Moving Beyond the Biopsychosocial Model in Clinical Social Work

The biopsychosocial model has long served as a foundational framework in clinical social work education and practice, often presented as a comprehensive and integrative approach to understanding mental illness. However, this paper argues that the model, while historically useful in resisting biomedical reductionism, has become conceptually incoherent and clinically misleading. By conflating etiology with treatment and encouraging unprincipled eclecticism, the biopsychosocial model undermines diagnostic clarity and therapeutic specificity. Two clinical examples illustrate how reliance on this framework can lead to ineffective or even harmful interventions. In its place, the paper advocates for methods-based pluralism, a model rooted in accurate diagnosis and treatment selection guided by the nature of the specific disorder. Drawing on the work of Jaspers, Havens, McHugh, Slavney, and Ghaemi, this paper outlines a disciplined alternative to the biopsychosocial model—one that avoids dogmatism without succumbing to conceptual chaos. Particular attention is given to the role of clinical social workers, who are often at the front lines of mental health care and must be equipped to make sound, theory-informed decisions. Methods-based pluralism is proposed as a more coherent, responsible, and sustainable framework for contemporary psychotherapeutic practice.