Biopsychosocial model: what it is and how it understands mental health

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, focused on the disease itself and on the "mind-body" dichotomy.

However, in 1977 and at the hands of psychiatrist George L. Engel, a new model emerged, which is here 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 coping with a certain state of health or disease, disability or disorder.

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Biopsychosocial model: definition and characteristics

The biopsychosocial model is one of the models that we find in the field of psychology, and even psychotherapy. It is an approach that establishes that there are various factors that influence the development and well-being of a person, in the context of a disease, disorder or disability.

These factors, as the name of the model itself indicates, are of three types: biological (genetics, heredity...), psychological (behaviors, emotions, thoughts...) and social (educational opportunities, poverty, unemployment…).

Origin: 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 disease, disorder or disability, the three types of factors mentioned coexist (to which we can also add the factors spiritual).

This is extrapolated to the state of health; 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 medical model. traditional (and that we will see a little later), and considers the functioning of people from a holistic and comprehensive.

In this way, in this complex system of factors of various kinds, other subsystems interact, which are interrelated 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 it prior to him, the preponderant model was the medical or biological model (a traditional reductionist model, where only biological factors matter).

In this way, the biopsychosocial model goes further, and maintains that we must understand health and disease as two states that arise from the combination of these three types of factors in the life of the person. Furthermore, from this approach work is done for the well-being not only of the person or patient, but also for that of their family and community.

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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 can be explained solely from medical and biological terms, understanding the disease as a mere deviation from the normal functioning of the person, caused by a certain pathogen, genetic mutation, etc

In addition, in this model the patient is not part of his healing process, which can lead to resistance to change.

This model also receives other names, such as 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 pathologist approach, where the disease acquires great relevance, forgetting other factors that have a great influence on its origin, development and cure. On the other hand, it is a model that is based on the “mind-body” dichotomy.

Instead, 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. That is to say, in this model the patient begins to have a more active role, since he himself is an agent of change, and it is For this reason, they are 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 ill, but the person as a whole, with all that this implies.

Factors of the biopsychosocial model

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 consist of.

1. biological factors

Biological factors have to do with the biology of the person, that is, with their anatomy, their genetics, the cause of the disease in the case of suffering from one, mobility, 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 encompass their thoughts, emotions, behaviors, cognitive processes, coping styles, psychopathologies, personality, illness behavior...

In this group of factors, we could also include the most spiritual side of the person (or even situate it outside of it), since it also plays a key role in many disease processes and in the very health.

3. Social factors

Finally, within the social factors that the biopsychosocial model establishes to take into account in the development and coping of a certain disease or disabling condition, we find stress, the perception of the latter, the economic and work situation (for example, the situation of unemployment), the perception of the daily load, be it family or work, etc.

Fields 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 as a consequence, 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 acquires a special role. This is due, among other reasons, to the fact that people who are dedicated to the attention and care of these people work in this area, and who can address their needs from this model granting the necessary importance to all these factors for the rehabilitation or improvement of the person, who, let us remember, seeks to have an active role in their well-being and/or healing.

Bibliographic references:

• friend, i (2012). Psychological manual of health. Madrid: Pyramid.
• Dowling, A. S. (2005). George Engel, M.D. (1913 - 1999). American Journal of Psychiatry, 162(11): 2039.
• Engel, G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196: 129-136.
• Oblitas, L. (2006). Health psychology and quality of life. 2nd. Ed. Mexico: Thomson.