Did You Know?
The man who is believed to have suggested the biopsychosocial model before Engel, is Roy Grinker. He undertook training in psychoanalysis from Sigmund Freud himself.
The biopsychosocial model proposed by George Engel in the late 1970s claims that health, wellness, and disease are dependent upon the interaction between three factors: biological or physiological factors, psychological or mental factors, and social factors. According to this model, no disease or even good health can be the manifestation of a physiological condition alone. Psychological factors and the cultural environment surrounding an individual play an equally important role in either maintaining or deteriorating health.
Though George Engel is widely believed to have proposed this model first, some experts claim otherwise. According to them, it was Roy Grinker, a neurologist and psychiatrist, who proposed this model and even coined the term ‘biopsychosocial’ first. According to them, Grinker used the biopsychosocial approach in psychiatry in order to emphasize on the biological factors that were otherwise ignored, especially in mental illnesses. Critics of Engel’s biopsychosocial model of health and healthcare largely support Grinker’s approach.
Just like every other, the biopsychosocial model also has its advantages and disadvantages. Advocates highly praise the model’s efficiency to help faster recovery, while critics point out the many assumptions that are made when putting this model into use. Our next sections will talk about the advantages and disadvantages of the biopsychosocial model.
Advantages and Advocacy
✦ 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.
✦ Since the biopsychosocial model does not believe that disease and illness is caused only because of viruses or bacteria, it promotes better psychological conditions and better social interaction. Similarly, it advocates social support, leading to a promotion of community-based living in society. This in turn affects the general well-being of society at large for the better.
✦ The biomedical model does not contain any concrete explanation for diseases that are caused without any apparent physiological reason, i.e., psychosomatic disorders. However, the biopsychosocial model, analyzing the interaction between the three major factors in detail, can explain how and why psychological disorders, or social factors can sometimes result in physiological problems.
✦ The biopsychosocial model advocates for good mental and emotional health in order to maintain a healthy lifestyle. Controlling our mental health as well as the effects society can have on us, is in our hands, and if successful, it can help in disease prevention. Thus, it is cost-effective, as prevention is definitely better than cure in many cases.
✦ The treatment or therapy designed by the biopsychosocial model of healthcare is tailor-made in order to suit a particular patient’s physiological, psychological, and social needs and wants. Unlike the biomedical approach that does not take the person’s mind and emotions as well as social effects into consideration, this approach is used on an individual level.
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.
As we mentioned before, like every theory, the biopsychosocial model too has its share of advantages and disadvantages. Whatever may be the reception of this model today, we can conclude that the biopsychosocial approach to health and healthcare is very beneficial in several situations, and not so useful in others.
Disclaimer: This article is for informative purposes only. The author does not promote or criticize this model in any way whatsoever.