PROJECT SERNARIO

ACME Development Corporation (ADC), a developer of custom homes and apartment complexes, has decided to standardize its project management practices and processes across its national organization. The goal is to standardize with one single project-scheduling tool and to have the tool installed and be operational within 90 days. To this end, the company is forming a central project management office (PMO). Until now, project managers (there are 40 presently on staff distributed all over the United States) have been able to use whatever scheduling tool they liked, within their budget constraints. They have also been able to buy equipment and engage contractors at will. The PMO will be determining one scheduling tool that all PMs will be expected to use, exclusive of any other scheduling tools. The PMO will also develop and implement a standardized procurement process. Because the PMs are located across the United States, a Web-based solution seems likely to be the most successful tool.

As the project manager, you have been charged with implementing the procurement process, and you decide that your first project will be purchasing the scheduling tool for ACME Development Corporation.

PMI is one of the world’s largest not-for-profit membership associations for the project management profession. Our professional resources and research empower more than 700,000 members, credential holders, and volunteers in nearly every country in the world to enhance their careers, improve their organizations’ success and further mature the profession.

PMI’s worldwide advocacy for project management is reinforced by our globally recognized standards and certification program, extensive academic and market research programs, chapters and communities of practice, and professional development opportunities.

Why do people become addicted to alcohol, tobacco and other drugs (ATOD)?

Write a definition of addiction/dependency:

Nature of addiction/dependency – etiology: what happens to a person who is addicted/dependent on ATOD (See also chapter 1 “Drug Dependence” and “Stages of Drug Dependence”; Chapter 2 “The vicious Cycle of Drug Addiction)

Bio-Psycho-Social Model: write your favorite explanations of why someone might become addicted to AOD, based on specific theories in each of the following categories

Biological causes/factors of addiction/dependency

Psychological causes/factors of addiction/dependency

Social causes/factors of addiction/dependency

The Biopsychosocial Approach

The biopsychosocial approach was developed at Rochester decades ago by Drs. George Engel and John Romano. While traditional biomedical models of clinical medicine focus on pathophysiology and other biological approaches to disease, the biopsychosocial approach in our training programs emphasize the importance of understanding human health and illness in their fullest contexts. The biopsychosocial approach systematically considers biological, psychological, and social factors and their complex interactions in understanding health, illness, and health care delivery.

Biosphere

Society/ Nation

Culture/Subculture

Community

Family

Individual

Nervous System

Organs

Tissues

Cells

Molecules

• Biological, psychological, and social factors exist along a continuum of natural systems, as depicted in the list here.

• Systematic consideration of psychological and social factors requires application of relevant social sciences, just as consideration of biological factors requires application of relevant natural sciences. Therefore, both the natural and social sciences are ‘basic’ to medical practice. In other words, psychological and social factors are not merely epiphenomena: they can be understood in scientific ways at their own levels as well as in regard to their biological correlates.

• Humanistic qualities are highly valued complements to the biopsychosocial approach, which involves the application of the scientific method to diverse biological, psychological, and social phenomena as related to human health.

• While the biomedical approach takes the reductionistic view that all phenomena are best understood at the lowest level of natural systems (e.g., cellular or molecular), the biopsychosocial approach recognizes that different clinical scenarios may be most usefully understood scientifically at several levels of the natural systems continuum.

To apply the biopsychosocial approach to clinical practice, the clinician should:

• Recognize that relationships are central to providing health care

• Use self-awareness as a diagnostic and therapeutic tool

• Elicit the patient’s history in the context of life circumstances

• Decide which aspects of biological, psychological, and social domains are most important to understanding and promoting the patient’s health

• Provide multidimensional treatment

The Biopsychosocial Approach

REFERENCES

Engel GL: The need for a new medical model: a challenge for biomedicine. Science 1977;196:129-136.

Engel GL: The clinical application of the biopsychosocial model. Am J Psychiatry 1980;137:535-544.

Frankel RM, Quill TE, McDaniel SH (Eds.): The Biopsychosocial Approach: Past, Present, Future.University of Rochester Press, Rochester, NY, 2003.

Borrell-Carrió F, Suchman AL, Epstein RM: The biopsychosocial model 25 years later: principles, practice, and scientific inquiry. Ann Fam Med 2004;2:576-582.

Cohen J, Brown Clark S: John Romano and George Engel: Their Lives and Work.University of Rochester Press, Rochester, NY, and Boydell and Brewer Limited, Suffolk UK, 2010.