The Biopsychosocial Dimension

Susan Tyler

The Biopsychosocial Dimension

Learning Objectives:

Describe the Disease and Medical Models
Describe Social Learning Theory
Explore how biological functioning impacts our overall health

Vignette

Jason covering face with hands — Photo by Christian Erfurt on Unsplash

Jason’s parents have been called by the school social worker to discuss concerns related to fighting with a peer and declining grades. His parents report concerns at home with poor sibling relationships, anger issues, and “a bad attitude, always talking back, never listening or doing what we ask him to do”. They report a long family history of substance abuse and mental health issues (anxiety and depression). They report increased concerns related to this as they recently found marijuana in Jason’s room. Jason (14 y/o) reports “My parents don’t know what they’re talking about. My little brother and sister just get me in trouble because I don’t let them touch my stuff, besides, my parents don’t care, they don’t listen to me, they just want me to do what they say. And I don’t see what the big deal is with me smoking a little weed, it helps me feel better and not be so mad all the time.”

*We will continue use of this vignette for this section as well.

The BioPsychoSocial Dimension allows us to take a more specific look into theories and models as we explore client issues or concerns.

The Disease Model is a problem-oriented approach concerned with identifying a problem or dysfunction and providing an intervention to “cure” the behavioral or physiological problem. Focusing on the problem first is how many people are used to working when trying to find a solution. While we work in a strengths-based approach, the disease model is popular in many health care settings, and having understanding of use of this model allows for communication and collaboration with other professionals that may also be involved in the client’s care.

The Medical Model is a disease-based model focused on identifying a disease based on symptoms, and then curing or alleviating the problem through scientific examination and intervention. An example of this would be use of the Diagnostic and Statistical of Mental Disorders (DSM-5) in clinical social work to assess symptoms reported by a client and then determine the correct diagnosis, which leads to chosen treatment modalities. This model has been widely used in social work and other professions to help conceptualize problems and interventions.

Observational Learning:

Social Learning Theory states people learn by observing others and are active in their learning.

Jason’s story – We can utilize Social Learning Theory to explore how Jason may have learned to express his emotions (how did/do parents or other influential people in his life express their emotions), use of different coping skills or trying out new behaviors (drug use by peers/other family members, isolation/withdrawal), communication style, and problem-solving skills to discover and understand where behaviors were learned, how they impact, and in determining how to best provide needed supports.

We will take a deeper look at some key elements of human biology in the following videos with an exploration of the brain, neurological functions, and genetics and their connection to wellness and how they can contribute/impact disease and issues related to this.

The Brain: The first two videos are short videos that explore the brain, different ways it may function, and how stress can impact brain functions. The second two videos are a bit longer and will explore how we perceive others and increasing our own self awareness for a healthy mind.

Human Brain: Major Structures and their Functions.

The Neurobiology of Stress on Brain Function.

What do others think of you? How the brain perceives other people:

What is a Healthy Mind?:

Executive Function and Self Regulation skills are the mental processes that enable us to plan, focus attention, remember instructions, and juggle multiple tasks successfully. The brain needs this skill set to filter distractions, prioritize tasks, set and achieve goals, and control impulses.

3 types of brain functions:

Working memory governs our ability to retain and manipulate distinct pieces of information over short periods of time.
Mental flexibility helps us to sustain or shift attention in response to different demands or to apply different rules in different settings.
Self-control enables us to set priorities and resists impulsive actions or responses.

These functions are highly interrelated, and the successful application of executive function skills requires them to operate in coordination with each other.

Children are not born with these skills—they are born with the potential to develop them. If children do not receive appropriate and healthy responses to their needs from their relationships with adults and the conditions in their environments, their skill development can be seriously delayed or impaired.

It would be important to explore executive functioning and self-regulation skills with Jason to determine if a referral to other supports such as developmental therapy (possible cognitive delays) or occupational therapy (possible sensory issues) are needed.

Functions of the Nervous System:

It is important to recognize our internal systems are interconnected and are affected by one another. Ex: how chronic stress can impact our physical health, emotional health, and functioning.

How might Jason’s physical and mental health be impacted by increased stress?

Genetics:

Here we look at the exploration of genetics and environment and come back to the age old question – nature vs nurture? Does one have a stronger impact than the other in shaping who we are and how we respond to our world? As in most cases, you will need to look at both and determine which may be impacting your client more.

Jason may be influenced more strongly to explore drug use and experience mental health issues due to his family genetics and history. He may also be influenced more strongly at this time due to his stage of development where peer approval/acceptance is the driving factor in many of his choices.

Please continue on to Chapter 3: Lifespan Theories to learn more about Erikson’s Psychosocial development, Piaget’s Cognitive development, Frued’s Psychosexual development, and Kohlberg’s Theory of Moral development.

Key Takeaways:

Social Learning Theory explores how observations of others and their responses to us shape our learning and responses to various feelings, situations, and others.
Piaget’s Theories of Cognitive Development states people develop cognitively from birth through teenage years in universal stages.
Erikson’s Theories of Psychosocial Development includes 8 stages we engage in throughout our lifetime with the goal of learning to trust others, to be independent, to pursue goals and interests, to be productive and successful, to develop a sense of identity, to look for closeness and intimacy in relationships, to begin investing in work, families, and communities and focus on others, and finally to reflect on lives to either develop a sense of well-being or of despair.
Freud’s Theory of Psychosexual Development states our moral self is shaped by society’s morals and values which gives us our sense of right and wrong. Anxiety or guilt is used to keep the ego and id in check.
We took a deeper look at biological functioning with the brain, nervous system, and genetics and impacts they have on our overall health and functioning.

References

Rogers, A. (2013). Human behavior in the social environment (Fourth Edition.). New York: Routledge.

Video Attributions

Khanacademymedicine. (2014, April 24). Functions of the Nervous System. Organ Systems [Video file]. Youtube. Standard YouTube License. https://www.youtube.com/watch?v=qrK-FBdjGk4

Khanacademymedicine. (2013, September 17). Observational learning: Bobo doll experiment and social cognitive theory [Video file]. Youtube. Standard YouTube License. https://www.youtube.com/watch?v=wf3-tRpmGmY

MedXclusive Learning. (2016, September 22). Human Brain: Major Structures and their Functions [Video file]. Youtube. Standard YouTube License. https://www.youtube.com/watch?v=EeE7Fpg061I

Scienceandnonduality. (2019, February 21). What is a Healthy Mind? Dan Siegel [Video file]. Youtube. Standard YouTube License. https://www.youtube.com/watch?v=-A_aYHEac6I

TEDx Talks. (2017, December 8). Twins: A window into human nature [Video file]. Youtube. Standard YouTube License. https://www.youtube.com/watch?v=c2__1Jrcpv4

TEDx Talks. (2015, November 19). What do others think of you? How the brain perceives other people [Video file]. Youtube. Standard YouTube License. https://www.youtube.com/watch?v=dfcnlADSuQ4

Yale School of Medicine. (2019, July 15). The Neurobiology of Stress on Brain Function [Video file]. Youtube. Standard YouTube License. https://www.youtube.com/watch?v=W9EvpJ9gZPI

License

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Human Behavior and the Social Environment I Copyright © 2020 by Susan Tyler is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.