make ethical decisions regarding whether or not their personal knowledge or connection to a particular patient should be disclosed. The client may need to be referred to another therapist because of a role conflict, which is one of the biological bases and ethical, and legal considerations of psychotherapy. A mental health counselor, for instance, should not give advice to someone who lives next door to them, especially when working in a rural environment setup (Kim et al., 2016).
Various psychology bodies have approved the Ethics Code or other comparable ethical standards or rules for the professional conduct of clinicians. When providing services to more than one individual in a joint session, such as to a group of patients, couples, family, children, and caregivers, a clinician must begin the interaction by delineating the limits of confidentiality, so that information between the parties can be shared amongst themselves. This requirement applies to situations in which the clinician is providing services to a family or couple, for instance, or when the clinician is providing services to a family or couple, or when the clinician is providing services to In contrast to individual therapy, where clinicians are expected to adhere to HIPPA rules and regulations.
One of the legal considerations in this aspect of family or group therapy is the clinician’s duty to warn, which was influenced by the Tarasoff decision. During family therapy, the clinician is responsible for warning the family members or the group if the patient poses a danger to other people, such as the risk of homicide and suicide. This will influence the level of expressed emotion that the family will accord the patient and help them to recover from the psychological illness.
 
 
References
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, 257. https://doi.org/10.3389/fgene.2018.00257Links to an external site..
It is a scholarly article since it has been peer-reviewed, and the study findings have been supported by other studies and literature, as evidenced by the number of citations and references in the article. The information in the article is clear and precise and is written by research experts.
 
Marano, G., Traversi, G., Nannarelli, C., Pitrelli, S., Mazza, S., & Mazza, M. (2012). Functional neuroimaging: points of intersection between biology and psychotherapy. Clin Ter, 163(6), e445-456.
The article is considered scholarly as research experts did the research, and other experts have analyzed the results, and the research is based on the literature and findings of other studies found in the references. It was done to add information on the gaps that other studies have done on the subject matter.
 
Hodgkinson, S., Godoy, L., Beers, L. S., & Lewin, A. (2017). Improving Mental Health Access for Low-Income Children and Families in the Primary Care Setting. Pediatrics, 139(1), e20151175. https://doi.org/10.1542/peds.2015-1175Links to an external site..
The article is scholarly as it is based on the findings of other studies and information done on the same topic and has been reviewed by other research experts. The findings have also been shared and analyzed by other peers before publication.
 
Kim, N. S., Ahn, W. K., Johnson, S. G., & Knobe, J. (2016). The influence of framing on clinicians’ judgments of the biological basis of behaviors. Journal of experimental psychology. Applied, 22(1), 39–47. https://doi.org/10.1037/xap0000070Links to an external site..
The article is scholarly as it bases its objective and study questions on previous studies done in the field of psychology and aims at testing a hypothesis and supporting or refuting evidence and data from other articles. The article has been based on other literature, evidenced by the references and citations.

References.pdf

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Collapse SubdiscussionAna Tattersall Cocke

Ana Tattersall Cocke
Nov 30, 2022Nov 30, 2022 at 6:55pm

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Discussion #1, Reply #2, Day #1
Hello, Maxine
I agree that confirmation bias can influence how mental health providers affect group therapy. I wanted to review the literature to see how the transgender (TGD) community has dealt with this since it erupted on the scene in the last two years. Miles (2020) remarks TGD community should be treated equitably and somewhat like any other social group and be allowed to identify their individual goals and issues they must confront. Some of the problems that want to be addressed in the TGD community are stressors of being misgendered by parents, classmates, and society and suicidal ideation. One way this article shows support is to use their preferred pronouns (Miles, 2020) also believes group therapy can be a more cost-effective way to provide services for this discriminated community. The article then recommends further research on how to develop ethical decision-making models for the TGD community.
References
Miles, J. (2020) Introduction to the Special Section on Group Psychotherapy and Gender IdentityLinks to an external site.. International Journal of Group                        Psychotherapy 70:4, pages 540-551.

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Collapse SubdiscussionJoy Obiokor

Joy Obiokor
Dec 2, 2022Dec 2, 2022 at 4:46pm

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Reply#1
 
Hello Maxine,
Great job on your post, I agree with the Tarasoff decision’s influence on the clinician’s duty to warn. In group and family therapy, ethical and legal issues is a big area we must consider if group participants can be more willing to uphold an ethical code if they take ownership of it, such as by signing a contract that promises confidentiality (Trachsel & Grosse Holtforth, 2019).
A situation in which a therapist must consider their moral and legal obligations would be when a client expresses a desire to murder a coworker but does not name anyone in particular. The difficulties associated with group treatment and the goals of doing good and doing no harm make it essential to have informed consent. Before a client joins a group, the referring therapist should have a one-on-one discussion. Unlike group discussions, some people can voice their concerns or request explanations during one-on-one discussions. A more private conversation allows the counselor to assess the client’s perception of classification issues in a group setting. (Trachsel & Grosse Holtforth, 2019).
 
Reference
Trachsel, M., & Grosse Holtforth, M. (2019). How to Strengthen Patients’ Meaning Response by
an Ethical Informed Consent in Psychotherapy. Frontiers in psychology, 10, 1747.
https://doi.org/10.3389/fpsyg.2019.01747Links to an external site.
Understanding Group Therapy. Retrieved November 30, 2022, from
https://www.apa.org/topics/psychotherapy/group-therapy
 

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Collapse SubdiscussionSherill A Broderick

Sherill A Broderick
Dec 3, 2022Dec 3, 2022 at 11:50am

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Maxine,
I agree that socioeconomic status can affect psychotherapy. A study done by Blackshaw et al., (2018), shows how socio-economic status can negatively affect mental health and can be overlooked in psychotherapy. According to Blackshaw et al., (2018), psychotherapeutic intervention maybe an area of discomfort because of their lack of control over events and maybe challenging for the ther


Ethical and Legal Principles in Nursing

Ethical and Legal Principles in Nursing
Ethical and legal principles in nursing provide a framework that influences nurses’ goals, actions, and strategies while providing patient care. Nurses face dilemmas requiring ethical and legal principles to make decisions. In this blog, you will learn ethical and legal principles in nursing, physical therapy, and nursing education.
Legal and ethical principles in nursing
Nurses are required to observe and apply some ethics while dealing with patients. Below are legal and ethical principles in nursing;

Autonomy

Autonomy is recognizing individuals’ rights to decide on their healthcare. It demands that patients be informed about their condition, benefits, and risk of the treatment. The law allows adult patients to refuse treatment even if it’s the most beneficial to their health unless their decision would negatively affect the well-being of another individual.
As a nurse, you should support your patient’s wishes even if you disagree with them. A patient’s refusal of treatment may be influenced by general health, gender, culture, social status, sexual orientation, age, etc.

Justice

The principle of justice requires nurses to treat their patients fairly despite their religion, social-economic status, sexual orientation, race, or gender. Nurses should provide impartial medical care to all patients regardless of their condition, resulting in better patient outcomes. An example where justice is practiced is in a screening clinic available to all individuals regardless of their circumstances.

Beneficence

The beneficence principle requires nurses to be kind to their patients, society, and community. The nurse should offer the best care for the patient putting aside their personal feelings. Nurses must deal with patients individually with their opinions, life circumstances, and experiences to achieve the best care possible.
Nurses should act to benefit the patient and protect the right of others, help people with disabilities, prevent harm, rescue people from danger, and eliminate issues that can cause harm.

Non-maleficence

The non-maleficence principle requires nurses not to harm their patients. Nurses should prevent harm while providing health care to their patients. In cases when patients are not conversant enough about a particular process, the nurse should always act without hurting the patient. This principle is essential while making end-to-life decisions, in pain control, etc.

Accountability

Accountability principles require nurses to be responsible for their actions while caring for patients. They must accept any personal or professional consequences that may occur due to their action. Accountable nurses aim to provide quality patient care and build good relationships with their patients.

Fidelity

The principle of fidelity requires nurses to be loyal and faithful to their patients. Fidelity helps nurses create trust and fulfill their commitment which leads to positive outcomes. However, fidelity may lead to a dilemma since sometimes commitments may not lead to the best outcome for the patient. Fidelity also involves protecting, maintaining, and respecting confidential information, including health records.

Veracity

The principle of veracity requires nurses to be honest and open to their patients, even if the information may cause distress. Veracity helps strengthen the patient-nurse relationship and helps patients make decisions based on the information.
Legal framework and ethical principles in nursing
Nursing law establishes legal actions in patient care, creates a boundary for independent nursing action, differentiates the nurses’ duties from other health practitioners, and maintains standards. The legal indication of nursing practice is carried out by the law, policy, licensure, etc. Nurses’ skills and knowledge provide a framework for the nursing practice.
Legal actions are taken when a nurse fails to maintain the standards of practice. For example, a nurse touching a patient even after a refusal is considered a crime of assort, tort, or battery. Informed consent should be carried out once the patient can make decisions. Any harm or injury while offering patient care is also against the law
Nurses can have their licenses revoked or reprimanded due to malpractice, negligence, or breaking patient confidentiality while providing care. To avoid that, nurses and nursing students should follow the codes and ethics and employer procedure, protocol, and policies.
Legal and ethical principles in nursing PT information
External factors, including rules and regulations, influence nurses to provide the best patient care. The physical therapist follows the American Physical Therapy Association (APTA) practices to provide the best care for patients. Members of the association include occupational therapists, psychologists, rheumatologists, pharmacists, and orthopedics.
A physical therapist should follow the fiduciary (financial) principle while providing patient care. The principle requires that all patients be billed according to Medicaid services methodology regardless of the patient’s ability to pay. Nursing ethics aim to achieve a caring response when carrying out the nursing role and its function.
Moral commitment helps physical therapists deliver quality healthcare services to their patients, collaborate with colleagues, and maintain public trust. The APTA teaches members professional, ethical behavior such as publications and core documents. Knowing the scope of rules, ethical codes, and laws help in taking the correct cause of action.
Ethical and legal principles in nursing education
The National League for Nursing (NLN) addresses ethical issues involving violence, privacy, and dishonesty in nursing education. The NLN provides ethical principles that guide nursing education. Ethical practice in nursing education involves integrity, diversity, excellence, and caring.
The diversity principle requires a nurse educator to appreciate the uniqueness of different learners and apply different learning approaches to fit them. Equal treatment should be applied to all learners despite their age, gender, race, ethnicity, or religion. Integrity involves handling students with respect, dignity, and professionalism in and out of class.
Nurse educators should also respect and care for students to achieve good outcomes. They should also promote excellence by building a culture of innovation and research. However, legal action could be taken if;

A nurse educator fails to supervise students in a clinical setting leading to patient harm.
A nurse educator assumes to take measures against a student accused of unethical practice.
A patient suffers injury or harm due to poor training of the student.

Legal and ethical issues in nursing
Nurses experience ethical dilemmas while providing healthcare for patients. Some of these issues are the patient’s refusal of treatment due to personal or cultural beliefs, discomfort with treatment, or making life-or-death decisions. Many legal and ethical issues in nursing can result in loss of licensure, termination of employment, or even jailing. Below are legal and ethical issues in nursing;

Negligence

Negligence is carelessness or deviation from the basic standards of patient care, which could be intentional or unintentional. A nurse can be liable for negligence when it results in serious mistakes, such as wrong medication, lack of communication, etc.

Defamation

Defamation is making false statements about a patient, which can harm them, for example, making false claims about a patient on social media.

Confidentiality

According to the code of ethics, a nurse should maintain the privacy and confidentiality of a patient’s health records. If a nurse shares the information with an unauthorized person, they must face legal action.

Battery

Battery refers to physical harassment or touching patients without their knowledge. Nurses should ask permission from the patient when physical contact is needed. Patients can refuse physical contact or treatment, and nurses should respect that.

Mandatory reporting

A nurse practitioner has the legal and moral duty to report neglect, abuse, epidemic, or infectious disease. They should also report unsafe practices by their colleagues for the good of their patients.

Informed consent

Before performing a medical procedure, the nurse should acquire full consent from the patient. Patients should be well informed of the benefits and risks of any medical procedure or treatment. If the patient does not understand the implications, the nurse should inform the patient’s close family, who will provide consent on the patient’s behalf.

Patients’ belief

Before performing any medical procedure, nurses should understand a patient’s religious and cultural implications. The nurse must inform the patient about the relevant procedure and modify it if it violates their religious or cultural belief.
Ethical decision-making in nursing
Nurses face an ethical dilemma while providing health care which requires strong decision-making skills. Medical development and technological advancement have contributed to more challenges. Nurses are supposed to make decisions based on ethical principles. Ethical decision-making is the framework nurses use to make decisions while assessing the impacts of their actions.
Using principles of ethics, each nurse can achieve compassionate and safe patient care. Also, nurses should understand ethical principles, code of ethics, legal obligations, and law about nursing care. For example, a nurse may support a patient planning to stop cancer treatment from joining hospice care, demonstrating a nurse adhering to the code of ethics in nursing.
Final word
Ethical and legal principles in nursing help nurses make decisions regarding issues they face while providing patient care. Such issues can be patients’ refusal of treatment or making life-or-death decisions. Nurses should understand ethical principles, laws, and legal obligations to work with boundaries and provide care effectively. Read this article to understand the underlying principles for legal and ethical issues in nursing.


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