The Clinical Application of the Biopsychosocial Model in Mental Health: A Research Critique
Abstract
Engel applied the term biopsychosocial to medicine to emphasize the need to take into account the psychologic and social aspects of medical practice. After an overview of the history of the biopsychosocial (BPS) model, we review criticisms of the model to reformulate its deficiencies and then analyze its application in mental health care. The objectives of this paper are 4-fold: (1) to examine the use of the BPS model since Engel's 1977 article to the present; (2) to examine the reasons for the popularity of the BPS model as well as the problems it faces when applied to mental health care; (3) to introduce two instruments, the International Classification of Functioning, Disability, and Health and the INTERMED, which implement the BPS model; and (4) to show why the BPS model is not yet a model of mental health practice. A total of 62 publications were retrieved and reviewed in the ScienceDirect, PubMed, and Scopus databases, and 32 of them were eventually included in this review. This is the first review of the studies published that applied the BPS model in mental health in the last 33 yrs. These criticisms are used to construct a more workable vision of the BPS model of clinical practice.
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Several studies have documented the difficulty of implementing biopsychosocial and gender approaches clinically.
“several studies have documented the difficulty of implementing these approaches clinically. 99”
From Factors associated with gender and sex differences in anxiety prevalence and comorbidity: A systematic review (2022) · cites this paper as [99]
Some authors explicitly argue that due to inherent characteristics of the biopsychosocial model, its applicability in clinical practice is difficult and should be understood only as a theoretical model.
“some authors explicitly argue that due to the inherent characteristics of the biopsychosocial model (e.g. subjectivity and individuality in the patient's approach), its applicability in clinical practice is difficult and should, therefore, be understood only as a theoretical model. 99”
From Factors associated with gender and sex differences in anxiety prevalence and comorbidity: A systematic review (2022) · cites this paper as [99]
Cites
The Need for a New Medical Model: A Challenge for Biomedicine
Engel, G. L. (1977) · Science · doi:10.1126/science.847460 · Cited by 12,887 · see citing works
The biopsychosocial model 25 years later: principles, practice, and scientific inquiry
Borrell-Carrio, F. (2004) · The Annals of Family Medicine · doi:10.1370/afm.245 · Cited by 1,546 · see citing works
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Farhane-Medina, N. Z., Luque, B., Tabernero, C., & Castillo-Mayén, R. (2022) · Science Progress · doi:10.1177/00368504221135469 · Cited by 409 · see citing works
“subjectivity and individuality in the patient’s approach), its applicability in clinical practice is difficult and should, therefore, be understood only as a theoretical model.(99) Other authors doubt the scientific view of the gender/feminist perspective and its implementation in health.”
BackgroundAlcohol use disorder relapse factors: A systematic review.
Sliedrecht, W., de Waart, R., Witkiewitz, K., & Roozen, H. G. (2019) · Psychiatry Research · doi:10.1016/j.psychres.2019.05.038 · Cited by 358 · see citing works
Stein, D. J., Shoptaw, S. J., Vigo, D. V., Lund, C., Cuijpers, P., Bantjes, J., Sartorius, N., & Maj, M. (2022) · World Psychiatry · doi:10.1002/wps.20998 · Cited by 331 · see citing works
- Authors
- Álvarez, A. S., Pagani, M., & Meucci, P.
- Affiliations
- European Commission (BE)
- Corresponding author
- Álvarez, Ana Sabela
- Venue
- American Journal of Physical Medicine & Rehabilitation
- Published
- 2012-02
- Volume
- 91
- Issue
- 13
- Pages
- S173-S180
- ISSN
- 0894-9115 (ISSN-L)
- OpenAlex
- W2018694397
- Cited by
- 75
- References
- 2
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 4 · 2023: 6 · 2022: 13 · 2021: 3 · 2020: 4 · 2019: 5 · 2018: 7 · 2017: 5 · 2016: 2 · 2015: 2 · 2014: 4 · 2013: 3 · 2012: 1
- FWCI
- 1.97
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Physical Medicine & Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Iris (University of Trento) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Medicine, History, and Philosophy
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Health Sciences › Health Professions › General Health Professions › Health, Medicine and Society
- Keywords
- biopsychosocial model, mental health services, International Classification of Functioning, Disability and Health, INTERMED, model limitations, clinical practice
- MeSH terms
- Female, Humans, Italy, Male, Mental Health, Mental Health Services, Models, Theoretical, Professional Practice, Psychophysiology, Needs Assessment, Interdisciplinary Communication, Biomedical Research
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