The University Record, May 21, 2001

Social Work partners with life sciences

By Suzan Alexander
School of Social Work

Although its research activities are more likely to employ pens than pipettes, to compare community demographics rather than biochemical reagents, or to analyze socioeconomic variables rather than the sequences of genes, the School of Social Work can play a vital role in the development of the University’s Life Sciences Initiative.

“Because the Initiative is not limited to cellular or molecular levels of discovery, but is about life and everything related to its study, Social Work represents as integral a partner as units working on DNA synthesis,” says Social Work Dean Paula Allen-Meares. “The consideration of ethics, the inclusion of disadvantaged populations in study groups and the recognition of socioeconomic barriers to new developments in health care are all key topics that can benefit from Social Work expertise and collaboration.”

The School, she says, is planning an ambitious program of investment for research and instructional activities to enhance and support the University’s Life Sciences Initiative. This will capitalize on the School’s leadership in the profession, distinguish the U-M’s Initiative through the inclusion of key social work contributions, and enhance the University’s goal of campuswide, diverse activities in this area, she adds.

According to Social Work Prof. Kristine Siefert, the School is one of only a few to receive funding from the National Institutes of Health to study the social aspects of health and disease.

“There is increasing evidence of the profound impact of our social environment on health and genetics, but this area has only begun to be studied,” she says. “No other schools have made this a central focus yet, so we are particularly well-positioned to play a leadership role in this area.”

The School of Social Work’s NIMH-funded Poverty Research Center is a prime example of such work, Siefert says. In collaboration with U-M colleagues in public health and other disciplines, the Center’s faculty are studying social factors that affect the prevalence of health and mental health problems, such as depression, hypertension, diabetes, infection, chronic inflammation, obesity and excessive production of stress hormones among African American and white low-income mothers.

Funded by the National Institute on Child Health and Development, this research examines the link between these problems and issues of unemployment, greater job turnover and welfare use. It also looks at whether family and community resources, as well as social programs and policies, reduce the consequences of stress and lessen the impact of physical health burdens on employment.

This research, Siefert says, will advance basic scientific knowledge of the relationship between the social environment and health, as well as have major implications for health and social policy.

The area of genetics research represents another particularly timely pathway for social work involvement in the Life Sciences Initiative. Deborah Wilkinson, assistant professor of social work, sees genetics and social work as a natural fit that has been neglected for far too long.

While genetic counselors and geneticists carry the bulk of the load in providing genetic information in terms of testing and explaining risks, they have neither the time nor the training to provide psychosocial services, says Wilkinson, whose mother, social work scholar Sylvia Schild, wrote the first article about the role of social workers and genetics in 1966.

“We can work as a team,” Wilkinson says. “This is a burgeoning field in which the social worker can meet some unmet needs. We can explain what the risks mean, help people to make decisions to change their lives and help protect people from potential bias.”

Wilkinson, who is developing a course on the practice, and the ethical, legal and social implications of genetics in social work, believes that such a partnership can have greater importance beyond counseling. It also can affect adoption policy and the use of genetic information in adoption procedures, access to testing services for underserved and disadvantaged populations, the use of genetic information in the school setting, and identification of gaps in genetic services, she says.

Another example of the School’s collaboration in genetics includes a large-scale project to develop evidence-based guidelines of psychosocial services for genetics counseling.

Social work-based research on long-term psychiatric disorders represents another opportunity for investment and collaboration within the Life Sciences Initiative. According to Social Work Prof. Carol Mowbray, genetic factors appear relevant to individuals’ predispositions to such disorders, but environmental factors are required for expression of the illness—and many socioeconomic factors may influence the course and success of treatments.

Although social workers represent the dominant professional service providers to individuals with serious mental illnesses, most definitive research has been conducted by psychiatrists and other behavioral scientists. As such, Mowbray says, there are some major limitations to interpretation and meaning of results, since the dependent and independent variables selected for study may not be the most reliable indicators of longer-term outcomes.

She believes that social work researchers can add expertise to developing and selecting more appropriate predictor variables, such as interpersonal and role functioning, especially in tandem with researchers from cognitive psychology.

“Sometimes researchers are too narrow in their approach,” Mowbray says. “They only look at symptoms, such as responses to perceptual and learning tasks. Having social workers be part of the initiative can help ensure that outcome variables are broader and more meaningful.”

She says that collaboration in this area can benefit social workers as well and that such shared research will result in findings that are more likely to be useful to society.

Mowbray and colleagues agree that social workers need to be well-informed in cognitive neuroscience, as it is increasingly applicable to populations served by social workers. As a result, the School of Social Work intends to update and enrich its master’s-level curriculum with new courses and new content in existing courses that focus on genetics and social work, cognitive neuroscience and other bio-psychosocial factors affecting professional practice.

Another development is the interest in offering a certificate program in genetics for social workers with the Medical Center’s Genetic Counseling Program. According to Allen-Meares, social workers are particularly well-suited to develop curriculum materials that can be used to educate other health and human service professionals about critical social and ethical issues raised by the integration of knowledge about genomics and gene-environment interactions.

Finally, the School hopes to establish an interdisciplinary training group to develop educational models for health professionals that would promote cultural competence in the development and implementation of genetic services and in the responsible use of genetic information. This effort eventually would expand to include educational interventions for professionals in non-clinical settings, such as the criminal justice system, the child welfare system, school systems and workplace settings.

At present, no institution of higher education investing in the life sciences has accompanied this commitment with collaborative links to social work, and none of these competing institutions have social work programs as highly ranked as U-M’s, Allen-Meares says.

“Investing in this unique opportunity will distinguish the University’s Life Sciences Initiative as a particularly bold and effective partnership between the basic sciences, social sciences and the helping professions,” she says. “It is a partnership in which the role of social work concerns, such as ethics and access to new therapies by underserved populations, will be an important one, and which will have the power to affect millions of lives.