(079) ENCOURAGING A GREATER AWARENESS OF ALL RELEVANT FACTORS WHEN SEXUAL MEDICINE AND SEX THERAPY CLINICIANS APPLY THE BIOPSYCHOSOCIAL MODEL
Authors: Perelman M 
Published: June 2024

Abstract

Introduction
The biopsychosocial model is generally considered the current gold standard for the diagnosis and treatment of sexual disorders (Rullo et al, 2016). Shortcomings in how clinicians apply it remain. Given the model’s importance to our field, we must periodically re-examine ways to optimize its strengths and minimize misapplication. This presentation encourages all to examine our understanding and application of the model so it remains adequately inclusive and robust for diagnosis and treatment. Doing so will remind clinicians of how they already use it productively but will also alert them to potential “blind spots” resulting from their specialized training and practice cultivated within their professions of origin. The biopsychosocial model must be a “stand-in” for all the predisposing, precipitating, and maintaining biological, medical/surgical, cognitive, behavioral, emotional, social, and cultural factors involved in the etiology and treatment of sexual disorders. The relevant aspects of those factors are best understood at a granular detail level that recognizes their proportional contribution to a given individual’s sexual response. Most clinicians pay lip service to using a biopsychosocial approach, but too frequently, there is an overly exclusive focus on one or two aspects of the model, with insufficient awareness of other contributing factors. How many sex therapists offering diagnosis and treatment worldwide (typically aware of psychosocial nuances) are conversant with the impact of the biomedical diagnostic and treatment advances for cancers and chronic diseases, which may extend life but often result in diminished sexual function and satisfaction? How many know the latest benchwork discoveries and investigative techniques that improve understanding of drug interactions and mechanisms illuminating etiology? Reciprocally, do most physicians attend to the many cognitive, emotional, behavioral, and cultural factors contributing to or exacerbating a sexual disorder? How many physicians, when prescribing, inquire of the patient (or their partner) if the patient’s goals for sexual activity are aligned with those of their partner? Physicians who prefer broader assessment find time limitations negating the potential for multilayered engagement. Finally, how many of us provide competent cultural awareness and sensitivity when evaluating and treating our patients? Telehealth is accelerating global access to patients, which creates an ever-increasing need for practitioner sensitivity to patient population differences. Many subscribe to a multidisciplinary model, whether working alone or in a team setting, but siloed thinking is still reinforced. There is increasing collegial respect, but perspectives remain separated. Therefore, it becomes incumbent upon all to mindfully seek continuing education opportunities (offered by our professional societies, etc.) to fill in the gaps we must recognize in our expertise. In applying our model, we must aspire to include recognition of all relevant factors, in effect leading to more comprehensive care while retaining the ease of use of the term “biopsychosocial.”

Objective
Given the biopsychosocial model’s importance to our field, we must periodically re-examine ways to optimize its strengths and minimize misapplication.

Methods
Expert opinion commentary.

Results
There are shortcomings in how clinicians apply the biopsychosocial model.

Conclusions
We must aspire to recognize and appreciate all relevant etiologic and treatment factors when applying our model, leading to more comprehensive care and greater patient and clinician satisfaction.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Palatin, Sprout, Pfizer, Roman, Mediflix, Kanna.