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(Junk?) "Challenging the Biopsychosocial Model in a Chronic Constipation Clinic"


Senior Member
The title caught my attention: the biopsychosocial model is often what the CBT school call their model for ME/CFS.

So I thought there is a possibility this paper might be interesting; at the same time, it might not be at all! (I can't tell without seeing the full text).

It also has a few references involving CFS (that's how I came across it).

Challenging the Biopsychosocial Model in a Chronic Constipation Clinic

Megan Wainwright1
Andrew J. Russell1
Yan Yiannakou2

1Durham University, Durham, United Kingdom
2County Durham and Darlington NHS Foundation Trust, Durham, United Kingdom
Megan Wainwright, Durham University, Medical Anthropology Research Group, Department of Anthropology, Dawson Building, South Road, Durham DH1 3LE, United Kingdom Email: megan@meganwainwright.ca
Earlier versions of this paper were presented by the first author at the Medical Anthropology Research Group (MARG) seminar on March 3, 2010, at Durham University, United Kingdom, and at the joint McGill Programs in Whole Person Care and McGill Qualitative Health Research Group seminar on January 8, 2010, at McGill University, Canada.


In this article we discuss the results of an ethnographic study of professionals and patients experiences within a specialist constipation clinic in England. Chronic constipation tends to be poorly understood and inadequately treated. Eleven patients were followed through their illness trajectory during a 5-month fieldwork period, involving 21 home interviews, clinic-based interviews, participant observation, and a focus group. Professionals were likewise observed and interviewed. The clinic could be broadly described as biopsychosocial in its approach. However, professionals expressed uncertainty about how best to provide biopsychosocial care and suggested that some patients were not open to psychosocial therapies or to discussing psychosocial aspects of their disease. Patients concerns were with being taken seriously, receiving treatment, and narrating intersections of life events, emotional well-being, and the bowels. We situate these findings within the discourse of functional disorders and discuss why implementing a biopsychosocial approach is problematic in this case.

Published online before print July 25, 2011, doi: 10.1177/1049732311416824
Qual Health Res December 2011 vol. 21 no. 12 1643-1657
It's good to see people thinking about how well these models actually work in the real world. Has anyone read the full paper?


Senior Member
Logan, Queensland, Australia
I don't recall the paper, but I recall reading about a situation where evidence based medicine was introduced into an aged community. Costs went up, but outcome was worse. Evidence based medicine and the biopsychosocial approach are associated. I am trying to figure out how deep that association is. Bye, Alex