According to Engel, psychiatrists adopting a purely biomedical model would limit the field to behavioral disorders consequent to:

Dysfunctional upbringing

Brain dysfunction

Drug abuse

Chemical imbalance

In the example of insomnia treatment, the biological aspect may be treated with medications, the social part through understanding the effect of situations on sleepiness, and the psychological part through:

A new medication that "turns off the waking system"

Cognitive behavioral therapy

Using a sleep mask to reduce light exposure

Telling patients not to watch television when in bed

Cannon proposed the existence of homeostasis -- biochemical changes throughout the body that maintained internal integrity as a response to:

Anticipation

Thoughts and feelings

External changes

Psychiatric illness

The most significant barrier to change and adoption of the biopsychosocial model is that the medical establishment:

Does not believe in mental illness

Pursues and preserves social power

Hasn't changed since Hippocrates said "first do not harm"

Always puts the patient first

An example of a social factor that impedes the implementation of a treatment plan is:

Some patients cannot afford medications

Medications don't always work

Patients may live in housing with more than two generations

Patients may have more than one disease

Engel notes that implementation of a biopsychosocial model is hindered by:

Lack of interest among students and young physicians

The absence of a framework for teaching psychosocial medicine

Minimal impact of treatment of psychosocial factors

Psychosocial medicine is only useful in psychosomatic disorder

Rebecca Onie asks that we look at healthcare not as a way to treat disease but as a way to:

Provide food for the needy

Use medications wisely

Maintain an adequate workforce

Stay healthy