The biopsychosocial model is lost in translation: from misrepresentation to an enactive modernization.
Physiother Theory Pract May 28, 2022
The biopsychosocial model (BPSM) is often recommended for musculoskeletal research and practice, but its interpretations and applications vary widely, many deviating from George Engel's original model. This critical narrative review identifies two main versions running in parallel: a humanistic interpretation centered on person- and relationship-centeredness, and a causation interpretation focused on multifactorial contributors to illness. Both have been used in reductionist ways, leading to confusion and suboptimal care. The authors propose an "enactive" modernization that can accommodate both interpretations, aligning with Engel's vision while addressing theoretical limitations and potentially reducing misapplications.