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Transforming disability assessment in Albania: progress and challenges of the biopsychosocial modelSocial Sciences in Health - Review article

Xhulia Musta1, Rudina Rama1, *, Edita Fino ORCID...2
1 University of Tirana, Faculty of Social Sciences, Tirana, Albania
2 University of Bologna, Alma Mater Studiorum, Bologna, Italy

Introduction: Disability assessment in Albania has traditionally relied on a medical model that conceptualises disability as a personal deficit arising from individual impairment. This model has been widely criticised for its stigmatising nature, inefficiency, and limited capacity to improve quality of life for persons with disabilities (PwDs). In 2019, Albania initiated a policy shift towards the biopsychosocial model, which recognises disability as the outcome of complex interactions among biological, social, and psychological factors.

Aim: This article reviews the progress of the biopsychosocial model's implementation in Albania since its inception, with particular emphasis on structural barriers and facilitating factors.

Methods: A literature review approach was adopted to synthesise legislative, administrative, and academic evidence on the biopsychosocial model's implementation in Albania between 2017 and May 2025.

Results: 37 multidisciplinary assessment teams have been established to provide services to PwDs. Financial assistance mechanisms have been operationalised with some success; however, the integration of health and social services remains a critical challenge. Key issues include limited services availability and the lack of a coherent referral system to connect individuals with available services. These shortcomings significantly limit the model's potential to enhance the well-being of PwDs.

Conclusion: This policy shift underscores the need for a multidisciplinary and holistic approach that enables context-sensitive assessments of individuals' needs. The article concludes with evidence-based recommendations to address these gaps, calling for a coordinated, multi-sectoral strategy aligned with the biopsychosocial framework to strengthen disability assessment and service delivery in Albania.

Keywords: Biopsychosocial model; Disability assessment; ICF; Integrated healthcare and social services; Multidisciplinary teams
Conflicts of interest:

The authors have no conflict of interest to declare.

Received: June 3, 2025; Revised: October 12, 2025; Accepted: January 26, 2026; Prepublished online: January 27, 2026 

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References

  1. Adam S, Koutsoklenis A (2023). Who needs the social model of disability? Front Sociol 8: 1305301. DOI: 10.3389/fsoc.2023.1305301. Go to original source... Go to PubMed...
  2. Alehagen L, Bölte S, Black MH (2025). Application of the International Classification of Functioning, Disability, and Health in autism and attention-deficit hyperactivity disorder: A scoping review. Autism 29(2): 310-328. DOI: 10.1177/13623613241272044. Go to original source... Go to PubMed...
  3. ASET (2024). Udhėzues pėr vlerėsimin bio-psiko-social tė fėmijėve me aftėsi tė kufizuara. Intervistimi i fėmijėve dhe mbėshtetja e prindėrve dhe kujdestarėve ligjorė tė tyre. Tiranė. [online] [cit. 2025-01-22]. Available from: https://asetcenter.al/wp-content/uploads/2025/05/UDHEZUES-PER-VLERESIMIN-BIO-PSIKO-SOCIAL-TE-FEMIJEVE-ME-AFTESI-TE-KUFIZUARA.pdf
  4. Ashcroft R, Sheffield P, Adamson K, Phelps F, Webber G, Walsh B, et al. (2024). Scoping review of social workers' professional roles in primary care. BMJ Open 14(12): e090527. DOI: 10.1136/bmjopen-2024-090527. Go to original source... Go to PubMed...
  5. Australian Interest Group (2022). The ICF and its potential uses in the National Disability Insurance Scheme (NDIS). A technical paper of the International Classification of Functioning, Disability and Health. University of Melbourne. [online] [cit. 2025-01-22]. Available from: https://disability.unimelb.edu.au/__data/assets/pdf_file/0005/4817651/ICF-and-potential-uses-for-the-NDIS-FINAL87.pdf
  6. Azhar H, Maqbool S, Ullah E, Khan T (2019). Use of ICF-CY in assessing level of knowledge of different professionals working with children having cerebral palsy. Pak Armed Forces Med J 69(5): 1035-1040.
  7. Beck M (2024). Empowering Vulnerabiliy: The Social Model of Disability and Digital Government. Technology and Regulation. 273-290. DOI: 10.71265/mkh2tx21. Go to original source...
  8. Bolton D (2023). A revitalized biopsychosocial model: core theory, research paradigms, and clinical implications. Psychol Med 53(16): 7504-7511. DOI: 10.1017/S0033291723002660. Go to original source... Go to PubMed...
  9. Brinkman AH, Rea-Sandin G, Lund EM, Fitzpatrick OM, Gusman MS, Boness CL (2023). Shifting the discourse on disability: Moving to an inclusive, intersectional focus. Am J Orthopsychiatry 93(1): 50-62. DOI: 10.1037/ort0000653. Go to original source... Go to PubMed...
  10. Clanchy KM, Baque E, Headrick J, Irvine-Brown L, Sulek R (2022). Thinking beyond impairment: Recommendations from contemporary models of care for working with children and disability. Aust J Gen Pract 51(5). DOI: 10.31128/AJGP-03-21-5898. Go to original source... Go to PubMed...
  11. Costantino C, Campbell P, Simpson S (2022). Stuttering and the social model. J Commun Disord 96: 106200. DOI: 10.1016/j.jcomdis.2022.106200. Go to original source... Go to PubMed...
  12. Damyanov K (2024). International Classification of Functioning, Disability, and Health for Children and Youth (ICF-CY) as a framework for Early Intervention Planning in Inclusive Education. Open J Soc Sci 12: 85-98. DOI: 10.4236/jss.2024.1211006. Go to original source...
  13. Dan B (2021). The metaphysical model of disability: Is this a just world? Dev Med Child Neurol 63(3): 240. DOI: 10.1111/dmcn.14775. Go to original source... Go to PubMed...
  14. Dan B (2024). The ICF as a socio-psycho-biological model for the full participation of disabled individuals. Dev Med Child Neurol 66(11): 1398-1399. DOI: 10.1111/dmcn.16044. Go to original source... Go to PubMed...
  15. Davies N, Soni A (2025). Reflecting on the models of disability utilised in schools. Support for Learning 40(2): 233-241. DOI: 10.1111/1467-9604.70002. Go to original source...
  16. Engel GL (1977). The need for a new medical model: A challenge for biomedicine. Science 196(4286): 129-136. DOI: 10.1126/science.847460. Go to original source... Go to PubMed...
  17. Forde S, Herner LB, Helland IB, Diseth TH (2022). The biopsychosocial model in paediatric clinical practice: An interdisciplinary approach to somatic symptom disorders. Acta Paediatr 111(11): 2115-2124. DOI: 10.1111/apa.16517. Go to original source... Go to PubMed...
  18. Hartley SD (2011). World Report on Disability (WHO). DOI: 10.13140/RG.2.1.4993.8644. [online] [cit. 2025-01-22]. Available from: https://www.researchgate.net/publication/282877201 Go to original source...
  19. Hassan SM, Khalid A, Arshad M, Qursam S (2020). Social inclusion of disabled persons: Role of a professional social worker in Pakistan. J Account Financ Emerg Econ 6(2): 643-649. DOI: 10.26710/jafee.v6i2.1331. Go to original source...
  20. Hebbeler K, Spiker D (2016). Supporting young children with disabilities. Future Child 26(2): 185-205. Go to original source...
  21. Hiragami F, Macdonald CA (2025). The biopsychosocial model in rehabilitation medicine and the contribution of Cultural Historical Activity Theory. Open J Soc Sci 13(6): 315-347. DOI: 10.4236/jss.2025.136022. Go to original source...
  22. ILO (2021). Review of social protection system in Albania: coverage, expenditure, adequacy and financing. ILO DWT/CO-Budapest. [online] [cit. 2025-01-22]. Available from: https://www.ilo.org/sites/default/files/wcmsp5/groups/public/@europe/@ro-geneva/@sro-budapest/documents/publication/wcms_798635.pdf
  23. INSTAT (2024). Censusi i popullsisė dhe banesave nė Shqipėri 2023: Rezultatet kryesore. Tiranė. [online] [cit. 2025-01-22]. Available from: https://www.instat.gov.al/media/13615/cens-i-popullsise-2023.pdf
  24. Jafri SK, De Camargo OK (2020). Knowledge and use of the International Classification of Functioning, Disability and Health (ICF) among health professionals in a developing country. Pak J Neurol Sci 15(2): 23-25.
  25. K.M. (2019). VKM nr. 722, datė 11.11.2019 "Pėr pėrcaktimin e masės, tė kritereve, procedurave dhe dokumentacionit pėr vlerėsimin dhe pėrfitimin e aftėsisė sė kufizuar e tė ndihmėsit personal dhe tė strukturave pėrgjegjėse e tė detyrave tė tyre." [online] [cit. 2025-01-22]. Available from: https://www.sherbimisocial.gov.al/wp-content/uploads/2025/01/Vendim-Nr.-722-date-11.11.2019-Per-percaktimin-e-mases-te-kritereve-procedurave-dhe-dokumentacionit-per-vlere.pdf
  26. K.M. (2020). VKM nr. 182, datė 26.02.2020 "Pėr pėrcaktimin e masės, tė kritereve, procedurave e dokumentacionit pėr vlerėsimin dhe pėrfitimin e pagesės pėr personat me aftėsi tė kufizuara, si dhe tė ndihmėsit personal." [online] [cit. 2025-01-22]. Available from: https://www.sherbimisocial.gov.al/wp-content/uploads/2025/01/Vendim-Nr.-182-date-26.2.2020-Per-percaktimin-e-mases-te-kritereve-procedurave-e-dokumentacionit-per-vleresim.pdf
  27. K.M. (2022). VKM nr. 77, datė 02.02.2022 "Pėr disa shtesa dhe ndryshime nė VKM nr. 722, datė 11.11.2019 'Pėr pėrcaktimin e masės, tė kritereve, procedurave dhe dokumentacionit pėr vlerėsimin dhe pėrfitimin e aftėsisė sė kufizuar e tė ndihmėsit personal dhe tė strukturave pėrgjegjėse e tė detyrave tė tyre'". [online] [cit. 2025-01-22]. Available from: https://qbz.gov.al/eli/vendim/2022/02/02/77/236af7ef-99a7-4a92-af22-c2e0dee2e716;q=vkm%20nr.%2077,%20date%202.2.2022
  28. Kasongo BM, Molima CEN, Mparanyi GJ, Makali SL, Mwene-Batu PL, Tambwe AM, et al. (2024). Patient involvement in the biopsychosocial model of care integrated with primary health services: Experience from three health districts in South Kivu, Democratic Republic of Congo. medRxiv DOI: 10.1101/2024.09.05.24313096. Go to original source...
  29. Kim HJ, Choi B, Choi E, Kim H, Jang SN, Lim JY, et al. (2025). Use of the International Classification of Functioning, Disability and Health (ICF) in integrated care for people with disabilities: A scoping review using the SELFIE framework. Disabil Health J 18(4): 101854. DOI: 10.1016/j.dhjo.2025.101854. Go to original source... Go to PubMed...
  30. Liu J, Yu H, Cheung WC, Bleakney A, Jan YK (2025). Societal attitudes and structural barriers in coaching para-athletes: A mixed-methods systematic review. PLoS One 20(6): e0326585. DOI: 10.1371/journal.pone.0326585. Go to original source... Go to PubMed...
  31. Lutte I, Schneider M, Kapita A, Gille A, Staquet P, Tomberg C (2024). Impact of the biopsychosocial model of disability on the medicolegal assessment of personal injury. Arch Public Health 82(1): 248. DOI: 10.1186/s13690-024-01471-6. Go to original source... Go to PubMed...
  32. Marotta N, Ammendolia A, Marinaro C, Demeco A, Moggio L, Costantino C (2020). International Classification of Functioning, Disability and Health (ICF) and correlationbetween disability and financial assets in chronic stroke patients. Acta Biomed 91(3): e2020064. DOI: 10.23750/abm.v91i3.8968. Go to original source... Go to PubMed...
  33. MSHMS (2019). Reforma e vlerėsimit tė aftėsisė sė kufizuar. Tiranė. [online] [cit. 2025-01-22]. Available from: https://view.officeapps.live.com/op/view.aspx?src=https%3A%2F%2Fwww.sherbimisocial.gov.al%2Fwp-content%2Fuploads%2F2025%2F06%2FDOKUMENTI-I-POLITIKAVE-PER-REFORMEN-E-AFTESISE-SE-KUFIZUAR.docx&wdOrigin=BROWSELINK
  34. Murniati N, Al Aufa B, Kusuma D, Kamso S (2022). A scoping review on biopsychosocial predictors of mental health among older adults. Int J Environ Res Public Health 19(17): 10909. DOI: 10.3390/ijerph191710909. Go to original source... Go to PubMed...
  35. Observatori pėr tė Drejtat e Fėmijėve dhe tė Rinjve (2021). Mekanizmi i ankimimit pėr PAK. Tiranė. [online] [cit. 2025-01-22]. Available from: https://view.officeapps.live.com/op/view.aspx?src=https%3A%2F%2Fwww.sherbimisocial.gov.al%2Fwp-content%2Fuploads%2F2025%2F01%2FMekanizmi-i-ankimimit-te-aftesise-se-kufizuar.docx&wdOrigin=BROWSELINK
  36. Oliver M (1990). The individual and social models of disability. Paper presented at Joint Workshop of the Living Options Group and the Research Unit of the Royal College of Physicians. [online] [cit. 2025-01-22]. Available from: https://disability-studies.leeds.ac.uk/wp-content/uploads/sites/40/library/Oliver-in-soc-dis.pdf
  37. Otte T, Decuman S, Gelade W, Duyver C (2023). Perceptions of medical advisers on ICF core sets' use for evaluating work incapacity related to back pain in French-speaking Belgium. Work 74(4): 1401-1418. DOI: 10.3233/WOR-210247. Go to original source... Go to PubMed...
  38. Ramachandran R, Das H (Eds) (2024). Best practices in social work - disability rehabilitation. National Institute for Empowerment of Persons with Multiple Disabilities (Divyangjan). [online] [cit. 2025-01-22]. Available from: https://cdnbbsr.s3waas.gov.in/s33837a451cd0abc5ce4069304c5442c87/uploads/2024/09/20240924248659875.pdf
  39. Robertson ZS, Jaswal VK (2024). Barriers to inclusion: Incorporating the social model in the study of children's understanding of disability. Cognitive Development 70: 101435. DOI: 10.1016/j.cogdev.2024.101435. Go to original source...
  40. Saleeby PW (2025). Using the International Classification of Functioning, Disability and Health (ICF) to improve understanding of disability and functioning. Rev Disab Stud 11(4): 1-9.
  41. Seyed Alitabar SH (2025). The biopsychosocial model in modern healthcare: Overcoming barriers to holistic patient care. Int J Body Mind Cult 12(2): 1-4. DOI: 10.61838/ijbmc.v12i2.950. Go to original source...
  42. SHSSH (2021). Analiza Vjetore 2020. Tiranė. [online] [cit. 2025-01-22]. Available from: https://www.sherbimisocial.gov.al/wp-content/uploads/2025/10/ANALIZA-VJETORE-2021.pdf
  43. SHSSH (2022). Analiza vjetore 2021. Tiranė. . [online] [cit. 2025-01-22]. Available from: https://www.sherbimisocial.gov.al/wp-content/uploads/2025/10/ANALIZA-VJETORE-2021.pdf
  44. SHSSH (2023). Analiza vjetore 2022. Tiranė. [online] [cit. 2025-01-22]. Available from: https://www.sherbimisocial.gov.al/wp-content/uploads/2025/10/ANALIZA-VJETORE-2022.pdf
  45. SHSSH (2024). Analiza vjetore 2023. Tiranė. [online] [cit. 2025-01-22]. Available from: https://www.sherbimisocial.gov.al/wp-content/uploads/2025/10/ANALIZA-VJETORE-2023.pdf
  46. SHSSH (2025a). Statistika pėrfitues PAK 2014-2025. Tiranė. [online] [cit. 2025-01-22]. Available from: https://www.sherbimisocial.gov.al/statistika-pak/
  47. SHSSH (2025b). Analiza vjetore 2024. Tiranė. [online] [cit. 2025-01-22]. Available from: https://www.sherbimisocial.gov.al/wp-content/uploads/2025/10/ANALIZA-VJETORE-2024.pdf
  48. SHSSH (2025c). Harta e Shėrbimeve Sociale. Tiranė. [online] [cit. 2025-01-22]. Available from: https://www.sherbimisocial.gov.al/wp-content/uploads/2025/10/hartezimi_2025.pdf
  49. Slorach R (2024). 40 Years of the Social Model of Disability: How Relevant Is It Today? Imperial College London. [online] [cit. 2025-01-22]. Available from: https://nadp-uk.org/wp-
  50. content/uploads/2024/06/1.-R.-Slorach-40-Years-of-the-Social-Model-of-Disability-How-Relevant-Is-It-Today.pdf
  51. Sulaiman SK, Mohammad AH, Ibrahim AA, Abdu SI, Kaka B (2021). Revisiting the International Classification of Functioning, Disability and Health, a comprehensive model for exploring disablement in low- and middle-income countries: a narrative overview. Iran Rehabil J 19(3): 261-272. DOI: 10.32598/irj.19.3.1362.1. Go to original source...
  52. Syed S, Syed S, Bhardwaj K (2020). The role of the bio-psychosocial model in public health. J Med Res 6(5): 252-254. Go to original source...
  53. Sykes CR, Maribo T, Stallinga HA, Heerkens Y (2021). Remodeling of the ICF: a commentary. Disab Health J 14(1): 100978. DOI: 10.1016/j.dhjo.2020.100978. Go to original source... Go to PubMed...
  54. Taukeni SG (2019). Introductory chapter: biopsychosocial model of health. Psychology and Psychiatry 4(1). DOI: 10.5772/intechopen.85024. Go to original source...
  55. Tedeschi MN, Limeri LB (2024). Models of disability as research frameworks in biology education research. CBE Life Sci Educ 23(3): ar8. DOI: 10.1187/cbe.24-01-0026. Go to original source... Go to PubMed...
  56. UN (2006). Convention on the Rights of Persons with Disabilities. New York. [online] [cit. 2025-01-22]. Available from: https://chr-observatories.uwazi.io/en/
  57. Smart KM (2023). The biopsychosocial model of pain in physiotherapy: past, present and future. Phys Ther Rev 28(2): 61-70. DOI: 10.1080/10833196.2023.2177792. Go to original source...
  58. entity/qp2w3yhy39/text-search?gad_source=1&gad_campaignid=20825787022&gclid=EAIaIQobChMI_KGilon8kQMV_YeDBx15SgXdEAAYASAAEgIKlPD_BwE
  59. Waddington L, Priestley M (2021). A human rights approach to disability assessment. J Int Comp Soc Policy 37(1): 1-15. DOI: 10.1017/ics.2020.21. Go to original source...
  60. WHO (2001). International Classification of Functioning, Disability and Health: ICF. Geneva: WHO. [online] [cit. 2025-01-22]. Available from: https://psychiatr.ru/download/1313?view=name=CF_18.pdf
  61. WHO (2007). International Classification of Functioning, Disability and Health for Children and Adolescents. Geneva: WHO. [online] [cit. 2025-01-22]. Available from: https://iris.who.int/server/api/core/bitstreams/81e04699-2930-4da2-ac97-76725c7dcc07/content

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