Biopsychosocial Model: Examples, Overview, Criticisms

George Engel first articulated the biopsychosocial model in 1977, proposing that understanding a person’s medical condition requires assessing not only their biology but also psychological and social influences.

The biopsychosocial model encompasses three primary elements: physiological, psychological, and sociocultural aspects.

For example, biological factors can include a person’s age, genetic makeup, health history, and gender. Psychological influences can include the individual’s emotions, thoughts, and behavior. 

Finally, social aspects like economic status, family relationships, and access to healthcare services can drastically alter one’s choices.

This method emphasizes that people possess unique well-being needs, recognizing the interrelationship of these three components for optimal care.

By taking a comprehensive approach to patient healthcare, medical practitioners can understand the root causes of illness, thus enabling them to craft individualized care plans.

Overview of the Biopsychosocial Model

A biopsychosocial model is a holistic approach to understanding health and illness considering multiple influences. It recognizes the interplay between biological, psychological, and social factors on health throughout a person’s lifespan (Bolton & Gillett, 2019).

Through this model, practitioners can gain insight into how physical, psychological, and social stressors can interact to affect an individual’s overall health. 

According to Erb and Schmidt (2021), a biopsychosocial model:

“…is a general model of care, positing that biological, psychological (i.e., thoughts, emotions, and behaviors), and social factors all play a significant role in human functioning in the context of disease or illness (p. 29).

While traditional medical models focus purely upon problems’ pathological origins, this alternative considers multiple aspects beyond mere biological cause.

This method focuses on comprehending how combined biological, psychological, and social aspects can affect our well-being.

Kusnanto and colleagues (2018) state that:

“…the biopsychosocial model is an ideal representation of science and humanism in medical practice, although many argue that the model is hard to implement” (p. 497). 

Integrating mental, physical, and social factors into patient care can be arduous. Its primary goal is to give a complete view of patient care by concentrating on nurturing the individual as an entirety rather than solely focusing on their medical symptoms.

For example, a person suffering from persistent pain could find relief through integrated physical and psychological therapies, along with the assistance of their psychologist. The treatment plan must always be carefully tailored to an individual’s needs accordingly.

Simply, the biopsychosocial model allows practitioners to understand the root causes of ailments or discomfort, enabling them to create more tailored treatment strategies.

Three Components of the Biopsychosocial Model

The biopsychosocial healthcare model comprises three interrelated components: biological, psychological, and social (Landow, 2006).

Let’s look at each of these components:

1. Biological Component

This component refers to the physiological and genetic characteristics of the individual that affect his health. It includes predisposition to certain diseases, immune system, age, gender, and other biological factors.

For instance, hereditary factors may make a patient with a family history of type 2 diabetes more prone to developing the disorder.

2. Psychological Component

The psychological aspect covers the patient’s emotional and psychological state, including stress, anxiety, mood, and consciousness.

Psychological factors can influence health through behavioral and cognitive processes.

As in the first case, in a patient with a chronic condition such as arthritis, increased stress levels can increase pain and cause depression.

3. Social Component

This component affects the social environment and cultural factors that affect human health.

For example, it may include health care availability and quality, family support, economic status, and educational attainment.

A patient with low socioeconomic status may have limited access to quality health care or a healthy diet, leading to chronic diseases.

Biopsychosocial Model Examples

• Eating Disorders: The biopsychosocial model offers invaluable insights into the development of eating disorders, such as anorexia nervosa, bulimia nervosa, and binge eating, by exploring their biological, psychological, and social nuances. Evidence affirms that these conditions cannot be attributed to any cause but rather a combination of factors from several domains. So, treatment plans must look at all aspects of an individual’s condition rather than solely focusing on physical symptoms.
• Anxiety Disorders: Anxiety can be attributed to biological, psychological, and social factors. Thus, by blending biological elements such as neurotransmitter imbalances with psychological approaches like cognitive behavioral therapy (CBT) and social paradigms, including supportive networks – it is achievable to mitigate the symptoms of anxiety conditions, for example, panic disorder or OCD.
• Depression: This psychological condition can be caused by various components, such as genetics, hormone imbalances, detrimental thought patterns and environmental pressures. An effective treatment should take into consideration each of these contributing aspects to successfully tackle depression symptoms.
• Addiction: Addictive behaviors may have a biological base due to chemical imbalances in the brain or genetic predispositions. Still, they can also be triggered by personal struggles or difficult situations in a person’s life. So, before developing a treatment strategy, it’s important to consider all the contributing factors to an individual’s addiction.
• Chronic Pain: If you experience persistent pain, there is likely to be a physiological cause. Additionally, psychological and environmental elements can contribute to distress. To successfully handle chronic soreness requires physical treatments that address the root of your condition and cognitive-behavioral strategies designed to lessen its emotional impact while receiving support from family members or friends.
• Heart Disease: Biological risk factors like smoking or high cholesterol levels and psychological elements like stress and lack of physical activity can contribute to this chronic condition. Understanding these different components helps healthcare professionals create comprehensive prevention plans for individuals at risk of developing heart disease.
• Autism Spectrum Disorders: Like many other conditions, ASD can be the result of biological factors such as neural development or genetic makeup. Psychological issues, including anxiety, or social problems, such as communication or social interaction difficulties, can also influence it. Integrating all of these components into treatment plans can help to improve the lives of those struggling.
• ADHD/ADD: Biological causes, like an increase in certain neurotransmitters levels alongside environment elements e.g. absence/or not enough parental monitoring and inadequate nutrition are known causes culminating to Attention Deficit /Hyperactive disorder (ADHA/ADD). So, treatment plans should take all of these factors into consideration to help those affected by this condition.
• Schizophrenia: This mental disorder is associated with multiple biological changes in the brain and possible genetic influences. However, social factors, including trauma or relationship issues, may trigger its onset or exacerbate existing symptoms. Thus, creating an effective treatment plan should include assessing these contributing components. 
• Insomnia: Studies suggest that there are both physical and emotional drivers behind insomnia. Thus, if you have insomnia, a comprehensive treatment plan should include not just lifestyle interventions such as reducing caffeine and alcohol intake. In addition, consider taking some form of mental health guidance such as CBT (cognitive behavioral therapy) aimed at detecting and addressing underlying emotions capable of disrupting adequate slumber.

Origins of the Biopsychosocial Model

In the 1970s, George L. Engel – an American psychiatrist – proposed a biopsychosocial model as an alternative to the biomedical model that was then prevailing (Smith, 2002).

The biomedical model focused exclusively on the physical and biological aspects of the disease. It marked the beginning of a revolutionary new era in psychiatry and medicine.

Still, this model took a reductionist approach and only looked at the disease from an anatomical, physiologic, and chemical perspective of the body. Thus, psychological and social influences were disregarded.

According to Smith (2002), based on various studies and clinical experience, Engel proposed the biopsychosocial model to combine diseases’ biological, psychological, and social aspects. 

This model emphasizes the significance of taking into account all three elements in combination in order to gain a comprehensive insight into diseases and their causes.

Over time, the biopsychosocial model has earned immense global recognition from researchers.

It found considerable traction in many current approaches to diagnosing, curing, and averting ailments ranging from psychological conditions to chronic illnesses.

Criticisms of the Biopsychosocial Model

While the biopsychosocial model may look a promising unified approach to patient treatment, its ambiguity in terms of outcomes, lack of unity amongst practitioners, and its complexity have been heavily criticized.

Here are some key criticisms of this model:

• Lack of clarity and structure: One major criticism of the biopsychosocial model is its relative uncertainty and absence of structure. The lack of clear boundaries and criteria for each component (biological, psychological, and social) can make developing and evaluating standard treatment techniques challenging (Carey et al., 2014).

• Lack of unity: The biopsychosocial model is often seen as an alternative to the biomedical model but is not always integrated with it. This separation can lead to interaction problems between specialists in different fields and a lack of a unified treatment strategy.

• Complexity: Measuring and evaluating psychological and social factors can be complex and subjective. Determining the relationship between these components and diseases can take time, creating difficulties in developing and evaluating treatment effectiveness (Carey et al., 2014).

• Resource limitations: The biopsychosocial model requires a broader and deeper approach to treatment, which can require significant resources and time. Implementing such an approach can be challenging, especially with limited budgets and overburdened healthcare facilities.

Conclusion

To gain insight into every aspect of one’s well-being requires a comprehensive perspective such as what’s provided by the biopsychosocial model.

This evidence-based approach helps us gain greater insight into how physical and mental issues come about – giving us an invaluable tool for improving our overall health.

Developed by George Engel in the late 1970s, healthcare practitioners have widely adopted this model due to its comprehensive and integrative approach.

Despite its advantages, the biopsychosocial model has been criticized for its lack of certainty, structure, unity, complex process, and resource limitations. 

Still, it serves as a significant means of comprehending and dissecting physical and mental healthcare challenges, whilst devising potent treatments for multiple conditions.

References

Bolton, D., & Gillett, P. G. (2019). The biopsychosocial model 40 years on. In www.ncbi.nlm.nih.gov. Palgrave Pivot. https://www.ncbi.nlm.nih.gov/books/NBK552030/

Carey, T. A., Mansell, W., & Tai, S. J. (2014). A biopsychosocial model based on negative feedback and control. Frontiers in Human Neuroscience, 8. https://doi.org/10.3389/fnhum.2014.00094

Erb, M., & Schmid, A. A. (2021). Integrative rehabilitation practice: The foundations of whole-person care for health professionals. Jessica Kingsley Publishers.

Kusnanto, H., Agustian, D., & Hilmanto, D. (2018). Biopsychosocial model of illnesses in primary care: A hermeneutic literature review. Journal of Family Medicine and Primary Care, 7(3), 497–500. https://doi.org/10.4103/jfmpc.jfmpc_145_17

Landow, M. V. (2006). Stress and mental health of college students. New York: Nova Science Publishers.

Smith, R. C. (2002). The biopsychosocial revolution. Journal of General Internal Medicine, 17(4), 309–310. https://doi.org/10.1046/j.1525-1497.2002.20210.x