Patient‐centred care is an approach intended to include service‐users' needs and perspectives as crucial aspects of clinical treatment, superseding any attempt to paternalistic and unilateral attitude in the therapeutic relationship. It is a call to think about persons and not simply of their diseases and implies the adoption of a biopsychosocial perspective and shared decision making. Nonetheless, thinking about persons inevitably means taking the context into due consideration, as individuals are not isolated and any kind of illness experience cannot be thought as a simple matter of inner thoughts and feelings. This perspective article builds on the core tenets of systems thinking and the biopsychosocial approach, with the aim of developing a multilevel approach to patient‐centred care. Within this framework, a literature review has been conducted to gather relevant research findings concerning each level of analysis and the interrelations of such levels. Systems thinking is an ideal framework for capturing the multilayered aspects of illness, from the biological processes that lead to a given disease to the social context where people live. From this angle, we can argue that systems‐centred care is the framework we actually need to truly accomplish patient‐centred goals. This means seeing people as complex dynamical systems and always bearing in mind the ecology of their lives. This also means gearing research and clinical practice towards this direction because complex phenomena like health require adequate methods of inquiry and treatment plans. A multilevel approach is the main road to effective and enduring outcomes. On the contrary, fragmentation of knowledge and excessive specialization without integration can pave the way to short‐term solutions and weak or vanishing improvements in the long run, with obvious costs for persons, families and the community.
The study of such complex issues as mind functioning and mental health requires a multilevel approach. The general system theory elaborated by Ludwig von Bertalanffy in the first half of the twentieth century can still be viewed as a landmark contribution to address these issues scientifically. His seminal work represents an incomparable conceptual framework for understanding how biological, psychological and social dimensions are causally interrelated. The biopsychosocial approach informed by this theory should allow, at least in principle, to interpret mental and physical aspects as integral features of a multilayered interplay between genetic constraints, developmental trajectories and life contexts. In spite of this potentiality, however, most of modern interpretations of biological and psychological processes are still relying almost exclusively on reductionist theories. This entails reducing the complexity of many developmental processes to the laws of interactions and to their sustaining mechanisms, rather than considering them as parts of larger wholes worth of being approached trans-disciplinarily as emergent relationships. In this paper, we aim at reexamining the general system theory in relation to the biological issues that have provided the conceptual foundations for a variety of psychological constructs and, secondly, to show how several of von Bertalanffy's original ideas may still be further elaborated to yield more advanced theories of mind and learning.
Study AimsThe article aims at reiterating the importance of a biopsychosocial approach to mental health, taking stock of the critiques that have been raised and moving forward throughout a reconsideration of the theoretical background of systems thinking and emphasizing the relevance of the concept of thick description for the promotion of an adequate reflection on methodology and case formulation.Literature ReviewIt is our opinion that the biopsychosocial approach is still a powerful framework for making sense of the growing data collected in the different fields related to mental health and for designing proper treatment plans. A crucial challenge for mental health is that of surpassing the dichotomies and ideological disputes that still contaminate the field with detrimental effects on the advancement of knowledge and on the integration and continuity of different kind of interventions.ConclusionsThe time is ripe for building bridges among neuroscience, humanities and social sciences, and this can only happen within the umbrella of a biopsychosocial perspective reinstated into its systems thinking background.
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