Biopsychosocial model

The biopsychosocial model (BPS model) or cognitive behavioral model (CBM) looks at biological, psychological and social factors to explain why disorders occur and is a tool used by psychologists to examine how psychological disorders develop.

BPS model in chronic fatigue syndrome
Vercoulen et al. (1998) created a highly influential biopsychosocial model for chronic fatigue syndrome.

Wessely and Harvey (2009) further developed the biopsychosocial model for chronic fatigue syndrome; Wessely and Harvey's model has been referred to as a psychosocial model.

History
In a 1977 article in Science, (Abstract) psychiatrist George L. Engel called for "the need for a new medical model." The BPS model is the dominant model used to understand mental illness and combines biological, psychological and social factors.

Criticism
The use of the BPS model for treating ME/CFS has been heavily criticized by many researchers, charities and patient groups. The BPS model provides the justification for the use of exercise therapy in ME/CFS. Davey Smith states that peptic ulcer was "the classic BPS disease" but that "cognitive behavioural therapy rather disturbingly had no effect"; only the discovery of helicobacter pylori in 1983 allowed the patients to be cured.

Notable studies

 * 2009, A review on cognitive behavorial therapy (CBT) and graded exercise therapy (GET) in myalgic encephalomyelitis (ME) / chronic fatigue syndrome (CFS): CBT/GET is not only ineffective and not evidence-based, but also potentially harmful for many patients with ME/CFS


 * 2011, Health-related quality of life in patients with chronic fatigue syndrome: group cognitive behavioural therapy and graded exercise versus usual treatment. A randomised controlled trial with 1 year of follow-up (Full)


 * 2016, 'Blaming the victim, all over again: Waddell and Aylward’s biopsychosocial (BPS) model of disability'


 * 2016, 'Chronic fatigue syndrome: is the biopsychosocial model responsible for patient dissatisfaction and harm?


 * 2017, Contesting the psychiatric framing of ME/CFS (Full text)


 * 2018, 'Myalgic encephalomyelitis/chronic fatigue syndrome and the biopsychosocial model: a review of patient harm and distress in the medical encounter'


 * 2019, The ‘cognitive behavioural model’ of chronic fatigue syndrome: Critique of a flawed model (Full text)

Controversy
Inappropriately applied to organic biological diseases and disorders that cannot yet be fully explained by medical science. ME/CFS, fibromyalgia (FM/FMS), and peptic ulcers are now understood to be physiological diseases. The incorrect application of the BPS model for ME/CFS has led to graded exercise therapy (GET) and cognitive behavioral therapy (CBT) as treatment for ME/CFS in the UK. These inappropriate treatments are being used due to the PACE trial which Robert Courtney, Keith Garreghty, Angela Kennedy, Tom Kindlon, Alem Matthees, David Tuller, Mark Vink and many others have exposed as fraudulent.

The UK Parliament House of Lords PACE Trial debate 6th February 2013 and the UK Parliament Grand Committee Room debate 21st June 2018 debated the PACE trial. Carol Monaghan MP for the Scottish National Party stated at a February 20th debate in the House of Commons Hansard, “I think that when the full details of the trial become known, it will be considered one of the biggest medical scandals of the 21st century.”

Learn more

 * Notes on the Ineffectiveness of the Biopsychosocial Model for Treating Myalgic Encephalomyelitis