The Common-Sense Model of Illness Self-Regulation

The Common-Sense Model of Illness Self-Regulation

One of the greatest difficulties in providing a therapeutic service is delivering that service in a way that is understandable and engaging. I have long felt that the need to tailor therapeutic interventions to individual’s needs is essential. However, this can then cause large deviations from the norm that brings into question the validity of such interventions. When thinking about how best to deliver a specific intervention to a person it’s important to consider how they interpret their current circumstances

The Common Sense Model (CSM) of illness self-regulation (Leventhal, Meyer, & Nerenz, 1980; Leventhal, Nerenz, & Steele, 1984) suggests that beliefs about illness have five core dimensions: cause; identity; perceived control; severity of illness consequences; and time line. Subsequent research has added further dimensions including illness coherence - a belief that the illness 'makes sense' - to this core set of illness beliefs (Moss-Morris, et al., 2002). The CSM predicts that illness perceptions (e.g., perceived control of diabetes, or severity of illness consequences) will influence emotional outcomes such as illness-related distress (Hagger & Orbell, 2003)

Leventhal, Phillips & Burns (2016) recently reviewed research on the CSM. They described the CSM as provides a conceptual framework for examining the perceptual, behavioural and cognitive processes involved in individuals’ self-management of ongoing and future health threats. The CSM describes a dynamic, multi-level process that generates individuals’ representations of threats to health, procedures for management, and a system for creating action-plans and implementing action. The process is often initiated by somatic sensations and deviations from normal function (e.g., symptoms, falls), as well as by observation and discussions of illness in others (including medical diagnoses), and on occasion from mass media and other environmental cues. These stimuli activate prototypes, or memory structures of the individual’s normal functioning self, past experiences of illnesses, and treatments and lifestyle activities; and they generate mental representations of illness threats (i.e., beliefs regarding illness identity, cause, control, consequences, and duration/timeline beliefs), possible treatments, and action plans.

The CSM provides a helpful framework for clinicians, patients and families. It provides understanding of the interplay of factors that contributes to an individuals response to an illness or disorder. The use of the CSM during case formulation could contribute to and increase in compliance, recovery and relapse prevention.

 

References

Hagger, M. S., & Orbell, S. (2003). A meta-analytic review of the Commonsense Model of illness representations. Psychology and Health, 18(2), 141-184.

Leventhal, H., Phillips, L. A., & Burns, E. (2016). The common-sense model of self-regulation (CSM): A dynamic framework for understanding illness self-management. Journal of Behavioral Medicine, 39(6), 935-946. http://dx.doi.org/10.1007/s10865-016-9782-2

Leventhal, H., Meyer, D., & Nerenz, D. (1980). The common sense representation of illness danger. In S. Rachman (Ed.), Contributions to medical psychology (Vol. 2, pp. 7-30). Oxford, UK: Pergamon Press.

Leventhal, H., Nerenz, D. R., & Steele, D. J. (1984). Illness representations and coping with health threats. In A. Baum, S. E. Taylor & J. E. Singer (Eds.), Handbook of psychology and health (Vol. IV Social psychological aspects of health, pp. 219- 252). Hillsdale, NJ: Lawrence Erlbaum.

Moss-Morris, R., Weinman, J., Petrie, K. J., Horne, R., Cameron, L. D., & Buick, D. (2002). The revised Illness Perception Questionnaire (IPQ-R). Psychology and Health, 17(1), 1-16.