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- Kaunitz, Catrine, 1971-
(författare)
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Aggression Replacement Training (ART) i Sverige : - spridning, programtrohet, målgrupp och utvärdering
- 2017
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The manual- based prevention program Aggression Replacement Training (ART) is used in treatment of young people with behavioral problems. This thesis is based on two attempts to evaluate ART in Sweden. Using ART as an example, the aim of the thesis is to describe and analyze how a manual-based program is spread and applied within Swedish social services. The aim is also to discuss the conditions for conducting efficacy studies of manual-based programs in regular in-home care and in secure institutional youth care. In addition, the thesis includes a systematic review of existing international and Swedish effect and efficacy studies of ART (Brännström, Kaunitz, Andershed, South & Smedslund 2016).The first sub-study presented in the thesis consists of two different surveys of how and to what extent ART was used within the Swedish municipal social services in 2006 and 2012. The results show that ART has been widely spread within local social services though the program adherence has been low and the variations of ART used in practice have been far from adherent to the original manual-based program.The second sub-study examines and describes the target group of youth receiving ART within the Swedish social services. Results show that program participants are a crime active group but the variation is large in terms of seriousness and extent. According to self-reported data, program participants neither use alcohol or drugs to any greater extent than other peers. Furthermore they seemed to have social skills (interpersonal skills, ability to assert themselves, self-control and empathy) within the normal range for young people of the same age. Roughly one in three participants did not complete the ART training as planned.The third sub-study describes two aborted attempts to carry out efficacy studies of ART within regular in-home and secure youth care in Sweden. A number of factors such as low adherence to the program - which affects the ability to carry out efficacy studies in this research field - are reported and discussed.According to the systematic review of effect and efficacy studies of ART, most international studies show more or less positive results. After checking the quality of the studies and risk for bias, it appears that all of the studies - in varying degrees - have substantial methodological flaws. The scientific evidence is therefore insufficient for drawing conclusions about effects of ART.Finally the results are discussed in relation to contemporary demands and expectations of an evidence-based youth care, in relation to other studies that have been carried out in this field, and in relation to the existing conditions for using manual-based programs in youth care regular practice.
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| 2. |
- Skerfving, Annemi, 1946-
(författare)
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Barn till föräldrar med psykisk ohälsa : Barndom och uppväxtvillkor
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this doctoral thesis is to – from a child perspective and with children as informants – describe and analyze childhood conditions for children whose parents suffer from severe mental illness. The method used is qualitative – 28 children, 10 boys and 18 girls, 7–18 years old, were interviewed about their parents’ mental disorder; the family situation and their own personal life – in school and during free time. The analyses are based on Sociology of Childhood and Family Sociology. Previous studies have, to a great extent, focused on the risk the children run of developing mental health- and social problems and what helps them to grow up healthy. The increased risk of mental health- and social problems has been well confirmed, but also that preventive interventions can contribute to resilience in the children. Although some studies have explored children’s experiences of their parents’ mental illness and the challenges they meet, research from a childhood perspective, has so far been scarce. The results of this study reveal different degrees of emotional, physical and social exposure for the children. Their childhood conditions were related to gender, relations, communication, problem load and social situation of the family. If the parent with a mental illness was a woman, the situation for the child was often more exposed than if it was the father – most likely due to parental roles and expectations on men and women in the Swedish society at that time. Girls seemed more emotionally involved in the parents’ problems than boys, especially if the parent with a mental illness was a father. Most of the parents were divorced or had never lived together. Parental conflicts complicated the life of the children, who were expected to have maintained relationships to both parents. Lack of communication about the parent’s mental disorder in - and outside the family - was common. The children were often uninformed about the parent’s problems. If hindered to pass information between and outside their two homes, they were left to handle difficult, sometimes dangerous, situations with the mentally ill parent, alone. The home was not always the safe place for rest and recovery, as homes are expected to be. The heavier the total problem load of the family, the more exposed was the child. Most exposed were children whose both parents had severe problems – mental illness or addiction. They were often placed in out of home care, for longer or shorter periods. The kind and degree of exposure the children experienced varied. Four kinds of childhood sceneries could be recognized: (1) the well organized childhood, where the parent’s mental health problem was mainly an emotional burden for the children; (2) the complicated childhood, where the parents conflicts and inability to protect the child made the child either too involved or too lonely in handling the problems that the parent’s mental illness caused them; (3) the problematic childhood where the parent’s mental illness was not the only problem in the family, but factors like the other parent’s drinking, siblings’ problems, social and economical difficulties added to the burden and (4) the exposed childhood where none of the parents was able to take care of the child. Knowledge and openness, about the parents’ problems, seemed to increase competence and decrease feelings of guilt and responsibility for the parent. All of the children stood forward, not as passive victims, but as competent agents in their own lives – although often more or less powerless because of their dependence of their parents and other adults around them. It was clear, though, that there is a need for professionals in adult psychiatry, social services, school and preschool, to pay attention to the children of parents with mental health problems and see to that they get the information and support they need. Keywords: Children, childhood conditions, children as agents, parental mental illness/mental disorders, mental health knowledge, exposed life situations, competence.
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| 3. |
- Storm, Palle, 1977-
(författare)
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Betydelsen av kön och hudfärg i äldreboendets vardag under olika organisatoriska villkor
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Even though nursing home care in Sweden and Canada takes place in different care contexts and utilizes different organisational models, in both countries, the traditional image of an ideal care worker is characterized by femininity and whiteness. However, today, in both countries, the care workforce is becoming far more diverse, with increasing numbers of white men, and non-white women and men.The overarching aim of this thesis is to study the meaning of gender and skin colour in the everyday life in Swedish and Canadian nursing homes. The study, based on observations and interviews, focuses on how organizational conditions contribute to creating, maintaining and challenging notions of gender and skin colour.The thesis consists of four articles, analysing the following questions:How is gender, in interaction with ethnicity and sexuality, expressed by women and men care workers in a Swedish nursing home? How do organizational conditions shape and influence men’s positions and their possibilities to be integrated and accepted as care workers in two Canadian nursing homes characterized by different care models? How do organizational conditions impact on care workers’ strategies to handle skin colour, racism and language problems in Swedish and Canadian nursing homes characterized by different scope for care workers to exercise discretion? How do non-white men born outside Europe describe their experiences of working in Swedish nursing homes, and what does it mean for them to have a body that differs from the traditional image of a care worker?Overall, the findings demonstrate that an interaction of gender and skin colour shapes the workers’ experiences and position in the everyday life of care. The most profound impact is on those who deviate the most from the normative care worker, non-white men care workers. Significantly, the results also show that the ability for the organization to handle diversity is highly dependent on whether or not the workers are able to exercise discretion in their daily work. If these organizational conditions do not exist, there is a high risk that men and non-white workers will be seen as problematic by both co-workers and residents.In order to mitigate these risks and manage the increasing diversity of those working in nursing homes, it is essential to recognize the importance of organizational conditions that can create and ensure acceptance and integration of care workers from diverse backgrounds. Therefore, questions about gender and skin colour must be recognized as a priority for management, an organizational matter that should not be left to the individual or the work group to handle.
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| 4. |
- Ulmanen, Petra, 1968-
(författare)
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Omsorgens pris i åtstramningstid : Anhörigomsorg för äldre ur ett könsperspektiv
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis examines the extent of family care for older people, primarily filial care, and the costs of caring in the Swedish welfare state. Costs of caring are understood as the negative effects of caregiving, primarily on the caregivers’ working life. The analysis is inspired by feminist theories on the importance of welfare state provisions for care for women’s citizenship, including personal autonomy and economic independence.The main aims of this thesis are twofold. The first is to explore the extent and development of family care for older persons in Sweden, primarily filial care, and the consequences of caregiving for well-being and working life. The second is to explore how older persons’ family members have been represented and the possible consequences of these representations for the development of publicly financed eldercare services and other forms of support for family carers, as well as for family members’ living conditions.The thesis consists of four studies. The first reviews the literature concerning the extent and consequences of family caregiving for older persons and the welfare state’s policy responses to older people’s care needs. The second study analyses how older persons’ family members and their role in eldercare have been represented in Swedish eldercare policy since the 1950s. The third study analyses surveys to explore changes during the 2000s in the role of the family, the public sector and the market in providing care for older persons in Sweden. The fourth study is a survey analysis of the extent, content and consequences of filial care among middle-aged women and men in Sweden in 2013.The policy analysis found that the expansion of eldercare was motivated solely in relation to older persons’ needs; thus working daughters’ needs of eldercare have been a blind spot in Swedish eldercare policy.Since 2000, every fourth residential care bed has disappeared and the increase in homecare services did not fully compensate for the decline, resulting in a significant increase in filial care in all social groups, and among both sons and daughters. Daughters of older persons with shorter education, however, remained the primary providers of filial care.Both daughters and sons are affected by caregiving. They suffer to the same extent from difficulties in managing to accomplish their work tasks and taking part in meetings, courses and travels. They are also equally likely to reduce their working hours and to quit their job. It is however clearly more common that daughters experience mental and physical strain, difficulties in finding time for leisure and reduced ability to focus on their job. Although more daughters than sons retire earlier than planned due to filial care, this is very rare.Managerial care (handling contacts with health and eldercare services) has a more salient role in a welfare state such as Sweden, with generously provided care services, less intense filial care and high employment rates among both sexes. The high labour force participation however makes middle aged children more vulnerable when their parents’ care arrangement does not work. The decline in eldercare services since 1980 has reinforced co-ordination problems in health and eldercare services. The managerial care required to handle this development, while living up to the demands of work and family life, stands out as especially demanding for the well-being and working lives of daughters.
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