Pertemuan 5

SOCIOCULTURAL
AND
BIOPSYCHOSOCIAL
MODEL
Rullita Aristya Mintarsih, M.Psi
 SOCIOCULTURAL
PERSPECTIVE
Emphasize the circumtances surrounding individual and how their behavior are affected specifically by
other people, social, and cultural.
 Sociocultural Perspective
How to better Accepts and integrates the impact of cultural and

understanding
social norms to obtain information about their cultural
patterns into a unique treatment approach based on
their particular situation. Race, ethnicity, gender,

sociocultural family, age, religion, socioeconomic status, sexual

orientation, etc. also play major role in describing
people's behavior and mental processes.

perspective? Cultural Competence

Mental health professionals must understand, accept,
honestly and openly address issues of race, culture,
ethnicity, and other variables in terms of how these
shape their own life and attitudes and how they shape
experiences of others. So therapist could provide a
better treatment also could understand, appreciate,
and interact with people from culture or belief system
differences.
Socioeconomic
Factors

Low socioeconomic status

Due to persistent concern over unemployment or
underemployment, low wages, lack of health
insurance, no saving, and the inability to provide
food, which leads to feeling hopeless, helpless, and
dependency on others.
The impact...
Kondisi ini memicu tingginya tingkat penyakit mental
ataupun fisik karena tekanan hidup menyebabkan
mereka mudah mengalami gangguan kecemasan dan
depresi.
Gender Factors
According to research
Gender
It is important to understand that gender is not the
cause of mental illness, though differing demands
placed on males and females role by society and
their culture can influence the development of a
disorder.
Eating disorder, higher among women than men.
In contrast, men have a concern over not be
muscular enough, muscle dysphoria.
OCD, boys than girls.
Anxiety disorder, women than men.
ADHD, males than females.
Autism Spectrum Disorder, boys.
Depression, women than men.
PTSD, women than men.
Environmental
Factors
Environment
Experience of traumatic life event, unstable
relationships, experiencing racism or
discrimination, poverty, family dysfunction, the
impact of cultural expectations and demands, state
of physical health and nutrition, level of stress in
the environment (rural vs city living), social support
network (family, friends, co-workers, or society)
often influencing the level of stress of a person.
According to research
Experiencing traumatic life event such as
abandonment, abuse, toxic relationships, and
adversity during childhood - Borderline
Personality Disorder.
ADHD - smoking, alcohol use, or drug use during
pregnancy.
Depression - trauma, stress, and extreme
stressor.
Malnutrition before birth, exposure to viruses,
and other psychosocial factors - schizophrenia.
Anxiety Disorder - Divorce or the death of a
spouse, parenting and family environment, school
environment.
Multicultural
Factors
Racial, Ethnic, and Cultural factors
Normal or abnormal behavior needs to be seen
from the uniqueness of the individual, and the value
system of a particular culture or group. Racial and
ethnic minorities must contend with prejudice,
discrimination, racism as a part of their daily life
can lead to disordered behavior.
What should be done...
Untuk mengatasi faktor unik ini, terapis perlu
memiliki kepekaan budaya dan kesadaran akan nilai-
nilai budaya, berbagai macam hambatan sosial,
stresor, dan prasangka yang dihadapi klien,
mengidentifikasi kemarahan dan rasa sakit yang
ditekan akibat ekspektasi dari masyarakat, agar
mampu memberikan treatment yang efektif dan
efisien dalam peningkatan harga diri klien.
 01 Ethnic minorities tend to utilize less mental
health service.

BARRIERS TO
02
Lack of bilingual treatment, stigma, fear of
not being understood, family privacy, and

TREATMENT lack of education.

03
Perceptions and attitudes towards mental
health services as an unreliable place of
treatment.
04
People belonging to ethnic groups that report concerns
about prejudice and discrimination, they consider someone
who has mental illness was a sign of personal weakness
and would bring shame to the family.

05 Language differences are a further barrier to treatment.

06
The lack of understanding, or obtaining and integrating
some information about their client's cultural patterns into
a unique treatment.
TREATMENT
Multicultural counseling and therapy

Aims to offer both a helping role and process that

uses modalities and defines goals consistent with
the life experiences and cultural values of clients.
Sociocultural therapy can include individual,
group, family and couples treatment modalities.
 MULTIDIMENSIONAL
APPROACHES
Because the unidimensional explanation of mental health are insufficient to understanding mental illness
Works as a system
is a set of elements that interact or are interdependent on one another, but forms a
coherent whole and interacts with its environment and/or other systems.

Our mind and body are inseparable.

Mental disorder are systemic outcomes, influenced by multiple factors. Including
biological (genetics, hormones, neurotransmitters, and the brain), psychological
(learned behaviors, attitudes, emotional responses, cognitive, or social developmental
stage), and sociocultural forces (social support or lack of it, rejection, stress,
environmental influences) that constantly interact to each other.
The
Biopsychosocial
Model
This model aimed for a more holistic approach by
recognizing that each patient has hos or her own
thoughts, feelings, and histories.
George L. Engel emphasized that the biomedical
approach is flawed because the body alone does
not contribute to illness. instead the individual's
mind (psychological and social factors) plays a
significant role in how an illness is caused and
how it is treated.
 BPS model may vary depending on how dominant
one element towards the other elements can be.

INTERDEPENDENT Based on concordance rate in identical twins, with

ELEMENTS a strongly biologically influenced disorder. But, not

all twins will develop a disorder. Clearly, social/
cultural and psychological elements play important
roles on symptoms and prognosis.
 MAJOR DEPRESSION DISORDER
RISK FACTORS WITH BPS MODEL
BIOLOGICAL
Genetics
Neurotransmitter unbalances
Synaptic changes
Dysregulated stress response
Dysfunctional emotions
Dysfunctional cognition
Dysregulated physical functioning
PSYCHOLOGICAL
Anhedonia
Loss of motivation
Difficulty thinking/concentrating
Grief and psychological pain
Hopelessness/worthlessness/guilt
Chronic stress
Ability to cope life stressors
SOCIOCULTURAL
Isolation/loneliness
Lack of interest
Unsupported
Lack of opportunities
Stigma
Over expectations and demands
Living environment
The Diathesis-
Stress Model
Vulnerability and Stress
Both factors, diathesis/vulnerability (usually genetic, biological, and
physiological conditions) and environmental stress are necessary in the
development of a disorder. But having vulnerability or a diathesis does not
mean the person will actually develop the disorder.
Similarly, someone could be exposed to significant life stressors that
disrupt a person's stability or functioning in life, will not develop a
disorder, if they do not have a diathesis to a disorder or less vulnerability.
One can't manage their level of life stress when the combination of a
vulnerability and life stress exceeds the person's threshold.
When the vulnerability and stress reach the level of
threshold, it will overflow and lead to a disorder.

ALCOHOLISM
Gene-Environment
Correlation Model rGE is defined as the tendency of individuals to
generate environment based on genetic
feature that influence behavior, thought, and
feeling.

Epigenetics is the study of how social,

psychological, and environment influences can
actually change which genes in a person's
DNA may activate or inactivate. there is a
change in phenotype without a change in
genotype.

Genotype - warisan genetik dari orang tua ke anak yang terdiri dari susunan genom
yang berbeda, kecuali kembar identik.
Phenotype - ciri khas individu yang mudah diamati dan dapat berubah
menyesuaikan lingkungan.
NATURE VS NURTURE
Abuse and Antisocial Behavior

Gene Monoamine Oxidase A Gene (MAOA)

- low activity of neurotransmitter
(dopamine, norepinephrine,
serotonin).

Environment Exposed to child abuse

Antisocial Behavior
- Criminal offenders
- Hostility
- Conduct problems
 01 Individual Therapy
menuntaskan masalah individu

Group or couple Therapy

02
saling mendukung dan berbagi
pengalaman pembelajaran dalam latar
TREATMENT kelompok
membantu meningkatkan komunikasi
dan menuntaskan perbedaan dalam
pasangan

03
Family Therapy
identifikasi pola komunikasi
menyelesaikan konflik peran
membangun keluarga harmonis
THANK YOU