Mind Body Connection: The Brain and Social Work

A Brief Examination of the Intersection of Neuroscience and Social Work: Implications for Individual and Macro Level Social Work Practice

            The practice of social work requires an understanding of human behavior. Humans exhibit an immense range of behaviors in their interactions with other people and their various environments. One common factor in the diverse landscape of human behavior is that human behavior is dependent upon the functions of the brain. Without the brain, human behavior cannot occur. How can understanding the brain and its relationship to human behavior help social workers? The key to answering this question lies in the field of neuroscience.

            According to Dictionary.com (n.d.), neuroscience is “the field of study encompassing the various scientific disciplines dealing with the structure, development, function, chemistry, pharmacology, and pathology of the nervous system.” This paper will examine how an increased understanding of neuroscience can enhance social workers’ abilities to serve the populations they work with on both micro and macro levels.

Neuroscience and the Mind-Body Connection

            As a practitioner with an interdisciplinary background, spanning the fields of business, biology. healthcare, and public health, I have always been fascinated by the intricate relationship between the brain and human behavior. The brain is a miraculous and incredible organ. Despite decades of collective human brainpower dedicated to finding the complete picture, a full understanding of the brain escapes humankind. One thing that is known is that human behavior and psychological processes depend on the intricate function of the brain. This paper will explore how an increased understanding of neuroscience both reveals the connection between brain activity and human behavior and can augment social workers’ capacity to meet the needs of the clients they serve.

In this section I will discuss physiological aspects of a few key anatomical structures of the brain. Understanding the neuroscience of these brain regions can help social workers to better conceptualize the connections between the biological basis of neurological function and cognition, emotion, and behavior—a perspective essential in understanding the mind-body connection. 

Trauma

Dr. Bessel Van Der Kolk is an expert in trauma with three decades of experience in working with survivors of severe trauma in both medical/biological and psychological clinical applications (Van Der Kolk, 2015). His work reveals how the structure and function of the brain is changed by trauma, thereby facilitating a person’s ability to survive trauma but then also resulting in the survivor operating from a brain that has been radically changed (Van Der Kolk, 2015). His work is especially significant for social workers dealing with individuals in various states of distress, ranging from acute crisis to chronic conditions like posttraumatic stress disorder (PTSD) to unresolved early childhood wounds. By understanding how the brain is affected by trauma, social workers can provide a more supportive milieu for clients struggling to understand their own responses to trauma.

Brain Stem

            The brain stem is responsible for maintaining homeostasis; it does this by regulating essential body functions, such as heartbeat, respirations, temperature regulation, elimination of urine and feces, and together with the hypothalamus, it regulates the immune system, appetite, sleep, energy levels, digestion, and arousal (Van Der Kolk, 2015). It is also important to note that the autonomic nervous system interacts and runs through the anatomical region of the hypothalamus and brain stem (Higgins, 2018). By considering the vast array of functions that the brain stem and hypothalamus control, and that the autonomic nervous system runs through this region, one can see how the fight or flight mechanism (especially if it does not turn off and return to a calm state) can significantly impact a client’s body on many levels. This critical influence of the brain on the body can exert influence on behavior, i.e.: disturbed eating, sleeping, or relational patterns.

Limbic System

The limbic system is a part of the brain that is involved in emotion and monitoring the environment for danger (Van Der Kolk, 2015.) There is a trend to move away from the term limbic system and discuss the structures that comprise the limbic system: hippocampus, the amygdala, and the cingulate gyrus individually (Higgins, 2018). The cingulate gyrus functions to maintain self-awareness. The hippocampus is a unique area of the brain in that new nerve cells can grow here even in adults; this area is involved in the development of memories (Higgins, 2018). The hippocampus is known to be associated with PTSD, Alzheimer's disease, and major depression (Higgins, 2018).

Amygdala

Van Der Kolk (2015) calls the amygdala the smoke detector of the brain, meaning that it automatically, without any thinking required, detects danger and alerts the body to take action for survival. Anyone who has ever been suddenly frightened and reacted by taking a gasp of air, clutching their chest, and feeling their heart pounding or their stomach “drop,” has experienced the physical effects of the brain stem, hypothalamus, and the limbic system (specifically the amygdala) responding to stressful stimuli. Interestingly, the olfactory centers are directly wired to the amygdala which may explain why certain smells can trigger the recall of specific memories. Fortunately, in addition to the automatic alarm of the amygdala, there is another part of the brain created to turn off the alarm, this is the medial prefrontal cortex.

Prefrontal Cortex

The prefrontal cortex (PFC) has four areas that are often mentioned in scientific literature pertaining to human behavior, these are the lateral, orbital, and medial PFC as well as the cingulate gyrus (Higgins, 2018). (Notice that the cingulate gyrus is mentioned as part of both the PFC and the limbic system; this is because the brain is one organ made up of overlapping and intertwined functional areas that are not always distinct and separate anatomical structures.)

The PFC is integral to a myriad of human behaviors; verbal expression of language (a specific area of the PFC called Broca’s area), taste, food cravings, smell, memory, learning, temporal ordering of events, simulation, reality monitoring, attention, orientation, changing behavior according to task demands, future predictions, conceptualization of finance, encoding and retrieving information, attitude, spatial reasoning process, conceptual reasoning process, planning, bimanual coordination, body arousal, self-initiated movements, conflict resolution, pain perception, decision making, metacognition, ability to anticipate outcomes, social and emotional behavior, emotional processing, visual search and gaze function, and executive functions such as higher level thought and intelligence (Siddiqui et al., 2008). Depression, anxiety, schizophrenia, attention deficit hyperactivity disorder, and disorders of violence and anger are associated with the PFC (Higgins, 2018).

Van der Kolk calls the medial PFC “the watchtower,” by this he means this part of the brain works with the smoke detector (amygdala) to analyze data about threats (Van Der Kolk, 2015). For example, if one were startled by something (a response of the amygdala), the medial PFC would then allow one to pause, think about what is occurring and decide if one should continue with the emergency response or return to a normal response because it was a false alarm. For people with PTSD, the amygdala and medial PFC have been impacted by trauma in that they are no longer working as if in a homeostatic state, but as if in a constant state of crisis (Van Der Kolk, 2015). This can result in an exaggerated or hypersensitive startle response, becoming easily enraged, misinterpreting cues from the environment (including facial expressions of others), as threatening, or freeze at being touched by another person (Van Der Kolk, 2015).

Insula

            The insula is located deep within the folds of the PFC underneath the cingulate gyrus, it has been shown to be involved in schizophrenia, bipolar disorder, major depression, substance abuse disorder, obsessive compulsive disorder, and anxiety disorders (Higgins, 2018). The insula relays messages from the visceral organs to the brain’s emotional centers; it contributes to our sense of physical self-sensing and body awareness (Van Der Kolk, 2015). fMRI research showed that the self-sensing parts of the brain in a group of patients with chronic PTSD were not active at all as compared to the brains of the control group who did not have PTSD (Van Der Kolk, 2015). This study showed that when asked to lie in an MRI machine and think about nothing in particular, the brains of non-traumatized people began to monitor the body and focus on self-sensing. You may have noticed this if you have ever tried meditating and then suddenly noticed that your feet are really cold or that the chair you are sitting in is actually uncomfortable, this would be an example of your brain’s insula and other self-sensing parts working as they should. In traumatized people, this system is impaired (Van Der Kolk, 2015). Social workers may see this in clients who state not feeling present in their bodies or report a lack of awareness of bodily sensation such as pain or pleasure.

Blood Brain Barrier

            An understanding of the concept of the blood brain barrier can shed light on its relevance to the field of social work. The central nervous system, consisting of the brain and spinal cord, contains a closed system of circulating cerebrospinal fluid. Meaning it is a sterile system not exposed to or open to the external environment, unlike the urinary system or the gastrointestinal system which are open to the outside of the body through the urinary meatus, the mouth, and the anus (Higgins, 2018). This cerebrospinal fluid circulation system has what is called the blood-brain barrier (BBB). It acts as a guardian of the brain by maintaining the sterility of the system, keeping toxins out and monitoring blood levels of hormones and other substances that impact the brain (Higgins, 2018). Breaching the BBB can result in illness or acute damage as in the case of the virus that causes meningitis or high levels of alcohol that can cause loss of consciousness or brain damage. Conversely, intentional crossing of the barrier can be helpful such as in the case of antipsychotic drugs like risperidone and olanzapine that decrease psychiatric symptoms (Higgins, 2018).

Biochemical Neuroscience

Hormones vs Neurotransmitters

The brain monitors blood levels of potentially toxic substances (both unnatural such as drugs or natural such as carbon dioxide). In addition to monitoring chemical substances, it also makes its own biochemical neurotransmitters and hormones to control the body’s function and maintain homeostasis. Neurotransmitters are different from hormones in that they are not formed by glands and then secreted into the blood circulation; they are located in the brain at the neural synaptic junction, examples are glutamate, GABA, and norepinephrine (Higgins, 2018). Hormones are slower acting, they circulate through the blood making them have a wider reach throughout the body. They have various effects on the organs of the body, and they can also fluctuate with circadian rhythms, examples are estrogen, testosterone, and oxytocin (Higgins, 2018). The hypothalamus and the pituitary gland (both located in the brain) produce hormones that control and influence a myriad of functions in the body (Higgins, 2018).

Hypothalamic Pituitary Axes

Two critical concepts for social workers to understand are the hypothalamic-pituitary-thyroid axis (HPT axis) and the HPA (hypothalamic-pituitary-adrenal) axis, both have a direct impact on the mental well-being of clients. The HPT axis is the intricate interplay and balance of the hormones produced by each of these structures and the impact that they have on the mind and body (Higgins, 2018). Being aware of the connection between the HPT axis and its connection to mood disorders and psychiatric symptoms can help social workers facilitate conducting a more thorough differential diagnosis analysis (Higgins, 2018). Psychiatric symptoms associated with HPT axis imbalance include anxiety, irritability, difficulty concentrating, emotional lability, depressed mood, decreased libido, memory difficulties, delusion, hallucinations as well as weight changes and fatigue (Higgins, 2018). Ruling out a medical disorder that involves the HPT axis is crucial for accurate DSM diagnosis.

The other axis of importance is the HPA (hypothalamic-pituitary-adrenal) axis. The HPA axis is more complex because more hormones, more organs, and more body functions are involved, and it plays a significant role in stress response, regulation of sex hormones and kidney function (Higgins, 2018). The stress response is an important aspect for social workers to consider. After the brain’s autonomic nervous system activates in a fight or flight response, the HPA axis then activates which makes the adrenal glands release cortisol, further augmenting the signal already sent by the autonomic systems to release epinephrine (also called adrenaline) (Higgins, 2018).  The HPA axis can also be activated in response to chronic stress, a chronically activated HPA axis can result in long term effects such as hypertension, diabetes, ulcers, impaired memory, and immune function as well as contribute to anxiety and depression (Higgins, 2018).

Social workers can help clients to restore balance to their HPA axis by teaching and promoting stress reduction (Harvard, 2020). Social workers can help clients implement such things as physical activity, increasing social support and relaxation techniques such as abdominal breathing, visualization techniques, prayer, yoga, or tai chi (Harvard, 2020).

The Peripheral Nervous System

This system consists of two parts. The first is the wiring that wires the brain into the rest of the parts of the body. The sensory-somatic system is the 12 cranial nerves and the 31 spinal nerves that run throughout the body and serve as a two-way highway bringing information from the parts of the body to the brain and vice versa. The nerve most commonly involved in mental health issues is the vagus nerve. One of the reasons for this is that this nerve is wired into the heart and lungs and when it is activated we tend to notice how this feels in our bodies. The vagus nerve is the main nerve of the parasympathetic nervous system.

The autonomic nervous system has two further subparts, the sympathetic and the parasympathetic branches. The sympathetic nervous system is responsible for the body's fight or flight response to escape danger and survive. The parasympathetic system can be seen as the reverse of that, it is responsible for helping the body rest and digest. These two systems work like brake and gas pedals to control the body's involuntary response to external stimuli.

Neuroscience Applications in Work with the Individual

Recognizing the profound mind-body connection, social workers can use neuroscience to inform and enhance their mental health treatment approaches. Social workers might not think of abdominal breathing and visualization as neuroscience-based modalities, but in reality, just about everything we do has an impact on the brain. A comprehensive review of treatments that are overtly based in neuroscience is beyond the scope of this paper, but here I will present some major applications of neuroscience in the treatment of mental health concerns and disorders.

Mindfulness

Clinical research on mindfulness meditation began in the 1980s and has progressed to large scale random controlled trials and meta-analyses (Wielgosz et. al., 2019). Mindfulness meditation was introduced to the clinical field by Jon Kabat-Zinn; it refers to practices that help clients develop a sense of self-awareness and cultivation of the brain’s self-sensing capabilities (Wielgosz et. al., 2019). Mindfulness meditation has been shown to impact the prefrontal cortex, including the insula, the anterior cingulate cortex, the amygdala, and the central executive network, thereby effecting executive functioning, cognitive performance, meta-awareness, memory, attention, emotion reactivity, emotional awareness, reward processing, and ability for cognitive reappraisal (Wielgosz et. al., 2019). Evidence based research in the clinical application of mindfulness meditation in the areas of depression, anxiety, pain, and substance abuse show effectiveness, while other areas, such as eating disorders and PTSD, have preliminary evidence showing potential treatment effectiveness (Wielgosz et al., 2019).

Vagus Nerve Therapy 

As previously stated, the parasympathetic and sympathetic nervous systems are functionally part of the autonomic nervous system, which is anatomically part of the peripheral nervous system. The peripheral nervous system is comprised of the nerves that run throughout the body and bring messages from the body and to the brain and vice versa (Waxenbaum et al., (2023). One of these nerves is called the vagus nerve; stimulation of this nerve can result in a decrease in seizure activity and improved mood (Higgins, 2018).

Polyvagal theory can help clients to recalibrate their autonomic nervous systems by influencing their vagus nerves through polyvagal exercises (Dana, 2020). It is based on the premise that the autonomic nervous system is shaped by early or traumatic experiences and that habitual automatic response patterns can be interrupted and replaced with more adaptive responses allowing clients to create conditions that promote feelings of safety and allow for better interpersonal connection (Dana, 2020).

Neurofeedback 

Neurofeedback, an advanced form of biofeedback, involves teaching client’s self-control of the brain by providing feedback via auditory or visual cues to maintain or discontinue the targeted brain activity (Hengameh, 2016). There are many different types and variations of neurofeedback including feedback that focuses on specific brain wave activity (alpha, beta, theta, delta, gamma waves), placement location of EEG electrodes on the cranium that correspond to different anatomical areas of the brain and types of delivery (Hengameh, 2016). Types of neurofeedback include surface neurofeedback, slow cortical potential neurofeedback, low energy neurofeedback systems (LENS) , hemoencephalographic (HEG), live Z-score neurofeedback, low-resolution electromagnetic tomography (LORE-TA) and functional magnetic resonance imaging (fMRI) (Hengameh, 2016).

Protocols that target specific brain waves have been used to treat mental health conditions that social workers are likely to encounter in their work with clients. Alpha wave neurofeedback protocols are used to treat anxiety, pain relief, improve memory, reduce stress and help with insomnia (Hengameh, 2016). Beta protocols can help with depression, ADHD, insomnia, increase cognitive function, and treat OCD and alcoholism (Hengameh, 2016). Alpha/theta waves are an indicator of the state between awareness and sleep, this protocol of neurofeedback has been used to treat severe depression, addiction, anxiety, and healing from trauma (Hengameh, 2016). Delta protocols can be used for sleep difficulties, learning disorders, pain management including headaches, and traumatic brain injury treatment (Hengameh, 2016). Gamma protocols are used for cognitive processing and memory issues (Hengameh, 2016). Theta waves are associated with the first phase of sleep, this treatment is used to treat anxiety, depression, emotional disorders, and ADHD (Hengameh, 2016).

Several studies have shown that neurofeedback therapy for people with schizophrenia has produced positive outcomes (Hengameh, 2016). Similar results have been shown in the treatment of autism and epilepsy as well (Hengameh, 2016). Neurofeedback has also been used to treat PTSD, Tourette’s syndrome, nicotine addiction, and for non-diagnosis specific uses such as reregulating the autonomic nervous system after a difficult therapy session or during a time when a client is feeling dysregulated (Currie et. al., 2014). In some instances, with proper training and equipment, clients can even practice neurofeedback in their own homes (Currie et. al., 2014). Social workers can be mindful of this treatment as it can be helpful in a wide variety of clinical applications, and it may be overlooked by other professionals that are not aware of its effectiveness.

EMDR

Eye movement desensitization and reprocessing is a therapeutic technique based in neuroscience. As described above, the brain is affected by trauma. During EMDR treatment, bilateral stimulation of the brain via eye movements produces a significant deactivation of the prefrontal cortex and the limbic structures which results in higher control of the amygdala as well as a normalization of blood flow to the area (Luber, 2018). For trauma patients, this translates into improved symptoms and better quality of life (Luber, 2018).

Art Therapy and Clinical Neuroscience

Neuroscience can illustrate the connection between the mind and body by clinical studies that show nerves are two way streets facilitating communication between the mind and body (Carr & Hass-Cohen, 2008). Art therapy uses artwork as concrete representations of the mind-body connection which contribute to feelings of mastery and control (Carr & Hass-Cohen, 2008). Art therapy facilitates self-expression that uses parts of the brain that may not be used in other therapies (Carr & Hass-Cohen, 2008). Repeated sensory art experiences create new neuronal pathways in the brain that benefit the client’s mental health (Carr & Hass-Cohen, 2008). Relational art activities, which implement art exercises in dyads or groups of clients, can increase attachment and trust between participants (Carr & Hass-Cohen, 2008). Art therapy holds many possibilities for mental health improvement especially for clients who are not benefiting from more traditional therapy modalities.

Aromatherapy

            Aromatherapy may sound out of place here due to its ubiquitous presence in spas and candle shops and other commercial applications, but aromatherapy can be used clinically. It mechanism of action involves neuroscience. As the name implies, aromatherapy involves aroma or smell from plants. The compound that produces the odor is extracted from the plant for use in aromatherapy, this compound is called a volatile oil or essential oil (Sattayakhom, 2023). Because these oils evaporate easily when exposed to air, they are ideal for inhalation, but can also effect change via topical application and sometimes internal ingestion (Sattayakhom, 2023). When inhaled through the nose, olfactory nerves send signals to the brain that stimulate the secretion of neurotransmitters that regulate mood (Lv, et al, 2013).

Essential oils have been shown to create various effects including, antibacterial, antiviral, anti-inflammatory, immune support, enhancing memory and alertness, creating a calming effect and exerting change in mood and well as in the hormonal  and circulatory domains (Sattayakhom, 2023). Molecular research on the use of aromatherapy as an adjuvant therapy in the treatment of psychiatric disorders is ongoing (Lv et al., 2013). Given that the molecular structure of some natural essential oils resembles that of hormones, and the role that hormones can play in mental health, it is hopeful that advances can be made in this area (Sattayakhom, 2023).

Pharmacology

           Social workers care for people who take prescription medications of all types includes psychotropic medications. Many of these medications mechanisms of action take place in the brain. For example, SSRI antidepressant drugs (i.e. Paxil, Prozac, Zoloft) inhibit neuronal reuptake of serotonin in the brain and antipsychotic drugs block dopamine receptors in the brain (Vallerand & Sanoski, 2019). The field of neuropharmacokinetics is dedicated to studying how drugs, including antipsychotic drugs, cross the blood brain barrier and the impact they have on the brain (Luptáková et al., 2021).

Other Applications

Trauma informed care also has a basis in neuroscience as evidenced by the work of Bessel van der Kolk who has illuminated the field of mental health with his research and providing evidence for which modalities of treatment can target these deficits and result in positive outcomes for patients (van der Kolk. 2015).

By its name one can also infer that cognitive behavior therapy (CBT) also has foundations in neuroscience, as cognition is an executive function of the prefrontal cortex. De Raedt (2020) discusses CBT treatment frameworks that utilize neuroscience to treat depression by recognizing changes in the prefrontal cortex that impact cognitive and affective processes, interventions are designed that target the neurocircuitry underlying the maladaptive cognitive and affective processes to create positive treatment outcomes for clients suffering from depression.

In addition to CBT, Applegate and Shapiro (2005) provide an in-depth look at the role neuroscience plays in memory, affect and attachment theory. They also present clinical application examples of the implementation of therapeutic treatment modalities such as CBT, family therapy and psychodynamic approaches from a neuroscience framework. 

Neuroscience Implications for Macro Level Policy Development and Human Rights Advocacy

            Social workers, poised at the intersection of individual care and policy development, play a crucial role in upholding human rights and advocating for ethical practices.  Many healthcare workers and mental health providers are positioned to bear witness to the lived experience of their clients, however social workers are uniquely positioned both to bear witness and they are also trained to advocate for protection of client’s rights on a macro policy level.

Imagine the ethical dilemma of having been a social worker at the University of Iowa where a randomized control trial was conducted on orphan children in which the control group of children received speech therapy and the variable group of children received abusive comments for any speech imperfections and were told by experimenters that they were stutterers (Algahtani et. al., 2018). Or suppose you were a social worker for the U.S. Public Health Service working on a study to assess the course of disease in syphilis patients, only the patients are not told that they have syphilis and instead of being treated for their infection, they are provided with free meals and burial service, many of them then spread the disease to their families and die (Algahtani et. al., 2018). Consider being a social worker at the University of California and working on an experiment to study the effects of medication in patients with schizophrenia where 50 stable patients are taken off of their medication with no clear date of when or if to restart the medication treatment regimen, many have serious mental health relapses including homicidal ideation and one patient successfully commits suicide (Algahtani et. al., 2018).

These are all real examples of unethical practice in research. Thankfully, many cases of unethical research led to policy that provides protections for human research subjects such as the Nurenberg Code (1947), the Belmont Report (1979), US Common Rule (1991), the Declaration of Helsinki (2000) and the requirement for the establishment of internal review boards for ethical approval of scientific research (Algahtani et. al., 2018). However, let us not lull ourselves into complacency, thinking that because these protective policies exist, therefore all clients are protected from harm. The schizophrenia medication experiment is a case in point as it ended in 1994, well beyond the passage of many of the above stated regulations (Algahtani et. al., 2018). Social workers must continue to remain vigilant for the need to implement client protective policies. Unethical practice is not exclusively confined to the auspices of research.

Any one of us is capable of unethical practice. A key feature of the National Association of Social Workers Code of Ethics is working with integrity in a competent, ethical manner that preserves and protects the dignity and worth of everyone we work with especially those who are vulnerable, oppressed and/or living in poverty (National Association of Social Workers [NASW], 2021). In addition to protecting individuals considering participating in research, social workers should also be mindful of advocating for individuals participating in any mental health treatment, any intervention that has potential risk and any situation where informed consent is required.

Social workers are required to obtain informed consent when providing direct services to clients, they are responsible for promoting clients wellbeing and their right to self-determination (NASW, 2021). When social workers are working with clients who are considering engaging in something that does require informed consent, to promote the wellbeing and self-determination of that person, social workers should ensure that clients have been fully informed of the risks and benefits, have had the opportunity to have their questions answered and that they are truly making an informed decision.

As the field of neuroscience develops it is wonderful to celebrate its’  many successes and accomplishments. But it is also important to be mindful of keeping watch for potential harm to clients. As neuroscience biotechnologies develop it is important for social workers to assess for both possible benefits to their clients and to be aware of potential harms.

Brain computer interface

Brain computer interface (BCI) and implantable neurological devices are areas of new technological advancement in the field of neuroscience. One type of BCI involves software that is researched and designed to create virtual environments (VE) that produce a measurable change in behavior by having the user engage with a video game type program (Hengameh, 2016). Some of these technologies are being developed within the scientific and academic community while some are being developed privately, like Elon Musk’s implantable Neuralink device. Neuralink is a type of physically implantable BCI capable of sending and receiving neural signals to an external device such as a computer or a phone (Reuters, 2022). This device is projected to treat neurological illnesses such as Alzheimer’s and dementia; its creators plan to start clinical trials on humans now that animal trials--that resulting in 1500 animal deaths--are coming to a close (Reuters, 2022).

Implantable neurological devices have the potential to radically change and control brain function (McGlynn et. al., 2021). Bioelectric neurologic interventions are being developed to treat a range of neurological disorders including mood disorders, Parkinson’s, and depression (McGlynn et. al., 2021). Early bioelectric neurologic interventions included electroconvulsive therapy (ECT) treatment for mental health disorders such as depression (McGlynn et. al., 2021). A memory etched in my mind relates to an experience I had with a patient receiving ECT against her will despite her attempts to obtain a court order to cease treatment. I remember the patient telling me that she disliked the feeling of her body rising up off of the table during the convulsions and worst of all, the grief she felt at having no memory whatsoever of giving birth to or raising her children.

Advances in mental health treatments often result in positive results for clients, but when they don’t, these vulnerable victims will need someone to advocate for them. Clients should perform a risk to benefit analysis when considering engaging in emerging neuroscience interventions. Concerns such as physical or psychological safety, privacy, and other risks should be considered. Long term consequences may be difficult to assess in newly emerging technologies that are too recently released to have completed long term studies. Examples of this are micromagnetic stimulation and optogenetics that require insertion of genetically modified tissue (Glynn et. al., 2022). Implantable neurologic devices may also have risk of creating immune response, damage from device overheating, corrosion, and toxicity of material (Glynn et. al., 2022).

Artificial Intelligence

Lastly, a discussion of neuroscience technology would not be complete without mentioning artificial intelligence (AI). Neural implants and BCI rely on deep learning (DL) which is an AI based function (Ienca & Ignatiadis, 2020). AI itself is derived from neuroscience and is based on the human brain, this is evident in AI terminology that use the same nomenclature as neuroscience such as artificial neural networks and deep neural networks (Ienca & Ignatiadis, 2020). One concerning aspect when considering use in humans is that it is currently not known what actually causes AI to work (Ienca & Ignatiadis, 2020).

Social workers should understand the difference between open-loop and closed-loop BCI, in open-loop the patient has a degree of personal autonomy in that they can communicate their desires/needs to the human healthcare provider who can then recalibrate the settings of the BCI device (Ienca & Ignatiadis, 2020). However, in closed-loop BCI, the system runs automatically without human intervention, but relies solely on AI (Ienca & Ignatiadis, 2020). Instances of a persons own decision-making process being overridden by AI driven BCI, thereby depriving the person of agency over their own actions, have been documented (Ienca & Ignatiadis, 2020). AI powered neurotechnologies can also have an impact on the cognitive liberty of individuals thereby affecting their personal autonomy (Ienca & Ignatiadis, 2020).

Just as humans have risk for introducing bias and discriminating against marginalized populations, so can AI, not based on personal bias but based on unrepresentative datasets. For example, facial recognition software has been shown to work less effectively in dark skinned women versus light-skinned males due to unequal representation in learning datasets (Ienca & Ignatiadis, 2020). Lastly, AI can invade one’s privacy, a concept termed neuroprivacy (Ienca & Ignatiadis, 2020). Due to the enormous amounts of data collected from methods such as digital phenotyping (the AI process of gathering content, location, sound, pattern and other data from electronic devices such as smartphones, wearable devices, social media, software and apps to gain insight about cognitive and emotional states (Insel, 2017) client identity can be revealed even if de-identified as it could be reidentified via triangulation with other datasets (Ienca & Ignatiadis, 2020). Potential examples being persons who participated in a sensitive study and wish to remain anonymous are identified or persons who are predicted by AI to develop a debilitating disease are denied insurance coverage based on those predictions (Ienca & Ignatiadis, 2020).

Social workers must be alert for the dehumanization of mental health care as AI begins to enter the field of mental health. AI is already being used to diagnose, through digital phenotyping, and in some cases to treat mental illness (Minerva,& Giubilini, 2023). Treatment via AI can be preferred over human interaction by populations that do not like or avoid human interaction, those that feel stigmatized by seeking mental health care and those who lack access to in person care (Minerva,& Giubilini, 2023). AI driven technologies hold much promise, but they demand scrutiny to prevent dehumanization and erosion of dignity for the client.

Conclusion

An understanding of neuroscience and its implications on social work holds significant benefit for social workers navigating an ever-changing landscape of diverse conditions. Of critical importance is neuroscience’s application in aiding clinical social workers in the process of ruling out differential diagnoses. A neuroscience perspective equips social workers with an increased understanding when implementing important aspects of their code of ethics in their work with individuals and communities. Incorporating neuroscience allows social workers an additional lens from which to base their assessments regarding the societal need for client protective policies. At the intersection of neuroscience and social work lies the integrity of the client, the core focus of social work.

References

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Applegate, J. S., & Shapiro, J. R. (2005). Neurobiology for Clinical Social Work: Theory and Practice. W. W. Norton.

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Currie, C. L., Remley, T. P., & Craigen, L. (2014). Treating trauma survivors with neurofeedback: A grounded theory study based on the practice of experienced mental health professionals. International Society for Neurofeedback & Research. https://digitalcommons.odu.edu/cgi/viewcontent.cgi?article=1042&context=chs_etds

Dana, D. (2020). Polyvagal Exercises for Safety and Connection: 50 Client Centered Practices. Norton.

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Glynn, E., Nabaei, V., Ren, E., Galeote-Chea, G., Das, R., Curia, G., & Heidari, H. (2021). The future of neuroscience: Flexible and wireless implantable neural electronics. Advanced Science. 8. https://doi.org:10.1002/advs.202002693  

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Hengameh, M., Marateb, H. R., & Mansourain, M. (2016). Neurofeedback: A comprehensive review of system design, methodology and clinical applications. Basic Clinical Neuroscience. 7(2). 143-158. https://doi.org/10.15412/j.bcn.03070208

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