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The Biopsychosocial Model 25 Years Later: Principles, Practice, and Scientific Inquiry
Open accessAbstract
The biopsychosocial model is both a philosophy of clinical care and a practical clinical guide. Philosophically, it is a way of understanding how suffering, disease, and illness are affected by multiple levels of organization, from the societal to the molecular. At the practical level, it is a way of understanding the patient's subjective experience as an essential contributor to accurate diagnosis, health outcomes, and humane care. In this article, we defend the biopsychosocial model as a necessary contribution to the scientific clinical method, while suggesting 3 clarifications: (1) the relationship between mental and physical aspects of health is complex--subjective experience depends on but is not reducible to laws of physiology; (2) models of circular causality must be tempered by linear approximations when considering treatment options; and (3) promoting a more participatory clinician-patient relationship is in keeping with current Western cultural tendencies, but may not be universally accepted. We propose a biopsychosocial-oriented clinical practice whose pillars include (1) self-awareness; (2) active cultivation of trust; (3) an emotional style characterized by empathic curiosity; (4) self-calibration as a way to reduce bias; (5) educating the emotions to assist with diagnosis and forming therapeutic relationships; (6) using informed intuition; and (7) communicating clinical evidence to foster dialogue, not just the mechanical application of protocol. In conclusion, the value of the biopsychosocial model has not been in the discovery of new scientific laws, as the term "new paradigm" would suggest, but rather in guiding parsimonious application of medical knowledge to the needs of each patient.
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“A trauma-focused treatment model typically involves empathy, curiosity, and trust (195).”
From A Biopsychosocial Overview of the Opioid Crisis: Considering Nutrition and Gastrointestinal Health (2019) · cites this paper as [195]
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“Meanwhile, a purely medical approach to treatment (e.g., MAT alone) often fails to consider the importance of the patient-clinician relationship in the recovery process (195).”
From A Biopsychosocial Overview of the Opioid Crisis: Considering Nutrition and Gastrointestinal Health (2019) · cites this paper as [195]
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Metadata
- Authors
- Borrell-Carrio, F.
- Venue
- The Annals of Family Medicine
- Publisher
- Annals of Family Medicine
- Published
- 2004-11-01
- Volume
- 2
- Issue
- 6
- Pages
- 576-582
- ISSN
- 1544-1709 (ISSN-L)
- 1544-1717
- PMC
- PMC1466742
- OpenAlex
- W2138876001
- Cited by
- 1,546
- References
- 65
- Citations by year
- 2026: 108 · 2025: 105 · 2024: 98 · 2023: 100 · 2022: 116 · 2021: 126 · 2020: 146 · 2019: 113 · 2018: 80 · 2017: 66 · 2016: 62 · 2015: 67 · 2014: 63 · 2013: 46 · 2012: 50
- FWCI
- 10.44
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- The Annals of Family Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- Revista Chilena de Medicina Familiar (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Arts and Humanities › History and Philosophy of Science › Medicine, History, and Philosophy
- Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Keywords
- biopsychosocial model, mind-body problem, circular causality, clinician-patient relationship, empathy, self-awareness, clinician bias, intuition, patient education, therapeutic relationship, clinical decision-making, new paradigm
- MeSH terms
- Delivery of Health Care, Humans, Models, Psychological, Hospital-Patient Relations, Observer Variation, Evidence-Based Medicine
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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