Introduction and overview: Early systematic psychosocial matched care > The biomedical vs. the biopsychosocial model in workers' compensation

In contrast, the biopsychosocial model offers a more comprehensive and holistic approach to managing injured workers' health and recovery. It recognises recovery and RTW are influenced by our thoughts, emotions, behaviours and social environment.

The collective available evidence tells us that psychosocial factors dominate the reasons people do not return to work. We see this in our everyday practice, and it has been highlighted in formal research studies. For example, a NSW study[13] of workers with time lost from work, evaluated within 1-3 weeks of lodging their claim, found that:

•workers who have high levels of psychosocial risk (score >50/100) had over 3 times as many days off work as those with low risk (67 days for the high risk vs 23 days for the low-risk workers).

•evaluation of the days lost from work noted that for every 1-point increase in the total ÖMPSQ-SF score the predicted chance of returning to work reduced by 4%.

Under a biopsychosocial model, as soon as possible case managers and healthcare providers conduct a thorough assessment of the injured worker, especially those identified by simple screening to be at high risk for delayed recovery. By addressing these factors through targeted interventions healthcare providers can promote recovery, prevent the development of long-term disability and facilitate a faster RTW.

A key strength of the biopsychosocial model is its patient-centred approach. It actively engages the individual in their own recovery process by helping them, in a non-judgemental way, to see how their personal psychosocial responses may be influencing their pain, distress and functional capacity.

Table 3 compares the 2 models.

Table 3 - Comparing the biomedical and biopsychosocial models

Aspect	Biomedical model	Biopsychosocial Model
Understanding of pain	Pain is viewed strictly as a symptom of physical injury or disease.	Pain is understood as a complex experience influenced by physical, psychological and social factors.
Diagnostic approach	Focuses on physical exams and tests (for example, MRIs and X-rays) to find an anatomical or physiological cause for the pain.	Incorporates physical exams and considers the patient's psychological state and social context to understand the pain.
Mental health	Mental health conditions can be medicalised to provide a clinical diagnosis separate from the worker’s physical injury	Includes psychosocial assessment to identify and address the multiple factors contributing to combined mental health issues and physical injuries.
Treatment focus	Primarily treats the physical cause of pain, often through medication, surgery or physical therapy. Treatments for psychological conditions focus on symptom management.	Aims to address physical symptoms while also targeting psychological and social aspects contributing to the pain and distress.
Role of patient	Patient is typically passive, receiving treatments prescribed by healthcare providers.	Patient is active and engaged in their own care, decision-making and self-management strategies.
Treatment methods	Medications, surgery and physical treatments focused on the physical aspect of pain.	All disciplines normalise psychosocial responses, build insight and self-management skills to empower the worker.
Outcome measures	Reduction or elimination of pain.	Improvement in pain management, function and quality of life, taking into account physical, emotional and social well-being. Reduction in unhelpful psychosocial responses.
Patient education	Often limited to information about the physical condition and how to manage physical symptoms.	Comprehensive education about pain, including how thoughts, emotions and behaviours can affect physical health.

Many studies have shown that the biopsychosocial model leads to better health outcomes, reduced disability and quicker RTW compared to the traditional biomedical approach. However, there are also numerous barriers for this approach to be adopted widely in healthcare. Without a structured approach, extra time with each patient and superior communication skills are needed.

The biopsychosocial model

The biopsychosocial model