Date of Award

Summer 2008

Document Type

Dissertation - Restricted

Degree Name

Doctor of Philosophy (PhD)



First Advisor

Melchert, Timothy

Second Advisor

Campbell, Todd

Third Advisor

Edwards, Lisa


The biopsychosocial (BPS) framework in health care stresses the importance of a systemic view of the individual and emphasizes an integration of biological, psychological, and sociocultural factors when attempting to understand human development and functioning. Though a BPS approach to mental health practice was presented as early as 1917 as a part of the psychiatry curriculum at Johns Hopkins School of Medicine by Adolf Meyer, it was first fully articulated by Engel (1977) in reaction to the prevailing biomedical model. Engel (1977) argued that by restricting their views of patients' illnesses to only biological causes, physicians limit their ability to fully understand and treat their patients. Further, not only does the use of the biomedical model exclude important psychological and sociocultural factors, the reductionist nature of the model does not take into account the multiple causal factors of disorders, instead favoring the perspective that there is a single cause to each illness. Engel (1977) argued that grief, for example, could not be viewed simply as biological in origin. While biological symptoms may be present, the psychological suffering of the individual is of paramount importance, as are the sociocultural issues ranging from the loss of the loved one, new family and community dynamics, religiosity, and spirituality. Further, Engel (1977) noted that diseases previously viewed as strictly biomedical, such as diabetes, have multiple other causal factors that impact the etiology, treatment, and course of the disorder such as diet, exercise, and socioeconomic status...



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