Biopsychosocial Model

Introduction
The Biopsychosocial model was first conceptualized by George Engel in 1977, suggesting that to
understand a person's medical condition it is not simply the biological factors to consider, but
also the psychological and social factors.

Bio (physiological pathology)

Psycho (thoughts emotions and behaviors such as psychological distress, fear/avoidance beliefs,
current coping methods and attribution)

Social (socio-economical, socio-environmental, and cultural factors such as work issues, family
circumstances and benefits/economics)

This model is commonly used in chronic pain, with the view that the pain is a
psychophysiological behavior pattern that cannot be categorized into biological, psychological,
or social factors alone. There are suggestions that physiotherapy should integrate psychological
treatment to address all components comprising the experience of chronic pain.

Explanation:
The biopsychosocial approach systematically considers biological, psychological, and social
factors and their complex interactions in understanding health, illness, and health care delivery.

The biopsychosocial model reflects the development of illness through the complex interaction
of biological factors (genetic, biochemical, etc.), psychological factors (mood, personality,
behavior, etc.) and social factors (cultural, familial, socioeconomic, medical, etc.). non-primary
source needed. For example, a person may have a genetic predisposition for depression, but he
or she must have social factors such as extreme stress at work and family life and psychological
factors such as perfectionistic tendencies which all trigger this genetic code for depression. A
person may have a genetic predisposition for a disease, but social and cognitive factors must
trigger the illness.

Specifically, Engel revolutionized medical thinking by re-proposing a separation of body and

mind. The idea of mind–body dualism goes back at least to René Descartes, but was forgotten
during the biomedical approach. Engel emphasized that the biomedical approach is flawed
because the body alone does not contribute to illness. Instead, the individual mind (psychological
and social factors) plays a significant role in how an illness is caused and how it is treated. Engel
proposes a dialogue between the patient and the doctor in order to find the most effective
treatment solution.
The Biopsychosocial Model is a very important step in medical care as it broadens the scope
with which health and illness can be examined in clinical practice. Considering this model leads
to the patient being interviewed as a person with an individual lifestyle and not simply as a
patient with a disease which has deviated them from normal functioning. Thus the clinician will
have many avenues to explore before they make their diagnosis and hopefully they will be able
to provide preventative information to the patient about how they may adjust their lifestyle in
order to have a better quality of life. This model can be used in medical schools to train doctors
in the art of good communication, understanding and compassion.

ADVANTAGES OF BIOPSYCHOSOCIAL MODEL

The biopsychosocial model claims that three factors influence health, healthcare, and disease,
which are physiological, psychological, and social. This means that it takes into consideration the
smaller picture of any biological problems at an individual level, as well as the bigger picture of
psychological issues and the effect society has on that individual and on his/her situation. Hence,
this model takes both the micro as well as macro viewpoints into consideration when analyzing a
patient. This helps in administering better treatment, say advocates of the model.

The biopsychosocial model does not consider health to be a deviance from some constant
physiological state. Instead, it emphasizes on health and illness being a result of social,
psychological as well as biological factors interacting together. Hence, this medical approach
does not treat health just from the physiological point of view, but concentrates on having
healthy all-round development, cure, and maintenance of all three factors.

Another advantage of the biopsychosocial model is that cure, recovery, and good health are not
completely in the hands of medical experts, but are in fact, partly in control of the patients
themselves. Along with medical experts taking care of the biological treatment, patients and their
families can maintain a demeanor that will result in quick psychological and social recovery,
which will ultimately help better and faster physiological recovery. When using this medical
approach, patients rarely feel helpless or out of control.

DISADVANTAGES AND CRITICISM

The biopsychosocial model assumes that all mental illnesses are, in fact, biopsychosocial. Critics
feel that assuming every mental disorder to be biopsychosocial actually increases the stigma that
is attached to these disorders, instead of reducing it. Assuming that a physical injury or effect of
society results in every mental illness is not practical, and if assumed thus, can also lead to
confused treatment which may have grave consequences. Some mental disorders can be
explained with the biopsychosocial model; but it is wrongly assumed that the model is applicable
to every disease.
Some critics feel that incorrect behavior (such as anti-social behavior, for instance) cannot be
treated as a medical condition, as very rarely do biological factors have a role in inducing it.
Critics feel that assuming such behavior to be a disease reduces the credibility of the field of
psychiatry, as it seems irrational to classify schizophrenia (a real disease) on the same lines as
anti-social behavior.

According to some critics, another disadvantage of this model is that despite intensive efforts, it
is very difficult to teach this model to psychiatry students in an academic setting. Not all students
are convinced by the three-fold approach of the model, and are not convinced about its
credibility or usefulness. Critics feel that the vagueness of the model, and giving equal
importance to all three factors in every situation, can discourage prospective psychiatry students
from the very beginning, thus compromising on the number of students who wish to become
psychiatrists.

One more disadvantage of the model as pointed out by critics is that, for a new user of this
model, it can be confusing and misleading to use it correctly and appropriately. The model
vaguely tends to suggest that biology and psychology are two separate fields in medicine. This
leads to misunderstandings on the part of a new user, who may not understand what symptom of
a patient is to be categorized in which factor.

The biopsychosocial model takes into consideration the effects of society on an individual,
including his religious beliefs, primary and secondary relationships, work history, past incidents,
etc. However, it can get very impractical to take so many social factors into consideration when
trying to analyze a patient’s problem. For experts, it can also be difficult to decide which social
factors should be considered along with the psychological and biological factors. Hence, critics
feel that treatment can get delayed or confused because of the consideration of so many things.