Applying a Systems Approach to Common Medical Problems

  • Thomas Campbell
  • Susan McDaniel


The clinical application of systems theory to common medical problems can open up new perspectives on diagnosis and new options for treatment of patients and their families. This model, also known as the biopsychosocial model (1), is more than just adding psychosocial data to the biomedical data. A systems approach to health care emphasizes the interdependency and interplay among different levels of the system—whether it is, for example, the interaction among the heart, the cardiovascular system, the individual, significant others, or whether it also includes interactions among factors involving the family, the community, and the society-level systems that can impact health and disease. All interact with one another to affect the patient who walks into a clinic with a presenting complaint. Recognizing and acknowledging the interaction between these different levels of systems allows one to better understand those mysterious, vague, or persistent clinical problems seen in day-by-day practice. The art and science of applying a systems approach to health care turns on the choice of systems levels with which to work. Which areas deserve further exploration and evaluation? Which components might provide the most powerful leverage for successful treatment?


System Approach Anorexia Nervosa Chronic Illness Family Physician Carpal Tunnel Syndrome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Engel BL: The clinical application of the biopsychosocial model. Am J Psychiatry 1980;137:535–544.PubMedGoogle Scholar
  2. 2.
    Minuchin S, Baker L, Rossman BL, et al: A conceptual model of psychosomatic illness in children: Family organization and family therapy. Arch Gen Psychiatry 1975;32:1031–1038.PubMedGoogle Scholar
  3. 3.
    Minuchin S, Rosman BL, Baker L: Psychosomatic Families. Cambridge, MA, Harvard University Press, 1978, pp 21–50.Google Scholar
  4. 4.
    Baker L, Minuchin S, Rosman B: The use of beta adrenergic blockade in the treatment of psychosomatic aspects of juvenile diabetes mellitus, in Snart A (ed); Advances in Beta Adrenergic Blockade Therapy. Princeton, NJ, Excerpta Medica, 1974, pp 67–80.Google Scholar
  5. 5.
    Baker L, Minuchin S, Milman L, et al: Psychosomatic aspects of juvenile diabetes mellitus: A progress report. Mod Prob Paediatr 1975;12:332–343.Google Scholar
  6. 6.
    White K, Kolman ML, Wexler P, et al: Unstable diabetes and unstable families: A psychosocial evaluation of diabetic children with recurrent ketoacidosis. Pediatrics 1984;73:749–755.PubMedGoogle Scholar
  7. 7.
    Cerretto MC, Travis LB: Implications of psychological and family factors in the treatment of diabetes. Pediatr Clin North Am 1984;31:689–710.Google Scholar
  8. 8.
    Doherty WJ, Baird MA: Family Therapy and Family Medicine. New York, Guilford Press, 1983.Google Scholar
  9. 9.
    Morisky DE, Levine DM, Green LW, et al: Five year blood pressure control and mortality following health education for hypertensive patients. Am J Pub Health 1983;73:153–162.CrossRefGoogle Scholar
  10. 10.
    Hoebel FC: Brief family interactional therapy in the management of cardiac related high risk behaviors. J Fam Pract 1976;3:613–618.PubMedGoogle Scholar
  11. 11.
    Medalie JH, Snyder M, Groen JJ, et al: Angina pectoris among 10,000 men: 5 year incidence and univariate analysis. Am J Med 1973;55:583–594.PubMedCrossRefGoogle Scholar
  12. 12.
    Medalie JH, Goldbourt U: Angina pectoris among 10,000 men: Psychosocial and other risk factors as evidenced by a multivariate analysis of a five year incidence study. Am J Med 1976;60:910–921.PubMedCrossRefGoogle Scholar
  13. 13.
    Patterson J: Critical factors affecting family compliance with home treatment for children with cystic fibrosis. Fam Relat 1985;34:78–90.CrossRefGoogle Scholar
  14. 14.
    Heinzelman F, Bagley RW: Response to physical activity programs and their effects on health behavior. Pub Health Rep 1970;85:905–911.Google Scholar
  15. 15.
    Oakes TW, Ward JR, Gray RM, et al: Family expectation and arthritis patient compliance to a hand resting splint regimen. J Chron Dis 1970;22:757–764.PubMedCrossRefGoogle Scholar
  16. 16.
    Doherty WJ, Schrott HG, Metcalf L, Iasiello Vailas L: Effect of spouse support and health beliefs on medication adherence. J Fam Pract 1983;17:837–841.PubMedGoogle Scholar
  17. 17.
    Doherty WJ, Baird MA: A protocol for family compliance counseling. Fam Syst Med 1984;2(3):333–336.CrossRefGoogle Scholar
  18. 18.
    Penn P: Coalitions and binding interactions in families with chronic illness. Fam Syst Med 1983;1:16–25.CrossRefGoogle Scholar
  19. 19.
    Sheinberg M: The family and chronic illness: A treatment diary. Fam Syst Med 1983; 1(2): 26–36.CrossRefGoogle Scholar
  20. 20.
    Van Eijk J, Grol R, Huygen F, et al: The family doctor and the prevention of somatic fixation. Fam Syst Med 1983; 1(2):5–15.CrossRefGoogle Scholar
  21. 21.
    Reifler BV, Okimoto JT, Heidrich FE, Invi TS: Recognition of depression in a university based family medicine residency program. J Fam Pract 1979;9:623–628.PubMedGoogle Scholar
  22. 22.
    Hoeper EW, Nycz GR, Cleavy PD, et al: Estimated prevalence of RDC mental disorders in primary medical care. Int J Ment Health 1978;8(2):6–15.Google Scholar
  23. 23.
    Hirschfeld RMA, Koslow SH, Kupfer DJ: The clinical utility of the dexamethosone suppression test in psychiatry. Summary of a National Institute of Mental Health workshop. JAMA 1983;250:2172–2174.PubMedCrossRefGoogle Scholar
  24. 24.
    Watzlawick P, Weakland JH, Fisch R: Change: Principles of Problem Formation and Problem Resolution. New York, Norton, 1974.Google Scholar
  25. 25.
    Tennant FS, Day CM, Ungerleider JT: Screening for drug and alcohol abuse in a general medical population. JAMA 1979;242:533.PubMedCrossRefGoogle Scholar
  26. 26.
    Sherin KM, Piotrowski MS, Panek SM, Doot MC: Screening for alcoholism in a community hospital. J Fam Pract 1982;15:1091–1095.PubMedGoogle Scholar
  27. 27.
    Chick J, Kreitman N, Plant M: Mean cell volume and gamma glutamyl transpeptidase as markers of drinking in working men. Lancet 1981;1:1249–1951.PubMedCrossRefGoogle Scholar
  28. 28.
    Steinglass P, Davis D, Berenson D: Observations of conjointly hospitalized alcoholic couples during sobriety and intoxication: Implications for theory and practice. Fam Process 1977;16:1–16.PubMedCrossRefGoogle Scholar
  29. 29.
    Davis D, Berenson D, Steinglass P, Davis S: The adaptive consequences of drinking. Psychiatry 1974;37:209–215.PubMedGoogle Scholar
  30. 30.
    Berenson D: Alcohol and the family system, in Guerin P (ed): Family Therapy: Theory and Practice. New York, Gardner Press, 1976 pp 284–297.Google Scholar
  31. 31.
    Jacob T, Dunn NJ, Leonard K: Patterns of alcohol abuse and family stability. Alcoholism: Clin Exp Res 1983;7:382–385.CrossRefGoogle Scholar
  32. 32.
    Steinglass PA: A life history model of the alcoholic family. Fam Process 1980;19:211–226.PubMedCrossRefGoogle Scholar
  33. 33.
    Steinglass P: The alcoholic family at home: Patterns of interaction of dry, wet, and transitional stages of alcoholism. Arch Gen Psychiatry 1981;138:578–584.Google Scholar
  34. 34.
    Baird MA: Chemical dependency: A protocol for involving the family. Fam Syst Med 1985;3(2):216–220.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag New York Inc. 1987

Authors and Affiliations

  • Thomas Campbell
  • Susan McDaniel

There are no affiliations available

Personalised recommendations