:Biopsychosocial model

A 2024 review proposed use of the BPSM because the biomedical model did not fit the social and psychological aspects of health problems.{{Cite journal|url=https://www.bmj.com/rapid-response/2011/10/29/introducing-biopsychosocial-model-good-medicine-and-good-doctors|title=Introducing the Biopsychosocial Model for good medicine and good doctors|first=Shane J. Mc|last=Inerney|date=March 29, 2025|via=www.bmj.com}}

A 2023 review said that in the previous decades substantial evidence had arisen supporting BPSM, although the theory of it remained unclear.{{Cite journal|title=A revitalized biopsychosocial model: core theory, research paradigms, and clinical implications|first=Derek|last=Bolton|date=December 31, 2023|journal=Psychological Medicine|volume=53|issue=16|pages=7504–7511|doi=10.1017/S0033291723002660|pmid=37681273|pmc=10755226}}

A 2021 review found a substantial gap between healthcare professionals knowledge of the BPSM and their adoption of it in clinical practice.{{cite journal | url=https://journals.lww.com/pain/abstract/2021/08000/barriers_and_enablers_influencing_healthcare.2.aspx | doi=10.1097/j.pain.0000000000002217 | title=Barriers and enablers influencing healthcare professionals' adoption of a biopsychosocial approach to musculoskeletal pain: A systematic review and qualitative evidence synthesis | date=2021 | last1=Ng | first1=Wendy | last2=Slater | first2=Helen | last3=Starcevich | first3=Cobie | last4=Wright | first4=Anthony | last5=Mitchell | first5=Tim | last6=Beales | first6=Darren | journal=Pain | volume=162 | issue=8 | pages=2154–2185 | pmid=33534357 }}{{cite journal | doi=10.3389/fpain.2023.1169178 | doi-access=free | title=Applying the behavioural change wheel to guide the implementation of a biopsychosocial approach to musculoskeletal pain care | date=2023 | last1=Ng | first1=Wendy | last2=Beales | first2=Darren | last3=Gucciardi | first3=Daniel F. | last4=Slater | first4=Helen | journal=Frontiers in Pain Research | volume=4 | pmid=37228807 | pmc=10204590 }}

A 2018 review found that BPSM in primary care could lead to improved clinical outcomes, through creating awareness of factors impacting health and enhancing self-management of patients' illnesses.{{Cite journal|title=Biopsychosocial model of illnesses in primary care: A hermeneutic literature review|first1=Hari|last1=Kusnanto|first2=Dwi|last2=Agustian|first3=Dany|last3=Hilmanto|date=March 31, 2018|journal=Journal of Family Medicine and Primary Care|volume=7|issue=3|pages=497–500|doi=10.4103/jfmpc.jfmpc_145_17|doi-access=free |pmid=30112296|pmc=6069638}}

A 2007 review said that the biopsychosocial model was widely accepted as the most heuristic approach to understanding and treating chronic pain.{{cite journal | vauthors = Gatchel RJ, Peng YB, Peters ML, Fuchs PN, Turk DC | title = The biopsychosocial approach to chronic pain: scientific advances and future directions | journal = Psychological Bulletin | volume = 133 | issue = 4 | pages = 581–624 | date = July 2007 | pmid = 17592957 | doi = 10.1037/0033-2909.133.4.581 | url = https://cris.maastrichtuniversity.nl/ws/files/76755442/Peters_2007_The_biophysical_approach_to_chronic.pdf }}

A 2004 review said the BPSM was widely used as both a philosophy of clinical care and a practical clinical guide useful for broadening the scope of a clinician's gaze. It proposed the model had evolved into a biopsychosocial and relationship-centered framework for physicians. It proposed three clarifications to the model, and identified seven established principles.

• Self-awareness.
• Active cultivation of trust.
• An emotional style characterized by empathic curiosity.
• Self-calibration as a way to reduce bias.
• Educating the emotions to assist with diagnosis and forming therapeutic relationships.
• Using informed intuition.
• Communicating clinical evidence to foster dialogue, not just the mechanical application of protocol.{{cite journal | vauthors = Borrell-Carrió F, Suchman AL, Epstein RM | title = The biopsychosocial model 25 years later: principles, practice, and scientific inquiry | journal = Annals of Family Medicine | volume = 2 | issue = 6 | pages = 576–582 | date = Nov 2004 | pmid = 15576544 | pmc = 1466742 | doi = 10.1370/afm.245 }}

In the decade to 2015 there was a rising interest among healthcare researchers and practicing medical professionals in the biopsychosocial model. However, despite the rising interest, medical schools had limited use of the model in their curriculums relative to the increasing literature about the model.{{Cite journal |last1=Jaini |first1=Paresh Atu |last2=Lee |first2=Jenny Seung-Hyun |date=September 2015 |title=A Review of 21st Century Utility of a Biopsychosocial Model in United States Medical School Education |journal=Journal of Lifestyle Medicine |volume=5 |issue=2 |pages=49–59 |doi=10.15280/jlm.2015.5.2.49 |issn=2234-8549 |pmc=4711959 |pmid=26770891}}

The biopsychosocial and biomedical models offer distinct perspectives on understanding and addressing health and illness.

The biomedical model, which was historically prevalent, takes a reductionist approach by focusing on biological factors and treating diseases through medical interventions. It sees diseases as isolated physical abnormalities.

While this approach was once deemed sufficient, research within psychology and the social sciences cast doubt on its effectiveness.{{cite web | title=Introducing the Biopsychosocial Model for good medicine and good doctors | website=The BMJ | date=2024-08-05 | url=https://www.bmj.com/rapid-response/2011/10/29/introducing-biopsychosocial-model-good-medicine-and-good-doctors | access-date=2024-08-06}}

The biopsychosocial model adopts a holistic viewpoint, acknowledging the complex interplay of biological, psychological, and social factors in shaping health and illness.{{Cite journal |last1=Kusnanto |first1=Hari |last2=Agustian |first2=Dwi |last3=Hilmanto |first3=Dany |date=May 2018 |title=Biopsychosocial model of illnesses in primary care: A hermeneutic literature review |journal=Journal of Family Medicine and Primary Care |language=en |volume=7 |issue=3 |pages=497–500 |doi=10.4103/jfmpc.jfmpc_145_17 |pmid=30112296 |pmc=6069638 |doi-access=free }} It sees diseases as outcomes of dynamic interactions among various dimensions. The model emphasizes the interconnectedness of these dimensions, recognizing their mutual influence on an individual's health.{{Cite journal |last1=Newman |first1=Marc C. |last2=Lawless |first2=John J. |last3=Gelo |first3=Florence |last4=Dmin |first4=Null |date=2007-05-01 |title=Family-Oriented Patient Care |url=https://www.aafp.org/pubs/afp/issues/2007/0501/p1306.html |journal=American Family Physician |language=en-US |volume=75 |issue=9 |pages=1306–1310|pmid=17508523 }}

The BPSM has been extended to consider additional holistic elements influencing the perceived necessity for healthcare and the focus on health-related matters: Information, Beliefs, and Conduct. Based on the model's dependence on perception, it has been considered imperative to actively engage the individuals or communities whose requirements are being addressed,{{Cite journal |last1=King |first1=Denae W. |last2=Hurd |first2=Thelma C. |last3=Hajek |first3=Richard A. |last4=Jones |first4=Lovell A. |date=2009 |title=Using a Biopsychosocial Approach to Address Health Disparities—One Person's Vision |journal=Journal of Cancer Education |volume=24 |issue=Suppl 2 |pages=S26–S32 |doi=10.1080/08858190903412091 |issn=0885-8195 |pmc=2883460 |pmid=20024822}} regardless of whether the focus is on their health, education, employment, housing, or any other needs. A key term in the biopsychosocial model is "syndemic" which refers to a set of health problem factors that interact synergistically with each other ranging from socioeconomic status to genetics.

Treatment under the biopsychosocial model is comprehensive, involving medical, psychological, and social interventions to address overall well-being.

Health inequities, often rooted in social determinants of health, highlight the disparities in health outcomes experienced by different populations.{{Cite web |date=2023-05-26 |title=Health Disparities {{!}} DASH {{!}} CDC |url=https://www.cdc.gov/healthyyouth/disparities/index.htm |access-date=2023-12-07 |website=www.cdc.gov |language=en-us}}

The BPSM provides a framework for comprehending how health disparities arise and persist, which makes it a model of interest in targeting health inequities.{{Cite journal |last1=Wade |first1=Derick T |last2=Halligan |first2=Peter W |date=August 2017 |title=The biopsychosocial model of illness: a model whose time has come |journal=Clinical Rehabilitation |language=en |volume=31 |issue=8 |pages=995–1004 |doi=10.1177/0269215517709890 |issn=0269-2155 |pmid=28730890 |s2cid=206486211 |doi-access=free}}

Some patients that fall under the biopsychosocial model may not fall under the biomedical model, as the biopsychosocial model considers factors that may not physiologically manifest in a person.{{cite book |doi=10.1016/B978-0-08-097086-8.14060-7 |chapter=Behavioral Medicine |title=International Encyclopedia of the Social & Behavioral Sciences |date=2015 |last1=Vögele |first1=Claus |pages=463–469 |isbn=978-0-08-097087-5 }} These patients include those affected by health inequities and those at risk of infirmity.

Preventative medicine considers preventative measures to stop patients from obtaining infirmity in the first place.{{Cite web |date=2005 |title=Biopsychosocial Medicine (DRAFT) |url=https://academic.oup.com/book/1047 |access-date=2023-12-07 |publisher=Oxford University Press |doi=10.1093/med:psych/9780198530343.001.0001 |isbn=978-0-19-853034-3 |editor-last1=White |editor-first1=Peter}} By combatting preventable chronic diseases which make up a majority of deaths in patients of the US, the BPSM has been considered a potential tool to improve patient outcomes.{{Cite journal |last1=Wade |first1=Derick T. |last2=Halligan |first2=Peter W. |date=August 2017 |title=The biopsychosocial model of illness: a model whose time has come |journal=Clinical Rehabilitation |volume=31 |issue=8 |pages=995–1004 |doi=10.1177/0269215517709890 |issn=1477-0873 |pmid=28730890 |s2cid=206486211 |doi-access=free}} SAMHSA has promoted BPSM approaches in preventing opioid use.{{cite web | url=https://www.samhsa.gov/blog/treatment-prevention-strategies-reduce-opioid-misuse | title=Treatment and Prevention Strategies to Reduce Opioid Misuse | date=23 April 2021 }}

Within the framework of the biopsychosocial model, gender is regarded by some as a complex and nuanced construct, shaped by the intricate interplay of social, psychological, and biological factors.{{Cite book |last=Iantaffi |first=Alex |title=How to Understand Your Gender: A Practical Guide for Exploring Who You Are |publisher=Jessica Kingsley Publishers |year=2017 |isbn=9781785927461 |language=en}} This perspective, as echoed by the Gender Spectrum Organization, defines gender as the multifaceted interrelationship between three key dimensions: body, identity, and social gender.{{Cite web |last=Prismic |title=Understanding Gender |url=https://genderspectrum.org/articles/understanding-gender |access-date=2023-03-04 |website=Gender Spectrum}}

In essence, this characterization aligns with the fundamental principles of the biopsychosocial model, emphasizing the need to consider not only biological determinants but also the profound influences of psychological and social contexts on the formation of gender.{{Cite journal |last1=Knudson-Martin |first1=Carmen |last2=Mahoney |first2=Anne Rankin |date=March 2009 |title=Introduction to the Special Section-Gendered Power in Cultural Contexts: Capturing the Lived Experience of Couples |url=https://onlinelibrary.wiley.com/doi/10.1111/j.1545-5300.2009.01263.x |journal=Family Process |language=en |volume=48 |issue=1 |pages=5–8 |doi=10.1111/j.1545-5300.2009.01263.x |pmid=19378641}}

According to the insights of Alex Iantaffi and Meg-John Barker, the biopsychosocial model provides a comprehensive framework to understand the complexities of gender. They illustrate that biological, psychological, and social factors are not isolated entities but rather intricately intertwined elements that continually interact and shape one another. In this dynamic process, a person's gender identity emerges as the result of a complex interplay between their biological characteristics, psychological experiences, and social interactions. This holistic perspective is in harmony with the biopsychosocial model's approach, which acknowledges the inseparable connection between these various dimensions in influencing an individual's overall well-being.

In essence, within the biopsychosocial paradigm, gender is not merely a product of biological determinants; rather, it is a dynamic and interconnected aspect of human identity. This perspective urges a more nuanced understanding, encouraging researchers and medical professionals to consider the intricate interplay of social, psychological, and biological factors when exploring and addressing the complexities of gender.

The following models or theories are regarded as biopsychosocial;

• Engel's model, as above.
• The Dynamic-Maturational Model of Attachment and Adaptation (DMM) describes how attachment relationships, and other factors, effect human development, information processing and functioning.{{Cite book | vauthors = Crittenden PM |url=https://www.worldcat.org/oclc/667877268 |title=Assessing adult attachment : a dynamic-maturational approach to discourse analysis |date=2011 |publisher=W.W Norton & Co |others=Andrea Landini |isbn=978-0-393-70667-3 |location=New York |oclc=667877268}} Crittenden considered this to be a biopsychosocial model.{{Cite book | vauthors = Crittenden PM |url=https://www.worldcat.org/oclc/893646939 |title=Raising parents : attachment, representation, and treatment |year=2016 |isbn=978-0-415-50829-2 |edition=2nd |location=London |oclc=893646939}}
• Kozlowska's Functional Somatic Symptoms approach sees attachment relationships and other factors as causes of somatic problems.{{cite book | vauthors = Kozlowska K, Scher S, Helgeland H | chapter = The Skeletomotor System and Functional Somatic Symptoms |date=2020 | doi = 10.1007/978-3-030-46184-3_7 | title = Functional Somatic Symptoms in Children and Adolescents | series = Palgrave Texts in Counselling and Psychotherapy |pages=137–160 |place=Cham |publisher=Springer International Publishing |isbn=978-3-030-46183-6 | s2cid = 226613256 }}{{Cite book | vauthors = Kozlowska K, Scher S, Helgeland H |title=Functional Somatic Symptoms in Children and Adolescents: A Stress-System Approach to Assessment and Treatment |date=2020 |publisher=Springer International Publishing |isbn=978-3-030-46183-6 |series=Palgrave Texts in Counselling and Psychotherapy |location=Cham |language=en |doi=10.1007/978-3-030-46184-3|s2cid=226614004 }} Siegel's Interpersonal Neurobiology (IPNB) model is similar to Kozlowska's approach, but sees the individual brain and mind, and interpersonal relationships, as part of one reality, rather than separate elements.{{Cite book | vauthors = Siegel DJ |url=http://worldcat.org/oclc/1141039476 |title=The developing mind: how relationships and the brain interact to shape who we are |publisher=The Guilford Press |year=2012 |isbn=978-1-4625-4275-8 |edition=3rd |location=New York: London |pages=59 |oclc=1141039476}}
• Some trauma informed care models are biopsychosocial models.{{Cite journal | vauthors = Huang LN, Flatow R, Biggs T, Afayee S, Smith K, Clark T, Blake M |date=2014 |title=SAMHSA's Concept of Trauma and Guidance for a Trauma-Informed Approach |url=https://store.samhsa.gov/sites/default/files/d7/priv/sma14-4884.pdf |journal=Substance Abuse and Mental Health Services Administration |language=en-US}}{{cite journal | vauthors = Sweeney A, Filson B, Kennedy A, Collinson L, Gillard S | title = A paradigm shift: relationships in trauma-informed mental health services | journal = BJPsych Advances | volume = 24 | issue = 5 | pages = 319–333 | date = September 2018 | pmid = 30174829 | pmc = 6088388 | doi = 10.1192/bja.2018.29 }}
• In 2012 Lumley and colleagues used a non-Engel model to conduct a biopsychosocial assessment of the relationship between pain and emotion.{{cite journal | vauthors = Lumley MA, Cohen JL, Borszcz GS, Cano A, Radcliffe AM, Porter LS, Schubiner H, Keefe FJ | display-authors = 6 | title = Pain and emotion: a biopsychosocial review of recent research | journal = Journal of Clinical Psychology | volume = 67 | issue = 9 | pages = 942–968 | date = September 2011 | pmid = 21647882 | pmc = 3152687 | doi = 10.1002/jclp.20816 }}
• In 1986 Zucker and Gomberg used a non-Engel biopsychosocial perspective to assess the etiology of alcoholism.{{cite journal | vauthors = Zucker RA, Gomberg ES | title = Etiology of alcoholism reconsidered. The case for a biopsychosocial process | journal = The American Psychologist | volume = 41 | issue = 7 | pages = 783–793 | date = July 1986 | pmid = 3527004 | doi = 10.1037/0003-066X.41.7.783 }}

When Engel first proposed the biopsychosocial model it was for the purpose of better understanding health and illness. While this application still holds true the model is relevant to topics such as health, medicine, and development. Firstly, as proposed by Engel, it helps physicians better understand their whole patient. Considering not only physiological and medical aspects but also psychological and sociological well-being. Furthermore, this model is closely tied to health psychology. Health psychology examines the reciprocal influences of biology, psychology, behavioral, and social factors on health and illness.

BPSM can improve primary care clinical outcomes, through creating awareness on the interactions among biological, psychological, sociocultural, and spiritual factors, and enhancing self-management of patients' illnesses.

BPSM is useful to address chronic diseases and ill-defined illnesses to which patients mount unique responses.

BPSM can be applied in relation to pain. Several factors outside an individual's health may affect their perception of pain. For example, a 2019 study linked genetic and biopsychosocial factors to increased post-operative shoulder pain.{{cite journal | vauthors = Simon CB, Valencia C, Coronado RA, Wu SS, Li Z, Dai Y, Farmer KW, Moser MM, Wright TW, Fillingim RB, George SZ | display-authors = 6 | title = Biopsychosocial Influences on Shoulder Pain: Analyzing the Temporal Ordering of Postoperative Recovery | journal = The Journal of Pain | volume = 21 | issue = 7–8 | pages = 808–819 | date = Dec 2019 | pmid = 31891763 | pmc = 7321871 | doi = 10.1016/j.jpain.2019.11.008 | doi-access = free }} Future studies are needed to model and further explore the relationship between biopsychosocial factors and pain.{{cite journal | vauthors = Miaskowski C, Blyth F, Nicosia F, Haan M, Keefe F, Smith A, Ritchie C | title = A Biopsychosocial Model of Chronic Pain for Older Adults | journal = Pain Medicine | volume = 21 | issue = 9 | pages = 1793–1805 | date = September 2020 | pmid = 31846035 | doi = 10.1093/pm/pnz329 }}

Correlation has been found between adverse childhood experiences and subsequent health and well-being outcomes.{{cite web | url=https://www.cdc.gov/violenceprevention/aces/about.html | title=About the CDC-Kaiser ACE Study {{pipe}}Violence Prevention{{pipe}}Injury Center{{pipe}}CDC | date=11 March 2025 }}

A BPSM appraisal can be used in diagnosis of depression and anxiety.http://www.nice.org.uk/indicators/ind103-depression-and-anxiety-biopsychosocial-assessment-at-diagnosis/IND103-20240429.pdf

One advantage of applying the biopsychosocial model to developmental psychology is that it allows for an intersection within the nature versus nurture debate. This model provides developmental psychologists a theoretical basis for the interplay of both hereditary and psychosocial factors on an individual's development.

The BPSM approach has been used as a framework for or component of care.http://www.england.nhs.uk/long-read/peer-support{{cite web | url=https://surgery.wustl.edu/three-aspects-of-health-and-healing-the-biopsychosocial-model/ | title=Three Aspects of Health and Healing: The Biopsychosocial Model in Medicine {{pipe}} Department of Surgery {{pipe}} Washington University in St. Louis }}{{cite journal | url=https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00623-8/fulltext | pmid=38879263 | date=2024 | last1=Löwe | first1=B. | last2=Toussaint | first2=A. | author3=Rosmalen JGM | last4=Huang | first4=W. L. | last5=Burton | first5=C. | last6=Weigel | first6=A. | last7=Levenson | first7=J. L. | last8=Henningsen | first8=P. | title=Persistent physical symptoms: Definition, genesis, and management | journal=Lancet | volume=403 | issue=10444 | pages=2649–2662 | doi=10.1016/S0140-6736(24)00623-8 }}

Wickrama and colleagues have conducted several biopsychosocial-based studies examining marital dynamics. In a longitudinal study of women divorced midlife they found that divorce contributed to an adverse biopsychosocial process for the women.{{Cite journal | vauthors = Wickrama KA, Klopack ET, O'Neal CW |date=2022 |title=Stressful family contexts and health in divorced and married mothers: Biopsychosocial process |journal=Journal of Social and Personal Relationships |language=en |volume=39 |issue=11 |pages=3436–3457 |doi=10.1177/02654075221098627 |s2cid=245279287 |issn=0265-4075}} In another study of enduring marriages, they looked to see if hostile marital interactions in the early middle years could wear down couples regulator systems through greater psychological distress, more health-risk behaviors, and a higher body mass index (BMI). Their findings confirmed negative outcomes and increased vulnerability to later physical health problems for both husbands and wives.{{cite journal | vauthors = Lee S, Wickrama KK, Futris TG, Simmons LA, Mancini JA, Lorenz FO | title = The biopsychosocial associations between marital hostility and physical health of middle-aged couples | journal = Journal of Family Psychology | volume = 35 | issue = 5 | pages = 649–659 | date = August 2021 | pmid = 33661683 | doi = 10.1037/fam0000827 | s2cid = 232123555 | doi-access = free }}

Kovacs and colleagues meta-study examined the biopsychosocial experiences of adults with congenital heart disease.{{cite journal | vauthors = Kovacs AH, Sears SF, Saidi AS | title = Biopsychosocial experiences of adults with congenital heart disease: review of the literature | journal = American Heart Journal | volume = 150 | issue = 2 | pages = 193–201 | date = August 2005 | pmid = 16086917 | doi = 10.1016/j.ahj.2004.08.025 | s2cid = 23459854 }} Zhang and colleagues used a biopsychosocial approach to examine parents own physiological response when facing children's negative emotions, and how it related to parents' ability to engage in sensitive and supportive behaviors.{{cite journal | vauthors = Zhang X, Han ZR, Gatzke-Kopp LM | title = A biopsychosocial approach to emotion-related parenting: Physiological responses to child frustration among urban Chinese parents | journal = Journal of Family Psychology | volume = 35 | issue = 5 | pages = 639–648 | date = August 2021 | pmid = 33705175 | doi = 10.1037/fam0000824 | s2cid = 232209248 }} They found parents' physiological regulatory functioning was an important factor in shaping parenting behaviors directed toward children's emotions.

A biopsychosocial approach was used to assess race and ethnic differences in aging and to develop the Michigan Cognitive Aging Project.{{cite journal | vauthors = Zahodne LB | title = Biopsychosocial pathways in dementia inequalities: Introduction to the Michigan Cognitive Aging Project | journal = The American Psychologist | volume = 76 | issue = 9 | pages = 1470–1481 | date = December 2021 | pmid = 35266748 | doi = 10.1037/amp0000936 | pmc = 9205325 }} Banerjee and colleagues used a biopsychosocial narrative to describe the dual pandemic of suicide and COVID-19.{{cite journal | vauthors = Banerjee D, Kosagisharaf JR, Sathyanarayana Rao TS | title = 'The dual pandemic' of suicide and COVID-19: A biopsychosocial narrative of risks and prevention | journal = Psychiatry Research | volume = 295 | issue = Jan | pages = 113577 | date = January 2021 | pmid = 33229123 | pmc = 7672361 | doi = 10.1016/j.psychres.2020.113577 }}

Despite its theoretical robustness and growing empirical support, the implementation of this model in clinical practice remains inconsistent, hindered by systemic, professional, and cultural barriers.{{Cite journal |last=Aung |first=Htet Lin |date=2025-02-26 |title=Adapting the Biopsychosocial Model: The Role of Young Healthcare Professionals in Myanmar's Evolving Healthcare System |journal=ScienceOpen Preprints |language=en |doi=10.14293/PR2199.001500.v1|doi-access=free }}

Artificial intelligence-driven tools are also being explored to integrate biopsychosocial data into clinical decision-making, enabling personalized treatment plans that reflect the complexity of each patient's condition.{{Cite journal |last=Alitabar |first=Seyed Hadi Seyed |date=2025-03-10 |title=The Biopsychosocial Model in Modern Healthcare: Overcoming Barriers to Holistic Patient Care |url=https://ijbmc.org/index.php/ijbmc/article/view/950#:~:text=The%20biopsychosocial%20model%20has%20reshaped,and%20sustainable%20healthcare%20systems%20globally. |journal=International Journal of Body, Mind and Culture |language=en |volume=12 |issue=2 |pages=1–4 |doi=10.61838/ijbmc.v12i2.950 |doi-broken-date=27 April 2025 |issn=2345-5802|doi-access=free }}

There have been a number of criticisms of Engel's biopsychosocial model.{{cite journal | vauthors = Benning TB | title = Limitations of the biopsychosocial model in psychiatry | journal = Advances in Medical Education and Practice | volume = 6 | pages = 347–352 | date = May 2015 | pmid = 25999775 | pmc = 4427076 | doi = 10.2147/AMEP.S82937 | doi-access = free }}{{cite journal | vauthors = McLaren N | title = A critical review of the biopsychosocial model | journal = The Australian and New Zealand Journal of Psychiatry | volume = 32 | issue = 1 | pages = 86–92 | date = February 1998 | pmid = 9565189 | doi = 10.3109/00048679809062712 | s2cid = 12321002 }}{{cite journal | vauthors = Ghaemi SN | title = The rise and fall of the biopsychosocial model | journal = The British Journal of Psychiatry | volume = 195 | issue = 1 | pages = 3–4 | date = July 2009 | pmid = 19567886 | doi = 10.1192/bjp.bp.109.063859 | doi-access = free }}

Benning summarized the arguments against the model including that it

• lacked philosophical coherence,
• was insensitive to patients' subjective experience,
• was unfaithful to the general systems theory that Engel claimed it be rooted in,
• engendered an undisciplined eclecticism that provided no safeguards against either the dominance or the under-representation of any one of the three domains of bio, psycho, or social.{{cite journal |vauthors=Lehman BJ, David DM, Gruber JA |date=August 2017 |title=Rethinking the biopsychosocial model of health: Understanding health as a dynamic system |journal=Social and Personality Psychology Compass |volume=11 |issue=8 |at=e12328 |doi=10.1111/spc3.12328 |doi-access=free}}

Psychiatrist Hamid Tavakoli argued that Engel's biopsychosocial model should be avoided because it

• unintentionally promoted an artificial distinction between biology and psychology, and
• caused confusion in psychiatric assessments and training programs,
• ultimately it has not helped the cause of trying to de-stigmatize mental health.{{cite journal | vauthors = Tavakoli HR | title = A closer evaluation of current methods in psychiatric assessments: a challenge for the biopsychosocial model | journal = Psychiatry | volume = 6 | issue = 2 | pages = 25–30 | date = February 2009 | pmid = 19724745 | pmc = 2719450 }} The perspectives model does not make that arbitrary distinction.{{cite book | vauthors = McHugh PR |title=The perspectives of psychiatry |date=1998 |publisher=Johns Hopkins University Press |location=Baltimore |isbn=978-0801860461 |edition=2nd}}

A number of these criticisms have been addressed. For example, the biopsychosocial pathways model describes how it is possible to conceptually separate, define, and measure biological, psychological, and social factors, and thereby seek detailed interrelationships among these factors.{{cite journal | vauthors = Karunamuni N, Imayama I, Goonetilleke D | title = Pathways to well-being: Untangling the causal relationships among biopsychosocial variables | journal = Social Science & Medicine | volume = 272 | pages = 112846 | date = March 2021 | pmid = 32089388 | doi = 10.1016/j.socscimed.2020.112846 | s2cid = 211262159 | url = https://osf.io/dfu59/ }}

As of 2017 whilst Engel's call to arms for a biopsychosocial model had been taken up in several healthcare fields and developed in related models, it had not been adopted in acute medical and surgical domains.

The BPSM was proposed in the late 1800s.{{cite journal | vauthors = Wade DT, Halligan PW | title = The biopsychosocial model of illness: a model whose time has come | journal = Clinical Rehabilitation | volume = 31 | issue = 8 | pages = 995–1004 | date = August 2017 | pmid = 28730890 | doi = 10.1177/0269215517709890 | s2cid = 206486211 | doi-access = free }}

The idea that there are several factors that may contribute to one's mental suffering is nothing new.{{Cite journal |last1=Vance |first1=Alasdair |last2=Winther |first2=Jo |date=October 2021 |title=Parent- and child-reported anxiety disorders differentiating major depressive disorder and dysthymic disorder in children and adolescents |url=http://journals.sagepub.com/doi/10.1177/1039856220960367 |journal=Australasian Psychiatry |language=en |volume=29 |issue=5 |pages=488–492 |doi=10.1177/1039856220960367 |pmid=32961097 |issn=1039-8562}}

Psychologist Urie Bronfenbrenner popularized the belief that social factors play a role in developing illnesses and behaviors. Engel later used Bronfenbrenner's research as a column of his biopsychosocial model and framed this model to display health at the center of social, psychological, and biological aspects.

Adolf Meyer's psychobiology model is considered the forerunner to the biopsychosocial model by many. Meyer emphasised understanding mental illness in the context of a patient's personal history over diagnostic categories.{{Cite journal |last=Wallace |first=Edwin R. IV |date=2007 |title=Adolph Meyer's Psychobiology in Historical Context, and Its Relationship to George Engel's Biopsychosocial Model |url=https://muse.jhu.edu/pub/1/article/249254 |journal=Philosophy, Psychiatry, & Psychology |volume=14 |issue=4 |pages=347–353 |doi=10.1353/ppp.0.0144 |issn=1086-3303}} Meyer laid down the groundwork for understanding the interplay of psychology and biology but tended to view these as separate entities that interacted. Engel's model represents a broader and more integrated approach that considers biological, psychological, and social factors as interconnected elements.

The WHO definition of health adopted in 1948 implied a broad socio-medical perspective.{{cite book |title = Constitution of the World Health Organization| publisher = World Health Organization | year = 1948}}

Roy Grinker actually coined the term 'biopsychosocial' long before Engel (1954 vs 1977).{{Cite journal |last=Ghaemi |first=S. Nassir |date=July 2009 |title=The rise and fall of the biopsychosocial model |url=https://www.cambridge.org/core/product/identifier/S0007125000007261/type/journal_article |journal=British Journal of Psychiatry |language=en |volume=195 |issue=1 |pages=3–4 |doi=10.1192/bjp.bp.109.063859 |pmid=19567886 |issn=0007-1250}} However Grinker was seeking to highlight biological aspects of mental health, rather than Engel's emphasis on psychosocial aspects of general health.

Engel broadened medical thinking by re-proposing a separation of body and mind. The idea of mind–body dualism goes back at least to René Descartes, but was forgotten during the biomedical approach. Engel emphasized that the biomedical approach is flawed because the body alone does not contribute to illness.{{cite web |date=17 March 2019 |title=The Bio-Psycho-Social Model |url=https://www.mentalhelp.net/articles/the-bio-psycho-social-model/ |access-date=18 April 2019 |website=MentalHelp.Net |publisher=American Addiction Centers |vauthors=Dombeck M}} Instead, the individual mind (psychological and social factors) play a significant role in how an illness is caused and how it is treated. Engel proposed a dialogue between the patient and the doctor in order to find the most effective treatment solution.{{cite book |title=Practical Management of Pain |vauthors=Gatchel RJ, Haggard R |year=2014 |isbn=978-0-323-08340-9 |pages=933–938.e2 |chapter=Biopsychosocial Prescreening for Spinal Cord and Peripheral Nerve Stimulation Devices |doi=10.1016/B978-0-323-08340-9.00068-2}}

George L. Engel and John Romano of the University of Rochester in 1977, are widely credited with being the first to propose a biopsychosocial model.{{cite web |title=The Biopsychosocial Model Approach |url=https://www.urmc.rochester.edu/medialibraries/urmcmedia/education/md/documents/biopsychosocial-model-approach.pdf | work = University of Rochester Medical Center | location = Rochester, NY |publisher=Rochester University |access-date=18 April 2019}} Engel struggled with the then-prevailing biomedical approach to medicine as he strove for a more holistic approach by recognizing that each patient has their own thoughts, feelings, and history.{{cite journal |vauthors=Engel GL |date=April 1977 |title=The need for a new medical model: a challenge for biomedicine |journal=Science |volume=196 |issue=4286 |pages=129–136 |bibcode=1977Sci...196..129E |doi=10.1126/science.847460 |pmid=847460}} In developing his model, Engel framed it for both illnesses and psychological problems.

The biopsychosocial model is not just one of many competing possibilities - another intelligently constructed explanation of health. Its emergence is best understood within a historical context. The biopsychosocial model's emergence in psychiatry was influenced by the credibility problem in psychiatry as a medical specialism that arose during wartime conditions.

By the 20th century, psychiatry was still a relatively new field. In the Victorian era, psychiatry was faced with two key challenges: firstly, taking control of the asylum system from lay administrators and secondly, constructing a credible knowledge base for medical authority over mental illness. At the time, the solution to this was developing a rhetoric of justification for psychiatry which was that the brain is the root of insanity, and physicians are the guardians of mental health. This position both reflected and contributed to the rise of eugenics thought in western intellectual culture. However, this was challenged by the shellshock problem after World War I – there was a fundamental incompatibility between a eugenic view of lunacy and the sad reality of respectable men breaking down with predictable regularity in the war trenches. This led to the recognition of neurosis and acceptance of psychoanalysis in psychiatric discourse. A year after the end of the war, the British Psychoanalytical Society and the Medical Section of the British Psychological Society were both established, marking the start of a nuanced interplay between biological psychiatry and medical psychotherapy. The Tavistock Clinic played a significant role in bridging the gap between these approaches and favoured a unified psychosomatic approach. Under these conditions, the biopsychosocial model was set up to revolutionise our understanding of psychiatry and health.{{Cite journal |last=Pilgrim |first=David |date=January 2002 |title=The biopsychosocial model in Anglo-American psychiatry: Past, present and future? |url=http://www.tandfonline.com/doi/full/10.1080/09638230020023930 |journal=Journal of Mental Health |language=en |volume=11 |issue=6 |pages=585–594 |doi=10.1080/09638230020023930 |issn=0963-8237}}

After publication, the biopsychosocial model was adopted by the World Health Organization (WHO) in 2002 as a basis for the International Classification of Function.{{cite book | vauthors = Hopwood V |title= Acupuncture in Neurological Conditions|url=https://archive.org/details/acupunctureneuro00nanj |url-access=limited |pages=[https://archive.org/details/acupunctureneuro00nanj/page/n44 39]–51 |publisher=Churchhill Livingstone |doi=10.1016/B978-0-7020-3020-8.00003-5 |chapter=Current context: neurological rehabilitation and neurological physiotherapy |year=2010 |isbn=978-0-7020-3020-8 }}

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Category:Interdisciplinary branches of psychology