| 1. |
- Knechtel, Maricel L, 1968-
(författare)
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Categorization Work in the Swedish Welfare State : Doctors and social insurance officers on persons with mental ill-health
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This dissertation contributes to the debate on street-level bureaucracy, which highlights how the decisions made by workers in public bureaucracies effectively become public policy. This debate has paid relatively little attention to the study of how professionals carry out their work by means of institutional categorization, a knowledge gap that this study helps to close. Moreover, this study contributes to the understanding of how persons with mental ill-health are matched with institutional categories.The aim of this dissertation is to shed light on the institutional categorization process involving persons with mental ill-health in two interrelated areas of welfare settings: primary healthcare and sickness insurance. To pursue this aim, 27 in-depth interviews with 30 participants (18 doctors and 12 social insurance officers) were performed. The interviews, which were based on vignettes – short hypothetical scenarios – made it possible to get insight into how doctors and social insurance officers would reason in a situation similar to that depicted in the vignette.This study emphasizes how discretion is exercised when individuals are matched with the institutional categories that doctors in primary health settings and social insurance officers have at their disposal. Ideally, this process is a rational process through which clients’ objective traits are assessed against the criteria that define the various institutional categories. However, the process is not straightforward; thus, different kinds of social mechanisms are linked to the processes of institutional categorization, such as signaling, screening, the logic of appropriateness, moral work, and discrimination. On a more practical level, this study emphasizes the difficulties imbued in the process of institutional categorization. There are multiple reasons for these difficulties. Human complexity is one of them: the interviewed professionals often work with situations that require responses to human dimensions, which are oftentimes too complicated to reduce to standard formats. Another reason for these difficulties has to do with the ambiguity and/or complexity of institutional category schemes. Moreover, the process of institutional categorization takes place in a context of conflicting demands and professional logics, both within a single organization and across the organizations that work together with respect to the same patient/client.Future research concerned with institutional categorization should address how persons with mental ill-health are matched with the institutional categories in other areas of welfare, such as social services and employment services. A deeper knowledge about how the various organizations of the welfare state match individuals with institutional categories, could bring us closer to an understanding of the problems of multi-organizational collaboration.
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| 2. |
- Lassinantti, Kitty, 1968-
(författare)
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Diagnosens dilemman : Identitet, anpassning och motstånd hos kvinnor med ADHD
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis explores the increasing medicalization of society, the process whereby social phenomenon are transformed into medical problems. Alike the general tendency of neu- ropsychiatric diagnoses, the number of people with ADHD (Attention Deficit Hyperactiv- ity Disorder) has increased and expanded from a boys’ diagnosis to include both adult men and women. Studies on the latter category is however scarce. The objective of the thesis is to contribute with a micro sociological and critical perspective on the effects of the biomedicalization process, by focusing women's experience of getting and living with ADHD. The empirical material consists of narrative interviews with sixteen women, diagnosed with ADHD in adulthood. The participants, age 20 to 50, were enrolled via Swedish NGO:s in 2010 and 2013.The thesis resides on four analytical themes: biomedicalization, pharmaceuticalizaton, functionality and gender. It shows how diagnostics evokes processes that involve learning and using a biomedical terminology to describe and understand oneself. ADHD is, in general, depicted as diffuse, expansionary, masculine and deviant sociability and cognitiv- ity. Unlike depression and anxiety, described as temporary and unwanted illnesses, the ADHD-diagnosis embraces the whole personality. Hence, the women find it difficult to identifying and separating ADHD from the self. Furthermore, categorizations of oneself as a ‘woman with ADHD’ imply constructions of individual and collective identity that has ideological implications, i.e. the individual narratives are related to grand narratives. These contradictory grand narratives bring about ideological dilemmas that are handled rhetorically in the women's everyday life. The masculine connotation of ADHD, for ex- ample, render the women experiencing themselves as transgressing not only femininity but also ADHD-personhood. Additionally, as social actions are attributed to the ‘ADHD brain’, the brain is portrayed as a pathological deviant and dysfunctional object for phar- maceutical intervention. Nevertheless, this discourse is also contested by the women by pointing to 1) positive aspects of the ‘ADHD-brain’ in everyday life, or 2) gender inequal- ities and demands of the late-modern society. Concluding, the women in this study are not only victims of their bodies or societal norms, but also agents negotiating– adapting and opposing to – expectations of how to be an ideal citizen or woman.
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| 3. |
- Holmberg, Lars, 1970-
(författare)
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Den frånvarande intellektuelle : En diskursteoretisk analys av en kollektiv representation
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- From an institutionalized conception of contemporary intellectuals as silent or absent, the aim of this thesis is to analyse how the representation of the intellectual changed from a hero of reason to a more or less absent actor. Descriptions of intellectuals that were initially analysed which showed that the representation of the intellectual, besides being linked to modernity, contained a relationship between the individual actor and political power, a relationship which could be traced back to ancient myths. Using discourse theory and concepts primarily from Ernesto Laclau and Chantal Mouffe, the dissertation demonstrates how the discourse of intellectuals changed the representation content in relation to the myth of the postmodern and to the myth of the modern society. In relation to the modern intellectual, the discourse linked the representation with elements as reason, freedom and politics. Texts written after the linguistic turn or the myth of the postmodern describe intellectuals as specific, bourgeois, academic and politicized. This makes the representation impossible in relation to the initial establishment. The main contribution of the thesis to research on the discourse of intellectuals is the myths bearing on how intellectuals can or should act and how the representation can be described. The notion of the intellectuals can only be understood in an already existing discourse based on what an intellectual should do or be.
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| 4. |
- Jacobsson, Maritha, 1960-
(författare)
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Terapeutens rätt : rättslig och terapeutisk logik i domstolsförhandlingar
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In this dissertation, I explore a quite unique legal situation, namely administrative court hearings relating to coercive interventions: the Care of Young Persons Act (LVU), Care of Abusers (Special Provisions) Act (LVM), and the Compulsory Psychiatric Care Act (LPT). There are three central participatory roles in the court hearings: The official party is the authority who files the application for coercive intervention – either a chief psychiatrist or a social welfare board (typically represented by a social worker or sometimes a lawyer assisted by a social worker), whereas the citizen party is the person about whom the application is brought. The citizen party is represented by a legal representative. The professionals represent two different logics: therapeutic and judicial.The purpose of this dissertation has been to study the tension between therapeutic and judicial logic in court hearings relating to compulsory care. With theoretical concepts from Scott (1995) and Wetherell & Potter (1998), it is possible to say that the therapeutic and judicial logics are built up by institutional elements that are communicated through interpretative repertoires. Three questions are central:1. How do professional participators handle the different role expectations embedded in therapeutic and judicial logic? In this case, I am particularly interested in role conflicts faced by social workers and psychiatrists.2. How do different institutional elements (regulative, normative/cognitive) play out in the court hearings?3. To what extent can these court hearings be considered a scrutinizing order of discourse, where the arguments of official party are subjected to critical examination?In my analysis I am inspired by both critical discourse analysis and organizational theory, more precisely, new institutionalism. These two perspectives provide useful insights and make it possible to combine the micro- and macro levels in the analysis. Data for the analysis consist of 43 court hearings and 31 interviews, gathered from two different county administrative courts in Sweden. All written documents used and produced by the courts are also part of our data.The dissertation consists of five studies that indicate that the court hearings hardly can be described as a scrutinising order of discourse. In spite of this, the court constantly finds that the legal criteria for coercive intervention are satisfied. Neither the official party nor the legal representative argue according to a judicial logic. Instead, therapeutic logic dominates the order of discourse. When the arguments for compulsory care are therapeutic, they are not explicitly related to the criteria in the law. In my interpretation, the reason why the conflict between therapeutic and judicial logic is not realised can be found in the existence of a logic of normalisation. This ideological logic of normalisation can be found in most of the institutions in the Swedish society and are built on the idea of traditional welfare norms.
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| 5. |
- Medina, Eduardo, 1957-
(författare)
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Från ”tyst vår” till ”hållbar utveckling” : En kritisk diskursanalys av miljöfrågans utveckling 1962–1987
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This dissertation studies the development of the environmental issue from a discursive perspective. Through an analysis of views on nature and the environment in several NGOs and main political organs, the dissertation tries to explain how a certain view became hegemonic. The analysis pertains to the period between the publication of Silent Spring in 1962 and the introduction of the concept sustainable development by the UN in 1987. From a realistic starting point and with critical discourse analysis (CDA) as its method, the dissertation aims to identify causal powers and mechanisms that have generated and institutionalized the environmental discourse. An analytical model is developed and applied on three levels; a sociolinguistic, institutional, and macrosocial level; which also reflect the methodological progression of the study from description to explanation.The result shows that the discursive practice was hegemonized by a Western view promoting economic growth. This discourse gradually gained ground at the expense of an anti-systemic discourse which posited structural societal changes as the answer to environmental problems. Mechanisms such as the exclusion of some views and actors from common discursive practices were crucial for the process of homogenizing the discourse and developing consensus. Through incorporating that part of the environmental movement which did not fight the dominant economic and political system, the UN turned it into support for its own project, which is part of the process of hegemony. At the same time the environmental objectives of the hegemonic discourse were established in the institutional spheres.The institutionalization of the environmental issue changed the focus from social critique to a question of development and technology, something which helped displace the original critical and partially anti-systemic character of environmental discourse. Through turning the critical and negative account of the situation into a more harmonious and hopeful vision, for instance in terms of sustainable development, a foundation was laid for the later development of ecological modernization. When the hegemonic discourse invested the concept of sustainable development with emphases on progress and economic growth, it encapsulated the environmental issue within the framework of the prevailing social system.
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| 6. |
- Olsen, Terje, 1967-
(författare)
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Versjoner av arbeid : Dagaktivitet og arbeid etter avviklingen av institusjonsomsorgen
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This dissertation is a study of employment and daytime activities for people defined as having an intellectual disability. The study’s point of origin is the somewhat paradoxical situation these individuals are put into when it comes to work and daytime activities. They are on the one hand granted a disability benefit and made objects for a logic of caretaking; they are regarded as vocationally disabled and defined as outside the workforce. On the other hand, they are still included in a hegemonic work ethic with political objectives for ‘full employment’ and ‘a working-life for all’. A main objective in this study has been to discuss what different types of work and daytime activities mean to these individuals themselves; what role work and daytime activities have in their identity management and self-presentation in everyday life.The study consists of three parts. Part I outlines a historical contextualisation of the relationship between intellectual disability and participation in work and production. This part also provides a brief account for the labour market situation for these individuals today, and discusses the present situation related to the official aims of the administrative reform, which closed down the state-financed institutions for people with intellectual disabilities. Part II discusses the theoretical perspectives and methodological approach used within the study. The theoretical perspectives are developed using concepts from Dorothy Holland et.al, Pierre Bourdieu and Erving Goffman. The methodological approach is based on qualitative case studies with participatory observations and interviews within the different settings where people with intellectual disability work. Part III presents and analyses data derived from fieldwork. Central elements in the meaning of work in identity management are discussed and classified in six basic ‘key stories’ about work and daytime activity. Different forms of adapted and ordinary work are discussed in context of gender roles and social class aspects.
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| 7. |
- Salmonsson, Lisa, 1978-
(författare)
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The 'Other' Doctor : Boundary work within the Swedish medical profession
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis is about medical doctors with immigrant backgrounds who work in Sweden. Based on 15 qualitative interviews with medical doctors with immigrant backgrounds, this thesis explores the medical doctors’ feeling of professional belonging and boundary work. This thesis focuses mainly on the doctors’ experiences of being part of the Swedish medical profession while, at the same time, being regarded as ‘different’ from their Swedish medical counterparts. It starts off with the idea that medical doctors with immigrant backgrounds may have, or could be regarded as having, contradictory social positions. By virtue of being part of the Swedish medical profession, they belong to one of the most privileged groups in Swedish society. However, due to their immigrant background these doctors do not necessarily occupy a privileged position either within their profession or in society in general. This thesis shows that doctors with immigrant backgrounds feel that they are not perceived as full-fledged doctors, which seem related to how they are somewhat ‘othered'. The results show that these doctors cope with being seen as different from doctor with non-immigrant backgrounds, by using the notion of ‘migranthood’ as a resource in negotiations in everyday work life but they also do what they can to overcome the boundaries of ‘Swedishness’. Belonging should therefore be seen as having a formal and an informal side, as getting a Swedish license does not automatically mean that you feel belonging to, in this case, the Swedish medical profession. This seems to put doctors with immigrant backgrounds in a somewhat outsider within position, which seems having to do with boundaries between who is included in the ‘us’ and in the ‘them’. Lastly, these findings indicate that sociologists need to expand the understanding of professional groups to also include boundary work within these groups. In order to do so, this thesis argues that sociological theory on professional groups could be combined with sociological theory about social positions as that is one way to understand the outsider-within position that these doctors (and presumably other skilled migrants) have to cope with.
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| 8. |
- Sépulchre, Marie, 1987-
(författare)
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This is not citizenship. Analysing the claims of disability activists in Sweden
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This dissertation aims to contribute to sociology, citizenship studies and disability studies by responding to T.H. Marshall’s ([1950]1992) invitation to examine the development of equal citizenship in a context of structural inequality, and Jenkins’ (1991) call to consider disability as a dimension of social stratification. Based on the analysis of blog posts and debate articles published in daily newspapers and written by Swedish disability activists (n=474), this dissertation argues that disability activism can be considered as a citizenship struggle claiming equal membership and rejecting the structural inequalities caused by disability. The analysis highlights a number of tensions and contradictions between and within the various components of citizenship as well as between and within the claims of the disability activists. These observations correspond to T.H. Marshall’s insight that citizenship is a developing institution full of contradictions, and to the observations of some citizenship scholars, arguing that citizenship claims-making features tensions and dilemmas. Moreover, the dissertation is in line with T.H. Marshall’s insight that the inclusion of previously excluded individuals – in this case, disabled people – as equal citizens brings forward important challenges, with respect to social (in)equality. In particular, challenges regarding recognition (who do we consider and value as full citizens?) and redistribution (how do we redistribute socio-material resources?). Based on the empirical analysis, this dissertation argues that the disability activists’ claims are defensive and proactive because the activists engage in both defending existing social rights and proposing new ways to construct citizenship for disabled people in Sweden. Finally, this dissertation points at different strategies used by the disability activists and at the dilemmas that some of these strategies imply. Among others, the Swedish disability activists highlight the importance of equal rights, while recognising the reality of costs; demand that disabled people be considered as ordinary citizens while asking for the accommodation of their specific needs; and view the state as the protector of equal citizenship while criticising it as a cause of the structural inequalities faced by disabled people. Thus, this dissertation opens new perspectives on citizenship and disability, and encourages future research to continue the analysis of citizenship in relation to structural inequalities.
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