biopsychosocial

Biopsychosocial is a holistic framework for understanding health and illness that emphasizes the interaction of biological, psychological, and social factors in shaping health outcomes. First articulated by psychiatrist George L. Engel in 1977, it was proposed as an alternative to the reductionist biomedical model that focuses primarily on pathology and physiology.

The framework identifies three interrelated domains. The biological domain includes genetics, physiology, and pathology. The psychological domain covers emotions, thoughts, beliefs, behavior, coping strategies, and mental health. The social domain encompasses factors such as socioeconomic status, family and social networks, culture, education, environment, and access to care. These domains interact dynamically to influence symptoms, functioning, and response to treatment, rather than operating in isolation.

In practice, the biopsychosocial model informs comprehensive assessment, patient-centered care, and multidisciplinary treatment planning. It is applied across settings such as primary care, psychiatry, pain management, rehabilitation, and public health. It supports interventions that address multiple domains, such as pharmacotherapy alongside psychotherapy, social support, and lifestyle or environmental modifications.

Criticisms and limitations include the model’s broad scope, which can hinder operationalization and measurement. Critics warn of ambiguous weighting among domains and the potential for overgeneralization if not applied systematically. Proponents emphasize the need for structured assessment tools, evidence-based integration, and attention to contextual factors to avoid neglecting essential biomedical evidence.

The biopsychosocial approach has influenced health policy and clinical guidelines, aligning with frameworks like the World Health Organization’s International Classification of Functioning, Disability and Health. It remains a flexible, integrative paradigm that complements advances in biology while foregrounding person-centered care.