Where’s does the power lie? A critical look at the biopsychosocial model with Karime Mescouto

The Words Matter Podcast with Oliver Thomson

Welcome to another episode of The Words Matter Podcast.

So this is the first episode after the CauseHealth series, which was a phenomenal experience and I’m delighted that it seems to have landed far and wide across the healthcare landscape.

The series was epic, and I’m recording this a couple of days after the release of the final episode with Rani, Matt and Christine, so it feels a bit like the morning after the night before.

The CauseHealth experience has had an impact on the focus I want for the podcast, and I think the series may have shaped the trajectory and the sorts of conversations I want to have and bring to you.

So exploring the underlying assumptions, theory and philosophy of clinical practice will now certainly be on the agenda of the show. But also, in many ways it’s business as usual and I’ll continue to have a focus on the stories, language and relationships which are fundamental to clinical practice and the health care of people.

So please stay tuned, listen, re-listen to the episodes and subscribe to the Podcast.

On this episode I’m speaking with Karime Mescoto. Karime is a physiotherapist originally from Brazil. She is currently a final year PhD student at the University of Queensland, where her research is looking critically at the biopsychosocial model in relation to low back pain.

Her research is underpinned by critical theory utilising the qualitative research methodologies of Foucauldian discourse analysis and ethnography to understand how the BPS model is conceptualised, enacted and embodied and the power dynamics within it, around it and underneath it in the management of low back pain (listen to Episode 21 with Prof. David Nicholls where we touch on similar themes related to critical theory).

In this episode we talk about:

• Karime’s excellent critical review of the BPS model and how it has been conceptualised by researchers and the associated discourses about it.
• The fragmentation off the BPS model and how there is often an emphasis (albeit unintended) on the biological aspects.
• How the social aspects are often forgotten, de-emphasised and marginalised and why the social is everywhere and cannot or shouldn’t be avoided.
• Finally, we discuss the underlying and overlying power structures within clinical practice and an audio recording on the this important topic with two of her PhD supervisors Dr Jenny Setchell and Dr Rebecca Olson (listen here).

I really enjoyed talking to Karime. Her fresh outlook on an oldish model, using even older theory gives a new perspective and uncovers the hidden assumptions, meanings and power of the BPS model and how these may play out during research and when clinicians interact with patients.

Karime is a future star, and I cannot wait to read her further work in this crucial area of clinical practice.

Find Karime on Twitter @KarimeMescouto

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