A Passion For The Biopsychosocial Approach
When asked, Jamie suggested I write about what I’m passionate about, and that was all?
I am passionate about improving the massage therapy profession because I feel that we have a tremendous opportunity to help those who are suffering.
I am passionate about the need for healthcare professionals to adopt a biopsychosocial approach to their clinical reasoning and critical thinking, informed by research and scientific principles.
It has taken me years of post-secondary education and consumption of research to begin to grasp some of the topics I will now discuss. I am not expecting everyone to have the time or interest in pursuing all of these, but I hope something piques your interest.
I will be dividing topics into the core components of the biopsychosocial approach.
Biology
Are you intrigued by the inner workings of our cells and organs?
Do you want to understand how notes on a piece of paper become beautiful music played with intricate fingers movements that seem to ‘know where to go’ while played by memory?
Are you curious about the way diseases and disorders produce physiological changes in our bodies?
Biological Topics to Explore:
- Biology
- Chemistry
- Physics
These core foundational sciences make up much of the first few years of any scientific education. I think some MTs miss out on this a bit. This is why certain MTs still tout things like ‘toxins’ building-up during exercise and needing to be released by massage.
Let me be more specific with some of my selected topics below.
- The birth of new neurons, and what conditions stimulate this in particular areas of the brain
- The ability for neural synapses to strengthen, weaken, or be created and under what circumstances this may occur
- The ability for our genetic code, DNA, to flip specific sections on or off, shifting the production of new proteins, including ion channels
Psychology
Are you interested in how we humans think, feel, and believe, and the tremendous effect this has on our daily behaviours, for better or worse?
Where do our beliefs come from, and how do they change?
How can our attitudes affect our behaviors, including positive health activities?
These are just a few examples of scientific questions explored in psychology.
Why is psychology important to manual therapists?
About 8% of adults will experience major depression at some point.
Roughly 5% of the population experiences mild to severe impairment caused by anxiety.
About 20% of the adult population in Canada will experience a mental illness in their lifetime.
We now understand that a complex interplay of genetic, biological, personality and environmental factors cause mental illnesses.
Research is also demonstrating a strong association between anxiety, depression, and pain. How many of your clients come to see you about pain? How many of these mention symptoms that could be considered depression or anxiety?
I am not suggesting that we treat depression or anxiety, just as we learn about medications, but do not prescribe, learning about these topics can help our clients.
Still not convinced of the importance?
Let me ask you, what are the most consistent therapeutic outcomes of massage, based on research?
How many of you have an answer to this question in the form or research?
Should this not be something we can answer with research, as healthcare professionals?
According to Moyer (a recent speaker at the RMTBC’s 2016 conference), Rounds, and Hannum (2004), the answer is a reduction in anxiety and depression. The results of this meta-analysis found the treatment effects to be similar to psychotherapy.
I strongly recommend reading this paper.
Psychology Topics to Study
- Pain science
- Depression
- Anxiety
- Self-reflection
- Self-awareness
Social
Are you interested in how we interact with humans as humans?
How are my words interpreted and understood by clients?
What effect do our behaviors and actions have on clients?
Social Topics to Investigate
Multicultural Clinical Competence
- Can you admit to being racist, or live in a racist country?
- Are you aware of the physiological responses that occur when white people encounter unfamiliar minority cultural members?
- Have you stopped to think how your worldview might be different from your clients?
- Have you thought about how the rapport you have with clients affects outcomes?
- Do you listen to your clients’ narratives and attempt to meet them where they are, or do you jump to tell them about what you think is ‘right’ and will ‘help them best?
- Are you the expert, and they need to learn from you to get better?
Contextual Factors (or Placebo Effect)
- Have you thought about how your physical clinical setting may impact the therapeutic outcomes of your treatments? They do.
- Do you think the unique properties of the modality you use are the primary driving factor in your therapeutic outcomes? They are not.
Research is finding amazing results when looking into contextual factors. From the size of the pill to the colour of your skin and the type of words you use, contextual factors affect therapeutic outcomes.
How To Learn?
Use resources available through professional organizations.
There is also google scholar for papers, and a few websites promoting the freedom to access scientific information concept by putting up every article they can obtain. There are amazing groups posting research articles and having wonderful scientific discussions on Facebook.
Free courses can be found throughout the internet with minimal time requirements needed.
Quality and Type of Research:
- Research and resources range in quality, and it is important that we always critically analyze and questions papers and their outcomes.
Research Methodology Topics for Examination:
- Quantitative and Qualitative Research
- Confounding Variables
- Statistical analysis
- Internal Validity
- External Validity
Do not just focus on single studies, explore trends in research. Different researchers, in different journals, and different labs across multiple continents. This is the beauty of science, as we ‘crowd-source’ collection knowledge gets refined over time. Two types of research reveal trends and summarize the findings of many papers.
The Systematic Review:
- The collection and critical exploration of multiple studies and papers looking at topics with a bird’s eye-view
The Meta-Analysis:
- A type of systematic review that collects qualitative and quantitative study data from many different sources into refined conclusions with better statistical power.
The paper cited by Moyer, Rounds, and Hannum (2004) is an example of a meta-analysis. These researchers combined the statistical data from multiple studies, factoring in all sorts of potential confounding factors, using all sorts of complication statistical analysis to determine overall effect sizes (the amount of positive change produced by the treatment in question).
What is the purpose?
Listed above is a wide spectrum of scientific concepts, ranging from a little bit of clinical applicability to very little. What they do, however, is guide our clinical reasoning and critical thinking skills. Education helps defend ourselves and clients from all the pseudoscience out there.
Photo by: Unsplash
Modalities and Techniques
Some readers may have noticed not one mention of any sort of physical modality or technique.
This was intentional.
Regardless of the type of hands-on technique you use, all the factors mentioned above come into play. Regardless of what ‘modalities’ are claimed to do, they all must be taken into account with the context of the therapeutic environment with a living organism (with thoughts, feelings, values, and needs). If we do not consider the whole person, any technique or modality will be incomplete and less effective.
One will improve and grow through reading, learning, and striving to be the most evidence-informed clinician possible. Relying on clinical experience alone for learning is asking for confirmation bias, self-serving bias, and hindsight bias (among many others) to cloud our judgement and obstruct us from evidence-informed clinical reasoning and critical thinking.
Read, watch videos, and listen to podcasts. The medium of learning is less important than the quality of the material and the push for constant progress and education as ethically responsible healthcare providers.
- A Passion For The Biopsychosocial Approach - August 8, 2016
Thankyou for posting! I enjoy reading all your various articles on massage! Always learn something new! :)
Glad that it’s helping!