Bio-Psycho-Social Model - ATI Psychology Institute：生物心理社会模型- ATI心理学研究所.ppt

Bio-Psycho-Social Model George Engel (1977) Rejected the biomedical model as dogma As professions mature, they seem to learn that many approaches have a piece of the puzzle Have we evolved past this notion of our approach being the right one? Why? “Who is right and who is wrong” “What works best in a given situation” Medical Schools 1980’s… patient-centered, problem-based interview skills Open-ended questions Reflection Attending to non-verbal behaviour Promoted yet not fully integrated (Zimmerman Tansella, 1996) Psychiatry Some adoption of BPS Multi Axial dimension to DSM IV Focus still on Axes III (Biomedical) psychology, social work, andcounselling Interdisciplinary care World Health Definition of Health (1948) “A complete state of physical, mental, and social well-being and not merely the absence of disease and infirmity.” E.G.’s of BPS model application across disciplines: Eating disorders (Ricciardelli McCabe, 2004; Rogers Smit, 2000) pain management (Covic, Adamson, Spencer, Howe,2003; Kellen, 2003; Truchon, 2001) Chronic fatigue (Johnson, 1998) Gastrointestinal illness (Drossman,1998) Substance abuse (Marlatt, 1992) HIV/AIDS (Markus, Kerns, Rosenfeld, Brietbart,2000) Schizophrenia (Kotsiubinskii, 2002; Schwartz, 2000) Antisocial behavior (Dodge Petit, 2003) Racism (Clark, Anderson, Clark, Williams, 1999) Infertility (Gibson Myers, 2000) Gestational weight gain (Olson Strawderman, 2003) Spinal cord injury (Mathew, Ravichandran, May, Morsley, 2001) Diabetes (Peyrot, McMurry, Kruger, 1999) Encouraging Wide ranging Not so encouraging Tends to be one or the other I.E. Biological or Psychosocial Evolving view of diseases Anatomical pathology Belief that disease was localized in anatomy (16th to 18th Centuries) Tissue pathology Specific tissues could become diseased while others remain healthy (Late 1800s) Cellular pathology Belief that life resided in cells and so cells must be the place to look for disease (19th century) Evolving