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What is the BioPsychoSocial Spiritual Model? [Full Guide]

BioPsychoSocial Spiritual. Sounds complicated, doesn’t it? But perhaps that is exactly the point; that we are not one-dimensional and should not be viewed through a single lens.  We are integrated and holistic beings and not a set of separate compartments. Many things can affect our emotional states such as underlying medical conditions; general physical health; family background; cultural and social contexts; career situation; stage of life; underpinning belief systems; and recent events.

 The path to wellness often involves working on different aspects of our being, that’s why counselling should consider all dimensions of self: the biological, the sociological, the psychological and the spiritual. So, let’s look at what makes us who we are.

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Biological Health

Many biological issues can affect mental health – sometimes it is not all in your head! Depressive or anxious feelings can be rooted in a medical cause such as a thyroid condition, hormonal changes, difficulty with pain management, and individual genetic make-up (read a case study involving an integrative medicine approach considering genetic make-up and mood disturbance).

Have you had a recent medical and health check-up? What are your risk factors and family conditions? Is genetic or other diagnostic screening appropriate to consider genetic mutations that affect methylation, energy levels and neurotransmitter activity? Has there been a recent change to your overall health such as a glandular illness or the start of an autoimmune condition?

Are you on medications that have side effects that affect mood? Is it worth exploring with your GP dosage or other medicine options? Do you have a good GP who works with you in partnership and empowers you with the information you need to make decisions that affect your life?   

Then there are general health considerations such as examining your sleep patterns and if you have good sleep hygiene.  We need to consider if you exercise regularly and what type of exercise (for example if you have adrenal issues and you’re doing intense cardio it can have the reverse effect on fatigue and mood). 

What is your diet like and is it genuinely nutritious? (iceberg lettuce on a Big Mac does not count!).  Are you eating ‘mood foods’ that build up your gut biome? (your gut is where serotonin receptors are).  If you take vitamin supplements, is it just producing expensive pee or tailored and in the right form and ratios for your individual needs?

Whilst a counsellor will not be an expert in these areas, they should be open to understanding these biological factors and considering them as part of who you are, making suggestions for other areas you may like to work on.


Sociological Health

Examining your sociological self means looking at lifestyle factors including:

Social life

What do you do with your time and do you have a social life?; What are your friends like – do they build you up or bring you to a level where you don’t like yourself?;  Do you have hobbies?; Would you see yourself as extroverted or introverted?; Do you even like people?! Perhaps you prefer animals or nature or a carefully constructed routine over exciting last-minute events with lots of people. 

Is social anxiety a factor and what do you notice about that? In today’s social media-crazed society, how much time do you spend on social media and what affect does it have on your well-being? Most importantly, who is a support person in your life, someone you can be raw and open with without the need to edit or suppress and who is lovingly truthful?


Family life and dynamics

Our family of origin has a strong influence on who we are and it is worthwhile to examine how your family has influenced you and what dynamics are in play.  Are there spoken or unspoken ‘core schemas’ that rule how your family operates, for example, “toughen up” or “you have to be the best” or “you’re not enough/too much” to name just a few.  How do these affect how you see yourself and the world? 

Is there significant trauma such as grief and loss, addiction, or abuse of some kind? Are there assigned roles like the rescuer or the trouble maker or the peacemaker?  What patterns can you identify as functional and dysfunctional and what do you want to do with those patterns?  By working on yourself, you change the existing ‘homeostasis’ of your family system and create a healthier dynamic.  


Cultural Context

How important is your cultural heritage or newly embraced cultural context – for example, immigrating to a new country presents different cultural contexts.  Identifying as LGBQTI+ and being part of this community is a form of cultural context that may be very different from your family of origin or ethnicity or spiritual heritage

Maybe it’s not either/or but navigating the territory of commonality and difference.  Rarely things are all bad or all good so where is the grey area for you? What pressures do you feel from your cultural contexts– are there parts you want to embrace and other parts that don’t quite fit where you feel different to the ‘cultural norm’?  How does this affect living authentically?


Career/Job Clubs, Interest Groups, Volunteering

These are all parts of life and identity that are worth examining.  Why are you attracted to a particular vocation or interest?  Did you choose this or was it chosen for you or just presented itself and you went along with it or do you feel obligated?  Is what you’re doing making you feel fulfilled?  What are your choices balanced with pragmatic need?  If you can’t change what you do, can you change how you see it and change yourself within context? How do your personal values, stage of life, personal growth and personality align with your career and extra-curricular activities? 


Socio-economic factors

Society at large assigns strata or categories based on socio-economic criteria such as income, work status, education, neighbourhood, stage of life, health status and culture.  How you identify with and function within a category or choose to reject and fight against can be a choice.  Feeling trapped by circumstance and not being able to ‘get ahead’ or ‘get away from’ are common feelings.  Working out who you are within your socioeconomic context and ‘living with’ rather than ‘being defined by’ is interesting groundwork to explore.


Psychological Health

biopsychosocial spiritual

Psychological states include the experience of conditions such as anxiety and depression; your thought life; patterns of behaviour; coping mechanisms; addictions and habits; past or recent trauma; and informal or formally diagnosed conditions.

Sometimes there is a mental health diagnosis to be considered:  what was the foreground to that diagnosis? Is there a family history? Are you ‘living with’ a condition or ‘being defined by’ the diagnosis and you can’t see yourself as separate from it? Do you agree with the diagnosis or is a second opinion wise?  Are you working with health professionals who you feel ‘get you’ and are other opinions warranted?  Are you on medication and how are you experiencing that? Are there other treatments?  Have you had a wounding mental health journey and your faith in finding solutions and a newfound hope is what’s needed?

Perhaps this is your first experience of a mental health issue and you’re wanting to find out why – is it biochemical or triggered by something specific and circumstantial; is it unresolved issues that have welled up to overflow or perhaps you’re at a life crossroads and experiencing confusion that’s throwing you off base in a state of flux. These are all things to be considered in exploring your experience of mental health.


Spiritual Health

Your worldview or spiritual belief system also has a major influence on identity, thoughts and behaviour.  Spiritual beliefs can be a major support or protective factor in your life. These beliefs can also be harmful and detrimental and in some cases, people have undergone spiritual abuse of many different forms. 

Maybe there is an absence of any spiritual beliefs but something in you is seeking a deeper meaning and you want to consider if there is something else out there bigger than you. Or perhaps you are evaluating an existing belief system and may not want to dispense of it altogether, but something isn’t sitting right with you and you are not sure how to navigate that without losing faith. Perhaps you may even feel guilty that you have doubts and wonder if you’re even ‘allowed’ to have your own interpretation. 

The role of an ethical counsellor is not to impose their beliefs or absence of beliefs but have the ability to acknowledge if you have a spiritual dimension in your life and explore what this means to you and the impact on your life. Some mental health professionals see faith-based beliefs as another psychological coping mechanism you put in place to have a cop-out or avoid facing real issues. 

Whilst this does happen in some cases and religious systems can be detrimental for some people, for other people, it is very real and they feel patronised and misunderstood to have this important part of life and identity dismissed as a ‘cognitive distortion’.  It’s important you work with a mental health professional who can hold their own beliefs in tension to openly navigate your beliefs without judgement and from a curious stance.

Conclusion – BioPsychoSocial Spiritual Model

So that’s a fairly intimidating list of things to explore and perhaps your head is spinning! During counselling sessions, I don’t systematically “tick and flick’ all of these areas and some of them may not even come up if your goals of therapy are specific.  I consider many of these factors as they are woven through the narrative of getting to know you.

I particularly dig deeper and consider all dimensions of being when a person has tried just about everything or seems at a loss of what to do next. Somewhere in the multi-faceted make-up of who you are, is the potential for insightful revelations and findings. It’s fascinating and hopeful and I’d be honoured to explore who you are with you!



Bio Psycho Social Spiritual Page

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Cognitive Behaviour Therapy [CBT]: A Modern Neuroscience Approach


To make an appointment with Brisbane counsellor Sara Martin, call 0413 742 076 or email me at

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