One of the interesting aspects of the recent physiotherapy discussions on social media about the benefits of the biopsychosocial model is the almost complete lack of the 'social'. Those who advocate for the model seem comfortable with the idea that physiotherapy might be ready to embrace its psychological dimensions - although, often, the 'psychological' is lazily referred to as a singular entity - but little is said about the social dimensions of physiotherapy. Perhaps physiotherapists are not aware of the full scale of the social dimensions of practice? Many practitioners, for instance, still ignore the fact that the social determinants of health (poverty, education level, access to … [Read more...] about Physiotherapy’s biopsycho (but not so much) social approach to future healthcare
Apologies for this longer than normal post...but we have much to discuss! Judging by the response to last week's post on the Biopsychosocial (BPS) Model, it is clearly a subject that is exercising the minds of a lot of physio/physical therapists. Not wanting to play a kind of 'dog-whistle' politics - where someone lights a torch under an incendiary issue and then walks away - I wanted to take in the flavour of the discussion before coming back to the blog to compose some reflections. So firstly, thanks to everyone who took the time to share their thoughts on the subject last week. The conversation felt thoughtful, courteous and respectful of people's different positions. In … [Read more...] about The biopsychosocial model revisited
It's quite common these days to see advocates of a more 'holistic' healthcare practice championing the Biopsychosocial (BPS) Model. In areas where healthcare has become increasingly complex - where people's individual values and beliefs can't be avoided, and where people's social context affects their lives so palpably that a biomechanical approach to assessment and treatment is simply inadequate - the BPS model is promoted as a way forward. But is it as sound as people seem to think? The BPS model was initially proposed by George Engel as a ‘unified concept of health and disability’ (Engel 1960) and was based on a very particular form of positivist psychology called General Systems … [Read more...] about Is the Biopsychosocial Model all it’s cracked up to be?
In this post, physical therapist Keith Waldron Jeffrey Bishop's article Rejecting Medical Humanism. In this article, published in 2007, Dr. Bishop writes eloquently of the metaphysics of medicine, referencing the works of Nietzsche, Foucault, Heidegger, and Deleuze, and how they relate to today’s biopsychosociologisms. He puts forth a compelling argument against the use of the humanities and narrative medicine as an add-on, or a compensation for the mechanisation of medicine. He writes of a continued dualism that no longer distinguishes the body from the mind, but instead focuses on the dichotomy between meanings and mechanisms. Dr. Bishop reflects on the ever-increasing emphasis … [Read more...] about Keith Waldron – Rejecting Medical Humanism – 30DoS #29
For a lot of its advocates, and there are many, pain has become a touchstone for new kind of physiotherapy practice: a more holistic, complex and person-centred practice that is more in tune with the modern face of healthcare; a healthcare where people want more from their health professional than 15 minutes of interferential and a quick manipulation. Some of the pain specialists in our profession are treated like rock stars and their presentations are guaranteed to fill out venues whenever they speak. People like Lorimer Moseley and David Butler have built their careers on bridging the divide between science and practice, the profession and public, and finding ways to make pain … [Read more...] about Pain or suffering?