Biopsychosocial Model
Prof. Masalakulangwa
11th January 2016
Learning Objectives
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Explain the theory of biopsychosocial
model
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Describe assessment, process, and
management in biopsychosocial
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Demonstrate application of
biopsychosocial model in medical care
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Outline
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Introduction
Biopsychosocial model
Biopsychosocial assessment
Biopsychosocial model of health and
illness
Biopsychosocial formulation
Biopsychosocial management
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Introduction
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Health (and illness) are caused/influenced by
many factors
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Mind and body are not separate
Relationships are significant to health
Health is on a continuum
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Introduction …
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Medical treatment involves pharmacologic
approaches as well as psychotherapy and
social interventions
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Medical care is incomplete without support
for psychosocial wellbeing (King, 2008)
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Illness is often caused by combination of
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Biological
Psychological and
Social factors
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Introduction …
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Bio psychosocial model reflects fundamental
changes in nature of illness, causes of death
and overall life expectancy
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By conceptualising diseases in purely
biological terms, the biomedical model has a
little to offer the prevention of chronic
diseases through efforts to change peoples
health beliefs, attitudes and behaviour
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Introduction …
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Bio-psychosocial model link individual
perceptions, beliefs and behaviours to
biological processes
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Biopsychosocial model adopts a holistic
approach
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Person as a whole be taken into account
It posits that separate issues are often related
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Biopsychosocial Model
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The biopsychosocial approach was developed
at Rochester decades ago by Drs. George
Engel and John Romano (Gross, 2010)
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The biopsychosocial approach systematically
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considers biological, psychological, and social
factors and
their complex interactions in understanding
health, illness and health care delivery
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Biopsychosocial Model …
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Decide which aspects of biological,
psychological and social domains are most
important to understanding and promoting
the patient’s health
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Provide multidimensional treatment
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Biopsychosocial Model …
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This model posits that each one of these
factors is not sufficient to bring about health
or illness, but the interaction between them
determines the course of one's development
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Issues with this model include the degree of
influence that each factor has, the degree of
interaction between factors, and variation
across individuals and life spans
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Biopsychosocial Model …
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A number of practitioners use biopsychosocial
assessment, including doctors, nurses,
psychotherapists, social workers
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Biopsychosocial Assessment
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Biopsychosocial assessment involves series of
questions asked to obtain information about
the major physical (bio), psychological, and
social issues of the individual
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Questions covering the biological sphere
could include any history of disease,
addiction, surgeries, medication use, and
family history of illness
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Biopsychosocial Assessment …
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Psychological assessment could have
questions that cover the presence of strong
stressors like recent bereavements, abuse,
risk of suicide; or self esteem, learned
behaviors
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Sociological questions may concern family,
living arrangements, relationships, finances,
stability of work, home, and school
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Biopsychosocial Model of
Health and Illness
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Biopsychosocial Model of Health
and Illness (adopted from Ogden, 2000)
Biological
 Genetic
 Viruses
 Bacteria
 Lesions
 Structural
defects
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Psychological
 Cognitions
 Emotions
 Behaviours
 Stress
 Pain
Biopsychosocial Model
Social
 Norms
 Pressure to
change
 Social values
 Class
 Ethnicity
 Employment
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Biopsychosocial Model of
Health and Illness
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Biopsychosocial Formulation
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In what way was the patient predisposed
to getting this condition?
What precipitating factors caused this
illness to emerge at this time?
What factors perpetuate this illness in its
current form?
What protective factors (strengths,
supports, resources) does this patient
have?
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Biopsychosocial Formulation …
Biological Psychological
Social
Predisposing
Precipitating
perpetuating
Protective
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Case Study
Irene was fired from her job one month ago because
she started making numerous mistakes and had
trouble concentrating. About three months ago she
started feeling “down” after a break-up with a man
she had been dating for a few months. She has
trouble falling asleep and has noticed a significant
decline in her appetite. She feels like a failure and
believes that no one will want to hire her again.
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Case Study ...
She has thoughts of committing suicide but admits, “I
could never do it.” The only thing that seems to help
is when she participates in a bible-reading group
every Tuesday night. She explains, “During that time
I’m more like my old self and at least that night I can
sleep.” She also reports that her mood improves
when she visits her friends. However, she reports such
low energy throughout the day that she is unable to
schedule a job interview.
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Case Study ...
She had a similar episode about two years ago after
she was laid off from her former job. She reports
that it took four months before she began feeling
“normal” again and positive about herself. Her
history indicates that her mother had severe
depression and was hospitalized on several
occasions when Helen was young. She describes her
as “negative” and often absent in her youth.
However, Helen always did well in school and had an
active social life. Her work history has been very
consistent up to her lay off.
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Biopsychosocial Formulation …
Biological Psychological
Predisposing Positive
history of MI
Parental
neglect
Social
laid off from
job
Precipitating
Stress and pain Break-up
of break-up
Perpetuating
Stress and pain Being fired
of being fired
Protective
Bible reading
Active social
group
life
Visiting friends
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Biopsychosocial Management
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Biological
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Psychological
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Medication as per diagnosis
Psycho education
Behavior therapy
Supportive therapy
Social
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Skills training to improve social skills deficits
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Conclusion
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The process of diagnosis must consider the
interaction of biological, psychological, and
social factors
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Treatment recommendations must take these
factors into account
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References
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King, L.A (2008) the Science of Psychology, McGraw-Hill
Gross, R. (2010) Psychology the Science of Mind and
Behaviors 6th edition; Macmillan Company
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