Swedish Social Workers Research Articles

Social work assessment of underage alcohol consumption: Non-specialised social services comparison between Sweden and Italy

AimThis research contributes to highlighting social work assessment of family situations with underage alcohol consumption and abuse. The comparative study invites reflection on the main features influencing an initial approach to adolescent problematic alcohol consumption outside specialised addiction services.Design– The study is based on a cross-national comparison. A questionnaire including a vignette story of a young girl (“Nadja”) and her family was submitted to thirty-five social workers employed in public social services in Stockholm, Malmö (Sweden), and Genoa (Italy). The participants were then invited to focus groups to discuss the main features that had emerged in the assessments.Results– Results show significant variations between Italian and Swedish social workers' assessments. Italian social workers are in general more concerned and interventionist than are their Swedish colleagues. Swedish social workers tend to intervene less, assuming that Nadja's consumption is “normal” teenage behaviour, while the Italian social workers, less accustomed to considering such behaviour as common, are more worried and prone to intervene immediately, in particular when Nadja is found drunk in the city centre.ConclusionThe assessment proposed by public social workers appears to be informed by cultural understandings of alcohol consumption which permeate and reveal predominant tendencies in the two groups of professionals. Moreover, in Italy the social service mandate appears to be fragmented among different service units, whereas Swedish social workers operate within a broad welfare system that allocates specific resources for adolescent alcohol consumers. Further elements influencing the assessment are found in the legislative framework and consequently in the different practices and perspectives of intervention social workers assume in Sweden and Italy.

Constructing cultural Otherness within the Swedish welfare state: The cases of social workers in Sweden

The aim of the article is to analyze how social workers frame the social problems of immigrant clients in Sweden. The study is based on in-depth interviews with 20 social workers in three different Swedish municipalities. While Swedish social work often assumes a discourse of color-blindness and universalism, this study indicates that Swedish social workers not only see cultural differences but also regard these differences as central when they frame, assess, and formulate their interventions. The discourse of culturalization not only produces and reinforces the ideas of cultural hierarchy and Swedish superiority, but it also tends to obstruct non-European immigrants from equal participation in the Swedish society since they are not allowed to enjoy their full citizenship. Consequently, there is a need for social work in Sweden to rethink its culturalist framework and go beyond cultural reductionism and take into consideration other issues such as unemployment, housing conditions, poverty, social isolation, marginalization, and ethnic discrimination.

A comparative study of experiences of client violence and its impact among Iranian and Swedish social workers

Client violence toward social workers has been recognized as a serious problem, and major concern has been raised with regard to its impacts on social workers' practice and physical and psychological health. There is recognition among researchers and policy-makers that it is time for the international social work community to develop conventions and agreements to address this issue globally. A cross-cultural study between Sweden and Iran was conducted to compare and contrast levels of violence between the two countries. Prevalence of violence was 72% in Sweden and 68% in Iran. Iranian social workers show a significantly higher increase in general mental health problems regarding client violence compared to Swedish social workers. Despite differences in rules and regulations between Sweden and Iran, client violence was found to be common in the two countries. Preventive policies for detecting potential violence situation are good but not enough. We suggest taking actions on building trust and supportive structures within organisations.

Evidence-Based Practice Among Swedish Medical Social Workers

We have explored Swedish medical social workers’ attitudes, beliefs, knowledge, and behavior concerning evidence-based practice (EBP) and investigated the properties of a questionnaire to measure EBP. One hundred seventy-four Swedish medical social workers within university hospital care and primary care participated in a cross-sectional survey. Our results showed positive attitudes toward EBP and the use of evidence to support clinical decision making. EBP was seen as necessary and something that needed to be implemented more often. The main barriers to implementing EBP were lack of time (78%), the perception that EBP does not take into account the limitations of the clinical practice setting (78%), and lack of knowledge about relevant research (46%).

Dilemmas in providing resilience-enhancing social services to long-term social assistance clients. A qualitative study of Swedish social workers.

BackgroundLong-term recipients of social assistance face barriers to social and economic inclusion, and have poorer health and more limited opportunities for improving their health than many other groups in the population. During recent decades there have been changes in Swedish social policy, with cutbacks in public benefits and a re-emphasis on means-tested policies. In this context, it is important to investigate the necessary conditions for social workers to offer social assistance and services, as well as the mediating role of social workers between public policies and their clients. Swedish social services aim to promote social inclusion by strengthening the individual´s own resources. We investigated the issues that arise when providing social services to long-term social assistance clients within the framework of resilience, which focuses on the processes leading to positive functioning in adverse conditions.MethodsInterviews were conducted with 23 social workers in Stockholm and analysed by qualitative content analysis.ResultsThe main theme to emerge from the interviews concerned the constraints that the social workers faced in providing social services to social assistance clients. The first subtheme focused on dilemmas in the interaction between social workers and clients resulting from the dual role of exercising authority and supporting and building trust with clients. Working conditions of social workers also played a crucial role. The second subtheme addressed the impact of the societal context, such as labour market opportunities and coordination between authorities.ConclusionsOverall, we found that social workers to a great extent tried to find individual solutions to structural problems. To provide resilience-enhancing social services to long-term social assistance clients with varying obstacles and needs requires a constructive working environment, supportive societal structures and inter-sectoral cooperation between different authorities.

Motorists, Non-drivers and Traffic Accidents between the Wars

This international overview focuses on the conflict between drivers and non- drivers in Britain, France, the United States, Germany, and Sweden during the interwar period. It suggests that on neither side of the Channel did pro-pedestrian movements make a major impact on national safety legislation. In the U.S.A. automobile-manufacturing interest groups undermined what they perceived to be threatening neighborhood opposition to the onward rush of the automobile. In Germany, which had earlier experienced high levels of anti-car activity, Hitler-inspired commitment to modernization nevertheless led, by the mid-1930s, to the consolidation of punitive measures against erring drivers. In Sweden, however, there appears to have been a high degree of complementarity between pro-motorism and policies designed to minimize dangerous driving. The paper concludes that an understanding of this “deviant“ position may be deepened through scrutiny of the values associated with the Swedish Social Democratic Workers' Party (SAP). A similar approach might be applied to the other nations discussed in the article.

Moving from ‘gut feeling’ to ‘pure facts’: Launching the ASI interview as part of in-service training for social workers

Several standardized assessment instruments have been introduced in social work in the last 10 years. One such instrument, the Addiction Severity Index, is used today in the Swedish social services, as well as in the prison and probation services. Swedish state authorities have strongly declared their intention to implement the Addiction Severity Index interview, though critics are sceptical towards both its practical relevance and epistemological grounds. Given this background, the launch of the Addiction Severity Index interview is important as a case of how new instruments (flagged under the banner of evidence-based practice) are introduced into the field of social work. The aim of this article is to analyse how the Addiction Severity Index interview is presented and taught through in-service training for Swedish social workers. From observations of in-service training sessions, two professional styles seem to surface: ‘traditional’ and ‘new’. The trainer tends to use contrasting dichotomies as resources for constructing these professional styles. For example, ‘objectivity’ and ‘scientificity’ are presented as new professional ideals, rather than common sense or ‘gut feeling’, the latter of which is connected to traditional social work. The construction of a new professional style can be seen as an endeavour to achieve professional status in a more classical sense, partly by making the profession and its content more visible, but also by asserting its legitimacy as evidence-based work.

Acceptance and commitment therapy for the treatment of stress among social workers: A randomized controlled trial

Chronic stress increases the risk of health problems and absenteeism, with negative consequences for individuals, organizations and society. The aim of the present study was to examine the effect of a brief stress management intervention based on the principles of Acceptance and Commitment Therapy (ACT) on stress and general mental health for Swedish social workers (n = 106) in a randomized, controlled trial. Participants were stratified according to stress level at baseline in order to examine whether initial stress level moderated the effect of the intervention. Two thirds of the participants had high stress levels at baseline (Perceived Stress Scale; score of ≥25). The results showed that the intervention significantly decreased levels of stress and burnout, and increased general mental health compared to a waiting list control. No statistically significant effects were, however, found for those with low levels of stress at baseline. Among participants with high stress, a substantial proportion (42%) reached criteria for clinically significant change. We concluded that the intervention successfully decreased stress and symptoms of burnout, and increased general mental health. Evidence is, thus, provided supporting ACT as brief, stress management intervention for social workers.

The limits of legitimacy: Service providers’ views on maintenance treatment in Sweden

Background: It is widely acknowledged that the social meaning of maintenance treatment (MT) with methadone is context-dependent and that different discourses influence how this approach to opiate addiction problems is practised. In Sweden, MT has long been ideologically controversial, even if the past decade's emphasis on evidence-based interventions has made it more accepted and prevalent in the treatment system. MT may thus be seen as a discursive field where science and values are intertwined and impact practice jointly, which emphasises the importance of analysing how MT is attributed with meaning.Objectives: The study aims to identify and analyse the discourses that service providers in Swedish opiate addiction treatment refer to in their efforts to legitimise MT.Methods: Twenty-eight interviews focused on MT-related issues were conducted with Swedish social workers and health care workers. The material was analysed qualitatively according to discourse theory.Findings: Three key features of MT were identified: as therapeutic intervention; as beyond harm reduction and as pragmatic solution. The respondents constructed MT as a necessary medical and psychosocial treatment aimed at rehabilitation and patients’ complete break with drug abuse, which reflects a policy-context where solutions to drug problems are supposed to be resolute, thorough and abstinence-oriented.Conclusions: The service providers handled the controversy between science and values by drawing on a decent-life discourse, where opiate addiction problems are solved with a pragmatic stance towards evidence and where only interventions that make patients’ lives allegedly decent are considered legitimate (excluding, e.g. heroin prescription and liberal methadone distribution).

Priorities and determinants of priorities of Swedish social workers

Priority setting is an integrated part of social work, in Sweden as well as internationally. In this article we explore Swedish social services and how social workers make priorities and what these priorities involve. By use of regression analysis we also study what circumstances are of importance for allocative precedence and what impact different distributive principles have. One primary result is that priorities are made frequently by social workers—mostly on what cases to work with next and how much time to spend on every client. Another somewhat expected result is a manifest area bias, suggesting that respondents tend to see to the interests of their own professional domain. The principle of need proved to be the most important of the distributive principles studied, while principles of capacity to benefit and economy were more endorsed by officials working with elderly and disabled than those in other sectors.

Guided or independent? Social workers, central bureaucracy and evidence-based practice

Since the start of the 1990s, a number of professional fields in the Western world have been confronted with increasingly explicit demands for scientific assurance regarding the effects of the work they do. The debate on the relationship between research and practice in social work has often been carried out under the heading of evidence-based social work or evidence-based practice (EBP). This article is based on a survey distributed to a representative sample of social workers and middle managers within the Swedish municipal social services. The results indicate a generally positive attitude among Swedish social workers towards EBP; at the same time they show a low level of active contact with the research literature of relevance for EBP. The results are contextualized and discussed against the background of some major methodological issues in EBP, such as, for example, the so called Dodo bird verdict in psychotherapy outcome research.

Modeling Ideal Treatment Recommendations: A Factorial Survey of Swedish Social Workers' Ideal Recommendations of Inpatient or Outpatient Treatment for Problem Substance Users

ABSTRACTWith the aim of examining predictors of social workers' ideal recommendations of inpatient or outpatient treatment for problem substance users, this study applied multilevel logistic regression to factorial survey data collected from a sample of 205 frontline social workers from 36 social services units in Sweden. The results show that social workers' ideal recommendations of inpatient or outpatient treatment are based on evaluations of a number of client characteristics. These include the clients' treatment preferences, their primary drug, levels of social resources, and age. In addition, it was found that professional recommendations are also determined by treatment availability and policy guidelines, and by the decision makers' own ideological convictions regarding alcohol and narcotics problems. This study brings to light the necessity of organizational routines that allow and encourage social workers to reflect on and to articulate their judgements and decisions.

Gender differences in social workers’ assessments and help-giving strategies towards single parents

The study investigates Swedish male and female social workers’ assessments and help-giving strategies towards single parents applying for income support. The study was carried out with the help of a vignette distributed as a mail questionnaire. Results show that social workers tend to conform to assessments and help-giving strategies that are consistent with expectations linked to their own gender role.

Assessment processes in social work with children at risk in Sweden and Croatia

The aim of this article is to compare Swedish and Croatian social workers’ assessments and protection of a 4‐year‐old child exposed to risk in its own family. The data were collected from 87 Croatian and 72 Swedish social workers by means of a questionnaire, which incorporated a vertical vignette. Effects of the participant's country of residence were investigated with respect to: (i) risk assessments; (ii) perception of the main problems; (iii) tolerance of corporal punishment; (iv) judgements about appropriateness of interventions. The results suggest that Croatian social workers have a more child‐protective approach than their Swedish colleagues. Swedish social workers have a more supportive approach than Croatian social workers. Despite fundamental similarities in assessments between the countries, significant differences were found in preferred interventions. The Swedish social workers were more in favour of keeping the child at home with the support of social services. The Croatian social workers were more in favour of removing the child from home by means of a care order. This might primarily be attributed to the differences in availability of family support services and to different discourses in Sweden and Croatia.

Differences in the Seriousness of Problems and Deservingness of Help: Swedish Social Workers' Assessments of Single Mothers and Fathers

Differences in the seriousness of problems and deservingness of help : Swedish Social workers’ assessments of single mothers and fathers

Privatisation as professionalisation? Attitudes, motives and achievements among Swedish social workers

The purpose of this article is to discuss the relationship between privatisation and professionalisation in social work. In social services, privatisation is often seen as a politically planned (policy-driven) process as part of liberalisation strategies for market orientation of the welfare state. However, there are several reasons to believe that there is also a process of spontaneous privatisation (sometimes driven by demand), where professionals go private and provide various types of services to local welfare authorities. In this article, our aim is to explore the extent, impact and consequences of such profession-driven privatisation and to discuss whether privatisation is a strategy for professionalisation. This article investigates: (1) attitudes among social workers and social work students toward privatisation in general and private practice in particular; (2) the extent and types of activities being performed privately; (3) the motives whether or not to choose self-employment; (4) the differences between public and self-employed social workers in terms of professionalisation. Data are based on surveys of 1,000 Swedish social workers and 801 social work students. The results show ambivalence among professionals toward privatisation. The authors discuss the reasons for this at an individual and collective level. Although the share of social workers in private practice in Sweden is low, between 6 and 8%, more than one third of Swedish social workers expect to be working in private practice within 10 years. The circumstances faced by self-employed social workers, who rank higher on almost every professionalisation indicator (i.e. formal education, attitude toward research, internal status, wage level, autonomy), support the hypothesis about profession-driven privatisation.

The dual-diagnosis concept used by Swedish social workers: limited validity upon examination using a structured diagnostic approach

A co-existence of chemical dependence and other psychiatric syndromes is commonly referred to as “dual-diagnosis.” This categorization is commonly made by social workers in several European countries assigned the primary responsibility for the care of drug and alcohol dependence. Here, we examined the validity of this categorization through systematic, structured patient evaluation following a minimum of 3 weeks of abstinence from drugs and alcohol. Less than one-third of patients originally labelled as suffering from “dual-diagnosis” by the social services did in fact obtain any Axis I DSM IIIR diagnosis, and less than half of the patients had any psychiatric diagnosis other than dependence. Syndromes commonly discussed in the context of self-medication, i.e., unipolar depression and anxiety syndromes, were not over-represented compared to a population sample, while chronic psychoses and bipolar syndromes were highly significantly more common. We conclude that the dual-diagnosis concept, unless substantiated through stringent diagnostic procedures by psychiatrically trained personnel, may be of questionable utility in caring for patients presenting with psychiatric symptoms and substance dependence. A systematic individual evaluation in an alcohol- and drug-free state of sufficient duration is necessary to obtain a basis for an adequate individual treatment plan.

Education, practice and research. Knowledge and attitudes to knowledge of Swedish social workers

This article deals with the knowledge base and methodological orientation of Swedish social workers and their attitudes to different sources of knowledge as a basis for practice. By means of a survey, 412 social workers in 12 municipalities responded to questions about their education, further training, the periodicals and books read and their views about the knowledge required for their tasks. The response rate was 93%. The data were analysed with quantitative techniques, including logistic regression analysis and show the following results: (1) The methods used in practice differ from what might be expected considering the content of social work education; (2) The Swedish methodological repertoire differs somewhat from that described in the Anglo-Saxon literature; (3) Different areas of social work display quite dissimilar images. Social workers in child welfare are closest to a coherent knowledge base, while those dealing with social assistance are least well off in this respect; and (4) Overall, there is an obvious lack of a common and up-dated knowledge base. Less than 1 in 10 read research-oriented periodicals and relevant books more than once or twice a year. These results are discussed in relation to the quality of social work education, social workers' attitudes to research-based knowledge, the research itself and the organisational setting of social work practice.

Liberals, Socialists, and Sobriety: The Rhetoric of Citizenship in Turn-of-the-Century Sweden

Many years have passed since temperance was treated solely as an expres sion of status anxiety, social control, or internalization of bourgeois norms.1 In the past decade, historians have documented how temperance functioned as part of liberation and empowerment movements: in Char tism, Irish patriotism, women's suffrage, and Russian socialism.2 In this article, I will discuss the role of temperance in turn-of-the-century Swedish suffrage movements, with particular attention to its use by the Swedish Social Democratic Workers' party. In 1866, Sweden had a new, two-house parliament. An indirect fran chise reserved the Upper House for the rich: aristocrats, industrialists, and government functionaries. The Lower House was comparatively open; its electorate consisted of Swedish males either of substantial property or with an income of over 800 crowns a year (workers usually earned between 400 and 600). About 23 percent of adult males, or 6 percent of the total popula tion, could vote in Lower House elections.3 Until 1898, the only cohesive parliamentary group was the Farmers' party. The farmers were not illib eral: They opposed state spending and militarism and?at least un til the 1880s?were in favor of moderate suffrage reform. A more res olutely democratic opposition also existed in the cities, where progres sive notables, academics, and writers, as well as workers' and artisans' associations, maintained traditions of working-class or small folk repre sentation.