Health from the bio-psycho-social point of view

By Merel van den Bos, psychologist io.
Presentation ICTAM at Timphu BT

My presentation will show you the approaches into health from the bio-psycho-social point of view.

I have worked for 30 years in a practice with modernisticly changed traditional holistic health care. The approach of the patient having to follow a track of changing behavior in order to get his or her health in balance again is, at least in Western countries, a very important aspect of the treatment. Acceptance, motivation and insight play a major part in therapy loyalty. This leads to a strategy of change.

The first important factor in this strategy is a clear and straightforward diagnosis, which indicates exactly where health has gone wrong. For this we need a strong medical analysis with resulting diagnosis. Of course this diagnosis has to be explained in such a way that the patient or its caretakers do accept its impact. This impact will imply a process of change of the patient as well of his environment like family and relatives.

The second important factor is the motivation of the patient or its caretakers to change behavior. As you all know it is very difficult to change habits that crept in. In order to change these habits, the patient or its caretakers must see clearly the relationships of the health complaints and the track of change that has to be followed. This is what we call patient's motivation. Of course this motivation is directly related to the importance of the health problems the patient arrived with.

The third factor is the insight of the patient in order to understand fully what has to be done. I will give you an example. A patient has to follow a diet that is to be called strictly meatless, because of a nutritional allergy for meat but not for fish, eggs or dairy products. This patient has to be explained as well that these allergens do reside also in gelatin, which is used by the nutritional industry in sweets, pastry and lots of other products like fish-jellies. Also this patient must be taught that every human being needs its daily dose of proteins, which according to the World Health Organization has to be between 22 and 25 grams per day. Of course these proteins must be picked from other food sources than meat, like fish, eggs, dairy products or vegetable proteins like beans. Of course this is only part of the information the patient needs as insight in order to change his or her habits in order to arrive at a better health and wellbeing balance.

In our practice we have worked out written instructions on nutrition, life-style and habits to educate a patient in being a well informed and motivated person, achieving a different health and well-being perspective than he or she had before. We arrived at a system of modules with remarks, explanation and instructions totaling up to 240 pages and those in three different languages. Of these pages the patient receives only those modules which are important to his or her daily situation. On average the patient receives a personalized instruction booklet of 20 pages. This booklet contains answers to most of the questions patients in these situations ask, as these booklets are updated yearly with new aspects in health-care, nutrition industry and so on. In other words: these personalized booklets are the result of a development in twenty plus years.

Paying attention to all of these aspects, even in a Western society like in Europe and in the Caribbean where we function, it is possible to achieve highly motivated therapy-loyal patients with lots of insight in the holistic medical approach. Effective well-being will result.