Case analysis necessitates the student to detail their knowledge and awareness of the wellness wheel and the biopsychosocial model in the development of an action plan for the client.
Please read the case study below and analyse it in the light of the theory presented and the literature.
Jason is a 29 year old mania) man with one child who is 3 years old. He has been with his partner for over 10 years and married when they found out their son was on the way. Since then Jason has adjusted to being married, their new baby son, loss of income as his wife is caregiving their son full time and the recent purchase of a family home.
Two months ago Jason was involved in 2 car accident. His car was off the road for a month which made it difficult to get to and from work, but he managed. Jason had a whiplash injury which persists in creating pain and discomfort, especially if he uses his computer for too long without a break. His job involves entering sales and other data for the company and he is usually using the computer for several hours a day. As the accident was on his way home from work, he understands that the payment of lost wages and medical expenses will be covered through workover.
Jason's supervisor has queried his claim for a week off after the accident as it was "only a minor accident so why did he need this rime off?" He also has queried the fact that Jason has lost ten half days due to appointments at the doctor and physiotherapist. His supervisor assured him that the query came from the insurers, not him, but he has to ask Jason to explain this request. Jason has expressed to his wife that he feels like the supervisor does not believe him about the impact of his injury and the insurers may not pay, and this has big implications for their finances. Needless to say Jason is feeling quite stressed about the situation and has come to you to discuss the matter. He also wants some ideas on how to manage computer usage and his neck pain.
In this assignment, case of Jason is being discussed. Jason was experiencing multifactorial issues. These issues were impacting his life significantly because all these issues are interrelated and these issues exaggerate each other. Biopsychosocial model is useful in elucidating Jason’s problems. Wellness wheel comprises of diverse aspects which can be implemented to provide comprehensive wellness to Jason. It is necessary to prepare care plan on individualised basis for the issues observed in Jason. It is necessary to bring positive physical and mental health and functioning in Jason. It is necessary to develop care plan for observed issues in Jason; also, plan should be prepared for potential issues because it is highly possible that these issues can exaggerate each other.
Identified issues: In this case study, Jason was associated with multidimensional issues like personal, functional, social, financial and professional issues. He was experiencing personal issues because he got married and purchased home without proper planning. Hence, he was experiencing subsequent financial problems. He was experiencing functional issues because he was not able to work for the longer duration due to injury. He was experiencing pain and discomfort after using computer for the longer duration. He was experiencing social issues because his manger was not supporting him during this phase and he was not believing him. Moreover, Jason was experiencing stressed which would lead to social isolation for him. Jason was experiencing financial issues because his wife was not working and recently, he purchased new home. His earnings were not enough to run their home. Jason was also experiencing professional issues because his manager was not believing him and not supporting him. For providing proper intervention to resolve these issues in Jason, it is necessary to assess the severity of these issues and origin of these issues. All the mentioned issues are related to the biopsychosocial aspects of Jason. Root cause of all these issues need to identify and eradicate this root cause. If root cause of all these issues is not going to be removed, there is possibility persistent augmentation of it. Integrated problem-solving approach would be helpful in resolving these issues effectively. All these issues would affect him in all the aspects. His personal, physical, psychological, financial and social life. All these issues are interrelated. Effect of one issue would significantly affect another factor. As a result of changes in physical aspects of Jason, there would be negative impact on psychological, financial and social life of Jason (van Dijk-de Vries et al., 2012).
Since, multiple biopsychosocial issues are associated with Jason, it is very important to assess which issue required intervention. These issues need to be categorised according to their grades and intervention need to be planned accordingly. It is not necessary to provide direct intervention to all these aspects. Most significant impact on Jason would be psychological effect like stress. Other issues can be effectively managed because these issues are visible and these can be effectively managed. Psychological symptoms are not visible in the person and it is difficult to plan intervention for psychological issues. Moreover, patients would not express about their psychological problems. Psychological problems can affect Jason for the longer duration because there is possibility of unidentified psychological symptoms. Psychological problems in Jason would lead to behavioural changes in him. It would lead to lack of motivation, ineffective communication, low in confidence, lack of support, discrimination and social isolation for Jason. Psychological, social and financial issues associated with Jason would not affect not only himself but also it would affect his family members. Hence, it is necessary to assess the psychosocial issues in his family members also (Smith et al., 2014).
Biopsychosocial model: In this study all the factors related to biopsychosocial model like biological, psychological, and social factors arises. Biopsychosocial model is based on the intricate interaction of biological factors like genetic and biochemical, psychological factors like mood, personality and behaviour and social factors like familial, socioeconomic and medical factors. Jason was experiencing biological issues like injury, psychological issues like stressed and social issues he was not getting support from his manager. All these factors are interrelated and these factors impact each other. As a result of injury his financial condition was disturbed and he was feeling stressed. Injury also affected his relation with his manager. His manager was not believing him. Hence, it is necessary to provide interventions for all the factors together. If interventions provided to one factor, remaining factors would remain untreated (Wade and Halligan, 2017).
It is highly possible that untreated factor would exaggerate remaining factors. In the initial phase, this model was considered suitable for psychiatric illness; however, in the later stage it was being used for physical and psychological illness. It was evident that in few of the cases, this model was used based on the personal preference of healthcare practitioner. Hence, generalised applicability and validity of this model need to be validated in large trials. It is necessary to consider professional limits and ethical considerations for broader applicability of this model (Kusnanto et al., 2018). Biopsychosocial model is considered as philosophy of clinical care and practical clinical guideline. This model is useful in exploration of relationship between physical and mental aspects of life. This model is very necessary in patients like Jason because relationship between physical and mental health is very complex. Since, Jason is experiencing all the issues like biological, psychological and social; this model is necessary in him to provide holistic intervention to him (Benning, 2015).
Wellness wheel: Wellness wheel is based on the seven dimensions. These dimensions include emotional, intellectual, physical, social, environmental, financial, and spiritual. All these dimensions are interconnected and all these aspects need to be kept balanced for well-rounded and balanced lifestyle. Wellness is not merely absence of illness; however, it is motivation for positive physical, mental and social well-being. It is useful in enhancing wellness and through self-reflection and goal setting. In case of Jason, aspects of wellness wheel like emotional, physical, social, environmental and financial need to be considered. Jason is emotionally disturbed due to his physical injury, financial loss and loss of social belief. Psychological stress in his life is also responsible for emotional disturbance. As a result of injury, physical wellbeing of the Jason gets badly affected and it produces pain and discomfort in him specifically when he would work on computer for the longer duration (Dziegielewsk, 2013).
Physical injury also made him to keep himself away from his job. Social wellness is associated with getting support and guidance in the stressful situation to get rid of stress. Social wellness is helpful in establishing healthy relationship. Social wellness of Jason gets affected because he was not getting support from his manager. Hence, he was feeling more stressful. Accident didn’t affect environmental wellness of Jason directly; however, it would impact him indirectly. Environmental wellness can be promoted through making environment more acceptable. However, due to injury and pain; he would not be able to clean his environment. Hence, environmental wellness of Jason gets affected (Kwon, 2015).
Action plan: Action plan for Jason should be individualised and there should be effective communication among Jason and healthcare providers. Healthcare providers should not address not only medical aspects but also feelings, symptoms and circumstances of Jason. Action plan should be directed towards feeling well for Jason. Healthcare provider should make sure that Jason feel bright, outgoing, energetic and humorous. Healthcare provider should provide counselling to him and should make him talkative. It would make him less stressed. Healthcare provider need to identify accurate emotional and psychological triggers for Jason (Nadir et al., 2018).
Jason need to be provided with comfort and should make sure that triggers are not going become more serious. It is necessary to perform him relaxation exercise for minimum 45 minutes on daily basis. Personal issues of Jason need to resolved by providing counselling to him. Social workers need to provide counselling to him. Functional issues of Jason need to resolved by asking him to perform exercise because due to long duration work, he was getting pain and discomfort (Bouras, 2017). Physiotherapist need to provide training to Jason to perform exercise; hence, he would not feel stressed during long duration of working hours. Intervention need to be provided to reduce pain in Jason (Deyo, 2015).
Social issues of Jason need to be solved by giving motivational education to him. It would be helpful for him to tackle his manager and convince manager to believe Jason. Financial issues of Jason would be solved by making arrangements of some financial resource for him. Physical issues of Jason would be resolved by providing him with proper treatment for fast recovery of his injury. It is necessary to cultivate certain characteristics like self-awareness, active cultivation of trust, self-calibration, minimisation in emotions, informed intuition and communication in him (Fassino, 2010).
Systematic approach was implemented for providing intervention to Jason. Issues and problems in Jason were identified and its impact on Jason were demonstrated. Biopsychosocial model was implemented to assess multifaceted problems in Jason. Wellness wheel was used for improving wellness in him. Synergy of different approaches proved useful in preparing care plan for Jason. This approach provided holistic perspective to the psychological, biological and social aspects of care plan of Jason. It helped to strengthen the positives and lessen the negatives in Jason.
Benning, T. B. (2015). Limitations of the biopsychosocial model in psychiatry. Advances in Medical Education and Practice, 6, 347–352.
Bouras, N. (2017). Social challenges of contemporary psychiatry. Psychiatriki, 28(3), 119-202.
Deyo, R.A. (2015). Biopsychosocial care for chronic back pain. British Medical Journal, 350, doi: 10.1136/bmj.h538.
Dziegielewsk, S. F. (2013). The Changing Face of Health Care Social Work, Third Edition: Opportunities and Challenges for Professional Practice. Springer Publishing Company. New York City, United States.
Fassino, S. (2010). Psychosomatic approach is the new medicine tailored for patient personality with a focus on ethics, economy, and quality. Panminerva Medica, 52(3), 249-64.
Kwon, S.H. (2015). Wheel of Wellness Counseling in Community Dwelling, Korean Elders: A Randomized, Controlled Trial. Journal of Korean Academy of Nursing, 45(3), 459-68.
Kusnanto, H., Agustian, D., and Hilmanto, D. (2018). Biopsychosocial model of illnesses in primary care: A hermeneutic literature review. Journal of Family Medicine and Primary Care. 7(3), 497–500.
Nadir, M., Hamza, M., and Mehmood, N. (2018). Assessing the extent of utilization of biopsychosocial model in doctor–patient interaction in public sector hospitals of a developing country. Indian Journal of Psychiatry, 60(1), 103–108.
Smith, R.C., Laird-Fick, H., D'Mello, D., Dwamena, F.C., Romain, A., ……… Frankel, R. (2014). Addressing mental health issues in primary care: an initial curriculum for medical residents. Patient Education and Counseling, 94(1), 33-42.
van Dijk-de Vries, A., Moser, A., Mertens, V.C., van der Linden, J., van der Weijden, T., and van Eijk, J.T. (2012). The ideal of biopsychosocial chronic care: how to make it real? A qualitative study among Dutch stakeholders. BMC Family Practice, 13, 14. doi: 10.1186/1471-2296-13-14.
Wade, D.T., and Halligan, P.W. (2017). The biopsychosocial model of illness: a model whose time has come. Clinical Rehabilitation, 31(8), 995-1004.
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