Clinical Applications of the Biopsychosocial Model

Vrinda Varnekar Apr 28, 2019
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The three-factor model of understanding health, illness, etc. has been used in clinical applications for patients with different problems. Read on.
The only thing I had to work with, in the hospital was my mind, and once you have your mind, you can put things back together again.
- Morris Goodman, The Miracle Man
Morris Goodman is an inspiring example of how psychological and social factors play a huge role in recovery. Being a victim of a plane crash, doctors had prophesied that he would remain a vegetable all his life. He, however, proved them wrong, rightly earning the title of The Miracle Man.
Suggested in the late 1970s by George Engel, an American psychiatrist, the biopsychosocial model (BPS model for short) opposes the biomedical approach in its beliefs― that biological factors cannot be held solely responsible for both health, as well as disease.
Commonly known as the mind-body connection, this three-factor model advocates that psychological and social factors too play a very significant and equally important role in wellness, the manifesting of disease, as well as recovery. 
Though it didn't really receive much support at first, this model has become a very popular healthcare approach in hospitals, and it provides a strong base for social workers to understand issues such as addiction and substance abuse.
The biopsychosocial model has its share of advocates as well as critics, and though it isn't a mandatory approach to health and healthcare in hospitals, it is widely used all over the world as a clinical application.
Psychiatrists, social workers, nurses, psychologists, and other medical authorities claim that its clinical application helps them understand the problems of a patient. This helps them decide the kind of treatment they want to provide him or her with. The next sections describe the various clinical applications of the biopsychosocial model.

Addiction

Why do people develop addictions? An addiction to alcohol, addiction to cigarettes, addiction to intravenous drugs, gambling, or anything else. Today, most adults tend to indulge in social drinking every now and then, or like cracking open a bottle of beer after a tough day at work. Does that mean all of them are addicted?
No. This fact is enough for us to assume that not everyone who indulges in these activities for pleasure or recreation gets addicted. What is it that affects only a few people, and not others? What causes an addiction?
The biopsychosocial model tries to explain the causes of addiction. The reasons for an addiction are quite complex, and the three factors mentioned in the biopsychosocial model play an equally significant part in inducing addictive behavior in a person.
 The biological factor in the model states that some people have a higher chance of developing an addiction as compared to others. Research actually suggests that individuals with a family history of addictions are more prone to develop them as compared to those who have no such family history.
Similarly, hormones can also be believed to play a part. Hence, it is possible that the biological factors of a person could play a role in developing addictive behavior.
 The psychological factor in the BPS model too plays a major role in developing an addiction. For many people, drinking, smoking, doing drugs, or gambling feels like rewarding behavior― they get happiness or relief by doing it.
The concept of rewarding behavior is actually psychological, the person only feels rewarded. However, the temptation of the good feelings that are generated for the person after indulging in something might lead towards an addiction for the same.
 The social factor of the BPS model consists of the social and cultural environment surrounding the individual. His relationships with the people around him, and his peer group play a huge role in developing addictions. Secondly, the availability of an addictive substance, or the general mindset about it also affects the possibility of addiction.
For instance, if smoking is 'cool' and necessary in a high-profile, stressful job, there is more chance of an individual getting addicted to it, as it is generally viewed as acceptable. Also, gambling is a common and popular activity all over the world. This may lead to an individual at risk to indulge endlessly in gambling and ultimately get addicted to it.
Social workers and psychiatrists take all three factors of the biopsychosocial model into consideration when analyzing addiction problems and addictive behavior. These factors help them understand the problem at hand from every point of view, and help in deciding what kind of treatment should be administered.

Healthcare

The biopsychosocial model, as we know, helps in determining the best kind of treatment to be administered to a patient according to his or her health issues. Studying and analyzing all three factors of the model in depth keeping the patient's issues in mind definitely helps, according to the advocates of the model.
 When the patient has to be administered medical treatment in the hospital, all three needs can be taken care of simultaneously: biological needs, psychological needs, as well as social needs.
  • Biological needs can be taken care of by providing the necessary medicines, any sedatives if required, the correct nutrition, appropriate safety facilities, as well as antidepressants, if applicable.
  • Psychological needs can be taken care of by being empathetic with the patient and making him feel safe and secure in the doctor's care. Emotional support, sympathy, and allowing the patient to feel comfortable in the doctor's company are ways to take care of the patient's psychological needs.
  • The social needs of a patient are fulfilled through support from family members, friends, peers, etc.
 When the patient is on the road to recovery, the biopsychosocial model can again be applied for quicker and better recovery.
  • Biological needs can be taken care of through antidepressants, the appropriate medicines, correct diet, etc.
  • Psychological needs are taken care of through counseling, information about the problem and information about recovery.
  • Social needs are taken care of through enhanced primary and secondary relationships, as well as being engaged in some or the other kind of activity so as to avoid frustration or depression.
The biopsychosocial model of healthcare thus helps doctors to identify and correct any underlying issues that may hamper a patient's recovery.

Pain Management

Pain of some sort of the other, especially chronic pain, is largely prevalent in society today. The cost of this pain, however, is extravagant and financially, hits most people hard.
To minimize these costs of pain, and to effectively treat patients suffering from pain at the same time, medical experts have begun using the biopsychosocial model to provide the appropriate treatment by studying the interaction between the biological, psychological, and social factors of that patient.
Pain, especially chronic pain, has three equally important reasons―

 Physical injuries or disorders in the body are a source of pain for an individual. Though that's what it seems like, these injuries are not the only source of the pain being experienced.
 Psychological factors such as frustration, depression, increased stress, are capable of causing physical harm to the body through heart attacks, nervous breakdowns, etc. Hence, psychological factors need to be taken into consideration in pain management.
 Social factors such as abuse, dysfunctional relationships, bullying, etc., indirectly have an effect on the psychological and biological states of an individual, thus leading to further problems. These factors also play a strong role in inducing or stalling recovery.
Pain management according to the biopsychosocial approach thus analyzes an individual's biological, psychological, and social factors and then designs a tailor-made plan of treatment that can be administered, and takes care of all three needs.

Mental Illness

Mental illness of any kind cannot be attributed to just any biological, psychological, or social reason alone. In fact, it is the interaction between the three factors that causes any disorder, be it physiological or mental. The reason why the biopsychosocial model can be useful to study mental health and its problems is as follows.
 Biological reasons such as heightened sensitivity to stress, fear, anxiety, etc. 

 Psychological reasons such as the individual's thoughts, perceptions, emotions, lack of confidence, feelings of trauma, etc.

 Social reasons, such as peer pressure, role models, relationships, subjection to abuse, traumatic experiences, etc.
The interaction between the given three factors broadly comes together to manifest mental illness such as personality disorders or anxiety problems, or something on similar lines. No single factor is sufficient to give birth to these psychological problems, but all three are.

Depression

The BPS model states that depression as a mental condition cannot be attributed to psychological reasons alone. In fact, the model states, that depression is attributed to the interaction between all three factors: biological, psychological, and social.
 The biological factors include an individual's imbalanced hormones, any physical disorder, a disability, etc. A person suffering from one or all these issues is more likely to get depressed than someone who is not.
 Psychological factors too, of course, influence and induce depression to a great extent. Self-confidence, pattern of thinking, negativity in the mind, emotional intelligence, and the ability to cope, influence depression.
 Social factors, such as lack of social support, traumatic incidents, abuse, or other stressful situations have the ability to affect the psyche and physical state of an individual. Social reasons generally affect the other two factors in an indirect manner, thus leading to depression as a full-fledged psychological condition.
The three factors are interdependent when inducing and influencing depression in humans. This interdependent nature makes it very necessary for medical experts to take all three factors into detailed account for analyzing the causes and effects of depression on a person.

Stress Management

Stress affects most individuals all over the world today. The reasons are―a tough job, difficulty in coping up with studies, fitting in with the so-called 'popular' group of people, or parental pressure, to name a few. Stress is induced, affected, and influenced by biological, psychological as well as social factors, even though it may not be very apparent.
Biological factors that either induce stress, or are the result of stress are patience levels, level of irritability, temperament, hunger (at that moment), digestive problems, etc. All these factors can be a result of excessive stress, or can even cause stress.
Psychological factors that induce or are the result of stress in an individual are sensitivity levels, individual perceptions, thoughts, and beliefs. Cognition plays a significant role in inducing or causing stress to an individual.
Social or cultural factors that result in stress can be anything from the external environment that surrounds an individual: from driving in traffic, to losing weight, from bullying, to getting married because of pressure.

The biopsychosocial model helps in understanding the different causes and effects of stress on an individual.
As all these factors are interdependent, it can be assumed that all of them affect one another directly or indirectly. Hence, analyzing all three categories of factors is important for effective stress management. If stress is not managed properly, it can lead to severe psychological and physiological problems that may have very serious consequences.
The biopsychosocial model indeed has a lot of significant clinical applications and is an important tool for doctors and social workers for understanding a patient's problems in great detail. Though it has had its share of criticism, this model has gained a stronghold in the medical world.
DisclaimerThis content is for informative purposes only. The author does not promote or criticize this approach to healthcare. Please do not use anything mentioned here as a substitute for medical advice.
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