Biopsychosocial Model Social

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Biopsychosocial Model -Social

• Kenneth S. Thompson, MD
• Associate Professor of Psychiatry
• University of Pittsburgh
• Western Psychiatric Institute and Clinic

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Goal

• The goal of this lecture is to provide an
  overview of the interactions between the social
  world, the self, the mind, the brain, psychiatric
  illness and psychiatric care.

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Specific Objectives

• 1. To describe the sociohistorical context of the
  biopsychosocial model of illness.
• 2. To define the social world and its interaction
  with the mind and brain, mental health and mental
  illness.
• 3. To have students understand how to incorporate
  the social world into their care of patients.
• 4. To describe the relational model of care.

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Why Biopsychosocial?

• Beyond Cartesian Dualism
• Reaction Against Reductionism Scientific
  Humanism

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Social

• From the Latin soci or socialis comrade living
  or disposed to live in companionship with others
  or in a community, rather than isolation.
• Man is a social being
• Websters Dictionary

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The Problem of Hierarchies

• Biopsychosocial Body Self Society

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Nested, Intertwined Hierarchies The embodied mind

• Interpenetrating levels of organization
• Complexity Theory

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Mmacrosocial Influences
Macrosocial Influences
Community Influences
immediate Surrounding Environment
Person
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What is the Social World?

• The water we swim in

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What is it made of?

• (The cells, tissues and organs of society)

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How does it impinge on human beings?

• Roles
• Life Path Exposures
• Resources
• Stressors Material
• Individual
• Social
• Conceptual

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How does it impinge on human beings? (contd)

• Attachments and Networks
• Status
• Conflict
• Culture (Shared Psychology)
• Values/Meanings/Frame of Mind
• Identity

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How does it impinge on human beings? (contd)

• Labeling/Definition
• Control - Power
• Dealing with Change

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How does it impinge on persons with psychiatric
illness?

• Stigma
• Social Control (Dealing with conflict,
  nationality, uncertainty change)
• Identity
• Need for and Access to Resources - Poverty
• Impediments to Healing

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What can the Physician do?
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Beyond Axis IV

• Problems with primary support group
• Problems related to the social environment
• Educational problems
• Occupational problems
• Housing problems
• Economic problems
• Problems with access to health care services
• Problems related to interaction with the legal
  system/crime
• Other psychosocial and environmental problems

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Assess how the Social World impacts on the
Patient

• Stressors and Assets
• Narrative Sense of Self/Identity Social
  Interactions

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Learn to Picture the Patients Worldand
understand their world view

• Be curious!
• Be flexible!
• Use your imagination!

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Practice with the Rational Model of Psychiatric
Care

• Doctor/Patient
• Doctor/Family
• Doctor/Team
• Doctor/Community

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Grow in Your Social Competency