The International Classification of Functioning, Disability and Health (ICF)is a framework for describing and organizing information on functioning and disability. The ICF is described as a biopsychosocial model of disability. Most simply and obviously, this means that it simultaneously considers biological factors, psychological factors and societal factors. By incorporating these three factors, this model is able to create a unique picture of an individual as they manage a health condition. In contrast, the biomedical model is limited to the biological aspects only. The biomedical model often overlooks important individual details, increasing chances that the clinician and child’s family have lack of alignment in their goals.
To demonstrate, when thinking of a child with hemiplegic cerebral palsy in the biomedical model, we may think of spasticity, range limitation, gait differences, asymmetry in sitting and limited reaching skills (this may describe any number of children). Working on the activity of stair climbing is going to hold different importance for a family living on the ground floor versus a family living in an apartment with 18 steps to enter. In the biospychosoical model we are aware of the ground floor versus the 18 steps. We also are aware of factors such as supportive parents and an older sibling, limited parental time due to demanding work schedules, multiple caregivers, a child who is easily frustrated and has an intense drive to explore, socialize, walk long distances, play ball-games and has difficulty sleeping restfully. As you can see, this presents a very unique picture for each individual. The biopsychosocial model helps the clinician to expand curiosity and increase engagement.
The biopsychosocial approach was developed by Dr. George Engel and Dr. John Romano in 1977/1980.
This 2004 article analyzes the biopsychosocial model and how it has developed over the decades. It describes the evolution of client-centered care. It also describes the calibration of health care providers in cultivating curiosity, creating trust, recognizing bias, using informed intuition, and communicating clinical evidence while using this approach.
Next in the ICF series: Exploring the ICF as a Conceptual Framework