European Union (2018) Challenges Facing Civil Society [Photograph]. Geneva: European Union.
Human Givens Institute (2020) Biopsychosocial Model [Infographic]. East Sussex: UK.
BIOPSYCHOSOCIAL MODEL DEFINITION
The biopsychosocial model was developed by Dr. George Engel an American psychiatrist, who transformed medical diagnosis to include a patient-centred approach to recovery. The biopsychosocial model includes within healthcare an understanding of the influence of one’s emotions, cognitions, beliefs, family life, work life, community life, etc. in relation to recovery. The medical professional develops an overall picture of a patient’s life story and experience and integrates these in a plan for their recovery.
THE BIOPSYCHOSOCIAL MODEL 40 YEARS LATER
“A further development in the decades since Engel’s papers that has added overwhelming weight to the case for a model that can encompass biological, psychological and social factors has been accelerating research on the causes of illness, the basis for primary prevention. The recent research…makes two things clear: first, that for many diseases, causes or risks are present from very early on, and second, that for many these causes or risks are combinations of biological, psychological and social. Prospective epidemiological studies suggest that risks for many major illnesses, physical and mental, start early in development, many in childhood, and that risks include social factors such as poverty and other forms of social exclusion, some specific family level factors such as neglect and abuse, and life–style factors such as exercise and diet.”
Reference: The Biopsychosocial Model of Health and Disease: New Philosophical and Scientific Developments by D. Bolton, G. Gillett, and C.H. Cham
TOWARD A RELATIONSHIP-CENTERED MODEL: POWER AND EMOTIONS IN THE CLINICAL RELATIONSHIP
“Patient-centered, relationship-centered, and client-centered approaches propose that arriving at a correct biomedical diagnosis is only part of the clinician’s task; they also insist on interpreting illness and health from an intersubjective perspective by giving the patient space to articulate his or her concerns, finding out about the patient’s expectations, and exhorting the health professional to show the patient a human face. These approaches represent movement toward an egalitarian relationship in which the clinician is aware of and careful with his or her use of power. This “dialogic” model suggests that the reality of each person is not just interpreted by the physician, but actually created and recreated through dialogue; individual identities are constructed in and maintained through social interaction. The physician’s task is to come to some shared understanding of the patient’s narrative with the patient…The patient’s story is simultaneously a statement about the patient’s life, the here-and-now enactment of his life trajectory, and data upon which to formulate a diagnosis and treatment plan”
Reference: The Biopsychosocial Model 25 Years Later: Principles, Practice and Scientific Inquiry by F. Borrello-Carrio, A. Suchman, and R. Epstein.
Caryl’s Power Biopsychosocial Point Slides
Art as Relational Encounter Article by Neil Springham and Val Huet
Neil Springham and Val Huet
“Biopsychosocial theory is strengthening psychotherapy by focusing on interactions that engage the attachment system. Art therapy has the potential to align coherently with current theory provided it addresses the value of art in engaging with the attachment system. This article describes an interpersonal theory of art therapy based on a model of ostensive communication that supports the attachment system as a mechanism of change in the art therapy triangular relationship of client, therapist, and art object. A clinical case vignette, derived from a client’s description of her art therapy experiences in an audio-image interview, illustrates ostensive communication theory and the development of epistemic trust in art therapy”. Springham, S. & Huet, V. (2018) Art as Relational Encounter: An Ostensive Communication Theory of Art Therapy, Art Therapy, 35 (1), 4-10.
Rethinking the Biopsychosocial Model of Health: Understanding Health as a Dynamic System
Lehman, B., David, D. and Gruber, J. (2017) Rethinking the Biopsychosocial Model of Health: Understanding Health as a Dynamic System, Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/spc3.12328 [Accessed 2 May 2020].
An Autopoietic Systems Theory for Creativity
Creative, psychic, and social systems are discussed in this article proposing the term Creatology. This is an interpretation of the biopsychosocial model.
Art Therapy and the Biopsychosocial Model
Some current examples…
I previously mentioned the socially engaged art therapy practice of Bobby Lloyd who is the CEO of Art Refuge and an art therapist based in London. Art Refuge has a brilliant and informative website and it is an example of a psychosocial model within art therapy. It is also an organisation that is changing the way art therapy is being practiced and understood—as as service to individuals, the addressing of social concerns, and a contribution to arts and health and arts and social engagement.
This is an inspiring example of art therapy as a biopsychosocial practice:
Building Communities by Making Art
The Art Hives Network connects small and regenerative community arts studios together in order to build solidarity across geographic distances. This effort seeks to strengthen and promote the benefits of these inclusive, welcoming spaces across Canada, and throughout the world. Also known as ”public homeplaces,” these third spaces, create multiple opportunities for dialogue, skill sharing, and art making between people of differing socio-economic backgrounds, ages, cultures and abilities.
An Art Hive:
- welcomes everyone as an artist and believes art making is a human behavior.
- celebrates the strengths and creative capacities of individuals and communities.
- fosters self-directed experiences of creativity, learning, and skill sharing.
- encourages emerging grass roots leaders of all ages.
- provides free access as promoted by gift economy.
- shares resources including the abundant materials available for creative reuse.
- experiments with ideas through humble inquiry and arts-based research.
- exchanges knowledge about funding strategies and economic development.
- partners with colleges and universities to promote engaged scholarship.
- gardens wherever possible to renew, regenerate, and spread seeds of social change.
The model and practice of Art Hives have evolved through two decades of sustained practice research, continuous observation and adaptation, and experimentation with spaces and organizational structures led by art therapist Dr. Janis Timm-Bottos.
Montreal Museum Partners with Doctors in “Prescribe Art”
Stephen Legari, Art Therapist, Montreal Museum of Fine Arts
This is a bilingual French and English video produced by the Musée des beaux-arts de Montréal (Montreal Museum of Fine Arts) April 16, 2020.
Stephen Legari was trained at Concordia University, Montreal and his art therapy service at the Montreal Museum of Fine Arts is part of the Art Hive movement.
Legari, S. 2020) Art Therapy Studio. [Photography]. Montreal: Montreal Museum of Fine Art.
Karen Mak, Arts, Place and Wellbeing, Anna Freud National Centre for Children and Families, Transformation Seminar
Karen Makes Presentation, April 29, 2020
Dr. Daisy Fancourt, Associate Professor, University College London “Her research studies the effects of different types of social factors (including loneliness, isolation, social prescribing, community interventions, and arts & cultural engagement) on health outcomes”. (Reference: University College London)
Daisy Fancourt recently produced a report for the World Health Organisation (2019) entitled: What is the Evidence on the Role of the Arts in Improving Health and Well Being?
Link to Report
Daisy Fancourt has initiated the development of the MARCH Network
The March Mental Health Network and Dr. Daisy Fancourt
The March Network is an example of the Biopsychosocial model in practice.
This is an initiative led by Dr. Daisy Fancourt which contributes to her research and advocacy of social prescribing.
MARCH focuses on social, cultural and community assets – which includes the arts, culture, heritage sites, libraries, green spaces, community centres, social clubs, community associations and volunteer groups – and the role they play in enhancing public mental health and wellbeing, preventing mental illness, and supporting those living with mental health conditions. There are an estimated 1 million of these assets in the UK.
The MARCH Network proposes that these Assets build Resilient Communities and therefore lie at the heart of Mental Health (M-ARC-H)
The organisation has developed a link called COVID 19 and Creative Isolation.
Podcasts and Videos: The March Network, Mental Health and Communities