Using the Biopsychosocial Model to Guide Patient-Centered Neurological Treatments

Abstract

The biopsychosocial model was defined by George L. Engel to propose a holistic approach to patient care. Through this model, physicians can understand patients in their context to aid the development of tailored, individualized treatment plans that consider relevant biological, psychological, and social–cultural–spiritual factors impacting health and longitudinal care. In this article, we advocate for the use of the biopsychosocial model in neurology practice across outpatient and inpatient clinical settings. To do so, we first present the history of the biopsychosocial model, and its relationships to precision medicine and deep phenotyping. Then, we bring the neurologist up-to-date information on the components of the biopsychosocial clinical formulation, including predisposing, precipitating, perpetuating, and protective factors. We conclude by detailing illustrative neurological case examples using the biopsychosocial model, emphasizing the importance of considering relevant psychological and social factors to aid the delivery of patient-centered clinical care in neurology.

Neuropsychiatric Treatment Approaches for Functional Neurological Disorder: A How to Guide

“…This gap can be filled by developing a clinical formulation using the biopsychosocial model. 31 Identifying predisposing vulnerabilities (risk factors), acute precipitants (triggers), and perpetuating factors influencing symptoms within this framework can help identify roadblocks and consider the optimal pairing and timing of available treatments. For example, for a patient with FND and major housing instability, it would be important upfront to engage case management/social work (see “Treatment Setting and Team Makeup” section for further examples).…”

Leveraging Social Networks for the Assessment and Management of Neurological Patients

“…Incorporation of this multidimensionality would enhance predictive value. 4 Clinical cutoff scores and risk classification systems would also be helpful to identify patients at risk.…”

“…To understand and leverage such social determinants, we need to use established and new tools to measure social interactions across a range of modalities and design interventions that move beyond decontextualized biology to a contextualized psycho-social–biological approach. 4 We provide interdisciplinary theories and methods to achieve this goal.…”

Psychotherapeutic Tools to Enhance the Neurologist-Patient Interaction

“…Active, empathic listening can also aid the collection of data important for developing a patient-centered, biopsychosocial-informed clinical formulation as detailed elsewhere in this Special Issue. 17 If you had not spent the time to hear the patient's ambivalence, you could have been confused as to why they did not engage in the clinical plan you had carefully constructed for them.…”