1.
Klamas, Maria
(författare)
Av egen kraft tillsammans med andra : Personer med psykiska funktionshinder, socialt stöd och återhämtning.
2010
Doktorsavhandling (övrigt vetenskapligt/konstnärligt) abstract
The purpose of this study was to describe and analyse the significance of social support to adults with psychiatric disabilities, based on the individual's experiences. This includes research questions concerning what type of social support was perceived to be beneficial or restrictive, which relational aspects were considered having a beneficial or restrictive effect on the support- and recovery process, as well as what strategies and capacities the individual developed on their own in order to cope with their obstacles and disadvantages.The empirical material was based on qualitative inteviews with ten individuals that defined themselves as having psychiatric disabilities. They were each interviewed on three occasions. The repetetive form of the interviews lead to three separate interview guides being created over the course of the data collection process. The goal of the first interview was to get a general idea of the subject's daily life, activities, arenas, relationships and support. The second interview focused on meaningful relationships. The third and final interview had one general and one individual part. The general part focused on the subject's psychiatric disabilities, their opportunities as well as existing and desired support measures. The subject matters in the individual part were related to the previous interviews with each of the participants and aimed to develop or expand on previous discussion.The material was analysed using theories about social support and recovery and was presented with roots in four different networking entities: close and extended family, friends, coworkers and fellow students, as well as formal support instances. The result showed that it is the support with mobilising qualities that is beneficial to the recovery process. It increases the individual's degree of control over their illness, obstacles and challenges. In addition, it appeals to the individual as a central actor and as a person with difficulties as well as resources. The fact that the social support from the various support agencies have varying focus and direction benefits recovery since it increases the individual's opportunity to maintain as well as develop their social bonds and roles within the community. A relational prerequisite for social support is an equal relationship, which benefits the recovery process as it encompasses acknowledgement and acceptance of both the individual on a personal level and of their situation. The type of social support that hinders recovery is the kind that lacks a connection between the individual's perceived problems, their need for support and their over time fluctuating ability to handle their psychiatric disability. This is due to the fact that it robs the individual of control over the situation, increases the need for support and strengthens their perception of themselves as sick. Recovery comes to a halt when the individual isn't included in the support and recovery process, which is clarified in relational aspects such as lacking attentiveness, subpar acceptance as well as rejection. The individual's will and capacity to actively take on the responsibility to steer their recovery in a positive direction was made visible through four groups of strategies that were crystallised through the course of the research; creation of understanding and legitimisation, cultivation, including strategies and the creation of boundaries.
2.
Mossberg, Linda, 1982-
(författare)
Mellan norm och praktik : Strategisk samverkan och brukarmedverkan inom verksamhetsområdet psykisk ohälsa
2018
Doktorsavhandling (övrigt vetenskapligt/konstnärligt) abstract
There is a steady critique towards the mental health field stating that people with mental health problems do not get the assistance they need. Often, this critique states that collaboration between different organisations is lacking or non-functional. As an increasingly common part in collaboration, service user participation has also been included in this critique as not being adequately performed. Within the mental health field,many studies has focus on collaboration and service user participation on operational level, with and between professionals in direct interaction with service users. Not as many has studied the strategic level of collaboration, between leaders and managers, planning and structuring the organisation of mental health services. This level has also within the operational level studies often been pointed out as paramount to collaboration on operational level.The present thesis aims to describe and analyse collaboration and service user participation on strategic level. The following research questions are included: how are the strategic collaboration councils composed, and how do the participants handle the work within them? What experiences and opinions on collaboration do the participants have? How do the participants handle possibly contradicting expectations and interests from the surroundings and from their own organisations? How are service users and service user participation socially constructed, and what do such constructions entail? How do the participants handle collaboration as a practically unavoidable way of working?Eight strategic collaboration councils from the north, middle, and south of Sweden were included in the study. The participants in these represented mostly social and mental health services, and in some cases Arbetsförmedlingen (the Swedish Public Employment Service), Försäkringskassan (Sweden's social insurance agency), and service user organisations. 80 participants in all were included in the study, mostly managers. The councils were observed during one year, and the participants were asked to participate inan interview and a questionnaire. The material was analysed with the assistance of NVivo9 and SPSS, and by the theoretical aid of new institutionalism, discourse analytic perspective, and negotiationThe results showed a collaboration between the participants that revolved around norm and practice of collaboration. While all participants had very homogenous opinions and experiences of collaboration, showing of a strong norm supported by laws and regulations, there were also a discussion that showed of the possibility to negotiate that norm. Through negotiation and normative arguments, the participants could adhere to the norm that brings legitimacy to the organisation and the collaboration council, while further own interests and interpretations. Negotiation about collaboration meant that the participants could discuss collaboration in itself. Through choosing normative arguments, they could put forward certain aspects of the collaboration norm which gave latitude within the norm. Here, the norm came forward as collaboration should be done by being or becoming to be united, while having good relationships and an open discussion. The dilemma that showed through the negotiation and normative arguments was that while collaboration must be built on good relationships that can withstand disagreements and criticism, one cannot jeopardize the relationships by bringing up contentious topics. But, if pressing matters because of this are not allowed to be discussed, collaboration is at risk to be perceived as pointless. Collaboration through negotiation showed negotiation as a mean to get things done and to handle interests and interpretations in the collaboration councils. These negotiations were both implicit and explicit and were based in the collaboration norm. Normative arguments also served a purpose in building and strengthening the relationships between the participants, putting relationships as a central part of collaboration. Through normative arguments based in the collaboration norm, participants could preserve consensus and discuss disagreements, interpretations, and interests without risking the relationships. Service user representatives tended to be apart in negotiation about collaboration, but not in collaboration through negotiation. Even so, the service user representatives made a mark within the collaboration councils indiscussions and agendas, showing a plausible increasingly stronger position within in strategic collaboration.
3.
Åberg, Linnéa
(författare)
Standardiseringsarbetets kollektiva praktik. En studie om att kvalitetssäkra integrationssatsningen Samhällsorientering för nyanlända.
2020
Doktorsavhandling (övrigt vetenskapligt/konstnärligt) abstract
Societal efforts to support the integration of newly arrived immigrants have been repeatedly highlighted in the political debate in Sweden and they are described as inadequate and ineffective. Demands have been made for improvements and one of the designated efforts is Civic Orientation (CO). The Civic Orientation programme is a course about Swedish society, targeting newly arrived refugees and their relatives who have received a residence permit. It provides basic information about Swedish society to aid and expedite integration (SFS 2010:1138). The criticism has led to the production of written, national instructions containing correct information that should be provided by the civil servants in CO. The aim is that quality should be high and equal across the country. The overall aim of the dissertation is to deepen the understanding and knowledge of the work-process to develop standard guidelines, that will be used in a welfare sector, where it is difficult to establish definitive knowledge. The dissertation's purpose is also to deepen the understanding and knowledge of instruction work as a collaborative activity. The term ‘instruction work’ covers both work that experts and managers undertake when they develop written guidelines, and work done when implementing these guidelines in local practice. The thesis is rooted in activity theory where work is viewed as a collaborative activity aimed at taking on a task, event or object, such as interpreting, paying attention, participating, thinking, and performing. The study involves five different categories of actors: a representative from the county administrative board, experts from various authorities and universities, coordinators and the head of a unit from a management group in a municipality, and integration workers, who are the local civil servants. The study is based on a field study where video recorded observations of meetings, lectures and workshops have been conducted. Semi structured interviews and written communication have also been used. The result shows that there are different perceptions of what work needs to be done to ensure that the instructions are correct. A variety of, sometimes contradictory, tasks developed: to make the information scientifically correct with multiple perspectives on social phenomena, to make educational simplification, to provide an ideal image of Sweden according to policy, or to describe Swedish society as irrational with hinders and obstacles (papers 1- 3). Another major task was to make the instructions politically neutral which meant producing information that was not offensive for external readers such as politicians and the general public (paper 1). When guideline models have been used for other welfare activities, the work is usually based on analysis of the needs of the target groups. That task took on an obscured role and was first noticed as important by the civil servants in the latter part when the material was used during implementation (papers 1, 3). A further result concerns the work of developing standard guidelines. The study shows that there is formal instruction work (paper 1) which is the planned work, most often done by experts and/or researchers, and informal instruction work (paper 2) often hidden and performed by civil servants in the implementation phase. This informal work is about transforming the instructions to be useful for the individual in the local situation. But the study also shows a third type of work - semi-formal instruction work (paper 3) that is also carried out by the local civil servants, where they, with their biographical and informal instruction work experience, try hard to influence formal instruction work. One conclusion is that it is more fruitful and accurate to perceive standardized instructions as dynamic and integrated in the practical work, than to see them as fixed by an externally controlled process. Developing standards to be used to improve practice is an ongoing fluid process that never ends, and that involves tensions and conflicts that need to be addressed.
