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- Alexanderson, Karin, 1952-
(författare)
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Vilja, kunna, förstå : om implementering av systematisk dokumentation för verksamhetsutveckling i socialtjänsten
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this study is to analyse conditions that either promote or hamper the implementation of methods for systematic documentation, follow-up and evaluation in social-work services with individuals and families. The theoretical framework consists of organization theories. Human Service Organizations (HSO) theory is complemented with concepts from the new institutionalism, domain theory, implementation theory, and theory about interventions.A concrete case, a project has been studied. The purpose of project was to implement methods for systematic documentation in public social services. With the notation “integrated” is meant that the methods should be built in and adjusted to the social-work practice. The methods were ASI (Addiction Severity Index) and IUS (a locally based model for integrated evaluation by inspiration from Göran Sandell).Data has been captured in a pretest/ posttest design (Marlow 2000). This means that “state of things” has been described before the intervention and after. The methods used were surveys and interviews (individual and group). The process has been documented through research notes proceeding records, protocols and some diaries written by social workers. Four municipalities from the middle of Sweden took part with five working groups. Two groups contained social workers acting with children and families and three groups were working with drug abusers. The population consisted of the social workers, the managers responsible for the individual and family entities, the politicians and the clients who were affected during the time of the project.The implementation of ASI and IUS has not occurred in the extent that was stated in the intervention theory. This means that ASI and IUS were not used in all new cases that occurred during the time of the project. The interviews supposed to be done in the beginning of the clients contact with the agency tended to be done more often than the follow-up interviews. After the project ended, three of five working groups decided to continue to use ASI (one group) and IUS (two groups). The overall impression is that the respondents comprehend, they have the willingness but they do not have the capability of using ASI and IUS. The organization does not seem to have the capacity of imposing requirements and giving resources. The outcomes do not seem to be the most important issue for the social services. These conditions are discussed in the study by means of the theoretical concepts. In the end, there is an effort to adjust the implementation theory to human service organizations.
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| 2. |
- Grell, Pär, 1966-
(författare)
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Komplexa behov eller komplexa organisationer? : konsekvenser av specialiserad individ- och familjeomsorg ur ett klientperspektiv
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Even though recent decades have seen a clear trend towards organizational specialization within Swedish personal social services (PSS), there is a lack of knowledge about the consequences of this, particularly from a client perspective. The aim of this compilation thesis is to describe and analyse the consequences of organizational specialization for clients with complex needs. The empirical material consists of a survey and an interview study, both addressing clients whose needs can be considered complex since they entail several parallel contacts with different specialized PSS units. Article one is a research review aimed at summarizing and discussing the research on organizational structures in the social services, and these structures' impact on work with clients. The review suggests that, to function adequately, social service organizations need to combine and balance aspects of both specialization and integration. Article two aims to describe and analyse how clients with complex needs perceive and value the service conditions of the organizationally specialized PSS. The main findings are that clients primarily perceive and value their encounters with the specialized PSS negatively, and that they experience several elements of service fragmentation. The aim of article three is to describe and analyse how clients with complex needs account for their handling of service conditions within specialized PSS. A key finding is that clients combine different approaches (categorized as consensus, resignation, fight, and escape) in a balancing act intended to promote their own best interests. Article four aims to describe and analyse how clients with complex needs perceive the conditions for helping relations in a PSS setting marked by organizational specialization. A lack of system trust, the people-processing dimensions of work, and an organizational and professional emphasis on formal organizational structures and boundaries were found to constitute unfavourable conditions. Conversely, the occurrence of individual trust, the people-sustaining and people-changing dimensions of client work, and the boundary-spanning efforts of both informal organizations and individual social workers constituted favourable conditions. The thesis concludes that there seems to be a substantial lack of fit between the logics and features of organizational specialization on one hand, and the complex and interwoven nature of clients’ actual needs and everyday lives on the other. It is also argued that organizational specialization means that the complexity involved in encounters between clients and the PSS is overlooked or obscured. Further research on the structural arrangements and service conditions that surround encounters between clients and the social services is suggested, especially research that adopts a client perspective.
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| 3. |
- Kullberg, Karin, 1950-
(författare)
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Man hittar sin nisch : Om män i socionomyrket - karriär, minoritet och maskulinitet
- 2006
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Denna rapport handlar om män i minoritet i ett kvinnoyrke, närmare bestämt socionomyrket. Rapporten bygger på enkäter ställda till män examinerade från socionomutbildningen i Lund under två perioder, början av 1980-talet och 1990-talet, samt intervjuer med män från sistnämnda grupp. Det framkommer att männens karriärer skiljer sig åt mellan de olika utbildningsgenerationerna. Medan de män som har examen längst bakom sig ofta gjort en vertikal karriär och blivit chefer väljer männen som examinerats under 1990-talet i stället en horisontell karriär. De hittar sin nisch i socionomyrket inom områden med hög intern status där de kan arbeta fritt och självständigt.
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| 4. |
- Perlinski, Marek, 1955-
(författare)
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Skilda världar : specialisering eller integration i socialtjänstens individ- och familjeomsorg
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The general objective of this dissertation is to describe and analyse how specialised respective integrated forms of organisation in the Swedish Personal Social Services (PSS) condition social workers’ interventions and client effects (outcomes). The three specific questions are: 1) How are structural conditions for social work with clients created in specialised versus integrated (generic) forms of organising PSS? 2) How do social workers carry out their work with clients in specialised versus integrated (generic) PSS-organisations? 3) How do different organisational models of PSS influence the results for clients? The research was conducted in three Swedish municipalities with different organisational models within the personal social services: 1) specialised organisation, 2) integrated organisation, and 3) a “combined” organisation with a mix between integration and specialisation. The research had a complex design. It was carried on as comparative case study. Data was collected in several different ways: 1) by means of survey among social workers, 2) by interviewing politicians, mangers and social workers, 3) focus groups consisting of social workers, 4) by collecting official documents, guidelines etc. 5) by mapping of the organisation of social services in the municipalities by means of analyse of their homepages and additional interviews by telephone. The data were analysed using both qualitative and quantitative methods. The main results in this dissertation are: 1) In the majority of Swedish municipalities the PSS are nowadays specialized. 2) The formal organizational structure of PSS is always challenged by the employees’ spontaneous organising process that goes in an opposite direction. 3) Only the integrated (generic) organisation emphasizes social workers professional competence and knowledge. 4) Social workers, as a professional group, have the collective power to (to a certain degree) influence political decisions on what kind of PSS organisation is chosen in their municipality. 5) Regardless of organisation model, social workers’ method use is more unspecific than specific. 6) Social workers, in general, place significantly more weight on working with clients’ relationships and aspects of trust than on (specific or unspecific) working methods. 7) A holistic (generic) view of a client can only exist in a direct relationship between social worker and the individual and a unique client. It seems difficult to build in holism into primarily specialised organisations. 8) One may question whether a specialised organisation leads to specialisation of its employees in a way that they become experts on specific problems. The three organisational models are not equally good. Neither the specialised organisation nor the combined organisation is able to create economic or organisational conditions for working with clients that are clearly experienced as good. This also holds true for assessment of need, possibilities to make relevant interventions, such as building relationships. Those two organisations show several deficits regarding work with clients.
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| 5. |
- Svanström, Rune, 1959-
(författare)
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När livsvärldens mönster brister : erfarenheter av att leva med demenssjukdom
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis is focusing on the lived experience of dementia. Both living with a partner as well as living alone. There is no unequivocal picture of how it is to live with dementia and few studies have been carried out in homes of afflicted persons. A deeper understanding of how it is to live with dementia can be a good starting-point for caring and the organisation of care. The aim of this thesis is to describe, clarify and explain the lived experience of dementia from a lifeworld theoretical point of view. Another aim is to illuminate how decision makers look upon persons with dementia, their life and their care. Interviews and observations have been used to collect data. Participating informants have been couples with one partner suffering from dementia, persons with dementia living alone, politicians, administrators and social workers. Data was analysed with a phenomenological and a hermeneutical approach. To live as a couple where one part has dementia (study 1) implies to live in a heteronomous existence where both the person with dementia and the partner become strangers in a world that should be the most well-known and familiar. The couple’s existence is narrowed and controlled by the impact of the dementia disease and the existence is characterised of hopelessness and homelessness. To live alone with dementia (study 2) means to live with a broken identity when the person with dementia gradually loses the memory of himself and his life. It becomes a life where the world of the individual is reduced to a quiet background that does not demand attention. The person with dementia does not longer know how he or she should relate to the world. The existence is characterised by a strong sense of loneliness and only a vague knowledge of the situation. The person with dementia longs for other people and gets a sense of boredom in the existence. The comprehensive interpretation (study 3) shows that life with dementia is characterised by a gradual loss of meaning in life due to a disturbed intentionality. With disturbed intentionality the person with dementia gets increasingly more difficulties in understanding the meaning of the use of everyday objects. The person with dementia fights this and tries to create meaningfulness in the existence – something which gets very difficult and strenuous in time, since even the easiest everyday chores have to be thought through to make sense and even to be accomplished. The effort can in time become overpowering for the person with dementia who then stops doing the chores and becomes passive. Politicians, administrators and social workers (study 4) are well aware that dementia gives suffering to the afflicted and the partner. The care is not designed to meet their needs for home care, and the decision makers don’t know how to change this. The person with dementia becomes like an object when the social workers don’t includes them in a dialogue about their needs and care. The partner is left alone in solving difficult problems and in making difficult decisions. The theory of intentionality can help the professionals in the care of persons with dementia. By helping the cared-for-person to ‘stretch the intentional threads’ the caregivers can give the person a possibility to be rooted in the world. A care that supports intentionality and identity and reaches all the way in to the homes of the person with dementia would improve their situation and increase their well-being. This is possible when engaging the person in every-day chores that promote meaning. This kind of care contributes to the possibility for the person with dementia to be rooted in language, time and space.
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