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Smiling, Janice left her office for the day. Her last client, a young man named Quinn, was overjoyed that he had been able to overcome his extreme fear of public speaking. “My presentation was awesome!” he’d said. “I bet I’ll get a promotion!” Unfortunately, Janice’s narrow focus on Quinn’s phobia had her overlook his excessive use of alcohol, and his inability to have a successful romantic relationship.
The current state-of-the-art-and-science views mental health and most psychological and psychiatric problems as biopsychosocial phenomena.
In plain language, this means that the majority of emotional difficulties stem from three interrelated factors: biological components, such as genetic predispositions, medical illnesses and metabolic conditions; psychological components, such as thoughts, moods, sensations and actions; and social components, such as interpersonal relationships and other environmental circumstances.
This is very important from a clinical standpoint because unless a therapist has this three-part perspective on the landscape of therapy, he or she will be likely to miss crucial elements that are necessary for success or lasting improvement.
This doesn’t mean that all therapists must be equal parts medical doctor, psychologist, and sociologist to be truly effective, but it does mean that they need a broad and fairly comprehensive knowledge base that includes at least some medical understanding, a healthy measure of social comprehension, and a great deal of psychological training.
This also doesn’t mean that all clients will invariably have significant components of all three aspects to their problems. But unless the therapist makes it a point to explore at least the possibility of biological, psychological, and social factors, critical information or important therapeutic directions may never be discovered.
Unfortunately for the consumer, many therapists lack a broad-spectrum approach when evaluating and treating their client’s problems. Instead of looking at their clients with a panoramic lens, many clinicians have tunnel vision and tend to reduce human difficulties to over-simplified labels and diagnostic categories.
- The fact is that therapists don’t treat mere illnesses or conditions—they treat people.
At least, that’s what they are supposed to do. And people are all unique and complex and require a broad based, customized therapeutic approach that considers at the very least biological, psychological, and social/environmental factors.
Indeed, in many cases there is much to address in all three of these zones (i.e., a person can have a stressful medical condition like diabetes, subscribe to a host of dysfunctional and irrational beliefs, and be in a highly conflictual marriage). In other cases, however, there may be only one area that requires therapeutic attention (e.g., a specific social skills deficit like lacking assertiveness, or a specific phobia, to name only a couple). And sometimes a person might seek therapy simply to express and explore thoughts and feelings in a safe place with a person he/she trusts and respects.
Also, some people may have a straightforward metabolic problem that masquerades as a psychological problem. For example, a person with significant hypothyroidism might present as clinically depressed, or dysthymic, but needs only a course of thyroid replacement therapy and no psychological intervention, per se.
The point is, by looking at clients through the biopsychosocial prism, no important stone will be left unturned and results can therefore be more thorough and durable.
Remember: Think well, Act well, Feel well, Be well!
Copyright Clifford N. Lazarus, Ph.D.
Reference:
Lazarus, C.N. (1991). Conventional diagnostic nomenclature versus multimodal assessment. Psychological Reports 68, 1363-1367.
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Clifford
