Understanding the Biopsychosocial Model in Social Work Practice
School
Georgian Court University**We aren't endorsed by this school
Course
SW 510
Subject
Psychology
Date
Dec 11, 2024
Pages
5
Uploaded by EarlFinchPerson1021
Hi everyone. Welcome to this week. Six already can't believe it. This week is an important week though, because we are talking about our biopsychosocial, which is an important part of what *** social workers really need to learn and need to do. Well, we're going to break it down today. We're going to probably spend more than just this week talking about it and breaking down the sections. But I'm going to give you the overview so that you have it so that we can begin working on the rest of our our assignments for this semester. Just getting into it, what is a biopsychosocial? It is an assessment that is typically conducted by therapists and counselors at the beginning of therapy. We assess for different factors. We assess for biological, psychological, social factors that can be contributing to a problemor problems with a client. It is usually part of the intake phase of working with aclient. It's broken down into those three different areas. We have bio, which is considers like the genetics, the physiology, the chemistry, the neurology of a client. The questions will address like things like diet, sleep habits, family history. Then there's the psycho which addresses a person's personality, their thoughts, ensuing emotions and behaviors. Questions usually address current cognitive functioning, coping skills, and mood. Then there's the social. The socialpart is any interpersonal or environmental aspect that affects a client's thoughts,feelings, or behaviors. Some of the questions will address the quality of family relationships, financial stability and educational background. The history of how we developed this biopsychosocial model, or sometimes it's even called like the strength based psychosocial. Either way, whichever one you tend to use, it was an evolution that came from the biomedical model. The biomedical model was really verypopular in the mid 20th century, 1950s, around there, '40s, '50s. The problem with the biomedical model is it did not really account for the client's experience, subjective experience. So we really didn't take into consideration at that point intime what a client's experiences were outside of maybe what was happening biologically. This goes back to the medical model. Remember the medical model looksat that the person is diseased with the biomedical model. It was really the components were, there were signs, there were symptoms, there were laboratory tests. That's really the only thing that really was accounted for in the bio medical model, A more comprehensive. The biopsychosocial was originally developed by George Angle that was to create more of a patient centered care plan. George wasa Dr. and psychiatrist who worked here in New York. He is really the one who developed the biopsychosocial model, taking into consideration that clinicians, doctors, and people in the helping field must attend to all aspects of a client's presenting concerns, meaning, what are the outside influences that are affecting the person's issues? A common statement that was used at that time was what affectsthe mind, will affect the body, and vice versa. So that's kind of what we look at now with the biopsychosocial model. And he first conceptualized that model around 1977. Okay, so it goes to show you that this has been, I say, fairly new model. A model that's being used for the past like 45 years biopsychosocial model. So beforewe get into what a biopsychosocial and the different components of it, I just want to take a second to really Talk about what is the assessment, what process has to happen when we are doing an assessment? What we're trying to really do is uncover as much as you can about the presenting problem. Analyze the relationship between the biological, psychological, and socio cultural factors in a client's life we aretrying to assess and assessing can occur also while implementing an intervention. What do I mean by that? It doesn't mean that the assessment we have to fully assessbefore we're actually going into help, Sometimes will put in an intervention while we're still continuing to assess. Assessment is always ongoing. It may need to be changed and updated to account for just maybe growth for progress, for development.It is really just like a snapshot in time and it should be a forever living document. We also want to consider that many factors contribute to the presenting problem. In the assessment process, we're looking at multiple different areas and lots of different factors could contribute. So some of the things we want to keep in mind as we are beginning to think about how we're going to create a biopsychosocial. A few things here, right? What I'm about to present to you is justone example of a biopsychosocial. They are going to vary a little bit depending on
the agency that you go to, an agency that you work within, or the frame, the framework that any agency, school, hospital uses. It is going to vary a little bit.The one that I'm presenting to you now is just an idea of a model for one. Okay? Itis really important to keep in mind that the core component of engaging and assessing with people is to ensure a focus on strengths and empowerment, Okay? So remember that we've already talked about this. This is where all the things that we've talked about begin to bleed into each other. So keeping in mind that we should always be working from a strengths based perspective, right? Some of the keythings to keep in mind when we are doing these is that the client can always have access to what is written about them. We say that is making sure that we're writingin a very, we've already talked about this respectful, understanding tone, okay? With also understanding that the importance of the relationship between the worker and the client has been well established, okay? We want to put ourselves in their shoes. It's critical that when we ensure that all of the matter of communication with people, with people, whether it be verbal or written, is done in a way that affirms them as a human being and ensures their dignity, okay, as well as their worth as a person. Something else to keep in mind as we go through and do, and lookat it through a strength based **** is to make sure that the assessment and the biopsychosocial is done in collaboration with the client. Okay. It's really important to make certain that the individual's perceptions, concerns, and understandings are the forefront of the assessment. Right? The interventions also should be developed in a way that really speaks to the client's goals and objectives. Remember, not necessarily ours, but what's their goals and objectives? The assessment should be occurring. As you are having discussions with your client,always remember that the relationship that you have with your client will be critical to the outcome of your work together. Remembering the relationship is so important and best developed when you demonstrate to your client the importance andguidance that you have. Just as important as the expertise that they have in their life, okay? So they bring a level of expertise that you will not have. Their expertise, client expertise in their life is just as important as the knowledge andguidance that the clinician or social worker brings. So what we're going to presentto you now is just an outline of what maybe a bio cycle social could include. Okay,you would want to take a look at this and structure this and think when you go in to see your clients, how will you ask these questions? And think about possible follow up questions that might be necessary in order to gather all the information,okay? You do want to take into consideration that depending on the population that you're working with, how to specifically address these questions from, you know, a client perspective. Meaning maybe some special populations might need to be considered. How to ask the question and analyze how to formulate the questions prior to. I'll give you an example. Adoptees, that might be someone, when we get into the family situation, be understanding that they may have a limited amount of information from the family of the biological family. That does not mean that they don't have family. They just have at some of the questions you may want to curb or understand that they may not have the same perspective as someone who is living in their biological family. As well as let's say L, L GT Community. Some of these questions might want to be formulated to reflect differently how we would ask thesequestions. Maybe undocumented immigrants, there would be another way to formulate some of the questions, as well as someone with a traumatic brain injury. So just take into consideration your client, the different areas to hit on and how to ask the questions to get the information, okay? So with that said, let's take a second,let me pull it up, okay? So here are the different areas that we would say are important to include in a biopsychosocial. We're going to break down each one of them, but there's the identifying information, there's the reason for referral or presenting concerns, client status and family description, functioning, maybe the relevant history and collaborative assessment. Now, the cheat and slash intervention plan we are going to leave off today. Now, that is generally the last component of a biopsychosocial, but we are going to cover that in a separate, um, aseparate week. Okay, so, so when we think about identifying information, this section should include information such as age, sex, gender, religion,
relationship, occupation, maybe living situation, sexual orientation, do they have children? It's really information that should be factual based on information from the client as well as from collateral contacts and from case records. Okay, So thisnext section should identify the referral source and give a summary of the reasonfor referral, Okay? It should include the client's description of the concern or services needed, which would include the duration of the concern, how long has it been presenting for, and the consequences that it has for the client. It could alsoinclude past intervention history or or anything, you know, past intervention history relating to the present concern. Especially, you can also address and comment on areas that might have been impacted by the present concern. We could break this down a little bit further in, um, maybe a follow up next week, but it could include a discussion of how the following systems have been impacted by the concern. Meaning, is it impacting the family situation? Maybe some physical or economic environment? Is it affecting educational or occupational history? You can address those different things. Does the presenting concern have anything with legal involvement? And I'm going to try and give you guys a good example of a biopsychosocial so that you can see and kind of it would really follow this format so that you can get an example of how it would be written. So this next section is going to be sort of described as client description and observation. So this is thesection that contains the data observed by the worker or a clinician. It should notcontain opinions and should only contain objective information. Okay, so the following sections would really want to be addressed. Okay? It's supposed to be as objective as possible. It is also important to note that some of these observationsmight be influenced by a workers. Personal experiences or biases. So you want to keep those in mind that you like. So like you may want to keep in mind certain information as you answer some of these questions. Like, does the client come rightto the appointment from working after a long shift? You know what I mean? Could that have led to maybe a tired looking appearance or what is the person's economic means? Maybe that's why the physical appearance or dress is, you know, maybe outside of the norm, right? What experiences has the individual had prior to the work with this particular agency or social worker, which may impact their receptiveness to the intervention or the help, or even the referral meaning. Are they highly defensive and are they like that because of their previous history? Just keeping in mind that we need to address our own biases and consider where the client is coming from as we answer some of these questions in client description and observations. Right? Ideally, this information here in this section should be collected from the first few interviews with the person. Okay, yes, let's leave it at that. So in this section, we should include some information about their physical appearance, like what's their dress? Are they dressed appropriately for the weather? You know, meaning like, you know, maybe they don't have the means. That's all fine. We're just, we're just we're just commenting on it. They're grooming, you know, maybe they are not able to groom, you know, we're just commenting whether they look disheveled or dirty or any of those kinds of things. So that we can help address those things, right? Communication styles, abilities and challenges we want to address that. Can they communicate? Okay? Are they, are they defensive in their communication style? So, we will address that, the thought process. Are they able to recall from memory? Maybe some intelligence might be addressed here, the clarity of thought. Are they able to put together a series of thoughts and verbalize them? Speech patterns we're going to talk about next. Maybe overt behaviors like mannerisms. Are they doing something that's distracting as you're speaking to them? Those are all things that you would want to address in this area. Again, facts, not necessarily any opinions here. You would include reports from professionals or yeah, pretty much anything like legal, medical, psychological, you can do that. And mental status, if appropriate, we will cover mental status in another presentation down the road. So for right now, I would leave that off. But we'll go ahead and address what mental status exams we can kindof take a look at. I may try to find a quick little video to include to kind of give you an idea on how to kind of do a client description. Cause I know it sounds like this is going to be something that might contain opinions, but it really
wouldn't, it would just be reporting what we see. Okay. So, you know, are they oriented to time to place? Are they disheveled? Are they well groomed? Are they able to communicate thoughts and ideas? This is where you would be putting that information together. So this section, the relevant history, should discuss past history as it relates to the presenting issue section should be as factual as possible. Again, it is the place to present how the specifics of the client's culture, race, religion, or sexual orientation may affect resolution of the concernor the presenting problem. How might perceptions affect the situation? Okay, we also want to keep in mind that the social worker may not think it is not accurate to have a significant impact. However, it's really up to the client, okay, their experience of the situation. So we would want to go through some of these differentareas. For example, we may break this down again a little bit further along just totalk about it. Separate family origin, family of creation, or family of choice, or family of experience. We're going to hear talk about maybe the family composition, the birth order. Where and with whom were they raised. What is the relationship with parents or guardians, or relationship with siblings? Is there any abuse or other trauma, any significant family events like birth, death, divorce, you know, what effect has it had on the person, you know, on our client? Maybe maybe for example, you know, is the family of origin history different from the family of experience? So what do I mean by that? Maybe a person was raised with original birth family members or were related or were they raised by individuals not relatedby birth? Right. Meaning like did they go from a birth history, a family of birth, and then they go to maybe a foster family or an adoptive family. We're also going to talk about relevant developmental history. Were there any problems or conditionsknown at birth or problems in the birth process? How were they with developmental milestones? Were they crawling, talking at the, at an appropriate time? We just want to address this, okay? This section is really important for when we're workingwith children. Okay? It is also important to keep in mind that we want to keep in mind folks that are maybe immigrants or migrating here, that we want to identify non western expectations and practices. Okay, when we're working with diverse backgrounds, noting that cultural expectations can be different as far as developmental milestones. Just keeping that in mind, the next section really talks about what happens within the family. Relationships within the family, do they havegood relationships? Do they have social networks? How do they handle things like disagreements, disappointments, rituals, celebrations? Okay? Just knowing that education and occupational history as we're going down here, we want to and addresswhat level of education, school performance, how do they do in school? Is there anylearning problems, any type of, you know, if it's occupational that we're addressing, the type of employment, employment, history, all that kind of stuff included in there. Religious and spiritual development, the importance of religion in upbringing. Okay. What's their current affinity for religion or spiritual socialrelationships? Okay. We're down to talking about the size and quality of their social network. Okay? Where are they with? Friends. Okay. Historical patterns of social relationships. Do they have broken social relationships? Are they able to maintain friendships, things like that? Intimate relationships, we want to here determine the type and quality of relationships, sexual history. Okay. Any significant losses or traumas when it comes to intimate relationships? Okay. And isthe client able to manage intimate relationships successfully? Okay. Is there any positive intimate relationships and positive or positive elements of relationships?So when we talk about H, and we're talking about health, we want to include drug, alcohol, or tobacco use, or misuse. Anything else? Emotional difficulties, maybe including some mental illness. Any hospitalizations, previous help for counseling, maybe. Any disabilities. To address all of that. In health, legal, you want to include any juvenile or adult contact with legal authorities. What was the extent of that? Have they been to jail? All that stuff addressed. The environmental conditions here, you can address where they live. Is it urban? Is it rural? What isthe living arrangement? History? You can put that in there in that section then. Any human rights issues we want to address in this, in this section, any human rights issues that may have been a part of your client's life experience and how
they may impact the current presenting problem, Okay, So this is just a breakdown. We may go more in depth with this particular history here. And so I can give you a little bit more of an example. Now, remember this is a pretty thorough assessment that I'm giving you. Okay. To break things down. Okay, so here we're going to starttalking about the next section, which is the collaborative assessment part of the biopsychosocial. This section should contain thoughts and opinions of the social worker in conjunction with the perspective used and understandings articulated by the client. It is based on initial observations and information. However, it reallyshould be taken to a newlevel, meaning it's not just basic observations. It should be really well thought out. Okay, they intergrate. So here the social worker would integrate his or her view with an understanding of the client, the situation and underlying clause. Thisis really where you're going to maybe write the most. Where like in these previous sections, like this is where you're doing a little bit of an analysis. Okay? Because in the previous sections it's mostly facts which this section should still be based on facts and truth. But it's a little bit more of an analysis where it is addressing these following concerns. The social emotional functioning. Okay, so howis the client able to express feelings? Ability to form relationships? What's theirpredominant mood or emotional pattern? Are they optimistic? Pessimistic? Are they anxious? You know, this is where you want to address those kinds of things. The psychological factors, this is where we would say whether they have good impulse control. Do they have good judgment? Do they appear to be showing good judgment, good insight? Do they have memory or recall issues? How's their coping style or do they have lack of coping skills? Do they really rely more on substances? Do they suffer? Are they able to are they showing like a lot of defense mechanisms? You know, maybe this is where we're going to put in a formal diagnosis. Okay? And we'regoing to state why we believe it's that diagnosis and kind of back it up with the DSM. Okay. Like meaning showing the symptoms, environmental issues. Okay. This is what we could talk about. Like, is there any areas in which the environment can offer for some improved functioning? So are there family friends, church, school, work clubs, all those things that could help support this client. Okay, So this is where you're going to talk about like your untapped resources that could potentially be there. And then you're going to do maybe some issues related to cultural or diversity, right? So this would be addressing, is there any supports inthe community or the family or is there constraints due to cultural issues as well?Okay, so we'll go a little bit more into that as we go on. The big issue here is making sure that we conclude with a statement about the client's motivation for change, as well as the agency or workers ability to provide the help and resources needed for change and what other resources outside might be needed to address the present concern. Okay, Also just the very last thing that you want to put in there is what is the anticipated outcome of the services that would be provided? What is the ultimate overall goal? Right? And that's why we're going to then fold into the last section, which is the intervention plan or the treatment plan, okay? And that's where we'll clearly define our goals out and put them in measurable ways to achieve it. Okay? So this is a biopsychosocial to begin with. Should just give you an overview and this is how we're going to do ours, especially for our Sanchez family. We're going to break it down into these five sections. Okay? Give you a little example of one at some point. But right now, it's important that you just have an understanding of what a biopsychosocial is.