Editorial: Bio/Psycho/Social Models and Multidisciplinary Team Working - Can Systemic Thinking Help?

Abstract

mental health care systems are providing services to a wide range of culturally and ideologically diverse client groups. Similarly, professional practitioners represent a diverse group. This complexity is further elaborated by the multilayered spirit of practice in modern health care systems, as found in the different professional approaches to assessment, formulation, intervention and evaluation. There is widespread recognition that no one discipline or system of thought has all the answers! The bio/psycho/social model of health care practice has been put forward as a means of bridging different disciplinary practices, models of mental and physical health and relationships with service users and carers. It has long been recognized that multidisciplinary team working in the context of physical and mental health services poses a challenge to practitioners, loyal to their own ideologies and occasionally less than accepting of others'. Professional differences in power and control within multidisciplinary teams often have not helped a mutual process of influence and crossfertilization of ideas, to the benefit of service users. It was hoped by many that a bio/psycho/social model, that recognizes the importance of an integrated approach to formulation and practice, would foster more holistic approaches to understanding and helping with human distress. In my view, the bio/psycho/social model has not delivered its promise, because it is primarily descriptive in function, rather than explanatory. Thus it does not readily help us take action, and problem solve within complex human systems. Systemic thinking can help, by broadening the disease-focused perspective, using ideas of circular processes and circular causality, encouraging feedback and following the feedback, exploring the relationship between change and stability, and focusing on interaction. Systemic thinking can provide an integrative theoretical structure for formulation and practice in multidisciplinary team working in ways that do not challenge preferred identities and ways of thinking (Vetere & Dallos, 2003). We know that good communication and respectful working alliances with service users are common factors in recovery and healing (Department of Health [DoH], 2004). Collaborative practices have found their way, somewhat belatedly, into the field of psychotherapy broadly, and we see an interesting example in medical prescribing practices. This literature has moved from advocating a position of patient compliance, through adherence, to concordance (Myers & Midence, 1998). It seems clear to me that we need an integrative approach that can bridge diverse ways of working and help with formulation and practice in complex settings.

Systemic Thinking and Working Partnership: A Cross Sectional Study in the South of Iran, 2015

“…On the other hand, increased attention to how new knowledge is gained, managed, exchanged, interpreted and integrated, and emphasis on a network-centric approach that encourages relationship-building among and between individuals and organizations across traditional disciplines and fields in order to achieve relevant goals and objectives are two fundamental systems-thinking perspectives and approaches that are shared across fields 7,8 . Systemic thinking offers the theory and methods for partnership working, across the boundaries of team and family relationships, and the professional boundaries within teams 9 . Systems thinkers achieve a holistic view of complex phenomena 10 and it leads to the employees' partnership with each other especially in public health issues and the focus of practitioners on improving overall system performance 11 .…”

Advances in Multidisciplinary Approach for Liver Cancer

“…Modification could also consider the resource demands, availability, and limitations. Increased workload due to increasing cases of liver with few health professionals could make efforts of multidisciplinary approach futile [35,36]. The following models are crucial for multidisciplinary team working for liver cancer patients.…”