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This open access book is a systematic update of the philosophical and scientific foundations of the biopsychosocial model of health, disease and healthcare. First proposed by George Engel 40 years ago, the Biopsychosocial Model is much cited in healthcare settings worldwide, but has been increasingly criticised for being vague, lacking in content, and in need of reworking in the light of recent developments. The book confronts the rapid changes to psychological science, neuroscience, healthcare, and philosophy that have occurred since the model was first proposed and addresses key issues such as the model’s scientific basis, clinical utility, and philosophical coherence. The authors conceptualise biology and the psychosocial as in the same ontological space, interlinked by systems of communication-based regulatory control which constitute a new kind of causation. These are distinguished from physical and chemical laws, most clearly because they can break down, thus providing the basis for difference between health and disease. This work offers an urgent update to the model’s scientific and philosophical foundations, providing a new and coherent account of causal interactions between the biological, the psychological and social.
This open access book is a systematic update of the philosophical and scientific foundations of the biopsychosocial model of health, disease and healthcare. First proposed by George Engel 40 years ago, the Biopsychosocial Model is much cited in healthcare settings worldwide, but has been increasingly criticised for being vague, lacking in content, and in need of reworking in the light of recent developments. The book confronts the rapid changes to psychological science, neuroscience, healthcare, and philosophy that have occurred since the model was first proposed and addresses key issues such as the model's scientific basis, clinical utility, and philosophical coherence. The authors conceptualise biology and the psychosocial as in the same ontological space, interlinked by systems of communication-based regulatory control which constitute a new kind of causation. These are distinguished from physical and chemical laws, most clearly because they can break down, thus providing the basis for difference between health and disease. This work offers an urgent update to the model's scientific and philosophical foundations, providing a new and coherent account of causal interactions between the biological, the psychological and social. This work was published by Saint Philip Street Press pursuant to a Creative Commons license permitting commercial use. All rights not granted by the work's license are retained by the author or authors.
To what extent do social factors such as stress cause physical diseases? How do psychological and social factors contribute to the healing process? The biopsychosocial model is an approach to medicine which stresses the importance of a holistic approach. It considers factors outside the biological process of illness when trying to understand health and disease. In this approach, a person's social context and psychological well-being are keyfactors in their illness and recovery, along with their thoughts, beliefs and emotions. Biopsychosocial Medicine examines the concept and the utility of this approach from its history to its application, and from its philosophical underpinnings to the barriers to its implementation. It is severely critical of the failure of modern medicine to treat the patient not the disease, andits neglect of psychological and social factors in the treatment of the ill. Focusing on chronic disabling ill health, this book takes the examples of arthritis, cancer, diabetes, lower back pain, irritable bowel syndrome and depression to show how the biopsychosocial model can be used in practice. It questions why, even when the biopsychosocial approach has been proved tobe more effective than traditional methods in overcoming these disorders, is not more routinely used, and how barriers to its implementation can be overcome. Controversial and challenging, Biopsychosocial Medicine will be essential reading for all those who feel the biomedical model is failing them and their patients. It will enable readers to understand the model and how it can be implemented, in order to enhance their confidence and success as healthprofessionals.
Developed in the twentieth century as an outgrowth of psychosomatic medicine, the biopsychosocial model is seen as an antidote to the constraints of the medical model of psychiatry. Nassir Ghaemi details the origins and evolution of the BPS model and explains how, where, and why it fails to live up to its promises. He analyzes the works of its founders, George Engel and Roy Grinker Sr., traces its rise in acceptance, and discusses its relation to the thought of William Osler and Karl Jaspers.
Psychology of Health - Biopsychosocial Approach is based on the bio-psychosocial model of health, which aims to examine how biological, psychological, and social factors influence people's behavior regarding their health status. This book reflects the application of the bio-psychosocial model of health in many disciplines such as public health, psychology, psychiatric, mental health, community health, and nursing education. All the authors of this book have demonstrated how the bio-psychosocial model played an important role in addressing mental disease, tuberculosis, post-traumatic stress disorder, and obesity. This is an important book for students, academics, policy-makers, and community health practitioners.
For thousands of years, Western culture has dichotomized science and art, empiricism and subjective experience, and biology and psychology. In contrast with the prevailing view in philosophy, neuroscience, and literary criticism, George Engel, an internist and practicing physician, published a paper in the journal Science in 1977 entitled "The Need for a New Medical Model: A Challenge for Biomedicine." In the context of clinical medicine, Engel made the deceptively simple observation that actions at the biological, psychological, and social level are dynamically interrelated and that these relationships affect both the process and outcomes of care. The biopsychosocial perspective involves an appreciation that disease and illness do not manifest themselves only in terms of pathophysiology, but also may simultaneously affect many different levels of functioning, from cellular to organ system to person to family to society. This model provides a broader understanding of disease processes as encompassing multiple levels of functioning including the effect of the physician-patient relationship. This book, which contains Engel's seminal article, looks at the continuing relevance of his work and the biopsychosocial model as it is applied to clinical practice, research, and education and administration. Contributors include: Thomas Inui, Richard Frankel, Timothy Quill, Susan McDaniel, Ronald Epstein, Peter LeRoux, Diane Morse, Anthony Suchman, Geoffrey Williams, Frank deGruy, Robert Ader, Thomas Campbell, Edward Deci, Moira Stewart, Elaine Dannefer, Edward Hundert, Lindsey Henson, Robert Smith, Kurt Fritzsche, Manfred Cierpka, Michael Wirsching, Howard Beckman, and Theodore Brown.
The Social Determinants of Mental Health aims to fill the gap that exists in the psychiatric, scholarly, and policy-related literature on the social determinants of mental health: those factors stemming from where we learn, play, live, work, and age that impact our overall mental health and well-being. The editors and an impressive roster of chapter authors from diverse scholarly backgrounds provide detailed information on topics such as discrimination and social exclusion; adverse early life experiences; poor education; unemployment, underemployment, and job insecurity; income inequality, poverty, and neighborhood deprivation; food insecurity; poor housing quality and housing instability; adverse features of the built environment; and poor access to mental health care. This thought-provoking book offers many beneficial features for clinicians and public health professionals: Clinical vignettes are included, designed to make the content accessible to readers who are primarily clinicians and also to demonstrate the practical, individual-level applicability of the subject matter for those who typically work at the public health, population, and/or policy level. Policy implications are discussed throughout, designed to make the content accessible to readers who work primarily at the public health or population level and also to demonstrate the policy relevance of the subject matter for those who typically work at the clinical level. All chapters include five to six key points that focus on the most important content, helping to both prepare the reader with a brief overview of the chapter's main points and reinforce the "take-away" messages afterward. In addition to the main body of the book, which focuses on selected individual social determinants of mental health, the volume includes an in-depth overview that summarizes the editors' and their colleagues' conceptualization, as well as a final chapter coauthored by Dr. David Satcher, 16th Surgeon General of the United States, that serves as a "Call to Action," offering specific actions that can be taken by both clinicians and policymakers to address the social determinants of mental health. The editors have succeeded in the difficult task of balancing the individual/clinical/patient perspective and the population/public health/community point of view, while underscoring the need for both groups to work in a unified way to address the inequities in twenty-first century America. The Social Determinants of Mental Health gives readers the tools to understand and act to improve mental health and reduce risk for mental illnesses for individuals and communities. Students preparing for the Medical College Admission Test (MCAT) will also benefit from this book, as the MCAT in 2015 will test applicants' knowledge of social determinants of health. The social determinants of mental health are not distinct from the social determinants of physical health, although they deserve special emphasis given the prevalence and burden of poor mental health.
This volume is the first comprehensive and interdisciplinary text to holistically improve understanding of the health of South Asians residing in the United States by considering biological, psychological, and sociocultural factors of health. The vast literatures of diverse fields – psychology, medicine, public health, social work, and health policy – are integrated by leading scholars, scientists, and practitioners in these areas to explore the impact of South Asian cultural factors on health, health risk, and illness. Chapters incorporate available theoretical and empirical information on the status of chronic health conditions in South Asians in the United States, with consideration of future directions to improve understanding of the health of this group. Cultural and ethnic insights imperative for clinical/community/medical practitioners to provide effective and culturally-appropriate care and treatment from an interdisciplinary lens are provided.
As the population of older Americans grows, it is becoming more racially and ethnically diverse. Differences in health by racial and ethnic status could be increasingly consequential for health policy and programs. Such differences are not simply a matter of education or ability to pay for health care. For instance, Asian Americans and Hispanics appear to be in better health, on a number of indicators, than White Americans, despite, on average, lower socioeconomic status. The reasons are complex, including possible roles for such factors as selective migration, risk behaviors, exposure to various stressors, patient attitudes, and geographic variation in health care. This volume, produced by a multidisciplinary panel, considers such possible explanations for racial and ethnic health differentials within an integrated framework. It provides a concise summary of available research and lays out a research agenda to address the many uncertainties in current knowledge. It recommends, for instance, looking at health differentials across the life course and deciphering the links between factors presumably producing differentials and biopsychosocial mechanisms that lead to impaired health.