The concepts (and states) of disease and health can be understood from different models or approaches. Until a few years ago, the predominant model in the field of medicine and psychology was the biomedical model, centred on the disease itself and the “mind-body” dichotomy.
However, in 1977 and with the help of psychiatrist George L. Engel, a new model emerged, which came to stay in many areas of health: the biopsychosocial model, which takes into account the biological, psychological and social factors of the person when explaining, understanding and facing a certain state of health or illness, disability or disorder.
Biopsychosocial model: definition and characteristics
The biopsychosocial model is one of the models we find in the field of psychology, and even psychotherapy. It is an approach that establishes that various factors influence the development and well-being of a person, in the context of an illness, disorder or disability.
These factors, as the very name of the model indicates, are of three types: biological (genetics, inheritance…), psychological (behaviours, emotions, thoughts…) and social (educational opportunities, poverty, unemployment…).
Source: George L. Engel
The origin of the biopsychosocial model can be found in the ideas of the American psychiatrist and internist George L. Engel (December 10, 1913 – November 26, 1999), who in 1977 proposed a model based on the idea that in all phases of a certain illness, disorder or disability, the three types of factors mentioned above coexist (to which we can also add the spiritual factors).
This is extrapolated to health status; that is, all these factors combine to influence both health and disease. Thus, the biopsychosocial model introduced by Engel moves away from the “mind-body” dichotomy postulated by the traditional medical model (and which we will see a little later), and considers the functioning of people from a holistic and integral point of view.
Thus, in this complex system of factors of various kinds, other subsystems interact, interacting through a dynamic process.
Beyond the Biomedical Model
The biopsychosocial model represents an advance in the understanding of health in general, and of mental health in particular, since before it the model that prevailed was the medical or biological model (a traditional reductionist model, where only biological factors matter).
In this way, the biopsychosocial model goes further, and holds that we must understand health and disease as two states that arise from the combination of these three types of factors in a person’s life. Moreover, from this approach we work for the well-being not only of the person or patient, but also of their family and community .
Traditional biological model vs. biopsychosocial model
As we have seen, the traditional biological model has a reductionist character , since it suggests that a person’s disease is explained solely from medical and biological terms, the disease being understood as a mere deviation from the normal functioning of the person, caused by a certain pathogen, genetic mutation, etc.
Furthermore, in this model the patient is not part of the healing process, which can lead to resistance to change.
This model is also called the “biomedical model” and was introduced by the English physician Richard Bright (1789-1858) in the 19th century. Thus, this model is based on a pathological approach, where the disease acquires a great relevance, forgetting other factors that have a great influence on its origin, development and cure. On the other hand, it is a model based on the “mind-body” dichotomy.
On the other hand, in the biopsychosocial model, it is believed in the power of the person to counteract the effects (or obstacles) derived from their disorder , disability or illness. In other words, in this model the patient becomes more active, since he is an agent of change, and that is why he is empowered – as far as possible – from the three aspects: biological, psychological and social.
Thus, according to the biopsychosocial model, in contrast to the traditional medical model, it is no longer the body that is sick, but the person in its full totality, with all that this implies.
Biopsychosocial model factors
As we have seen, the biopsychosocial model breaks with the traditional medical model because it takes into account factors that, until now, had not been taken into account when understanding a disease process, or a state of health. Let’s see, in summary, what each of these factors consists of.
1. Biological factors
The biological factors have to do with the biology of the person, that is, with his anatomy, his genetics , the cause of the disease in the case of having one, the mobility, the physiology, etc. These are the factors that predominate in the biomedical model.
2. Psychological factors
The psychological factors of the biopsychosocial model have to do with the most personal sphere of the person, and include his thoughts, emotions, behaviours, cognitive processes , coping styles, psychopathologies, personality, disease behaviour…
In this group of factors, we could also include the more spiritual side of the person (or even place them outside it), as it also plays a key role in many disease processes and in health itself.
3. Social factors
Finally, within the social factors that the biopsychosocial model establishes to be taken into account in the development and facing of a certain illness or condition of disability, we find stress, the perception of the latter, the economic and labour situation (for example, the unemployment situation), the perception of the daily burden, either family or labour, etc.
Areas of application
The biopsychosocial model is an approach that has been on the rise for some years now, and that we can find not only in psychology (and consequently in psychotherapy), but also in other sciences and fields of knowledge, especially in the field of health, such as: pedagogy, psychiatry, social work, occupational therapy, sociology, physiotherapy…
On the other hand, in the field of intellectual disability and chronic diseases, the biopsychosocial model takes on a special role . This is due, among other reasons, to the fact that people who work in this field are dedicated to the attention and care of these people, and that from this model they can address their needs by giving the necessary importance to all these factors for the rehabilitation or improvement of the person, who, we should remember, is sought to play an active role in their well-being and/or cure.
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