The Biopsychosocial Model - what's the theory?

Valmont

I was reading this article by Niall McClaren and this book review and it seems the biopsychosocial model has a dirty secret of sorts: it has no theory from which it was derived, therefore it can't be an actual model in the scientific sense of the word. So what is the biopsychosocial model considering it can't be an actual model? Thoughts anyone? Is it still useful if not scientific?

JuliusCaesar

It's an approach; yes, it is very useful; it counters the otherwise prevailing medical model.

Both your articles are from psychiatry sources, which tempts me to say "Well, they would say that, wouldn't they?"

Here's an article from an eminent psychologist.

krd

JuliusCaesar wrote: »

It's an approach; yes, it is very useful; it counters the otherwise prevailing medical model.

I prefer the socio-political model of mental wellness of Wolfgang Huber.

I'm not absolutely joking about that.

Or being that absolutely serious, either.



MOD EDIT:
krd, I have deleted the HUGE photo as it is irrelevant to the topic. Please don't do this again. JC

Valmont

JuliusCaesar wrote: »

It's an approach; yes, it is very useful; it counters the otherwise prevailing medical model.

How can it counter the medical model if it isn't actually a model? There is no agreed-upon or scientifically validated theory behind the biopsychosocial approach telling us how its three aspects interact. Could we say the biopsychosocial approach is simply an attempt to play it safe? Holistic seems a good adjective for the biopsychosocial approach. What are the implications for clinical psychology if the very approach adopted by its practitioners might not be scientific at all?

Velvety

Holistic isn't synonymous with unscientific. There's plenty of scientific evidence that psychological and social factors are very important in treating illnesses like hypertension, obesity, schizophrenia to name a few. Over and above an exclusively biomedical approach.

If there is evidence that this approach works better than the biomedical approach alone, why wouldn't you adopt it? If social and psychological treatments are found to be not at all useful in treating an illness, they won't be used. Evidence-based medicine only adopts what works.

Molecule

Valmont wrote: »

How can it counter the medical model if it isn't actually a model? There is no agreed-upon or scientifically validated theory behind the biopsychosocial approach telling us how its three aspects interact. Could we say the biopsychosocial approach is simply an attempt to play it safe? Holistic seems a good adjective for the biopsychosocial approach. What are the implications for clinical psychology if the very approach adopted by its practitioners might not be scientific at all?

I'm not sure what you mean by this. I read the abstract above and the review but I don't really find them particularly earth-shattering (as a trainee clinical psychologist). The biopsychosocial approach is an attempt to understand a person's presenting problems by taking into account all of the different factors that are coming together to create a problem for them. Do you mean that it lacks a unifying theory to show how biological factors, psychological factors and social factors interrelate to cause mental health difficulties? If so, how about neuroimmunology? It does a pretty good job of explaining how biology and environment interract to cause neurological and psychological difficulties, although it's a relatively new field so it doesn't yet have all the answers. Or newer research on childhood trauma and neglect and the resultant effects on brain development? This also has the potential to provide us with valuable information about how causal factors interact. Tbh I think if there was a great, unifying theory that showed exactly how biological, psychological, and social factors interact to 'cause' mental illness in 100% of cases then we could all quit researching and go home. I'm sorry if I'm missing the point but to me that abstract is saying 'this model is crap because it's based on not having all the answers' (as if the biomedical does??) I see the BPS approach as a useful basis for formulation. What are all the possible factors that could be contributing to your difficulties? How are these likely to be working together to maintain the problems? What factors are protective? What can we do to increase the protective factors and decrease the maintaining ones? Treatments are then chosen based on the evidence for their efficacy in particular presentations. Btw, I should add here that I'm no expert on the philosophy of science - hence me possibly entirely missing the point - but the connect between the three areas is something I see in pratice every day. I also do believe that one day we will understand exactly how physiology and environment interract but at the moment there is not one big theory but many smaller or partial theories that are, bit by bit, making all of this clearer.