Professor David Pilgrim
Two cheers for the biopsychosocial model: is it the past or
the future?
Abstract
At various times the biopsychosocial model has been accused of being too biological, not biological
enough, not social enough, not psychological enough or even of telling us little beyond common
sense. But the last of these claims also means that it might find a broad common consensus between
professionals and their patients in their general understanding of health and illness. From the outset,
it was offered by George Engel as a revision of the medical model not as a wholesale reflexive, let
alone critical, theory about health and illness. Indeed it was always a model not a theory and so only
ever had a limited range of explanatory value for any of us. This paper defends the model while
drawing attention to its limitations. Its loose alignment with General Systems Theory is examined
and the challenges it poses for healthcare professionals and health researchers appraised for its
future potential.
Biography
David Pilgrim PhD is Honorary Professor of Health and Social Policy at the University of Liverpool and
Visiting Professor of Clinical Psychology at the University of Southampton. He trained and worked in
the NHS as a clinical psychologist before completing a PhD in psychology and then a Masters in
sociology. With this mixed background, his career was split then between clinical and academic work
as a health policy researcher. His publications include Understanding Mental Health: A Critical Realist
Exploration (Routledge, 2015); A Sociology of Mental Health and Illness (Open University Press, 2005-
winner of the 2006 BMA Medical Book of the Year Award), Mental Health Policy in Britain (Palgrave,
2002) and Mental Health and Inequality (Palgrave, 2003) (all with Anne Rogers). All of this work is
approached from the position of critical realism and so the philosophy of science and social science is
an overarching framework in relation to any topic. Currently he is writing a book on child sexual abuse
and public policy.