| 1. |
- Billinger, Kajsa, 1949-
(författare)
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Få dem att vilja : motivationsarbete inom tvångsvården av vuxna missbrukare
- 2000
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The coercive care of adult substance abusers is aimed at motivating them to seek voluntary treatment. The purpose of the present study is to throw light on how motivational work is perceived and articulated by care providers working in coercive care.To select the LVM institutions for the study, an initial survey was made of the motivational work being carried out in the entire area of substance abuser care, both coercive and voluntary care. From this survey four institutions were strategically selected on the basis of their therapeutic points of departure. The focus group method was used for the data collection.The care providers at the four LVM institutions gave different pictures of coercive care, although they worked under the same paragraph of the law. The differences could be attributed to their different therapeutic points of departure. It was impossible to discern an explicit description of motivational work at any of the LVM institutions. The care providers did not present any methods or techniques that clearly differed from what we call diagnosis, education or upbringing. In their view, everything they did aimed at increasing their clients’ motivation. There were three main tools the care providers used to accomplish their central task of transforming unmotivated clients into persons who choose not to be substance abusers: assessment, treatment and the establishing of a relationship with the client and working within its framework. The clients’ needs were described in a corresponding way. They were to be led, taught or compensated. Only one of the four LVM institutions specifically treated the clients’ substance abuse problems. At the other three institutions, substance abuse was considered either secondary to the clients’ other problems, a symptom of underlying problems, or a topic to be avoided in order to focus on future solutions. The clients’ resistance and negative attitudes to coercive care were obstacles that care providers tried to overcome by various means. They encouraged clients to regard coercion as a privilege or tried to make them feel at home, or else the care providers worked as if the coercion did not exist. All in all, the picture that emerges is that because of the coercive element the care provided was without contours, the clients did not have a range of options from which to choose. The only thing the care providers could do was to get the clients to stay at the institution, or bring them back if they ran away. The goal of getting clients to take the next step into voluntary treatment had to give way to the less tangible goal of exerting a positive influence on them - of “sowing the seeds of change”.
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| 2. |
- Byberg, Ingrid, et al.
(författare)
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Kompetensutveckling inom socialtjänstens Individ- och familjeomsorg : - exempel och erfarenheter
- 2003
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Rapporten har tillkommit i ett samarbete mellan Socialstyrelsen och Institutionen för socialt arbete – Socialhögskolan vid Stockholms universitet. Syftet har varit att ge ett underlag för diskussioner om kompetensutvecklingsarbete – hur det kan struktureras och systematiseras. I rapporten beskrivs de modeller som utvecklats inom socialtjänstens Individ- och familjeomsorg i Norrköping och Göteborg samt synpunkter från i första hand arbetsledare och socialsekreterare på hur modellerna har uppfattats när de tillämpas. Den undersökning som har utförts har varit inriktad på att inventera de olika synpunkter och perspektiv som förekommer snarare än att utgöra en utvärdering av modellerna. Ett allmänt intryck av det material som presenteras är dock, att ett systematiskt kompetensarbete framstår som i hög grad meningsfullt.
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| 3. |
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| 4. |
- Ekendahl, Mats, 1971-
(författare)
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Tvingad till vård : missbrukares syn på LVM, motivation och egna möjligheter
- 2001
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Compulsory treatment is regulated by the Care of Alcoholics and Drug Abusers Act (LVM; 1988:870), and aims, among other things, at motivating addicts to treatment. Research has, up til now, mostly disregarded the client-perspective on compulsory measures. This dissertation has its starting point in the experiences of 54 alcohol- and drug addicts. The intention is to describe and analyse their view on coercive care and the possibilities to become motivated for change and/or voluntary treatment in such a context.A central question during the interviews (which took place at five different institutions for compulsory commitments) is the addicts´ problem recognition, desire for help and willingness to participate in treatment. These dimensions are also illuminated quantitatively by use of a questionnaire. The results of this questionnaire form the basis of a division of the addicts into three groups with varying de-gree of treatment motivation. Comparisons between the groups are done with reference to the evaluation of present treatment context and of the institutions’ efforts to enhance motivation. In addition to this the groups are compared regarding how they perceive limita-tions in their freedom of action.The results showed that the three groups had different motiva-tional structures. The “least motivated” stated that the addiction was not their major problem and wanted no help with that aspect of their lives. The “middle-group” claimed to have alcohol-/drug problems that, however, were not too serious. They were not sure that the coercive care was adequate for their situation. The “most motivated” said that they had vast problems with their addiction, were help-seeking and satisfied with having the chance to participate in any kind of treatment program at all. Less differences between the groups were noticeable when it came to a direct evaluation of com-pulsory treatment. The majority reported that they, through the co-ercion, had been exposed to violations of their autonomy. Whether motivated for treatment or not, the interviewees were also sceptical about the possibilities of the institutions to enhance motivation among the incarcerated addicts.In the dissertation, addiction and motivation is furthermore dis-cussed from the perspective of rational choice and motivational the-ory. It is concluded that committed addicts think and act strategically in order to maximise their personal use of involuntary incarcerations. It is also asserted that their view on what happens during commit-ment, in some respects, is opposed to the “establishment’s”. For instance, the addicts claim that you don’t become motivated by way of compulsory treatment, while the opposite of their notion form the basis of the legislation.
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| 5. |
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| 6. |
- Forssell, Emilia
(författare)
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Skyddandets förnuft : en studie om anhöriga till hjälpbehövande äldre som invandrat sent i livet
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This dissertation aims to examine and deepen the knowledge of family member caregiving where the care recipient is an elderly person who immigrated late in life. It also aims to contribute to the knowledge of the complexities underlying informal care giving and add to our understandings of what it means to be an immigrant in Sweden. The caregiver is in focus. The research conducted is explorative and partly inductive. The main material used is a qualitative interview study carried out with family members from different countries who are providing informal care to elderly immigrant relatives. The analysis gives three patterns of caregiving. One shows help from informal caregivers only who are not compensated economically. Another shows help from family members who are compensated. The third shows help from family members and staff from the public care system. Three ideal-typical informal caregiver roles show different positions vis-à-vis the new: “guardian”, “filter” and “reinterpreter of traditional care ideals”. Swedish born and immigrated informal caregivers are also compared through analysis of data gathered in telephone interviews with a representative selection of inhabitants in the County of Stockholm.A philosophy of action together with theory on integration and multiculturalism serves as theoretical frameworks to understand discrepancies and ambiguities in the data. Young immigrants experience different integration processes than do the older ones. They strive to protect older family members from changes linked to the migration experience. Talk about dependence on culture underlines family feelings and legitimates the processes of protection. Preconceptions about great differences between Swedish born and immigrant families are not supported by quantitative data. A conclusion is that protection can be understood in relation both to the traditional and the new, the latter in the forms of meetings with Swedish society where unequal relations prevail. It is a kind of counter-strategy where the range of actions is diminished, and thus it has its own logic. Protection can be loosened up when the circumstances change and the range of actions grow.
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| 7. |
- Hübner, Lena, 1958-
(författare)
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Narkotika och alkohol i den allmänna opinionen
- 2001
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of the thesis is to study public opinion on social problems, with focus on the problems of alcohol- and drug abuse. Public opin-ion is studied through a sur-vey, distributed to a cross-sectional, ran-domised and represen-tative sample of the Swedish population, aged 18 to 69 years. The survey was distributed in spring 1995 (N=3 000). Apart from background questions, the survey contains questions on how respondents perceive different aspect of alcohol- and drug prob-lems and what should be done about them.The theoretical perspective treats social problems as the result of collective de-fi-tio-nal processes, through which alcohol- and drug problems have been given diffe-rent cognitive and moral connotations. As a result, the problems have acquired objec-tive facticity. According to this perspective, reality is a social construction and reali-ty and soci-ety have a dual character of objective facticity and subjective mean-ing.The term "public opinion" is discussed in the thesis. The conclu-sion drawn is that there is mainly two ways of understanding public opinion. In the first case, public conversation and debate is seen as a prereq-uisite to public opinion, which is comprehended as a group-based discur-sive phenomenon. In the second case, public opinion is equated with the results of opinion polls.The results show that alcohol- and drug problems are perceived as serious social problems, though drug abuse is seen as more serious. Concerning drugs, the public perceptions are, to a large extent, unanimous. Drugs are dependency-generating, dangerous and should be forbidden. The punishment for drug-re-lated crimes should be more severe than today. Large parts of the respondents agree on all of this. Concerning alcohol, the results show greater differences between different groups of respondents. A majority of the women are less positive to alcohol than the men, and more in favour of alcohol re-strictions. The same goes for older people compared to younger. One central conclu-sion concerns the unamity in the percep-tion of drugs, while the perception of alcohol is much more varied. The low visibil-ity of groups expressing different views on the drug problem in public debate seems to be reflected in the results of the survey. The respon-dents’ perception of drugs is thus very much in line with official dis-course.
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| 8. |
- Karlsson, Magnus
(författare)
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Själv men inte ensam : om självhjälpsgrupper i Sverige
- 2002
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In this thesis, self-help groups are defined as small, autonomous groups of people that meet regularly to cope with a shared problem through mutual aid. There is reason to believe that self-help group activity is increasing in Sweden. Since no general attempts to map self-help group activity have been made in Sweden, one aim of this study was to map such activities in ten strategically selected geographical areas. A second aim was to analyze the internal and external circumstances of these groups in order to improve our knowledge about Swedish self-help groups in general.The thesis builds on four empirical studies. The first study aimed to map self-help group activity in the ten selected regions, using a questionnaire sent to vicars in the Church of Sweden, heads of welfare offices, head counselors in the health service and representatives of voluntary organizations (n=599). The second study sought a broader understanding of the internal and external circumstances of self-help groups. Eight groups, strategically selected from the outcome of the first study, were group interviewed. The aim of the third study was to examine whether the results of the group interviews were valid for all the groups found in the initial mapping. A questionnaire (27 items) was sent to key persons (n=73) in the groups. The fourth and final study had a partially deductive approach. One aim was to improve our understanding of the roles played by different kinds of knowledge in the groups. A second aim was to test whether the participants in the groups were “peers” or whether there were leaders in the groups in terms of creating, upholding and representing different kinds of knowledge. Four groups, comprising 18 migraine sufferers, were examined by means of a personal questionnaire, a network test and group interviews.The results of the studies showed that 0.5 percent of the population in the selected regions belonged to a self-help type of group at the time for the study. The most common problems among the 228 groups found were related to alcohol (44), illness and physical disorder (41), grief (22) and parenthood (21). Group members emphasized the importance of mutual understanding in their groups, and in the thesis the groups are understood on the theoretical basis of sociology of knowledge. The thesis argues that a specific kind of knowledge - experiential knowledge - is developed in self-help groups. This kind of knowledge is based on mutual understanding and contributes to a deeper understanding. Some differences between experiential knowledge and professional knowledge are highlighted. Besides mutual understanding, the participants valued the spirit of community and the information given in the groups. Finally, the results indicate that groups that had a formal leader (representing professional knowledge) tended to value information more, while groups where the participants were peers (relying on experiential knowledge) primarily valued mutual understanding.In this thesis, self-help groups are seen as belonging to the third sector, and therefore as related to voluntary organizations. However, it is argued that self-help groups may be a contemporary phenomenon with the participants often being consumers rather than members. Despite the group constellation, self-help groups may sometimes have the value of an individual project.
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| 9. |
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| 10. |
- Sallnäs, Marie, 1952-
(författare)
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Barnavårdens institutioner : framväxt, ideologi och struktur
- 2000
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The study presents an overview of the historical growth and deve-lopment of residential care for children and youth in Sweden as well as an analysis of the present-day structure and organisation. The empirical material consists of official statistics, government reports and data from a questionnaire addressed to all registered residential homes in the child welfare sector at the end of 1995. The history of residential care for children and youth is marked by a period of establishment and expansion in the first decades of the last century, followed by a process of major de-institutionalisa-tion in the period after the Second World War. A third phase was introduced with the Social Service Act of 1980, which laid down new premises for child welfare. Traditional concepts of children’s homes were replaced in the legislation by the “HVB-home” and the dividing line between institutions and foster homes became blurred. The study shows that contrary to what was intended, a growing part of out-of-home placements during the 1980:s and 1990:s where into residential care. In fact, residential care has taken over “market shares” from foster care in Sweden. Analysis of the range of alternatives shows that residential care today is relatively small-scale and that nearly all of the smaller units are privately run. Approximately half of the homes have teenagers as their target group and most homes work with longer-term pro-grammes of treatment and care. Educational background among staff varies considerably, but in general the level of educational is low. So far, no professional forces have proved strong enough to organise the field on a mutually knowledgeable, normative ground. A problem is the lack of unanimous concepts and a common language with a terminology that can be used for a systematic de-scription of the care or treatment given. What is clear, however, is that a new form of residential care can be identified – so-called hy-brid homes that are somewhere in between extended foster homes and small institutions – and that these homes have gained a con-siderable position in the field.
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