Abstract

This study examined the lived experience of Canadian clinical social workers in light of the organizational context in which they work. The literature indicates an alarming rise of occupational psychological distress in social workers, which aligns with the rise of the neoliberal ideology within the Canadian healthcare sector. While we know that organizational constraints and structural reforms affect social worker’s workplace well-being, it remains unclear how these changes are represented by front-line practitioners and how they affect the provision of social services in healthcare settings. To deepen our understanding of this issue, we conducted a thematic analysis of thirty semi-directed interviews with social workers currently practicing in three Canadian cities (Ottawa, Moncton and Winnipeg). Discussions of daily work life, responsibilities, autonomy and subjective understandings of the social worker’s role revealed which organizational constraints were the most significant in everyday practice and how they relate to their professional identity and mandate. Provincial healthcare reforms were generally found to have negative effects on clinical social workers, whose struggles for recognition were impaired by the fundamentally neoliberal ideologies behind the large-scale restructuring of service provision, themselves at odds with the humanistic principles of social work. Our findings further suggest that structural changes under the New Public Management frame could be detrimental to both the quality of services provided by clinical social workers and their well-being. Overall, this investigation highlights the importance of organizational improvements in the workplace through systemic changes that would concurrently target managerial expectations, resources allocation, autonomy, work-life balance and respect for professional values.

Highlights

  • Healthcare Reforms and Social Work: A Tumultuous AffairCanadian healthcare operates as a single-payer system with universal coverage (Ivers et al, 2018)

  • Two encompassing components emerged from our data that effectively structure the lived experience of healthcare social workers: cumulative organizational constraints and a paradoxical autonomy

  • Front-line practitioners endure numerous organizational constraints which reorient their practice in a direction which does not align with their sensibilities, priorities and values

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Summary

Introduction

Healthcare Reforms and Social Work: A Tumultuous AffairCanadian healthcare operates as a single-payer system with universal coverage (Ivers et al, 2018). Social Workers and Healthcare Reforms brackets nation-wide, healthcare management has been the subject of numerous reforms over the past decades These reforms have all kept with the general tendencies of the New Public Management (NPM) (Hutchison et al, 2011). In the healthcare sector, NPM equates the management of public services with the management of services in the free market and seeks the optimization of services primarily through an efficient use of economic resources and consumer-centered interventions. As such, it promotes a result-oriented governance for both patients and taxpayers (Sebai and Yatim, 2018)

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