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- Andersson, Lisa, 1983-
(författare)
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Addressing youth unemployment: what role for social work? : Policy responses to youth unemployment in Sweden and Europe
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Unemployed youth are a heterogenous group facing varying and sometimes complex problems. Being young and unemployed can have a negative impact on future life chances and quality of life. Studies on youth unemployment have mostly focused on education and labour market responses, leaving the involvement of social work aside. This thesis aims to explore policies for unemployed youth in three key policy areas: social work, education and labour market, in Europe and Sweden. The thesis consists of four separate studies highlighting how policy ideas are translated into agendas, and how responses are administered and organized at national and local level. Applying an institutionalist theoretic framework, the results are analysed with consideration to the structure of state and welfare state. Study I explored the ideas inherent to the social policy concept ‘social investment’, outlining three central dimensions of the concept: temporal-perspective, principles of distribution and policy coherence. A key result of study I is that social investment ideas are nuanced, and that social investments can take different forms. In the following three studies, the dimensions of social investment are used as heuristic tools to examine policy responses for unemployed youth. Study II examined how the EU recommendation on establishing a youth guarantee (YG), was translated in national YG plans. The results were analysed using tentative regime-types based on the structure of social work, the education system, and the social insurance system. The results showed that outreach as an early intervention was marginal across countries and regime types, and the involvement of social work was largely absent. In study III, the coordination within and between policy areas was analysed between Sweden and the UK, over time. Policy documents on national labour market programs in both countries between 1998-2011, were analysed. The results showed that coordination between labour market programs and social security benefits/social assistance had strengthened over time in both countries. How authority to regulate and administer different policy areas, was also linked to the occurrence of coordination between different policy areas. Study IV examined if and how specialization and coordination were part of organizing local level work with NEETs in Sweden. This was explored through structured interviews with local professionals in social work, education and labour market. The results showed a pattern of coordination and specialization among education and labour market actors. The involvement of social work was instead marginal, and primarily concerned social assistance. In conclusion, the results of this thesis show that the agenda, content and administration of policy responses to youth unemployment consists mainly of wide, universal and reactive responses. They are also characterized by coordination between labour market measures and social insurance/assistance, in line with an activation trend. An important finding is also the very limited involvement of social work, as noted in national policy agendas and programs, and in local level work. Both activation and social work involvement did however vary somewhat with administrative levels and between different policy areas. The results thereby indicate that institutional aspects such as organizational structure and administration, matter for the involvement of different policy areas in responses to youth unemployment.
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- Batljan, Ilija, 1967-
(författare)
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Demographics and Future Needs for Public Long Term Care and Services among the Elderly in Sweden : The Need for Planning
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Long term care and social services (LTCaS) for older people are an important part of the Scandinavian welfare state. The fast growing number of elderly people in Sweden has caused many concerns about increases in future needs (and particularly costs) of age-related social programs such as LTCaS. The general aim of this dissertation is to examine how projected demographic changes may affect future needs for long-term care and services in Sweden assuming different trends in morbidity and mortality. The following data sources are used: national population registers, register data on inpatient/outpatient health care from region Skåne, the Swedish National Survey on Living Conditions (SNSLC) for the period 1975-1999. Three alternative methods to inform simple demographic extrapolations of needs for health and social care for the elderly are presented. Furthermore, a new method for demographic projections has been developed. According to our studies, the health of older people (measured as the prevalence of severe ill-health) has improved during the study period. Taking into account health status, when projecting future needs for LTCaS, will result in a fairly substantial reduction of the rate of the demographically influenced increase in projected LTCaS needs. The changes in population composition regarding education and mortality differentials per educational level may have a significant impact on the number of the elderly in the future. On the other hand, the projected increase in the number of older people suffering from severe ill-health, as a consequence of population ageing, may be counterbalanced to a large extent by changes in the educational composition towards a higher proportion of the population having a high educational level and lower prevalence of severe ill-health. We need to improve our planning tools in order to support policy-makers to plan for uncertainty concerning future needs and demand for LTCaS.
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- Blomqvist, Jan, 1946-
(författare)
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Beyond treatment? : widening the approach to alcohol problems and solutions
- 1998
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The dissertation includes four different studies which, from different points of departure, aim to illuminate problems and prospects of social work with alcohol problems in contemporary Sweden.Paper 1 analyses the historical succession of predominant public images of, and societal responses to, alcohol problems in Sweden during the past century. The analysis distinguishes between a moral, an enlightenment, a medical and a compensatory approach to these problems. The main development in society's handling of alcohol problems is described to have been a gradual shift from the moral to the medical approach, despite the fact that the compensatory approach is in many respects the one most akin to the general social policy ideal of Sweden. The paper concludes by discussing the future prospects of community-based approaches to alcohol problems, relying on the assumptions of the latter approach.Paper 2 scrutinises, based on reanalyses of a variety of empirical sources, developments within residential care for substance misusers in Sweden during the past three decades. The results of these analyses belie several popular notions about the role of institutions in social work with alcohol problems. Thus they show, in contrast to claims in some public reports, that the annual number of alcohol misusers cared for decreased during most of the 1980s, already before the major decrease in the beginning of the 1990s. Further, they show that residential care has - despite a growing "treatment rhetoric" over the years - been primarily utilised for a rather small group of long-term misusers with severe social problems, and with a pattern of repeated - and often prematurely interrupted - admissions and readmissions over a long succession of years.Paper 3 reviews and discusses the significance of research on "spontaneous recovery" from substance misuse and treatment outcome research. The paper outlines and develops further the notion that there may be "common elements" or mechanisms in all successful change processes, whether these include professional interventions or not. Formal treatment is further discussed in terms of temporary interventions in the client's life course, which may, if successful, facilitate and accelerate "naturally" occurring rehabilitation processes. The paper concludes by proposing a closer integration of research on "spontaneous recovery" and treatment outcome research, as a way of learning more about the potential interplay between life events, formal interventions and change of lifestyle.Paper 4 is an account of an attempt to put the ideas of Paper 3 into practice, by comparing subjects who recovered from severe alcohol problems without formal assistance, with subjects who were assisted in doing so. Comparisons were made with regard to drinking patterns and occurrences of significant life events during a period of time, encapsulating four years before and two years after the resolution, and with regard to subjects' attributions as to what initiated and maintained recovery. As regards drinking patterns and event occurrences, comparisons were further made with assisted and unassisted subjects with current alcohol problems. The results indicate that initial attempts to solve the drinking problem and initial help-seeking, as well as long-term maintenance of the resolution, are influenced by environmental factors, operating outside the context of formal treatment. Unassisted remitters showed greater social stability before the resolution than assisted remitters, more often stated positive incentives for trying to change their lifestyle, and more often tapered their drinking gradually. The results underline the need to consider and try to harness contextual factors when planning individually directed and preventive measures.In an introductory chapter, the four papers are linked together by an examination of prevailing theoretical models of alcohol problems, and the outlining of an overarching perspective that accounts for habitual ex-cessive drinking as a "central activity" in the drinker's way of life. Finally, some joint implications of the four papers, with regard to social work with alcohol problems, and with regard to future research, are discussed.
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- Bromark, Kristina, 1973-
(författare)
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The user as a key actor in user participation : Exploring knowledge production in personal social services with a participatory approach
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The concept of user participation in social work is frequently debated. In Sweden, users are supposed to be active and involved in matters concerning them, a stance which is regulated in policy and law. The involvement of users in practice can be considered a form of knowledge production that can strengthen and develop users as well as the organizations. In practice, however, research shows that actual engagement, education or activation of users is difficult to attain and can be understood as a devaluation of user knowledge. The aim of this dissertation is to increase knowledge of how to understand and enhance the conditions for user participation in personal social services. To study this question, the dissertation focuses especially on young people’s participation in the context of out-of-home care. To explore user participation in personal social services, a participatory approach was applied. Data was gathered with young people and staff using participatory techniques as well as qualitative interviews. To explore challenges and possibilities with user participation, a future workshop was held with staff in personal social services (study I). This was followed by a co-design process in which staff, young people, and researchers collaborated on a support tool (study II), later to be implemented in practice (study III). The implementation process was explored by interviewing both staff and managers as well as a user representative (from a youth council). The co-design and implementation processes are problematized and discussed in the dissertation from a researcher’s perspective (study IV). The theoretical framework for understanding how users can be devalued as knowers is epistemic injustice. The assumption is that the role of a knower can shift, depending on social power and the structures in a context. The findings in this dissertation show that user participation is contingent on the distribution of power and responsibility and on perceptions of knowers and knowledge in practice. Although the general attitude towards user participation is positive, a reluctance in practice is revealed. It appears to be a challenge for staff to acknowledge the expertise of users, despite the fact that the users’ have the capacity and are willing to contribute with their knowledge. Work with user participation is identified as a team effort that requires actions at all levels of the organization as well as increased resources, leadership and a coherent understanding and agreement of the concept. A participatory approach to knowledge production with users is identified as a possible way to enhance epistemic justice and the inclusion of all relevant actors in activities and processes. The dimensions important to user participation can be acknowledged. For the dynamics to be maintained in a wider sense, however, an organizational infrastructure, with routines and methods, is necessary. To sustain epistemic justice in the implementation of user participation, a participatory culture with a solid and coherent understanding of user participation in practice is encouraged. A realization of user participation in practice requires a critical exploration of power and positions, systematic changes to infrastructure and transparency about roles and responsibility.
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- Fors, Stefan, 1976-
(författare)
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Blood on the tracks : Life-course perspectives on health inequalities in later life
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of the thesis was to explore social inequalities in: a) mortality during mid-life, b) health in later life, and c) old-age mortality, from a life-course perspective. The studies are based on longitudinal Swedish survey and registry data. The results from Study I showed substantial inequalities in health, based on social class and gender, among older adults (aged 55+). Moreover, the magnitude of these inequalities did not change during the period 1991-2002. The results from Study II revealed social inequalities in cognitive functioning among the oldest old (aged 77+). Social turbulence and social class during childhood, education and social class in adulthood were all independently associated with level of cognitive functioning in later life. In Study III, social inequalities in mortality during mid-life (i.e., between ages 25 and 69) were explored. The results showed that childhood living conditions were associated with marital status and social class in adulthood and that, in turn, these conditions were associated with mid-life mortality. Thus, the results suggested that childhood disadvantage may serve as a stepping stone to a hazardous life-course trajectory. Study IV explored the association between income in mid-life, income during retirement and old-age mortality (i.e., mortality during retirement). The results showed that both income during mid-life and income during retirement were associated with old-age mortality. Mutually adjusted models showed that income in mid-life was more important for women’s mortality and that income during retirement was more important for men’s. Thus, the results of the present thesis suggest that there are substantial social inequalities in the likelihood of reaching old age, as well as in health and mortality among older adults. These inequalities are shaped by differential exposures throughout the life-course that affect health in later life both through direct effects and through processes of accumulation.
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| 8. |
- Forsman, Hilma, 1985-
(författare)
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Addressing poor educational outcomes among children with out-of-home care experience : Studies on impact, pathways, and interventions
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Children with out-of-home care (OHC; foster family/residential care) experience is a high-risk group for future adverse outcomes. With an ambition of supporting the design of effective preventive child welfare measures targeting children in OHC, the overall aim of this thesis is to examine education as a possible intervention path for improving their development and overall life chances.The thesis consists of four interrelated empirical studies that address different aspects of poor educational outcomes among children with OHC experience by means of analyses of longitudinal survey and register data, and evaluations of two interventions aimed at improving their basic academic skills.Study I examined the hypothesized causal effect of poor school performance on adverse outcomes in young adulthood among children with OHC experience. The results showed that poor school performance has an impact on later psychosocial problems net of observed and unobserved factors, suggesting that the estimated effects allow for causal interpretations.Study II explored educational outcomes at different stages in the educational career, and pathways to varied educational outcomes for children with OHC experience and their peers. The results showed that the OHC group had lower educational outcomes across the life course. Yet, by large, their educational pathways did not differ significantly from their peers – cognitive ability and previous school performance had the largest associations with the outcomes in both groups. However, the influence of these factors were weaker in the OHC group whilst the influence of the birth family’s attitude towards higher education was stronger.Study III aimed at furthering our understanding of the book-gifting program the Letterbox Club’s potential impact on foster family children’s reading skills. The results showed that participation in the program was associated with small improvements. In general, the program was well received by children and carers, and could result in increased reading. The study furthermore suggested that promotion of carer involvement may improve its potential impact.Study IV explored the process of conducting a structured paired reading intervention involving foster family children and their carers. Findings showed that it is possible to engage carers in interventions targeting the education of children in OHC, but that this is no automatic process – carers need a rationale for getting involved, and support in delivering the intervention.In sum, this thesis shows that improving the educational outcomes of children in OHC may be a viable intervention path in supporting their life course development, a path that historically has been overlooked. The thesis furthermore shows examples of promising interventions which may improve the basic academic skills of children in OHC. The results also point out that the child welfare system should provide early and continuous educational support, and highlight the importance of addressing adults’ attitudes, expectations, and involvement in these children’s education.
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- Heap, Josephine, 1980-
(författare)
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Living conditions in old age: Coexisting disadvantages across life domains
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to analyse coexisting disadvantages in the older Swedish population. Coexisting disadvantages are those that occur simultaneously in various life domains. A person who simultaneously experiences several disadvantages may be particularly vulnerable and less well-equipped to manage daily life and may also need support from several different welfare service providers. Concerted actions may be needed for older people who experience not only physical health problems and functional limitations, but also other problems. Research that encompasses a wide range of living conditions provides a basis for setting political priorities and making political decisions.The studies in this thesis used data from two Swedish nationally representative surveys: the Level of Living Survey, which includes people aged 18 through 75, and the Swedish Panel Study of Living Conditions of the Oldest Old, which includes people aged 77 and older.Study I showed that the probability of experiencing coexisting disadvantages was higher in people 77 and older than in those aged 18 through 76. These age differences were partly driven by a high prevalence of physical health problems in older people. In all age groups, coexisting disadvantages were more common in women than men.The longitudinal analyses in Study II indicated that coexisting disadvantages in old age persist in some people but are temporary in others. Moreover, the results suggested a pattern of accumulating disadvantages: reporting one disadvantage in young old age (in particular, psychological health problems) increased the probability of reporting coexisting disadvantages in late old age. Study III showed that physical health problems were a central component of coexisting disadvantages. The results also showed that being older; female; previously employed as a manual labourer; and divorced/separated, widowed or never married were associated with an increased probability of experiencing coexisting disadvantages. However, the experience of coexisting disadvantages differed: the groups associated with coexisting disadvantages tended to report different combinations of disadvantage.Study IV showed that the prevalence of coexisting disadvantages in those 77 and older increased slightly between 1992 and 2011. Physical health problems became more common over time, whereas limited ability to manage daily activities (ADL limitations), limited financial resources and limited political resources became less common. Associations between different disadvantages were found in all survey years, but certain associations changed over time. The results suggest that in general, the composition of coexisting disadvantages in the older population may have altered over time.In sum, results showed that coexisting disadvantages were associated with specific demographic and socio-economic groups. Physical health problems and psychological health problems were of particular importance to the accumulation and coexistence of disadvantages in old age.
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- Heimdahl Vepsä, Karin, 1983-
(författare)
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Substance use, pregnancy, and parenthood : A study on problematizations and solutions
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- With the starting point in the view that how we interpret a problem is decisive for how we think this problem should be dealt with, the overall aim of this dissertation is to explore problematizations of substance use in relation to pregnancy and parenthood within different settings. The dissertation consists of four studies, based on different empirical materials, that analyze problematizations of substance use, pregnancy, and parenthood from different perspectives. Elucidating how these constructions are made in social work related settings can in the long run contribute to improve the ways that pregnant women and parents with substance use problems are approached.Study I analyzes the Swedish discussion on the diagnosing of Fetal alcohol spectrum disorders (FASD). The data consists of a report from a Swedish authority and webpage material from an FASD interest organization. The results show that the interest organization and the authority have different views on whether FASD diagnoses should be used. The analysis suggests that the discussion on FASD is structured by three main discourses; a scientific discourse, a pragmatic discourse, and an ethical discourse.Study II analyzes professional accounts of substance-using pregnant women’s transitions into parenthood. Professionals within maternity care were interviewed in focus groups. The results show that the professionals related to two, sometimes contradictory, ideals of, on the one hand, “believing in the patient” and on the other hand “being realistic” when reflecting on the patients’ prospects to function well as parents.Study III is carried out as a scoping review aimed to give an overview of research on psychosocial interventions targeting parents with substance use problems. It has a focus on underlying assumptions motivating these interventions. The results show that all studies but one focused on women as parents. Most of the interventions were primarily concerned with the psychological deficits of these mothers, while only seldom addressing broader social and structural factors.Study IV aims to explore how parents with previous substance use problems narrated their experiences of becoming and being parents. The study participants were all active in the 12-step movement. The results show that the way they narrated their experiences of substance use problems, recovery, and parenthood was structured by a classic 12-step storyline. The participants described how their recovery processes had made them more emotionally present and skilled in handling their own feelings – competences they described as important resources for them as parents. The four studies, taken together, show some patterns in how substance use, pregnancy, and parenthood were problematized in relation to each other. The problematizations tended to portray parents, and especially mothers, with substance use problems as posing risks towards their children’s psychological and physical wellbeing. Furthermore, there was a tendency to define these parents solely based on their substance use problems, without acknowledging potential individual variation in parenting capacity. Finally, the solutions presented had a clear individualistic focus, emphasizing, for example, the importance of individual motivation and the willingness to comply with treatment, but only occasionally taking contextual and structural factors into account.
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