General Therapeutic Framework at the Charlton School

Biopsychosocial Model

The therapeutic framework used by staff at the Charlton School relies on the biopsychosocial model. The biopsychosocial model, developed by psychiatrist George Engel, proposes that human psychological and physical conditions are complex and rarely the result of one cause; rather several factors and their unique interactions play a role. Engel’s biopsychosocial model (Engel, 1977), therefore, eschewed the dominant biomedical model that sought to understand psychological and physical conditions primarily through a biological lens - for example, that psychological conditions are a result of a brain disorder in which an imbalance in brain chemistry results in depression and as such, may simply be treated through antidepressants.

Engel’s model incorporates three dimensions:

  1. the biological (eg. pathology, genetics, physical trauma),
  2. the psychological (eg. thoughts, emotions, memories, self-construct, behaviors), and
  3. the social (eg. cultural, economic, environmental, peer and family dynamics).

It enables an interdisciplinary approach to treatment, informed by the understanding of the complex dynamic interplay between these dimensions. These are integral to developing a treatment protocol, which can be adjusted as new information from any or all of these dimensions are revealed through the course of treatment. Thus, the biopsychosocial model facilitates an evolving complex view of the patient which can inform treatment.

This model is now the predominant approach to understanding and addressing physical and mental health. The World Health Organization (WHO), for example, defines health as a “state of complete physical, mental and social well-being and not just the absence of disease or infirmity” (WHO, 2022).

In working with students, Charlton staff will use the biopsychosocial model, combining factors within biological, psychological, and social dimensions to understand a patient. Staff with differing expertise may offer unique insight. By integrating these forces together and considering how they shape and influence each other, staff will develop a formulation which will be used to understand prognosis and to guide treatment.

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