Biopsychosocial Model PDF

BIOPSYCHOSOCIAL MODEL Week 2, Review  BIOPSYCHOSOCIAL MODEL Complex challenging behaviour may have multiple medical, psychiatric, psychological, and environmental conditions What is the proportion of contribution to cause for each condition? How do the causes inte...

BIOPSYCHOSOCIAL MODEL Week 2, Review  BIOPSYCHOSOCIAL MODEL Complex challenging behaviour may have multiple medical, psychiatric, psychological, and environmental conditions What is the proportion of contribution to cause for each condition? How do the causes interact with each other?  Major models Psychopharmacological Behavioural BIOPSYCHOSOCIAL Integrative MODEL: biopsychosocial model GRIFFITHS AND Behavioural and emotional problems GARDNER STUDY Dynamic influence of biomedical (psychiatric and neuropsychiatric), psychological, and social environmental factors Individual effect as well as interplay of factors Behavioural challenges can be viewed as symptoms of other conditions Behaviour tells us nothing about the controlling conditions that influence occurrence, severity, variability, or durability GRIFFITHS AND GARDNER Identification and modification of causes of challenging behaviour is the focus Challenging behaviour is a non-specific symptom relative to controlling influences  GRIFFITHS AND GARDNER Assessment is the analysis of potential biomedical, social- environmental, and psychological factors and their interplay  GRIFFITHS AND GARDNER Instigating conditions “stimulus events that signal occurrence of challenging behaviours” (Gardner, 1998) Physical environment Social environment Psychological conditions Medical conditions Psychiatric/neuropsychiatric conditions Triggering (antecedent) or contributing (maintaining) stimulus conditions  GRIFFITHS AND GARDNER Vulnerability conditions Vulnerabilities represent features of the person and/or environment that create increased risk for challenging behaviours when exposed to conditions of instigation Either a personal feature of the individual or a feature of the environment that places the person at increased risk for challenging behaviours Personal features? Environmental features? GRIFFITHS AND GARDNER GRIFFITHS AND GARDNER  Assessment leads to a multimodal intervention GRIFFITHS AND GARDNER Need a staging plan Changes are progressively sequenced to allow for the relative influence of the various interventions  GRIFFITHS AND GARDNER Best Practice Features  GRIFFITHS AND GARDNER Best Practice Features  Assessment must be 1) interdisciplinary and must 2) include the client, family, and caregivers Assessment provides understanding –description of challenges that condition SUMMERS ET entails AL. Dual diagnosis as another label Key to success – guides appropriate treatment  SUMMERS ET AL. Biomedical factors Physical conditions, medications, and/or psychiatric conditions Careful medical and medication history and physical examination Laboratory work-up, mental status examination, neurological testing, sleep studies and diagnostic imaging Certain syndromes are associated with an increased risk of medical or mental health conditions Behavioral Diagnostic Guide for Developmental Disabilities (Gedye, 1998) – Assists in the identification of biomedical factors related to behavioural symptoms  On a piece of paper or on your computer, jot down 5-10 bio-medical influencers/measurements that might be THINK: important to consider when making a treatment plan for someone with schizophrenia AND a seizure disorder.  SUMMERS ET AL. Biomedical factors Screening for genetic disorders Specific disorders have medical conditions that require identification and treatment  SUMMERS ET AL. Psychological factors  Psychological history  Psychological factors SUMMERS ET AL.  Psychological history  SUMMERS ET AL. Psychological factors Psychological tests Intelligence tests Measures of adaptive functioning Language tests Academic achievement tests Instruments for assessing psychopathology and behaviour problems – see page 171 - 172  SUMMERS ET AL. Social-environmental factors Behavioural assessment Indirect, direct, and FA Specialized screening and assessment Socio-sexual testing and assessment Violence and sexual risk assessments SUMMERS ET AL. Issues in assessment of persons who are nonverbal or profoundly challenged Any ideas?  SUMMERS ET AL. Issues in assessment of persons who are nonverbal or profoundly challenged Lack of firsthand information from the client Risk of infringing upon their rights/dignity Co-existence of medical or sensory conditions Psychiatric illness may manifest differently in individuals with ID and specific disorders may need to be translated into “ID equivalents”