The Biopsychosocial Model
Health is traditionally equated to the absence of disease. A lack of essential conditions that are not normal was thought to define one’s health as ‘good”, whereas biologically driven diseases and conditions would reduce an individual with poor health and the label “diseased”. However, such a narrow scope on health limits our understanding of wellbeing, impedes Healing and Recovery efforts, and perhaps more importantly, suppresses prevention measures.
In contrast to the traditional theories, a model called the Biopsychosocial model has been developed to explain the complex interaction between the biological, psychological, social, and spiritual aspects of addiction.
The term “Biopsychosocial” comes from combining the individual factors that contribute to the model: biological, psychological [thoughts, feelings, behaviours], social, and spiritual.
“The BPS model was originally designed as an alternative to the prevailing biomedical model, which tends to reduce illness to a single source, then treat the illness with little regard for other contributing factors such as a patient’s psychological experiences or social behaviors” George Engel in 1977
“A decade later, Donovan and Wallace articulated a BPS model for addictive behaviors in recognition that drinking behavior and alcohol problems are multidimensional. Donovan recommended comprehensive assessment that could capture the biological, psychological, and social aspects of the individual’s life that are affected by drinking. This information, Donovan hypothesized, would improve diagnosis and treatment”.
For our purpose at Valley Hill Youth Treatment Centre, [VHYTC], the biopsychosocial model of Healing and Recovery, is a way of looking at the mind and body of a Participant as two important systems that are interlinked. The biopsychosocial model draws a distinction between the actual pathological [diagnostic] processes that cause disease, and the Participant’s perception of their health and the effects on it, called the illness.
Illness and disease do not necessarily run together. A Participant may be reasonably well (no sickness), but if they feel unwell that’s an illness. Similarly, Participants with something physically wrong with them are diseased, but they may feel completely all right, but they are not ill.
At VHYTC, we use Biopsychosocial model because it can most adequately explain the complex/complicated nature of alcohol and drug misuse.
The most important implication of the Biopsychosocial model for Healing and Recovery is the realization that a single Healing and Recovery approach is unlikely to be sufficient. Rather, as biological, psychological, social, and spiritual needs are assessed, an individualized integrated, comprehensive Healing and Recovery Journey response must be implemented to meet the entire range of needs of the Participant.
During the six [6] Phases at VHYTC, all of these components address each Participant’s drug and alcohol misuse in a holistic manner.
The biological component will focus on:
- The genetic and inherited components of alcohol and drug misuse
- The importance of alcohol and drug misuse, age of initiation
- The effects on the body itself, as well as the importance of nutrition, sleep, and exercise
The psychological component will focus on:
- The thoughts, feelings, behaviours surrounding and generated by misuse (triggers)
- The difficulties regulating emotions [i.e. anxiety, depression, anger etc.]
- The early and persistent problem behaviours
- The issues related to trauma, victimization, and extreme stress experiences
- Learning difficulties
- Low self-worth [esteem]
The social component will focus on their relationships with:
- A partner
- Parents or guardians
- Friends
- Children or dependents
- Disconnection from home or school
- Poor academic or employment performance
- Underdeveloped social competencies
- Poor refusal skills/peer pressure
- Association with frequent alcohol and drug users
- Exposure to neighbourhood risks such as crime, violence, and gangs
- Early access to alcohol and drugs
- Family conflict
- Early antisocial behaviour
- Racial discrimination or prejudice
The spirituality component will focus:
- Personal perceptions and personal beliefs.
The biopsychosocial model gives great importance to the illness; therefore, much more information needs to be gathered during a consultation. As well as the biological signs and symptoms, the Addictions Counsellor must find out about the Participant’s psychological state, their feelings, and beliefs about the illness, and social factors such as their relationship with families and the larger community and their personal belief system [spirituality].
Because many of the psychological and social risk factors for the Participants are easily influenced, or changeable, consideration of them in the individualized Healing and Recovery planning is critical to promote the best Healing and Recovery outcomes.
The first stage of this response requires a comprehensive assessment to determine the entire range of strengths, needs, and problems presented by the Participant. For this reason, the interview process will encourage the Participant to provide as much information about not only the physical symptoms, but also how the misuse has affected the Participant in many aspects of their life.