I'm no expert on the biopsychosocial model, but people like Simon Wessely and particularly Peter White are big proponents of it and have recommended restricting access to such payments so I'm not sure one can give the biopsychosocial approach much credit here (not that you explicitly did so but I just thought I would say this). Mansel Aylward is another person who comes to mind with similar viewsWhile addressing psycho-social needs is important (and I will include access to disability insurance and social benefits in this category), it is usually not on the top of the priority list when someone presents with ME. Just like someone with a stomach ulcer do not need to see a psychologist as first intervention.
High levels of patient dissatisfaction with the quality of medical care
Above, we outlined how ME/CFS patients experience difficulties in obtaining a diagnosis and accessing medical and social care. These barriers appear to be more pronounced for patients with a severe presentation of ME/CFS [81,82]. Furthermore, for those patients who do receive care, a large number report dissatisfaction with the medical support they receive [81–83]. Dissatisfaction is not simply related to problems getting a correct diagnosis, but includes doctors’ reluctance to perform tests and neglecting to deal with patients’ complaints [31,65,83,84]. This is not surprising given the BPS model of ME/CFS calls for minimization of medical investigations.
I mostly agree but I have a worry about this. The current bps euphemism/equivocation dynamic allows a sort of doublethink that patients are severely deluded - causing severe functional impairment via unhelpful beliefs of non-psychogenic causation - but also that it's not that big of a deal because the whole thing can be pretty well addressed via CBT/GET.I think the label "biopsychosocial" should be banned, and all practitioners should be encouraged to state what their approach is in words.
hi Tom, the Wessely and White type of BPS (precipitating and perpetuating factors) are one dimension of BPS. From my nursing training and likely from that OT on the ME association website, bio-psycho-social simply means that the whole aspect of the person is cared for, not just the biological needs. It means that while someone is caring for someone newly diagnosed with cancer and giving chemo, you assess for adjustments to new diagnosis, you assess for how the family is adjusting, and you also notice and address issues that may affect this person’s and their families’ capacity in coping and having their needs met.I'm no expert on the biopsychosocial model, but people like Simon Wessely and particularly Peter White are big proponents of it and have recommended restricting access to such payments so I'm not sure one can give the biopsychosocial approach much credit here (not that you explicitly did so but I just thought I would say this). Mansel Aylward is another person who comes to mind with similar views
I was tempted to go on and post a question whether Tina had actually read the paper. I think it sets out clearly what BPS was supposed to be. I’m wondering if Tina believes she has unhelpful illness beliefs that are perpetuating her CFSIn case you missed it, the comment was posted on the ME Association website. You could post your comment there also.
I think you're right. I'm pretty sure Tina was talking about integrated care, which addresses medical, psychological and social needs. As a non-nurse, my best experience of this type of care was my postnatal care, where visiting midwives came to check on my baby's health, but also attended to my mental state and my family support network.hi Tom, the Wessely and White type of BPS (precipitating and perpetuating factors) are one dimension of BPS. From my nursing training and likely from that OT on the ME association website, bio-psycho-social simply means that the whole aspect of the person is cared for, not just the biological needs. It means that while someone is caring for someone newly diagnosed with cancer and giving chemo, you assess for adjustments to new diagnosis, you assess for how the family is adjusting, and you also notice and address issues that may affect this person’s and their families’ capacity in coping and having their needs met.
This is from a nursing perspective.
So there is several dimensions in what is called BPS. In health care professional training, you learn to factor in everything into the continuum of care and I believe this is what Tina may have tried to say. Unfortunately the multi-disciplinary approach is centered towards the psycho-social (with most ofmthe bio stripped away). This is where we are at in Canada.
Don’t get me wrong though. It is coming from a nursing perspective. When I visit a doctor, it is because i want my medical issues addressed. I expect medicine, not psychology, not plattitudes such as ‘you have to meditate, healthy mind, healthy body’. From my perspective, family practitioners have no idea what to do and they are not interested in learning. There is no medical home for our disease, which leaves ample room for psycho-social approach and alternative approaches.A biopsychosocial approach to treating CFS would absolutely be fine if by bps you meant the sort of thing @Milo has been kind enough to share
That is exactly what is needed. Instead of sending the patient home and cash up their check, for once, they could speak up. Their voice can be powerful, if they use it.What I would like to see from them scientifically is to advocate for their patients with ME/CFS or other non-understood conditions by calling for that research, pushing for it, helping to facilitate it
yes exactly - what we call "BPS proponents" have a track record of appropriating terminology and twisting it to their own meaning - either it has to be dropped or people like Tina need to actively reclaim it and refute the misuseBut the term BPS has now been so misused of late that it confuses and misleads rather than clarifies
From my nursing training and likely from that OT on the ME association website, bio-psycho-social simply means that the whole aspect of the person is cared for, not just the biological needs.
It means that while someone is caring for someone newly diagnosed with cancer and giving chemo, you assess for adjustments to new diagnosis, you assess for how the family is adjusting, and you also notice and address issues that may affect this person’s and their families’ capacity in coping and having their needs met.
Perhaps one way to look at biopsychosocial care is to not assume what is done in its name is good.
For example, giving or not giving disability payments is considering the social aspect, but it is questionable to say that they are both good.
Similarly considering family supports is a social aspect, but telling family members not to be supportive (as can happen with CFS experts) is not necessarily as helpful as telling them to be supportive
@large donner I am sorry but you have no understanding of the nursing profession.
It means that while someone is caring for someone newly diagnosed with cancer and giving chemo, you assess for adjustments to new diagnosis, you assess for how the family is adjusting, and you also notice and address issues that may affect this person’s and their families’ capacity in coping and having their needs met.
I didn't say otherwise I was making the point that common sense connected services should not be claimed to be part of the claimed disease process and how dangerous it is to assume positions over patients claiming that BPS is just misused by some "other" people.We are worth so much more than passing the bedpan and make the bed.