Person-centered care: a new perspective on health

Abstract

The guiding question of this abstract is: what exactly is person-centered practice? This terminology is becoming increasingly common in discussions about healthcare practice, yet its definition and origin remain somewhat unclear. Therefore, this study aims to investigate epistemologically and ontologically the "person-centered" approach and its implications for the future of healthcare in Brazil, supported by Lifestyle Medicine (LM). The chosen methodology was bibliographic research, selecting articles and books from various fields that share a humanistic perspective of person-centered care in healthcare. Understanding what it means to be “person-centered” is essential in LM practice, as LM values are fully aligned with this new paradigm, and knowing this concept is crucial to the pillar of connection—a central pillar for understanding the therapeutic relationship between healthcare professional and patient. The worldview and concept of person in person-centered approaches represent a return to Hippocrates, to medicine, to philosophy, and to psychology as inseparable fields. While psychology has a documented history of the Person-Centered Therapy (PCT) principle, a psychotherapeutic approach founded by Carl Rogers, it is not easy to find literature that clearly defines the principle of Person-Centered Medicine (PCM) and other person-centered health practices, such as person-centered coaching and the person-centered clinical method, among others. However, this lack of epistemological depth reflects a disconnect with the foundational philosophies of this line of thought, which in broad terms, points to a poor dialogue between medicine and the humanities. This disconnect between knowledge areas is a significant loss for healthcare. It is essential to revisit the importance of philosophy as a millennia-old tradition that pursues truth—a precursor to the positivist science that dictated the biomedical model dominant in recent centuries. PCT arises from strong influences from existentialism (19th century) and humanism, a philosophical and literary movement of the 14th and 15th centuries. Thus, discussing humanization of care from a humanistic perspective emphasizes valuing the person. For Rogers (1951), the complex relationship between therapist and client (as the patient is called) is the primary healing factor in psychotherapy: the patient becomes a client, moving from a passive position to the main agent of their own care. This perspective is shared by PCM, which semantically evolves from “patient-centered” to “person-centered” (Balint, 1984). According to the International College of Person-Centered Medicine, PCM shifts focus from the disease to the person—a fundamental concept to LM. Here, the pillar of connection takes on a holistic dimension, recognizing that relationships should be valued in various contexts, and the bond between healthcare professional and person is fundamental to a humanized practice. It is essential to explore the core characteristics of person-centered practice, which moves away from verticality in the relationship, suggesting a greater emphasis on active listening, empathy, understanding, and authenticity in the therapeutic relationship. It shifts focus from the disease to finding the person affected by the disease, aligning with the holistic view of the human being. In short, person-centered care recognizes the person as a unique individual, endowed with potential and the protagonist of their own story; in LM, this perspective also aligns with Martin Seligman's Positive Psychology. Finally, this "new" paradigm is not necessarily new—it is a revival of values central to the origins of medicine but forgotten in the wake of the Cartesian scientific method's evolution. Psychology has demonstrated that it is possible to explore the therapeutic relationship as a horizontal, compassionate, and above all, human relationship. Person-centered care is human-centered care; it is the connection with the other that enables behavior change, and the connection itself is a factor of protection and healing: this is the old-new paradigm in healthcare that Lifestyle Medicine seeks to restore.