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Critical Clinical Social Work Practice: Pathways to Healing from the Molecular to the Macro

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Abstract

Interdisciplinary study in neurobiology, liberation psychology, and social work highlight the ways in which the brain is related to various cognitive, personality, and behavioral characteristics within a cultural context by blurring lines between dimensions, such as nature and nurture, person and environment, and micro and macro. This paper considers study findings that generate potential clinical social work strategies that are particularly relevant for communities of color experiencing ethno-racial trauma. The purpose of this paper is to support clinical practitioners’ efforts to use holistic approaches and practices by incorporating the “bio” component of the biopsychosocial paradigm as it relates to racism. There are at least three pathways by which racism may produce neurobiological consequences that affect the biopsychosocial functioning of populations of color: (a) socio-structural/environmental, (b) stress and/or trauma, and (c) epigenetics. The Flint, Michigan water crisis—wherein the local government allowed lead to contaminate the city’s drinking water causing negative health (brain and body) consequences for Flint residents, a predominantly Black and Brown community—presents an example of the intersecting pathways and autopoietic nature of racism that infects relationships, institutions and systems; causes dehumanizing affects; and produces ill effects as evidenced by racial health inequities. The issues, such as racial health inequities, that social workers struggle to resolve tend to be complex and multi-dimensional. Therefore, comprehensive practice is needed to support healthy biopsychosocial functioning. As such, this paper offers Critical Clinical Social Work Practice (CCSWP) informed by the Critical Transformative Potential Development (CTPD) framework. CTPD centers a trauma-informed and healing-centered approach to CCSWP by transforming consciousness into action to change self, relationships, and environment; ideally, working cyclically from the molecular to the macro. Given the field’s enduring commitment to social justice, the biopsychosocial model, and the person-in-environment perspective, social work is in a unique position to critically consider how brain health (bio) is affected by trauma (psycho) stemming from racism (social). These multi-level (molecular to macro) considerations empower clinical social workers to innovate integrated strategies that can overcome complex challenges perpetuating racial health inequities.

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Jemal, A. Critical Clinical Social Work Practice: Pathways to Healing from the Molecular to the Macro. Clin Soc Work J (2022). https://doi.org/10.1007/s10615-022-00843-1

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