Case study: BIOPSYCHOSOCIAL MODEL
The client interviewed by my classmate was Stanley Miller, a fifty eight year old white divorced man, with four children, two boys and two girls. He attended catholic and vocational schools, and later joined the Air force for two years as an Army National guard. He is a graduate with associate's degree, and was once employed as a social worker with Charles Belavia though he is unemployed now and supports himself through Collect VA disability. Mr. Miller has been divorced for the last nineteen years, rarely sees his family and currently lives alone, in New York (N. Syracuse NY); he is spiritual but not religious. His extended family consists of his two sisters and mother, as his father passed away when he was thirty eight. He talks to his mother on a weekly basis through the phone, but rarely does so with his sisters. In his youthful years, he got involve in community activities especially church activities as he worked for the carnival and at the same time, sang in the church choir.
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Mr. Miller suffers from Depression; but has never been hospitalized, had earlier therapy, or received medication for this. His main emotional and difficult past situation was when his father died, and he got himself in heavy drinking. This made him become an alcoholic and the reason he developed the current Diabetes Mellitus 2 he suffers from. Apart from the diabetes, he also has neuropathy and depression as mentioned earlier. Mr. Miller is a recovering Alcoholic for the last twenty years, and is an outdoor person, with few friends. His hobbies or the activities he enjoys during his free time are fishing, bowling and any other outdoor activity.
Mr. Miller presented himself for therapy as he suffers from depression. As a therapist, the above information was useful as a client's history plays a major role in explaining their current situation. In any psychological problem, it is necessary to understand the client's past, major occurrences, social situations, biological or family history, and their economic and social statuses. There are many approaches that could be used to understand Mr. Miller's health and psychological problems. Environmental, social, behavioral, developmental and medical psychologists offer theories that explain such issues; however, biopsychosocial approach is best suited here as it considers many aspects of the client's life. Developmental psychologies heavily focus on the person's childhood to adulthood development, and the fixations they could have encountered, to form explanations for a person's current problems. However, some neo Freudians' consider the social factors in their theories. Behavioral and environmental psychologists ignore the developmental, biological or psychological aspect of the individual and argue that a human person learns to control their immediate environment in relation to their situations hence learning their behaviors with the environment they are in. Without combination of other approaches to psychological problems, it is difficult to help a client with the behavioral model. This is because helping a patient to learn positively rewarding stimuli without understanding or considering other factors like background or biological factors could be futile. Biological approach gives focus on genetical inheritance and the internal body state of the individual. As much as this could give a good perspective in understanding such problems, it can not be entirely relied upon to explain certain problems. An approach that covers more aspects of the individual's life is most suitable in achieving best results for certain psychological and physical problems. In this case, Biopsychosocial is the best approach, and we shall understand why, as we go through the paper.
Developed by Dr. George Engel, biopsychosocial is an approach used to understand mental health problems in an attempt to treat them. It emphasizes on the importance of Psychological, biological and social factors in the analysis of mental problems. The main argument behind this model is that body and mind, although physically separate and different, are dependent on each other, for the wellness of an individual. Whatever affects the body, will definitely affect the mind, as such, what affects the mind is manifested in the body. The rationale is that if the mind is negative, unmotivated and does not function well, then the communication between the mind and the body is tampered with, hence, resulting to poor performance of body parts. A stressed person may neglect eating or taking care of him, resulting to physical weakness or other major medical problems likes ulcers.
In this assignment, we focus on Mr. Miller, who suffers from depression, and Diabetes @ Mellitus. On general information, we understand that Diabetes mellitus 2 is basically caused by lifestyle factors as well as genetics. Some lifestyle factors include smoking, drinking, poor diet, low physical activities and any other factor that could lead to obesity. There is also research that shows a strong connection between diabetes and liver cancer. Keeping in mind that Miller's father suffered liver cancer, we cannot rule out the possible consistence in their lifestyles and the possible close relationship they must have had. Both these diseases have commonality causes of obesity and alcoholism.
Depression is a mental disorder that affects a person's moods. Depression is characterized by extreme feelings of loneliness and sadness that persists for a long time. While it is normal to feel sad in response to daily life problems, a depressed person exhibits extreme sadness, helplessness, empty or lifeless, could have changes in appetite and weight, loss of energy, concentration problems, sleep changes, lack of interest in daily activities, especially those previously enjoyed, irritability and restlessness, and unexplained body pains. Depression, if not cured, leads to death through suicide. The main causes of depression are loneliness, financial strain, alcohol or drug abuse, marital problems, chronic pan, childhood trauma, lack of support (social), or family history of depression. With this information, it easy to understand Mr. Miller's situation as a depressed diabetic individual.
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Biopsychosocial entails three categories of a person's life: the psychological, includes thoughts, emotions and behaviors of the person. The social factors could include socio-economic status, culture, religion, or poverty. Mr. Miller is basically alone in the world. He is divorced, rarely sees his children and family as he only talks to his mother on a weekly basis. The importance of family in promoting mental health is that they offer support and encouragement. Mr. Miller does not have this kind of support from his family. He lives alone, and to add on to that he is unemployed. He also has few friends, whom he rarely gets into contact with. Basically, Mr. Miller is lonely and isolated. As a therapist, I would first help Mr. Miller change his negative thinking towards life. It is evident from his lifestyle that he has a low self esteem and a negative thinking pattern towards himself and the world at large. This is normal, considering his situation; however, he has poor coping skills. Group therapy with other people suffering from depression would help me recover quickly, and accept his situation; Group therapy offers support and gives the feeling that one is not really alone in the world. With group therapy, it is easier to give Mr. Miller a channel to share experiences and learn from others with the same problem. He gets people to talk to and rely upon to understand and not judge him. This could eliminate loneliness and help towards positive thinking. With this, his state as a recovering alcoholic would improve. It is common that a person with such a lifestyle would engage in heavy drinking as a strategy, but which is harmful at the end of it all.
Biopsychosocial model considers psycho education as an approach to healing psychological problems. The client must be aware of their condition providing enough information about depression, its causes, effects and symptoms would make Mr. Miller knowledgeable about his condition and improve his willingness to heal. With information, a patient can work towards developing better coping strategies as they prevent themselves from more harm. Psycho education requires the presence of family members in order to effectively accelerate the healing process. Encouraging Mr. Miller to invite his mother, and sisters could be quite helpful in this case. With their knowledge about his condition, they could also help him focus on healing, and offer the needed support and understanding. This will improve his social life, as he might stop drinking eventually. With this, Mr. Miller could become economically resourceful and have a better social life. This is the main focus of biopsychosocial. Through psycho education, Mr. Miler will get to understand the biological relationship between diabetes and depression. Some people, like Mr. Miller, are predisposed to depression, and diabetes. Mr. Miller's father having died of liver cancer must have suffered alcoholism or diabetes. Genetics play a major role in development of depressive disorders. Presence of genetic factors, when combined with the environmental factors, as in the case of Mr. Miller, it is highly likable that the person will develop depression. Another aspect of the biological component of Biopsychosocial is the biochemical factors in the brain that interact with the human body. Neurotransmitters such as serotin or norepinephrine are involved in pathophysiology. Neurotransmitter abnormalities are caused by certain diseases like HIV AIDS, substance abuse like alcohol, or environmental and inherited factors.
Psychotherapy is only successful in case where all the biological, social and psychological factors of the client are known and considered. Through psychotherapy and cognitive therapy, the client develops positive coping skills. Integration of all the psychological approaches to understanding psychological problems could be helpful here. The therapist must use the behavioral principles to help Mr. Miller learn the new coping skills and a more positive outlook towards life. Medication, together with therapy is also helpful in extreme situations. Antidepressant could be helpful in making Mr. Miller take an active control of his life. Poor lifestyle could hinder treatment of diabetes. A diabetic person is encouraged to watch what they eat . A person like Mr. Miller could easily ignore his health, leading to even more problems. However, with therapy, and education, he will take more control of his life and ensure to do what is required of him. Generally, the biopsychosocial model is an effective method of helping depressed people. Depression leads to health problems like cancer and diabetes.
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In conclusion, Mr. Miller requires a supportive social context to help him deal with his depression. His state as a divorced and unemployed person does not make him feel wanted in the society. He is also not religious. Religion helps us feel purposeful in the world, offers support through interaction, and gives hope. Encouraging Mr. Miller to be more involved in church activities could be helpful. Cognitive therapy could help him change his psychological sate, and make him think more positive towards himself, and the world as a whole. As seen previously, the biological context of a person, through the biochemical and inheritance factors also influence depression as well as diabetes. Therefore, Biopsychosocial, could be concluded to be the best model to understand such problems.
I think this assignment was quite helpful to me as an individual as it helped me gain knowledge which could be helpful in future. Depression is a common problem in the present world. I am in a better position to help a depressed person, as well as cope with my own stresses.
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