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George Libman Engel: The Biopsychosocial Model and the Construction of Medical Practice

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The Palgrave Handbook of Social Theory in Health, Illness and Medicine

Abstract

Pick up most medical practice textbooks published in recent decades and the term ‘biopsychosocial’ is prominent. Over this period, medical curricula internationally have been structured around the teaching of the biopsychosocial model, involving an integration of the biological, psychological and social (Neghme 1985; Suchman 2005). In a survey of 54 medical schools in 1997- 1999, Waldstein et al. (2001) found that 80 to 93 per cent used the conceptualisation and/or measurement of psychosocial factors in their curricula. The biopsychosocial approach is an attempt to redress the traditional model of biomedicine, with its predominant focus on pathophysiology and biological approaches to disease, and its lack of a comprehensive inclusion of the social and psychological aspects of health and illness.

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References

  • Adler, R.H. (2009) ‘Engel’s Biopsychosocial Model Is still Relevant Today’ Journal of Psychosoma tic Research 67 (6): 607–611.

    Google Scholar 

  • Armstrong, D. (1987) ‘Theoretical Tensions in Biopsychosocial Medicine’ Social Science and Medicine 25(11): 1213–1218.

    Article  Google Scholar 

  • Australian National Preventive Health Agency (ANPHA) (2013) State of Preventive Health 2013. Report to the Australian Government Minister for Health. Canberra: ANPHA.

    Google Scholar 

  • Baum, F. (2008) The New Public Health. Oxford University Press: South Melbourne.

    Google Scholar 

  • Borrell-Carrió, F.; Suchman, A.L. and Epstein, R.M. (2004) ‘The Biopsychosocial Model 25 Years Later: Principles, Practice, and Scientific Inquiry’ Annals of Family Medicine 2(6):576–582.

    Article  Google Scholar 

  • Buckner, J.D.; Heimberg, R.G.; Ecker, A.H. and Vinci, C. (2013) ‘A Biopsychosocial Model of Social Anxiety and Substance Use’ Depression and Anxiety 30(3):276–284.

    Article  Google Scholar 

  • Candib, L. (2005) ‘ “Isolated Instances of Banal Illness” or Why the Biopsychosocial Model Is Always Relevant’ Families, Systems and Health: The Journal of Collaborative Family Health Care 23(4):393–395.

    Article  Google Scholar 

  • Cohen, J. and Clark, S.B. (2010) John Romano and George Engel: Their Lives and Work. Meliora Press/University of Rochester Press: Rochester, NY.

    Google Scholar 

  • David, A.K. and Holloway, R.L. (2005) ‘The Biopsychosocial Model in Medicine: Lost or Reasserted?’ Families, Systems and Health: The Journal of Collaborative Family Health Care 23(4):422–425.

    Article  Google Scholar 

  • Downing, R. (2012) ‘Family Medicine’s Waltz with Systems’ Bulletin of Science, Technology and Society 32(4):269–272.

    Article  Google Scholar 

  • Engel, G.L. (1960) ‘A Unified Concept of Health and Disease’ Perspectives in Biology and Medicine 3:459–485.

    Article  Google Scholar 

  • Engel, G.L. (1961a) ‘Correspondence’ Psychosoma tic Medicine 23(5): 427–429.

    Article  Google Scholar 

  • Engel, G.L. (1961b) ‘Is Grief a Disease? A Challenge for Medical Research’ Psychosomatic Medicine 23:18–22.

    Article  Google Scholar 

  • Engel, G.L. (1977) “The Need for a New Medical Model: A Challenge for Biomedicine’ Science 196(4286): 129–136.

    Google Scholar 

  • Engel, G.L. (1978) “The Biopsychosocial Model and the Education of Health Professionals’ Annals of the New York Academy of Sciences 310:169–187.

    Article  Google Scholar 

  • Engel, G.L. (1980) ‘The Clinical Application of the Biopsychosocial Model’ The American Journal of Psychiatry 137(5):535–544.

    Article  Google Scholar 

  • Engel, G.L. (1982) ‘Sounding Board. The Biopsychosocial Model and Medical Education. Who are to be the Teachers?’ The New England Journal of Medicine 306(13):802–805.

    Article  Google Scholar 

  • Engel, G.L. (1997) ‘From Biomedical to Biopsychosocial. 1. Being Scientific in the Human Domain’ Psychotherapy and Psychosomatics 66(2):57–62.

    Article  Google Scholar 

  • Engel, G.L. (2005) ‘A Response from George Engel to Joseph Herman May 5, 1989’ A merican Psychological A ssocia tion 23:377–378.

    Google Scholar 

  • Engel, G.L.; Green, W.L. Jr.; Reichsman, F.; Schmale, A. and Ashenburg, N. (1957) ‘A Graduate and Undergraduate Teaching Program on the Psychological Aspects of Medicine’ Journal of Medical Education 32(12):859–871.

    Google Scholar 

  • Epstein, R.M. and Borrell-Carrió, F. (2005) “The Biopsychosocial Model: Exploring Six Impossible Things’ Families, Systems and Health: The Journal of Collaborative Family Health Care 23(4):426–431.

    Article  Google Scholar 

  • Feinstein, A.R. (1987) “The Intellectual Crisis in Clinical Science: Medaled Models and Muddled Mettle’ Perspectives in Biology and Medicine 30(2):215–230.

    Article  Google Scholar 

  • Fiscella, K. (2005) ‘George Engel Storytelling’ Families, Systems and Health: The Journal of Collaborative Family Health Care 23(4):410–412.

    Article  Google Scholar 

  • Fischer, J.L.; Korinek, A. and Mulsow, M. (2007) ‘Family Systems, Biopsychosocial Processes, and Lifespan Development: Introduction to Family Response to Alcohol Problems’ Alcoholism Treatment Quarterly 25(1/2): 1–9.

    Google Scholar 

  • Ghaemi, S.N. (2006) ‘Paradigms of Psychiatry: Eclecticism and Its Discontents’ Current Opinion in Psychiatry 19(6):619–624.

    Article  Google Scholar 

  • Ghaemi, S.N. (2009) ‘The Rise and Fall of the Biopsychosocial Model’ The British Journal Of Psychiatry: The Journal Of Mental Science 195(1): 3–4.

    Article  Google Scholar 

  • Ghaemi, S.N. (2010) The Rise and Fall of the Biopsychosocial Model: Reconciling Art and Science in Psychiatry. Johns Hopkins University Press: Baltimore.

    Google Scholar 

  • Grinker, R.R., Sr. (1964) ‘A Struggle for Eclecticism’ The American Journal of Psychiatiy 121:451–457.

    Article  Google Scholar 

  • Grinker, R.R., Sr. (1965) ‘The Sciences of Psychiatry: Fields, Fences and Riders’ The American Journal of Psychiatry 122:367–376.

    Article  Google Scholar 

  • Grinker, R.R., Sr. and Spiegel, J.P. (1983) ‘A Psychodynamic View of Character Pathology in Vietnam Combat Veterans’ Bulletin Of The Menninger Clinic 47(5): 472–474.

    Google Scholar 

  • Herman, J. (2005) ‘The Need for a Transitional Model: A Challenge for Biopsychosocial Medicine?’ Families, Systems and Health: The Journal of Collaborative Family Health Care 23(4):372–376.

    Article  Google Scholar 

  • Illich, I. (1976) Medical Nemesis. The Expropriation of Health. New York: Pantheon.

    Google Scholar 

  • Kontos, N. (2011) ‘Perspective: Biomedicine — Menace or Straw Man? Reexamining the Biopsychosocial Argument’ Academic Medicine: Journal of the Association of American Medical Colleges 86(4):509–515.

    Article  Google Scholar 

  • Lupton, D. (2012) Medicine as Culture: Illness, Disease and the Body. Third edition. SAGE Publications: London.

    Google Scholar 

  • McKay, R.; McDonald, R.; Lie, D. and McGowan, H. (2012) ‘Reclaiming the Best of the Biopsychosocial Model of Mental Health Care and “Recovery” for Older People Through a “Person-centred” Approach’ Australasian Psychiatry 20(6): 492–495.

    Article  Google Scholar 

  • McLaren, N. (1998) ‘A Critical Review of the Biopsychosocial Model’ Australian and New Zealand Journal of Psychiatry 32:86–92.

    Article  Google Scholar 

  • McWhinney, I. (1985) ‘Patient-Centred and Doctor-Centred Models of Clinical Decision Making’ in Sheldon, M. and Brooke, J. (eds.) Decision-making in General Practice. Macmillan: Basingstoke, Hampshire; Stockton: New York. pp. 31–46.

    Chapter  Google Scholar 

  • Mead, N. and Bower, P. (2000) ‘Patient-Centredness: A Conceptual Framework and Review of the Empirical Literature’ Social Science and Medicine 51:1087–1110.

    Article  Google Scholar 

  • Mosey, A.C. (1974) ‘An Alternative: The Biopsychosocial Model’ The American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association 28(3):137–140.

    Google Scholar 

  • Neghme, A.R. (1985) ‘Essential Teaching Philosophy Should Be That of the Biopsychosocial Method’ Social Science and Medicine 21(12): 1339.

    Google Scholar 

  • Nicassio, P.M. and Smith, T.W. (1995) ‘Psychological Practice: Clinical Application of the Biopsychosocial Model’ in Nicassio, P.M. and Smith, T.W. (eds.) Managing Chronic

    Google Scholar 

  • Blness: A Biopsy chosoáal Perspective. American Psychological Association: Washington, DC. pp. 1–31.

    Google Scholar 

  • Pew Health Professions Commission and Tresolini, C.P. (1994) Health Professions Education and Relationship-Centered Care: Report. Pew Health Professions Commission, UCSF Center for the Health Professions: San Francisco, CA.

    Google Scholar 

  • Pilgrim, D. (2002) “The Biopsychosocial Model in Anglo-American Psychiatry: Past, Present and Future?’ Journal of Mental Health 11(6):585–594.

    Article  Google Scholar 

  • Porter, R. (1997) The Greatest Benefit to Mankind: A Medical History of Humanity from Antiquity to the Present Harper Collins: London.

    Google Scholar 

  • Rose, N. (2007) The Politics of Life Itself: Biomedicine, Power, and Subjectivity in the Twenty First Century. Princeton University: Princeton, NJ.

    Book  Google Scholar 

  • Saariaho, T.; Saariaho, A.; Karila, I. and Joukamaa, M. (2012) ‘Early Maladaptive Schema Factors, Pain Intensity, Depressiveness and Pain Disability: An Analysis of Biopsychosocial Models of Pain’ Disability and Rehabilitation 34(14): 1192–1

    Google Scholar 

  • Samenow, C.P. (2010) ‘A Biopsychosocial Model of Hypersexual Disorder/Sexual Addiction’ Sexual Addiction and Compulsivity 17(2):69–81.

    Article  Google Scholar 

  • Scherger, J.E. (2005) ‘The Biopsychosocial Model Is Shrink Wrapped, on the Shelf, Ready to Be Used, but Waiting for a New Process of Care’ Families, Systems and Health: The Journal of Collaborative Family Health Care 23 (4):444–447.

    Google Scholar 

  • Seaburn, D.B. (2005) ‘Is Going “Too Far” Far Enough?’ Families, Systems and Health: The Journal of Collabora tive Family Heal th Care 23 (4):396–399.

    Google Scholar 

  • Segal, L.; Leach, M.J.; May, E. and Turnbull, C. (2013) ‘Regional Primary Care Team to Deliver Best-Practice Diabetes Care: A Needs-Driven Health Workforce Model Reflecting a Biopsychosocial Construct of Health’ Diabetes Care 36(7): 1898–1907.

    Article  Google Scholar 

  • Shorter, E. (2005) “The History of the Biopsychosocial Approach in Medicine: Before and After Engel’ in White, P. (ed.) Biopsychosocial Medicine: An Integrated Approach to Understanding Blness. Oxford University Press: Oxford; New York. pp. 6–19.

    Google Scholar 

  • Smith, R.C. (2002) “The Biopsychosocial Revolution: Interviewing and Provider-Patient Relationships Becoming Key Issues for Primary Care’ Journal of General Internal Medicine 17(4):309–310.

    Article  Google Scholar 

  • Smith, R.C; Fortin, A.H.; Dwamena, F. and Frankel, R.M. (2013) ‘An Evidence-Based Patient-Centered Method Makes the Biopsychosocial Model Scientific’ Patient Education and Counseling 91(3):265–270.

    Article  Google Scholar 

  • Sperry, L. (2006) ‘Biopsychosocial Model of Chronic Illness’ in Speny L. (ed.) Psychological Treatment of Chronic Blness [Electronic Resource]: The Biopsychosocial Therapy Approach. American Psychological Association: Washington, DC. pp. 25–39.

    Chapter  Google Scholar 

  • Spike, J.P. (2007) ‘The Philosophy of George Engel and the Philosophy of Medicine’ Philosophy, Psychiatry and Psychology 14(4):315–319.

    Article  Google Scholar 

  • Stein, H.F. (2005) ‘It Ain’t Necessarily So: The Many Faces of the Biopsychosocial Model’ Families, Systems and Health: The Journal of Collaborative Family Health Care 23(4):440–443.

    Article  Google Scholar 

  • Suchman, A.L. (2005) ‘The Cunent State of the Biopsychosocial Approach’ Families, Systems and Health: The Journal of Collaborative Family Health Care 23(4): 450–452.

    Article  Google Scholar 

  • van Dijk-de Vries, A.; Moser, A.; Mertens, V.; van der Linden, J.; van der Weijden, T. and van Eijk, J. (2012) ‘The Ideal of Biopsychosocial Chronic Care: How to Make It Real? A Qualitative Study Among Dutch Stakeholders’ BMC Family Practice 13(14): 1–8.

    Google Scholar 

  • Wade, D.T and Halligan, P. (2004). Do Biomedical Models of Illness Make for Good Healthcare Systems? BMJ 329:1398–1401.

    Article  Google Scholar 

  • Waldstein, S.R.; Neumann, S.A.; Drossman, D.A. and Novack, D.H. (2001) ‘Teaching Psychosomatic (Biopsychosocial) Medicine in United States Medical Schools: Survey Findings’ Psychosomatic Medicine 63 (3):335–343.

    Google Scholar 

  • Wilson, M. (1993) ‘DSM-III and the Transformation of American Psychiatry: A History’ The American Journal of Psychiatry 150(3):399–410.

    Article  Google Scholar 

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© 2015 Marilys Guillemin and Emma Barnard

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Guillemin, M., Barnard, E. (2015). George Libman Engel: The Biopsychosocial Model and the Construction of Medical Practice. In: Collyer, F. (eds) The Palgrave Handbook of Social Theory in Health, Illness and Medicine. Palgrave Macmillan, London. https://doi.org/10.1057/9781137355621_15

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