What Is The Main Argument In Support Of The BPS Model
Mental health is becoming a more widespread topic in recent years especially since characters with mental illnesses have become popular in movies and t.v., like the hit Netflix original 13 Reasons Why who’s main character battles depression. Pop-culture music, books, and social media have also taken to spreading awareness for mental illnesses, steps to improve your mental health, and creative works that hope to help those without mental illnesses understand their struggling peers. This focus on mental health in the United States is most likely due to the high amount of people who are battling mental illnesses. The National Institute of Mental Health stated that, “One in six U.S. adults lives with a mental illness (44.7 million in 2016)” but
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only 43.1 percent are being treated. These people are voters, parents, teachers, friends and citizens who have an impact on our community. Mental illnesses affect the decisions that people make which will impact our country’s future and the lives of those we cherish. Thankfully, mental illnesses are becoming normal topics of conversation and the stigma surrounding receiving professional help for mental struggles is decreasing as more individuals are seeking help from counselors and other mental health practitioners ("Survey says: More Americans are seeking mental health treatment", 2004). As the numbers of people looking to the mental health profession to combat these illnesses increases, it is more important than ever that mental health professionals are using safe and effective techniques to help their patients. One important approach to mental health that has been debated since the 70s is the biopsychosocial (BPS) model. This model was created by George Engel and its purpose is to integrate biological (science-based physical health), psychological (mental), and social aspects into mental health care. He believes that to understand a patient’s health you need to look at multiple factors that contribute to their current health state. This all-encompassing model is debated by many doctors, psychologists, and counselors to determine if the broad spectrum of health aspects that the BPS model incorporates will strengthen the medical and psychology field, diminish the efficiency of psychology due to being too complex and vague, or if the model needs to be altered before health care practitioners are able to integrate the model in their practice. The main argument in support of the BPS model is that the model integrates science-proven biological study along with sociological and psychological aspects that cannot be observed by science but still contributes the well-being of patients.
Many mental health professionals hope that the model will give psychology practitioners and doctors a more complete view of mental illnesses. Psychiatrist George Engel, the creator of the BPS model, writes that the medical field is neglecting the effects that psychological and social factors have on the health of patients and that the field of psychology is lacking proven strategies for improving their patients’ well-being (1977, p. 377-378). Engel recommends that doctors and mental health practitioners integrate the BPS model to ground the mental health field in science-based approaches as well as encourage medical practitioners to treat mental illnesses as real illnesses. (1977, p. 378, 384-385). Counseling professor Timothy Melchert agrees with Engel’s opinion that the psychology field needs to be based on science; “Perhaps the most important is that health care interventions should be based on scientific evidence regarding their safety and effectiveness.” (2010, p. 359-360). Many medical and psychology doctors alike also agree with Engle that integrating an all -inclusive model in their practice allows practitioners the opportunity to have a deeper understanding of their patients’ health. Two of these doctors are PhD Marco Stier and MD H. Helmchen. Stier comments that “Helmchen rightly cautions against any kind of dogmatism in psychiatry, regardless of whether it is a social, a psychological or a biological one. Instead, he favors the biopsychosocial model as a remedy for ‘the narrowing of conceptions that depict only partial aspects of mental illness’” (2014). Despite benefits of integrating the three-fold approach to mental health, mental and medical health professionals see some major flaws that prevent the model from
achieving true success.
Many counselors and psychologists argue that the BPS model attempts to cover too broad of a spectrum to realistically have a full understanding of a patient’s health status and doesn’t provide concrete steps for improving patients’ well-being. The BPS model was created to help mental health practitioners understand their patients in all areas of their lives, but psychiatrist Dr. Benning states that, “fidelity to complexity theory requires an acknowledgment that ultimately it may never be possible to know all the factors that contribute to any given health outcome” (2015). Mental health practitioners agree that the difficult, if not impossible, task of understanding all aspects of a patient’s life makes the BPS model impractical for practitioners. Ghaemi concurs that the “all-inclusive” approach that the model endorses is not helpful for mental health professionals since it leads to a lack of understanding of two or all aspects of BPS. “Even in prominent academic centres relatively simplistic scenarios apply in which a case will be presented, and the teacher will ask the students to describe the case in three facets: bio, psycho, and social. Often, two of the facets are rather weakly explored, and the student, for whatever reason, leans toward one particular aspect of the case. Or alternatively, no facet is explored in any depth.” (2011). He continues to describe that the weaknesses with the model are due to the “over-inclusiveness of the model and its poor boundaries” (2011) which he says leads to “superficial” understandings of the patient and their experiences thus diminishing the effectiveness of the BPS model. Health care practitioners have studied both side of the BPS model and have come to terms with both the benefits and the drawbacks of the model and wish to evaluate and alter the model until it becomes an acceptable strategy for improving the mental health of patients. The BPS debate does not only consist of “for and against” viewpoints since many mental and medical health professionals understand the benefits and limitations of practicing this model and cannot completely oppose or support it. Marco Stier is among the psychiatrists who embody the middle ground of the BPS debate. In a commentary about Dr. Helmchen’s “Different conceptions of mental illness: consequences for the association with patients”, Stier agrees with the BPS model’s understanding that mental health is not purely impacted by psychological matters or strictly due to biological factors, however, he expresses his discontentment with emphasizing one category of the model over the other categories; “Yet, it is not quite clear in which relation the three elements of the integrative model should stand and what its proposed grounding on scientifically proven concepts amounts to” (2014). One of the arguments in support of the BPS model is that there is scientific evidence associated with the biological aspect of the model, although, Stier questions if reliance on the biological side of the BPS model could result in neglecting important psychological and social circumstances that cannot be explained through science as he states “…it is up to now impossible to read off the brain whether someone feels depressed or not, whether she has delusions or not” (2014). Mental health professionals may suggest emphasizing the psychological aspect of BPS since the biological side is flawed, but Stier explains that relying more on psychological studies and techniques would turn the BPS model into a vague theory instead of an affective model due to the lack of scientific proof and absence of concrete courses of action. He continues by stating, “I assume that the biopsychosocial model either has to be based on biological facts or else it will remain arbitrary. But if it is based on biological facts—even if not exclusively—it will probably be charged with “biologism” in just the same way as current accounts of biological psychiatry” (Stier, 2014). Being too biologically focused or too psychologically focused is a problem that Stier sees within the model that allows its practitioners the ability to prioritize whichever side of the model they like which may discount the importance of the other two aspects of the BPS model. Stier, like many other mental health professionals, accepts that the idea of an all-encompassing approach to mental health is better than relying solely one of the three categories (biological, psychological, or social), however, he believes that the BPS model, in its current state, allows practitioners to emphasize one aspect of the model over the others which destroys the delicate balance that the model was created on. The conversation surrounding the biopsychosocial model impacts me as an aspiring counselor and as a friend to people who are battling mental illnesses. My desire is to teach patients how to improve their mental health by using the most effective models and strategies. Which models and strategies those are will be impacted by the outcome of the BPS debate. Understanding the benefits and potential consequences of using the model is important to ensure that I am prioritizing future patients’ health and safety. I am also concerned about the BPS model issue since my friends are seeking aid from counselors and their counselors’ stand on this topic could greatly impact the effectiveness of their sessions, treatments, and influence their overall health.
only 43.1 percent are being treated. These people are voters, parents, teachers, friends and citizens who have an impact on our community. Mental illnesses affect the decisions that people make which will impact our country’s future and the lives of those we cherish. Thankfully, mental illnesses are becoming normal topics of conversation and the stigma surrounding receiving professional help for mental struggles is decreasing as more individuals are seeking help from counselors and other mental health practitioners ("Survey says: More Americans are seeking mental health treatment", 2004). As the numbers of people looking to the mental health profession to combat these illnesses increases, it is more important than ever that mental health professionals are using safe and effective techniques to help their patients. One important approach to mental health that has been debated since the 70s is the biopsychosocial (BPS) model. This model was created by George Engel and its purpose is to integrate biological (science-based physical health), psychological (mental), and social aspects into mental health care. He believes that to understand a patient’s health you need to look at multiple factors that contribute to their current health state. This all-encompassing model is debated by many doctors, psychologists, and counselors to determine if the broad spectrum of health aspects that the BPS model incorporates will strengthen the medical and psychology field, diminish the efficiency of psychology due to being too complex and vague, or if the model needs to be altered before health care practitioners are able to integrate the model in their practice. The main argument in support of the BPS model is that the model integrates science-proven biological study along with sociological and psychological aspects that cannot be observed by science but still contributes the well-being of patients.
Many mental health professionals hope that the model will give psychology practitioners and doctors a more complete view of mental illnesses. Psychiatrist George Engel, the creator of the BPS model, writes that the medical field is neglecting the effects that psychological and social factors have on the health of patients and that the field of psychology is lacking proven strategies for improving their patients’ well-being (1977, p. 377-378). Engel recommends that doctors and mental health practitioners integrate the BPS model to ground the mental health field in science-based approaches as well as encourage medical practitioners to treat mental illnesses as real illnesses. (1977, p. 378, 384-385). Counseling professor Timothy Melchert agrees with Engel’s opinion that the psychology field needs to be based on science; “Perhaps the most important is that health care interventions should be based on scientific evidence regarding their safety and effectiveness.” (2010, p. 359-360). Many medical and psychology doctors alike also agree with Engle that integrating an all -inclusive model in their practice allows practitioners the opportunity to have a deeper understanding of their patients’ health. Two of these doctors are PhD Marco Stier and MD H. Helmchen. Stier comments that “Helmchen rightly cautions against any kind of dogmatism in psychiatry, regardless of whether it is a social, a psychological or a biological one. Instead, he favors the biopsychosocial model as a remedy for ‘the narrowing of conceptions that depict only partial aspects of mental illness’” (2014). Despite benefits of integrating the three-fold approach to mental health, mental and medical health professionals see some major flaws that prevent the model from
achieving true success.
Many counselors and psychologists argue that the BPS model attempts to cover too broad of a spectrum to realistically have a full understanding of a patient’s health status and doesn’t provide concrete steps for improving patients’ well-being. The BPS model was created to help mental health practitioners understand their patients in all areas of their lives, but psychiatrist Dr. Benning states that, “fidelity to complexity theory requires an acknowledgment that ultimately it may never be possible to know all the factors that contribute to any given health outcome” (2015). Mental health practitioners agree that the difficult, if not impossible, task of understanding all aspects of a patient’s life makes the BPS model impractical for practitioners. Ghaemi concurs that the “all-inclusive” approach that the model endorses is not helpful for mental health professionals since it leads to a lack of understanding of two or all aspects of BPS. “Even in prominent academic centres relatively simplistic scenarios apply in which a case will be presented, and the teacher will ask the students to describe the case in three facets: bio, psycho, and social. Often, two of the facets are rather weakly explored, and the student, for whatever reason, leans toward one particular aspect of the case. Or alternatively, no facet is explored in any depth.” (2011). He continues to describe that the weaknesses with the model are due to the “over-inclusiveness of the model and its poor boundaries” (2011) which he says leads to “superficial” understandings of the patient and their experiences thus diminishing the effectiveness of the BPS model. Health care practitioners have studied both side of the BPS model and have come to terms with both the benefits and the drawbacks of the model and wish to evaluate and alter the model until it becomes an acceptable strategy for improving the mental health of patients. The BPS debate does not only consist of “for and against” viewpoints since many mental and medical health professionals understand the benefits and limitations of practicing this model and cannot completely oppose or support it. Marco Stier is among the psychiatrists who embody the middle ground of the BPS debate. In a commentary about Dr. Helmchen’s “Different conceptions of mental illness: consequences for the association with patients”, Stier agrees with the BPS model’s understanding that mental health is not purely impacted by psychological matters or strictly due to biological factors, however, he expresses his discontentment with emphasizing one category of the model over the other categories; “Yet, it is not quite clear in which relation the three elements of the integrative model should stand and what its proposed grounding on scientifically proven concepts amounts to” (2014). One of the arguments in support of the BPS model is that there is scientific evidence associated with the biological aspect of the model, although, Stier questions if reliance on the biological side of the BPS model could result in neglecting important psychological and social circumstances that cannot be explained through science as he states “…it is up to now impossible to read off the brain whether someone feels depressed or not, whether she has delusions or not” (2014). Mental health professionals may suggest emphasizing the psychological aspect of BPS since the biological side is flawed, but Stier explains that relying more on psychological studies and techniques would turn the BPS model into a vague theory instead of an affective model due to the lack of scientific proof and absence of concrete courses of action. He continues by stating, “I assume that the biopsychosocial model either has to be based on biological facts or else it will remain arbitrary. But if it is based on biological facts—even if not exclusively—it will probably be charged with “biologism” in just the same way as current accounts of biological psychiatry” (Stier, 2014). Being too biologically focused or too psychologically focused is a problem that Stier sees within the model that allows its practitioners the ability to prioritize whichever side of the model they like which may discount the importance of the other two aspects of the BPS model. Stier, like many other mental health professionals, accepts that the idea of an all-encompassing approach to mental health is better than relying solely one of the three categories (biological, psychological, or social), however, he believes that the BPS model, in its current state, allows practitioners to emphasize one aspect of the model over the others which destroys the delicate balance that the model was created on. The conversation surrounding the biopsychosocial model impacts me as an aspiring counselor and as a friend to people who are battling mental illnesses. My desire is to teach patients how to improve their mental health by using the most effective models and strategies. Which models and strategies those are will be impacted by the outcome of the BPS debate. Understanding the benefits and potential consequences of using the model is important to ensure that I am prioritizing future patients’ health and safety. I am also concerned about the BPS model issue since my friends are seeking aid from counselors and their counselors’ stand on this topic could greatly impact the effectiveness of their sessions, treatments, and influence their overall health.