Social isolation is both a social and public health problem that is lethal across the life span. Its harmful effects have both psychological and physiological impact and is recognized by social workers and allied health professionals as a major barrier to quality of life for individuals and groups. The effects of social isolation have been reported to be as harmful as smoking 15 cigarettes a day and four times as harmful as obesity. These facts have galvanized the social work profession around eradicating social isolation with a focus on defining social isolation and identifying its causes, strategies for eradication and prevention, and addressing the differences between perceived isolation (loneliness) and objective isolation. Additionally, social isolation is examined through a cultural lens using both micro- and macroperspectives giving attention to social exclusion as well as to groups who have higher risks such as older persons, at-risk youth, prisoners, stigmatized groups, and historically oppressed populations.
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Social Isolation
Sandra Edmonds Crewe and Robert Cosby
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The Life Model of Social Work Practice: A Macro View
Alex Gitterman and Carolyn Knight
From its earliest days and roots in the Settlement House and Charity Organization Society movements, the social work profession has debated whether its focus should be on social change in the pursuit of social justice or on treatment in pursuit of social functioning. The Life Model of social work practice integrates these two approaches to improving the lives and functioning of individuals, families, groups, and communities into a coherent whole. Professional skills and strategies of life-modeled social work practice empower clients to address life stressors and overcome traumatic experiences. Life-modeled social workers also develop the skills needed to influence organizations to be more responsive to clients’ needs, mobilize communities to engage in collective action, and advocate for legislative and regulatory policies that promote social justice.
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Conflict Theory for Macro Practice
Susan P. Robbins and George S. Leibowitz
Conflict theory encompasses several theories that share underlying assumptions about interlocking systems of oppression and how they are maintained. The relevance of Marx’s theory of class conflict, C. Wright Mills’s power elite, and pluralist interest group theory are all important to understand and address social and economic gaps and informing policy for macro practice.
Conflict theory can provide an understanding of health disparities, racial differences in mortality rates, class relationships associated with negative outcomes, poverty, discrimination in criminal justice, as well as numerous factors that are broadly associated with inequality embedded in social structures. Social workers play a significant role in addressing disparities in research, curricula, primary and secondary intervention, and public policy, and conflict theory can provide the framework necessary to enrich this understanding.
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Mental Health and Older Adults
Hee Yun Lee, William Hasenbein, and Priscilla Gibson
As the older adult population continues to grow at a rapid rate, with an estimated 2.1 billion older adults in 2050, social welfare researchers are determined to fill the shortage of gerontological social workers and structural lag to best serve the baby boomers who are expected to need different services than previous generations. Mental illness impacts over 20% of older adults in the world and the United States. The major mental health issues in older adults include depression, anxiety, loneliness, and social isolation. Depression is considered one of the most common mental health issues among this population; however, the prevalence could be underestimated due to older adults linking relevant symptoms to other causes, such as old age, instead of as possible depression. Like depression, anxiety symptoms are often mistaken as results of aging. It is also difficult for providers to diagnose anxiety in this population due to anxiety frequently being coupled with other illnesses and the psychological stress that comes with old age. Because the presence of loneliness or social isolation can manifest depression and anxiety symptoms in older adults, it is also difficult to separate these two issues. With the anticipated increase of the older adult population within the next few years, measurement tools have been created to assess depression and anxiety specifically for older adults. In addition to adapting assessment tools, interventions tailored to older adults are essential to ensure treatment coherence, even though medications are the go-to treatment option.
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Sustainability
Juliana Svistova, Loretta Pyles, and Arielle Dylan
As awareness has grown about the damage being done to the natural environment, limits of the earth’s finite resources, and the realities of climate change, environmental advocates have demanded sustainable development practices so that future generations will be able to meet their needs. Meanwhile, the widespread exploitation of workers in the industrial sector triggered the labor movement’s fight for social-economic justice. This focus on socio-economic justice that characterizes the labor movements is enlarged in the “sustainable development” framework which articulates triple bottom line practices that emphasize the interconnectedness of people, planet, and profit. The social work profession has joined these efforts, expanding its notion of the person-in-environment as it advocates for the needs of individuals, families, organizations, and communities. However, some scholars have problematized “sustainability,” questioning what exactly is being sustained, how sustainability is measured/evaluated, and who benefits.
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Neuroscience and Social Work
Holly Matto
Environmental conditions, interpersonal relationships, and adverse experiences affect developmental outcomes and human functioning. Their affect is perhaps no more clearly visible than when examined through a neuroscientific lens. Key focus is specifically on mind-body-environment transactions which can be beneficial or destructive; the neuroscience of adversity which can explain whether and why hardship will result in toxic stress;s, and the neuroscience behind behavior change which can help tailor strategic interventions.e. The brain’s lifelong capacity to change and grow gives relevance to the hard work of the social work profession, as our interventions can be understood as potential neurobiological turning points across the life course. As will be seen, neuroscience helps to explain many of the challenges social workers confront in their work with clients and client systems. Yet neuroscience can also serve as a guide to address these same challenges by directing targeted interventions. As more and more schools of social work incorporate neuroscience into their curricula and social work scholars write about how this science could inform social work practice, the social work professionwill become a central partner in interdisciplinary coalitions that use neuroscientific discoveries to inform programs and policies to advance optimal human functioning and wellbeing across all system levels.
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Autism Spectrum Disorder
Sandy Magaña and Lauren Bishop
Autism spectrum disorder is a heritable, developmental disability that is characterized by challenges with social communication and the presence of restrictive and/or repetitive patterns of behavior. Autism spectrum disorder affects development and quality of life from very early development through old age. Social workers play a number of different roles in supporting and advocating for individuals on the autism spectrum and their families. It is important that social workers understand the etiology, diagnosis and treatment of autism spectrum disorder, how it manifests throughout the lifespan, and challenges faced by families affected by ASD.
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Interpersonal Neurobiology and Attachment
Arlene Montgomery
The attachment phenomenon is increasingly the focus of many social work interventions. Biologically described, differentiated types of attachment relationships result from qualities of repetitive interpersonal brain-to-brain encounters with caregivers that affect variations in emotional/affective arousal regulation; this research takes place within the field of interpersonal neurobiology. The particular focus of this entry is implicit and explicit manifestations of certain structures and functions of the brain and nervous system critical to the bio-regulation of emotions. In-born emotional circuitry is sculpted by postnatal caregiving, resulting in a pattern of emotion regulation that leads to certain attachment types. Although there is no attachment circuit per se, emotional circuits in the low brain can work together with other parts of the brain to create various types of attachment. Neurobiological influences act on the development of attachment styles during childhood that may persist into adulthood are briefly reviewed. Attachment research and often subtle biological arousal considerations are also mentioned. Over the years since John Bowlby first began to contribute his work on attachment, research has highlighted, more and more, the various biological aspects. These include the profound biological significance of the circular relationship between separation, responses to separation, and resulting attachment templates. The roles in the attaching process of neuroception, mirror neurons, transfer of affect, and long-term potentiation are described. Selected treatment theories, primarily from the social work literature, are examined for their implicit focus on aspects of the neurobiology of attachment relationships.
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Sexual Orientation
William J. Hall
Sexual orientation is a multidimensional phenomenon involving a person’s sexual attraction, sexual behavior, and sexual orientation identity. Sexual orientation patterns may remain consistent or fluctuate over time. Although heterosexual attractions, behaviors, and identities appear to be the dominant manifestations of sexual orientation, other sexual expressions exist. The causes of sexual orientation are still not completely understood; however, evidence suggests that biological factors play a strong role. Sexual development is an important part of human development, and there are parallel and differing developmental tasks and trajectories for those who are heterosexual and those who are queer. Non-heterosexual sexualities are often stigmatized, which contributes to homophobia and heterosexism. There is a continuing history in the mental health professions of efforts to change the sexual orientation of people who are queer, despite evidence of harm and ethical mandates. Researchers and service providers should assess sexual orientation because it is one of many important characteristics in the lives of individuals.
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Social Work and Coercion
Tomi Gomory and Daniel Dunleavy
Social work is perhaps most distinctive for its clear and outspoken commitment toward improving the well-being of society’s vulnerable and disadvantaged groups, while still emphasizing the importance of respecting and defending personal rights and freedoms. Though there is a fundamental necessity for coercion, or its threat, for eliciting civil social behavior in a well-functioning society, it is professionally and ethically imperative that social workers make explicit our rationales for, justifications of, and the evidence used to support or reject coercive practices in our work. Social work’s engagement with coercion inevitably entails the ethical and social policy arguments for and against its use, as shown in a review of the empirical evidence regarding its impact on the professions’ clients, exemplified by three domains: (1) child welfare, (2) mental health, and (3) addictions. Recommendations for future improvements involve balancing the potential for harm against the benefits of coercive actions.
