The Role of Patient-Centered and Recovery-Oriented Models in Medicine: An Introduction

  • Luigi GrassiEmail author
  • Thomas Wise
  • Michelle B. Riba
Part of the Integrating Psychiatry and Primary Care book series (IPPC)


As medicine achieves new scientific findings regarding disease causation and treatment, a human element has receded in actual clinical practice. This has limited the importance of the doctor-patient relationship which has serious implications for medical care as both patient and health-care provider exist in a biopsychosocial matrix. Various international health organizations are now working together to better integrate person-centered and recovery-oriented approaches into general medical care. Such a comprehensive approach to clinical patient care as well as medical research is more than mere psychosomatic medicine but requires attention to issues of functionality in an autonomous manner as well as participation in social groups. Dignity conservation, reaffirmation, and spiritual needs are necessary elements of the doctor-patient relationship. This requires appropriate communication abilities which include such psychosocial information in addition to careful review of biologic systems in both health and disease. The psychosomatic legacy is only part of the journey toward a true patient-centered model. This volume attempts to provide a rationale for its importance and provides clinical and educational examples about how to achieve such goals.


Psychosomatic medicine Person-centered medicine Recovery Dignity conserving care 


  1. 1.
    World Health Organization (WHO). Constitution of the World Health Organization. Geneva.
  2. 2.
    World Health Organization (WHO). Promotion of mental health. Geneva: WHO.
  3. 3.
    Milstein JM. Introducing spirituality in medical care: transition from hopelessness to wholeness. JAMA. 2008;299(20):2440–1.PubMedGoogle Scholar
  4. 4.
    Corbin J, Strauss AL. Accompaniments of chronic illness: changes in body, self, biography, and biographical time. Res Sociol Health Care. 1987;6:249–81.Google Scholar
  5. 5.
    Cloninger CR. Person-centred integrative care. J Eval Clin Pract. 2011;17:371–2.PubMedGoogle Scholar
  6. 6.
    Cox JL. Empathy, identity and engagement in person-centred medicine: the sociocultural context. J Eval Clin Pract. 2011;17(2):350–3.PubMedGoogle Scholar
  7. 7.
    Anthony W. Recovery from mental illness: the guiding vision of the mental health service systems in the 1990s. Psychosoc Rehabil J. 1993;16:11–23.Google Scholar
  8. 8.
    Slade M. Personal recovery and mental illness. Cambridge: Cambridge University Press; 2010.Google Scholar
  9. 9.
    Farkas M. The vision of recovery today: what it is and what it means for services. World Psychiatry. 2007;6:68–74.PubMedCentralPubMedGoogle Scholar
  10. 10.
    Whitley R, Drake RE. Recovery: a dimensional approach. Psychiatr Serv. 2010;61(12):1248–50.PubMedGoogle Scholar
  11. 11.
    Resnick SG, Rosenheck R. Recovery and positive psychology: parallel themes and potential synergies. Psychiatr Serv. 2006;57:120–2.PubMedGoogle Scholar
  12. 12.
    Seligman MEP, Csikszentmihalyi M. Positive psychology: an introduction. Am Psychol. 2000;55(1):5–14.PubMedGoogle Scholar
  13. 13.
    Mezzich JE. Positive health: conceptual place, dimensions and implications. Psychopathology. 2005;38(4):177–9.PubMedGoogle Scholar
  14. 14.
    Cloninger CR. The science of well-being: an integrated approach to mental health and its disorders. World Psychiatry. 2006;5:71–6.PubMedCentralPubMedGoogle Scholar
  15. 15.
    Jeste DV, Palmer BW, Rettew DC, Boardman S. Positive psychiatry: its time has come. J Clin Psychiatry. 2015;76(6):675–83.PubMedCentralPubMedGoogle Scholar
  16. 16.
    Mezzich JE. World psychiatric association perspectives on person-centered psychiatry and medicine. Int J Integr Care. 2010;10:3–7.Google Scholar
  17. 17.
    Mezzich JE. Psychiatry for the person: articulating medicine’s science and humanism. World Psychiatry. 2007;6:1–3.PubMedCentralPubMedGoogle Scholar
  18. 18.
    Mezzich JE, Botbol M, Christodoulou GN, Cloninger CL, Salloum IM, editors. Person centered psychiatry. Berlin: Springer; 2016.Google Scholar
  19. 19.
    Miles A. On a medicine of the whole person: away from scientistic reductionism and towards the embrace of the complex in clinical practice. J Eval Clin Pract. 2009;15:941–9.PubMedGoogle Scholar
  20. 20.
    Miles A. Towards a medicine of the whole person--knowledge, practice and holism in the care of the sick. J Eval Clin Pract. 2009;15(6):887–90.PubMedGoogle Scholar
  21. 21.
    Peabody FW. The care of the patient. JAMA. 1927;9:877–82.Google Scholar
  22. 22.
    Jaspers K. Der Arzt im technischen Zeitalter. Universitas: Zeitschrift für Wissenschaft, Kunst und Literatur. 1959;14(4):337–54. (English translation by Grugan AA). The physician in the technological age. Theor Med Bioeth. 1989;10(3):251–67.Google Scholar
  23. 23.
    Tournier P. Médicine de la personne. Neuchatel: Delachaux et Niestlé; 1940. (English Tr. The Healing of Persons. Harper Collins Pub, 1965).Google Scholar
  24. 24.
    Jacob RG, Hugo JA, Dunbar-Jacob J. History of psychosomatic medicine and consultation-liaison psychiatry. In: Ackerman KD, Dimartini AF, editors. Psychosomatic medicine. New York: Oxford University Press; 2015.Google Scholar
  25. 25.
    Alexander F. Psychological aspects of medicine. Psychosom Med. 1939;1:7–18.Google Scholar
  26. 26.
    Engel GL. The need for a new medical model: a challenge for biomedicine. Science. 1977;196:129–36.PubMedGoogle Scholar
  27. 27.
    Lipowski ZJ. Review of consultation psychiatry and psychosomatic medicine. 3. Theoretical issues. Psychosom Med. 1968;30:395–422.PubMedGoogle Scholar
  28. 28.
    Lipowski ZJ. Review of consultation psychiatry and psychosomatic medicine. II. Clinical aspects. Psychosom Med. 1967;29(3):201–24.PubMedGoogle Scholar
  29. 29.
    Balint M. The doctor, his patient and the illness. London: Pitman Medical Publishing; 1957.Google Scholar
  30. 30.
    Lipowski ZJ. What does the word “psychosomatic” really mean? A historical and semantic inquiry. Psychosom Med. 1984;46(2):153–71.PubMedGoogle Scholar
  31. 31.
    Galdston I. Psychosomatic medicine. AMA Arch Neurol Psychiatry. 1955;74:441–50.PubMedGoogle Scholar
  32. 32.
    Gitlin DF, Levenson JL, Lyketsos CG. Psychosomatic medicine: a new psychiatric subspecialty. Acad Psychiatry. 2004;28(1):4–11.PubMedGoogle Scholar
  33. 33.
    Lipsitt DR. Psychosomatic medicine: history of a “new” specialty. In: Blumenfield M, Strain JJ, editors. Psychosomatic medicine. Philadelphia: Lippincott Williams & Wilkins; 2006. p. 3–20.Google Scholar
  34. 34.
    Boland RJ, Rundell J, Epstein S, Gitlin D.: Consultation-Liaison Psychiatry vs Psychosomatic Medicine: What’s in a name? Psychosomatics. 2018;59(3):207–10.PubMedGoogle Scholar
  35. 35.
    Söllner W, Creed F, European Association of Consultation-Liaison Psychiatry and Psychosomatics Workgroup on Training in Consultation-Liaison. European guidelines for training in consultation-liaison psychiatry and psychosomatics: report of the EACLPP workgroup on training in consultation-liaison psychiatry and psychosomatics. J Psychosom Res. 2007;62(4):501–9.PubMedGoogle Scholar
  36. 36.
    Leentjens AF, Rundell JR, Diefenbacher A, Kathol R, Guthrie E. Psychosomatic medicine and consultation-liaison psychiatry: scope of practice, processes, and competencies for psychiatrists working in the field of CL psychiatry or psychosomatics. [corrected] a consensus statement of the European Association of Consultation-Liaison Psychiatry and Psychosomatics (EACLPP) and [corrected] the Academy of Psychosomatic Medicine (APM). Psychosomatics. 2011;52(1):19–25.PubMedGoogle Scholar
  37. 37.
    Lipowski ZJ. Psychosomatic medicine: past and present. Part II. Current state. Can J Psychiatr. 1986;31(1):8–13.Google Scholar
  38. 38.
    Lipowski ZJ. Psychosomatic medicine: past and present. Part III. Current research. Can J Psychiatr. 1986;31(1):14–21.Google Scholar
  39. 39.
    Lipowski ZJ. Consultation-liaison psychiatry at century's end. Psychosomatics. 1992;33(2):128–33.PubMedGoogle Scholar
  40. 40.
    Oken D. Current theoretical concepts in psychosomatic medicine. In: Kaplan HI, Sadock BJ, editors. Comprehensive textbook of psychiatry, vol. 2. 5th ed. Baltimore, MD: Williams & Wilkins; 1989. p. 1160–9.Google Scholar
  41. 41.
    Fava GA, Belaise C, Sonino N. Psychosomatic medicine is a comprehensive field, not a synonym for consultation liaison psychiatry. Curr Psychiatry Rep. 2010;12(3):215–21.PubMedGoogle Scholar
  42. 42.
    Deter HC. History, concepts and aims of internationally active societies in psychosomatic and behavioural medicine. Biopsychosoc Med. 2016;10:34. Scholar
  43. 43.
    Park EM, Sockalingam S, Ravindranath D, Aquino PR, Aggarwal R, Nemeroff SF, Gerkin JS, Gitlin DF, Academy of Psychosomatic Medicine’s Early Career Psychiatrist Special Interest Group. Psychosomatic medicine training as a bridge to practice: training and professional practice patterns of early career psychosomatic medicine specialists. Psychosomatics. 2015;56(1):52–8.PubMedGoogle Scholar
  44. 44.
    Deter HC, Orth-Gomér K, Wasilewski B, Verissimo R. The European Network on Psychosomatic Medicine (ENPM)—history and future directions. Biopsychosoc Med. 2017;11:3. Scholar
  45. 45.
    Wise TN. Psychosomatics: past, present and future. Psychother Psychosom. 2014;83(2):65–9.PubMedGoogle Scholar
  46. 46.
    Wise TN, Balon R. Psychosomatic medicine in the 21st century: understanding mechanisms and barriers to utilization. In: Balon R, Wise T, editors. Clinical challenges in the biopsychosocial interface. Update on psychosomatics for the 21st century. Basel: Karger; 2015. p. 1–9.Google Scholar
  47. 47.
    Whatley SD. Borrowed philosophy: bedside physicalism and the need for a sui generis metaphysic of medicine. J Eval Clin Pract. 2014;20(6):961–4.PubMedGoogle Scholar
  48. 48.
    Martin CM, Félix-Bortolotti M. Person-centred health care: a critical assessment of current and emerging research approaches. J Eval Clin Pract. 2014;20(6):1056–64.PubMedGoogle Scholar
  49. 49.
    Leamy M, Bird V, Le Boutillier C, et al. A conceptual framework for personal recovery in mental health: systematic review and narrative synthesis. Br J Psychiatry. 2011;199:445–52.PubMedGoogle Scholar
  50. 50.
    Davidson L, O’Connell MJ, Tondora J, et al. Recovery in serious mental illness: a new wine or just a new bottle? Prof Psychol Res Pr. 2005;36(5):480–7.Google Scholar
  51. 51.
    Slade M, Amering M, Farkas M, et al. Uses and abuses of recovery: implementing recovery-oriented practices in mental health systems. World Psychiatry. 2014;13(1):12–20.PubMedCentralPubMedGoogle Scholar
  52. 52.
    Drake RE, Whitley R. Recovery and severe mental illness: description and analysis. Can J Psychiatr. 2014;59(5):236–42.Google Scholar
  53. 53.
    Vogt H, Ulvestad E, Eriksen TE, Getz L. Getting personal: can systems medicine integrate scientific and humanistic conceptions of the patient? J Eval Clin Pract. 2014;20(6):942–52.PubMedGoogle Scholar
  54. 54.
    El-Alti L, Sandman L, Munthe C. Person centered care and personalized medicine: irreconcilable opposites or potential companions? Health Care Anal. 2017. p. 1–15. [Epub ahead of print].
  55. 55.
    Cornetta K, Brown CG. Balancing personalized medicine and personalized care. Acad Med. 2013;88(3):309–13.PubMedCentralPubMedGoogle Scholar
  56. 56.
    Ziegelstein RC. Personomics. JAMA Intern Med. 2015;175(6):888–9.PubMedGoogle Scholar
  57. 57.
    Ziegelstein RC. Personomics: the missing link in the evolution from precision medicine to personalized medicine. J Pers Med. 2017;7-11:1–5.Google Scholar
  58. 58.
    Ziegelstein RC. Personomics and precision medicine trans. Am Clin Climatol Assoc. 2017;128:160–8.Google Scholar
  59. 59.
    Ziegelstein RC. Perspectives in primary care: knowing the patient as a person in the precision medicine era. Ann Fam Med. 2018;16(1):4–5.PubMedCentralPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Luigi Grassi
    • 1
    Email author
  • Thomas Wise
    • 2
    • 3
    • 4
    • 5
  • Michelle B. Riba
    • 6
    • 7
  1. 1.Institute of Psychiatry, Department of Biomedical and Specialty Surgical SciencesUniversity of FerraraFerraraItaly
  2. 2.Department of PsychiatryInova Fairfax HospitalFalls ChurchUSA
  3. 3.Johns Hopkins UniversityBaltimoreUSA
  4. 4.George Washington UniversityWashingtonUSA
  5. 5.Virginia Commonwealth UniversityRichmondUSA
  6. 6.Department of PsychiatryUniversity of MichiganAnn ArborUSA
  7. 7.University of Michigan Comprehensive Depression Center and Psych Oncology ProgramUniversity of Michigan Comprehensive Cancer CenterAnn ArborUSA

Personalised recommendations