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The Biopsychosocial Model: Revolutionising Physio Practice.





Hey there, fellow Health enthusiasts! Today, I want to dive into the fascinating world of the Biopsychosocial model and how it’s transforming our approach to physiotherapy. Gone are the days when we only focused on the physical aspect of injuries. The Biopsychosocial model has broadened our horizons, helping us to consider the complex interplay of biological, psychological, and social factors in health and healing. Let's explore this paradigm shift and its implications for our practice.



What is the Biopsychosocial Model?


The Biopsychosocial model was first introduced by psychiatrist George Engel in 1977. He challenged the traditional biomedical model, which primarily focuses on the physical or biological aspects of disease and neglects the psychological and social dimensions. Engel argued that to understand a patient's experience and to provide comprehensive care, we need to consider biological factors (e.g., genetics, physiology & what scans show), psychological factors (e.g., mood, personality, anxiety, stress, fear/worry & behaviour), and social factors (e.g., cultural influences, family relationships, socioeconomic status) [1].



Why Should Physio's Care?


In physiotherapy, we often deal with patients who present with pain and functional limitations. By adopting a Biopsychosocial approach, we can better understand the multifaceted nature of their conditions. For instance, two patients with similar physical injuries might recover differently due to variations in their mental health, support systems, and stress levels. By considering these factors, we can tailor our treatment plans to address the whole person, not just the injury.



The Role of Psychology in Physio Practice


Research has shown that psychological factors such as anxiety, depression, and fear of movement can significantly impact a patient’s recovery from musculoskeletal injuries [2]. For example, a patient who is afraid of re-injury might avoid certain movements, leading to decreased mobility and prolonged recovery. By recognising these psychological barriers, we can incorporate strategies such as cognitive-behavioural therapy (CBT) techniques, motivational interviewing, and relaxation exercises into our treatment plans [3].


Social Factors and Their Impact


Social support is another critical element that can influence recovery. Patients with strong support networks often experience better outcomes than those who are socially isolated. Socioeconomic status also plays a role; access to resources such as nutritious food, safe housing, and healthcare can affect recovery times and overall health [4]. As physio's, we need to be aware of these social determinants and consider them when developing our treatment plans. This might involve working with social workers, community resources, or providing guidance on accessing support services.



Practical Applications in Physio


So, how do we integrate the Biopsychosocial model into our day-to-day practice? Here are a few practical tips:


1. Holistic Assessments: Include questions about mental health, stress levels, social support, and lifestyle in our initial assessments.


2. Patient Education: Educate our patients about the connection between their mind, body, and social environment. Encourage them to share their concerns and experiences.


3. Interdisciplinary Collaboration: Work closely with other healthcare professionals such as psychologists, social workers, personal trainers and occupational therapists to provide comprehensive care.


4. Personalised Treatment Plans: Develop treatment plans that address the physical, psychological, and social aspects of the patient's condition. This might involve a combination of physical therapy exercises, mental health support, and social interventions.


5. Continuous Learning: Stay updated with the latest research and best practices in biopsychosocial care. We make sure to attend workshops, read journals, and engage in professional discussions to enhance your understanding and skills.



Wrapping Up


The biopsychosocial model offers a more holistic and patient-centred approach to physiotherapy. By recognising the intricate interplay between biological, psychological, and social factors, we can provide more effective and compassionate care. We continue to embrace this model and to evolve our practice to meet the diverse needs of our patients. After all, healing is not just about the body - it's about the whole person. Until next time, keep moving and stay curious!


Our Barnet, Cockfosters & Enfield Physio's have tons of experience in dealing with all types of pain. Have confidence that our specialist Physiotherapists will closely assess, diagnose & treat you in the correct & evidence-based way for all injuries. You can book an appointment here.



Blog By: Emre Oz (Musculoskeletal Physiotherapist at Crouch Physio).




References


1. Gatchel, Robert J., et al. "The biopsychosocial model." The Wiley encyclopedia of health psychology (2020): 1-8.


2. Borrell-Carrió, Francesc et al. “The biopsychosocial model 25 years later: principles, practice, and scientific inquiry.” Annals of family medicine vol. 2,6 (2004): 576-82. doi:10.1370/afm.245.


3. Pincus, Tamar et al. “A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain.” Spine vol. 27,5 (2002): E109-20. doi:10.1097/00007632-200203010-00017 .


4. Marmot, Michael. “Social determinants of health inequalities.” Lancet (London, England) vol. 365,9464 (2005): 1099-104. doi:10.1016/S0140-6736(05)71146-6.

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