The biopsychosocial model in psychiatry: Engel and beyond

This chapter examines the biopsychosocial model in psychiatry. The term ‘biopsychosocial’ is most strongly associated with George L. Engel, whose most famous article on the biopsychosocial model was published in 1977. In advancing the model, Engel aimed to make explicit how the biological, the psychological, and the social all had a place in conceptualizing mental disorder, and to systematize and enshrine this recognition in the way in which psychiatry is practised. In making decisions about how to treat mental illness, or a given patient, adopting a biopsychosocial approach should involve keeping in mind that the most effective treatment may involve a solely biological intervention, a solely psychological one, a solely social one, or a combination of these. Indeed, a useful and effective biopsychosocial approach reminds one to consider all of these possibilities, and select the most promising one, based on the available empirical evidence.