Massage & Bodywork

MAY | JUNE 2021

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As efforts to embed evidence-based practice across manual therapy professions continue to grow, the biopsychosocial (BPS) healthcare model has been embraced particularly by practitioners of a holistic mindset, because of its potential for a more nuanced and compassionate whole-person approach. Yet, 50 years after its emergence, it has not seen the success some may have hoped for. In Part 1 of this series (March/April 2021, page 42, massageandbodyworkdigital.com/i/1338685-march- april-2021/44), I highlighted the development of the new discipline of narrative medicine that aims to achieve what the BPS model has been unable to, explaining why it is nothing less than a revolution set to rewrite the relationship between biomedicine and holistic health care. In this installment, I summarize and compare the principles of narrative-based, evidence-based, and BPS practice in the context of manual therapy in particular. 42 m a s s a g e & b o d y wo r k m ay/ j u n e 2 0 2 1 education | SOMATIC RESEARCH Solving the Biopsychosocial Problem From Evidence-Based Practice to Narrative Medicine By Sasha Chaitow, PhD THE BPS MODEL AND PAIN SCIENCE Conceptualized in the 1970s, the BPS approach to assessment and treatment has reshaped the majority of international medical curricula, and beyond the biomedical disciplines it has enjoyed considerable uptake in physiotherapeutic settings. 1 This approach emerged in an effort to counter a fresh swing toward reductionist thought in the biomedical sciences by addressing the whole patient and remedying specific biomedical shortcomings—particularly the assumption that there must always be a pathological cause of disease, and that by uprooting it, health will be regained. The focus here is on pathology, rather than attempting to understand the spectrum of contributing factors resulting in illness. 2 The BPS model aims for a more holistic approach originating in systems theory, taking the person's psychological, social, and cultural influences into account when assessing and treating a complaint. 3 It further differentiates disease (with a pathological cause) from

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