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  • 1.
    Forsman, Hilma
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Addressing poor educational outcomes among children with out-of-home care experience: Studies on impact, pathways, and interventions2019Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Children with out-of-home care (OHC; foster family/residential care) experience is a high-risk group for future adverse outcomes. With an ambition of supporting the design of effective preventive child welfare measures targeting children in OHC, the overall aim of this thesis is to examine education as a possible intervention path for improving their development and overall life chances.

    The thesis consists of four interrelated empirical studies that address different aspects of poor educational outcomes among children with OHC experience by means of analyses of longitudinal survey and register data, and evaluations of two interventions aimed at improving their basic academic skills.

    Study I examined the hypothesized causal effect of poor school performance on adverse outcomes in young adulthood among children with OHC experience. The results showed that poor school performance has an impact on later psychosocial problems net of observed and unobserved factors, suggesting that the estimated effects allow for causal interpretations.

    Study II explored educational outcomes at different stages in the educational career, and pathways to varied educational outcomes for children with OHC experience and their peers. The results showed that the OHC group had lower educational outcomes across the life course. Yet, by large, their educational pathways did not differ significantly from their peers – cognitive ability and previous school performance had the largest associations with the outcomes in both groups. However, the influence of these factors were weaker in the OHC group whilst the influence of the birth family’s attitude towards higher education was stronger.

    Study III aimed at furthering our understanding of the book-gifting program the Letterbox Club’s potential impact on foster family children’s reading skills. The results showed that participation in the program was associated with small improvements. In general, the program was well received by children and carers, and could result in increased reading. The study furthermore suggested that promotion of carer involvement may improve its potential impact.

    Study IV explored the process of conducting a structured paired reading intervention involving foster family children and their carers. Findings showed that it is possible to engage carers in interventions targeting the education of children in OHC, but that this is no automatic process – carers need a rationale for getting involved, and support in delivering the intervention.

    In sum, this thesis shows that improving the educational outcomes of children in OHC may be a viable intervention path in supporting their life course development, a path that historically has been overlooked. The thesis furthermore shows examples of promising interventions which may improve the basic academic skills of children in OHC. The results also point out that the child welfare system should provide early and continuous educational support, and highlight the importance of addressing adults’ attitudes, expectations, and involvement in these children’s education.

  • 2.
    Storm, Palle
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Betydelsen av kön och hudfärg i äldreboendets vardag under olika organisatoriska villkor2018Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    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.

  • 3.
    Pålsson, David
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    The Prerequisites and Practices of Auditing Residential Care: On the Licensing and Inspection of Residential Homes for Children in Sweden2018Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The aim of this dissertation is to describe and analyse the prerequisites and practices of auditing Swedish residential care for children. Residential care is a complex intervention provided to children in vulnerable life situations. The care is extensively delivered by private providers and shows difficulties in demonstrating clearly positive treatment effects. Licensing and inspections are policy instruments to address alleged quality problems in decentralised and marketised welfare services. However, in research there are mixed opinions on the ability of audits to generate improved service quality.

    The dissertation consists of four papers exploring central facets of the audit system. The empirical material is based on interviews (n=50) with inspectors and residential staff, documentation (n=286) in terms of guidelines and license/inspection decisions and observations (n=12) at inspection-related events. Each paper includes a unique set of data.

    Paper I analyses the controls that private residential homes undergo prior to their entry into the market. The results show that a majority of applicants are granted a license and that the controls do not reduce the need for ex post control. There is limited guidance on care content and research evidence is weakly incorporated in the controls. Overall, the state exerts limited influence over the composition and professional development of the care market.

    Paper II explores the operationalisation process of care quality in inspections. The results show that the standards display a marked variation and there is no differentiation between different residential homes. In general, the standards focus on reducing malpractice and not maximising care quality. In practice, the inspections are often discussion-based and standards relating to work with children are often indistinct.

    Paper III analyses how inspections are perceived by representatives from residential homes. The results show that inspections induce reflection and to some extent shape the administrative parts of care, but also that it is difficult to discern the actual impact of the inspections on the work. The inspections appear to bring a degree of stability and legitimacy to the work, but there are sometimes tensions between standards and professional judgment.

    Paper IV studies the influence the inspection process grants children in care. The results suggest that different inspectorial rationales (regulative, supportive and protective) may influence the agency children exert and that it is difficult to allow children’s views to have a substantial impact on the process. Overall, there tends to be a gap between what the children find important and what the audits can address in concrete terms.

    The theoretical ideas used to analyse the results are derived from institutional organisational theory and the thesis on the audit society. The overall analysis shows that 1) making certain core care aspects auditable and ensuring their impact is difficult (e.g., children-staff relationships, children’s views and use of research knowledge), 2) the system has a restrained character and is in many senses associated with inconclusive formative effects, 3) the use of uniform goals does not necessarily equal a more suitable care provision and 4) the audits signify strong symbolic values. Despite the limitations, the audits may help to discipline care providers, secure a minimum level relative to the audited care aspects and induce reflection among auditees.

  • 4.
    von Braun, Therese
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan. Högskolan i Gävle, Sverige.
    Theorizing the therapeutic process in substance use-related dependency treatment2018Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The aim of the thesis was to increase knowledge on how to understand the therapeutic process highlighting the importance of the therapeutic relationship as described by therapists and clients in substance use-related dependency treatment. The research questions were related to how the therapeutic process can contribute to a positive outcome considering the therapists’, the clients’ and close co-dependent relatives’ perspectives.


    The thesis followed a qualitative and narrative research design and consists of six studies (I-VI). Study I contributed a description of a multidimensional interactional model for the analysis of substance use-related dependency. The study revealed how a multidimensional interactional model can provide holistic and detailed knowledge about the complex processes involved in the use or misuse of alcohol and drugs. The interactional model was illustrated by a narrative analysis of qualitative empirical data. This model seemed to support a person-by-situation interactional analysis of substance use-related dependency. Study II revealed the possibilities and limitations of using a self-theoretical perspective in the analysis of the use or misuse of alcohol and drugs. The self-theoretical perspective was related to empirical case illustrations based on qualitative or narrative data. The implications of studies I and II were that a self-theoretical perspective can be integrated within a multidimensional model and can be a fruitful theoretical framework for the analysis of treatment processes of dependency. Study III presented conceptual contributions for understanding treatment of substance use-related dependency, focusing on the importance of the therapeutic process and the therapeutic relationship and the use of narrative methods. Study IV presented a structural perspective on clients’ narrative descriptions of different phases of the use or misuse of alcohol and drugs including phases of treatment. Study V contributed an in-depth analysis of three therapists’ narratives of therapeutic relationships in the treatment of drug-dependent clients. The analysis pointed out the multidimensional aspects of the treatment and focused on three phases of therapy; starting the therapeutic process and building a therapeutic relationship, the ongoing therapeutic process, and the closing phase of therapy. The study also presented an in-depth analysis of two narrative case histories on dependency treatment. Study VI focused on a qualitative in-depth analysis based on narrative data from a group of 10 clients that had undergone treatment for alcohol and drug use or misuse. The study also included qualitative and narrative data from four co-dependent clients and six therapists about their views on the treatment process and the therapeutic relationship. The results of the study described how to understand the experiential world of the clients and their cognitive, emotional and behavioral changes associated with the treatment process.


    The thesis’ contributions relate to an outline of a self-theoretical perspective integrated within a multidimensional interactional model for the analysis of the therapeutic process and the therapeutic relationship in substance use-related dependency treatment. The theoretical analysis sheds new light on the complexity of the treatment process and the clients’ struggle with their personal identity and sense of self, especially their drug self.

  • 5.
    Kaunitz, Catrine
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Aggression Replacement Training (ART) i Sverige: - spridning, programtrohet, målgrupp och utvärdering2017Licentiatavhandling, monografi (Övrigt vetenskapligt)
    Abstract [en]

    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.

  • 6.
    Månsson, Josefin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Cannabis discourses in contemporary Sweden: Continuity and change2017Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The aim of this thesis is to study how cannabis is constructed in contemporary Sweden, which policy responses are promoted as rational, and how international cannabis trends are received in this context. The four papers are the result of analyzing empirical material from three different sub-studies: 1) a qualitative study of online discussions about cannabis and drug policy, 2) a qualitative and comparative study of print media articles from 2002 and 2012, and 3) a qualitative study of oral presentations from cannabis information symposia. All papers are based on a social constructionist approach.

    A point of departure is that attitudes and regulations on cannabis have changed in large parts of the Western world. In Sweden, however, strict prohibition of cannabis is still central in the national drug laws. Some of the main findings can thus be gathered in discussions on continuity and change. In Swedish online discussions, there seems to be a strong desire to change the national cannabis policy in line with international developments. This discussion propagates alternative views on cannabis, in which comparisons to alcohol become vital and more liberal cannabis policies become logical. These discussions are also characterized by continuity, as many arguments for liberal cannabis policies seem to be based on traditional social democratic values and prohibitionist “scaremongering” arguments. Continuity is also what seems to characterize traditional print media, where cannabis is generally portrayed as a potent and illegal drug producing social problems. However, this arena also shows signs of change, as the material from 2012 includes stories on cannabis as an economic asset as well as a recreational substance. Both traditional print media and cannabis information symposia focus on youth consumers, who are seen as particularly vulnerable to cannabis effects. Such constructions seem important for protecting prohibition from international influences and for a continuous discourse centered on the dangers of cannabis.

    It is concluded that cannabis appears to be able to represent almost anything. As such it can be “used” for any purpose to promote a whole set of ideas related to policy often based on what is considered as scientific evidence. Depending on the context, it thus seems possible that cannabis is medicinal, recreational, harmful, and addictive. If so, and if all of these constructions are in some way “real,” then it is suggested that cannabis necessitates a much more tailored and nuanced response than that which prohibition can offer.

  • 7.
    Linell, Hanna
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Child protection through an abuse-focused lens: Adolescent victimization and Swedish social services responses2017Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Knowledge concerning the social services’ use of the Care of Young Persons (Special Provisions) Act 1990:52 (CYPA) is relatively scarce, especially when it comes to the protection of adolescents victimized by abuse. The overall aim of this thesis is to investigate and discuss different conceptualisations of abuse, adolescents’ agency regarding abuse, victimization and social intervention, and how abuse and adolescent victimization are responded to, primarily by the social services. This is done from a stance influenced by critical realism as well as victim- and child-centred responses. The dissertation consists of four papers and examines these themes in two samples of judgments and related documents concerning applications for care of adolescents aged 13-17 under the CYPA. The findings from the total study of all judgments in the selected year clearly confirm § 2 CYPA as a rare intervention to protect adolescents. In only 85 of Sweden's 290 municipalities was a CYPA application made, but a main finding is that such care to a large extent was used to protect adolescents from various forms of abuse. In the total study, the applications of § 2 CYPA concerned 196 adolescents, for 70 per cent of whom abuse was described, and where more girls (96) than boys (41) were being considered for care based on abuse. Of all the girls, 79 per cent were described as subjected to abuse and of the boys 55 per cent. Also in the smaller sample consisting of judgments for 37 girls in care under § 2 CYPA and §§ 2 and 3 CYPA, abuse was described for many. For several adolescents in both samples abuse was described as having been exerted to maintain standards of honour, shame and virginity, and/ or to enable a forced marriage. The initiative and agency of the adolescents themselves in both the disclosure of abuse as well as the decision on alternative care is one of the most striking findings in the thesis. The majority of the adolescents, 71 per cent, were categorized as having intentionally disclosed the abuse. The aftermath of the disclosure was for many of the adolescents described as intensely challenging. For the majority the abuse was denied during the investigation, not only by the alleged abusers but also by non-abusing parents and other relatives. The findings relating to the social services responses suggest that the initial response to a high degree could be understood as parent-oriented. For 33 per cent, the judgment also revealed that the abuse had been disclosed to authorities one or several times prior to the investigation leading to the application for care under the CYPA. That the abuse in these cases had been known to the social services for on average 5 years can from a child-centred position be seen as a major failure regarding the system’s ability to reach children and stop abuse. A central conclusion is that the various forms of abuse described seem more connected to domination, fear, power and control than to conflict; to some extent mirroring the kind of systematic oppression described for victimized adults seeking the protection of NGOs and public authorities. The findings imply that interventions under the CYPA may enable more child-centred, safe and stable protection of children subjected to this kind of abuse. Given the findings in the present thesis it is argued that it may be important to differentiate the concept of abuse as well as to acknowledge the agency of children in both research and in practice.

  • 8.
    Björk, Alexander
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Evidence-based practice behind the scenes: How evidence in social work is used and produced2016Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The aim of this dissertation is to examine empirically what Evidence-based practice (EBP) and its standardized procedures become when put into practice in social work. EBP builds on the idea that professional practice should be based on systematic and reliable knowledge of the interventions and instruments used in this work. This implies a standardization of both research and practice that has been highly contested. Inspired by works within science and technology studies (STS), this dissertation analyses the actual content of the standardized procedures and their uses in social work practice.

    The dissertation examines a ‘critical case’, a substance abuse social services agency that has worked extensively for several years at implementing EBP, and consists of four papers focusing on three standardized procedures used by the agency in order to enact EBP: 1) the Addiction severity index (ASI) assessment instrument; 2) the psychosocial intervention Motivational interviewing, and 3) the decision-making model Critical appraisal (CA). Ethnographic methods were employed to study the agency’s concrete uses of the standardized procedures in daily practice. MI was also followed in the research literature as it became established as an ‘evidence-based’ intervention.

    Fundamentally, the development of the standards of EBP can be a messy and paradoxical process. In the stabilization of MI, its differences and ‘fluidity’ have eventually been made to disappear and left a stable ‘evidence-based’ object.

    Findings from the ethnographic studies show that EBP, as enacted in the agency’s daily practice, is a bureaucratic project where the agency’s managers have decided on and control the use of a set of standards. Thus, what constitutes relevant evidence is based not on professional discussion within the agency but is ultimately determined by the managers.

    In practice, the standards introduce new logics that cause tensions within the agency, tensions which the social workers are left to handle. Main conflicts concern how the client work is ordered and contradictory organizational rationales. The three standards are used to varying extent, which can be understood by examining what they seek to standardize and how they are put to work. CA was not used at all, mainly due to its design. Disregarding organizational rationales that are unavoidable within the social services, it could not be adapted to the agency’s work. With ASI and MI the situation was different, mostly because of their organizational adaptability. ASI could be implemented in several phases of the agency’s work flow resulting in adjustments of both the instrument and the work flow. As a ‘fluid intervention’, MI was constrained by, but also adjustable to the organization. It was thus possible for both ASI and MI to transform and be transformed by pre-existing practices, in effect creating new practices.

    A major conclusion is that EBP and its standardized procedures is a more dynamic and multifaceted process than previously acknowledged in social work. Rather than a deterministic one-way path, there are different kinds, degrees, and mutual transformations of standardization processes, which must be appreciated in research and in practical efforts to implement EBP. Given the importance of the organization in professional social work, there is a need to move away from individualistic conceptions of EBP and to consider what evidence use might mean from an organizational perspective.

  • 9.
    Heap, Josephine
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Living conditions in old age: Coexisting disadvantages across life domains2016Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The aim of this thesis was to analyse coexisting disadvantages in the older Swedish population. Coexisting disadvantages are those that occur simultaneously in various life domains. A person who simultaneously experiences several disadvantages may be particularly vulnerable and less well-equipped to manage daily life and may also need support from several different welfare service providers. Concerted actions may be needed for older people who experience not only physical health problems and functional limitations, but also other problems. Research that encompasses a wide range of living conditions provides a basis for setting political priorities and making political decisions.

    The studies in this thesis used data from two Swedish nationally representative surveys: the Level of Living Survey, which includes people aged 18 through 75, and the Swedish Panel Study of Living Conditions of the Oldest Old, which includes people aged 77 and older.

    Study I showed that the probability of experiencing coexisting disadvantages was higher in people 77 and older than in those aged 18 through 76. These age differences were partly driven by a high prevalence of physical health problems in older people. In all age groups, coexisting disadvantages were more common in women than men.

    The longitudinal analyses in Study II indicated that coexisting disadvantages in old age persist in some people but are temporary in others. Moreover, the results suggested a pattern of accumulating disadvantages: reporting one disadvantage in young old age (in particular, psychological health problems) increased the probability of reporting coexisting disadvantages in late old age.  

    Study III showed that physical health problems were a central component of coexisting disadvantages. The results also showed that being older; female; previously employed as a manual labourer; and divorced/separated, widowed or never married were associated with an increased probability of experiencing coexisting disadvantages. However, the experience of coexisting disadvantages differed: the groups associated with coexisting disadvantages tended to report different combinations of disadvantage.

    Study IV showed that the prevalence of coexisting disadvantages in those 77 and older increased slightly between 1992 and 2011. Physical health problems became more common over time, whereas limited ability to manage daily activities (ADL limitations), limited financial resources and limited political resources became less common. Associations between different disadvantages were found in all survey years, but certain associations changed over time. The results suggest that in general, the composition of coexisting disadvantages in the older population may have altered over time.

    In sum, results showed that coexisting disadvantages were associated with specific demographic and socio-economic groups. Physical health problems and psychological health problems were of particular importance to the accumulation and coexistence of disadvantages in old age.

  • 10.
    Shanks, Emelie
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Managing social work: Organisational conditions and everyday work for managers in the Swedish social services2016Doktorsavhandling, monografi (Övrigt vetenskapligt)
    Abstract [en]

    The personal social services in Sweden have undergone major changes during recent decades, partly due to the reforms caused by the influence of New Public Management (NPM) and partly due to the trend towards greater specialisation. These changes have had consequences for both social work management and for social work practice. The consequences for practice have gained attention both from research and from the field, but the consequences for managers have rarely been discussed. In this thesis therefore, the attention is directed towards the managers.

    Inspired by a mixed methods approach, this thesis aims to explore the personal social service managers’ perceptions of their organisational conditions and the content of their everyday work, as well as to interpret the managers’ experiences against the background of NPM influence, increasing specialisation and the specific circumstances that come with managing politically governed organisations.

    The results show that the personal social service managers in general were former professionals with extensive social work experience. The managerial work was to a great extent perceived as reactive, entailing constant interruptions and acute situations. The managers experienced a heavy workload that appeared to prevent them from engaging in strategic work and leadership to the extent that they would have liked. Substantial proportions of managers were dissatisfied with their own levels of influence compared to that of politicians and, in general, the managers perceived themselves to have more influence regarding aspects that were operational (such as methods and working procedures) compared to aspects related to organisational structure. Through the managers’ descriptions of their relations with politicians, it was revealed that the roles could be muddled, and that both managers and politicians could have difficulties in distinguishing between politics and administration, or politics and profession.

    Several changes that could be attributed to the influence of NPM were described by the managers. Some changes had consequences for the more technical side of management, e.g. decentralised budget responsibility, increased focus on cost effectiveness and downsizing of support functions. Other changes were more related to the overarching concept of management, which had consequences for the choice of managerial training, the expectations placed on the managers, and to some extent the managers’ own views on what good management should be.

    Despite the many indications of changes that may be attributed to NPM, an important result in this thesis is that NPM does not appear to have permeated social work to the degree that might have been expected. Rather, there are clear indications of a remaining professional identity among managers on all managerial levels, as well a continuing bureau-professional regime within the personal social services.

  • 11.
    Skerfving, Annemi
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Barn till föräldrar med psykisk ohälsa: Barndom och uppväxtvillkor2015Doktorsavhandling, monografi (Övrigt vetenskapligt)
    Abstract [en]

     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.

  • 12.
    Selander, Viveca
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Familjeliv med personlig assistans2015Licentiatavhandling, monografi (Övrigt vetenskapligt)
    Abstract [en]

    The introduction of personal assistance in Sweden in 1994 showed an ambi­tion by policymakers to ameliorate the conditions of persons with extensive disabilities. The legislators expressed a vision of autonomy and integrity, and that persons with considerable disabilities should lead a life like others. This includes having a family and being a parent. The thesis “Family life with personal assistance” has aimed at exploring what it means to have an extensive disability and to have personal assistants in everyday family life. The thesis has had an explorative onset and is based on interviews with eight women and men and their family members: partners, children and members from the family of origin. They were interviewed about their experiences of daily life with personal assistance. The results are structured under three themes.

    The first theme is about power - loss of power and control – loss of control in different situations in everyday life. The results indicate that the assistance users, in spite of a legislation that allows the user to choose how they want to form their personal assistance, are confronted with different dilemmas striving to maintain power and control over their everyday life and daily help. To cope with these challenges the assistance users had developed different strategies.

    The second theme is about the results of applying a life course perspective on the different experiences depending on when in life the assistance users became disabled – if they were born with the impairment or if they had an accident or became ill as adults. These different experiences have had an effect on how they look upon personal assistance and it has also had an impact on how they formed their strategies about assistance and the assistant’s relations to their children.

    The third theme is about the role of the family. Family members play a significant role in making everyday life work. In designing and using personal assistance, the individual’s freedom is balanced against his or her need of autonomy on one hand and the family’s demands for privacy on the other.

  • 13.
    Ulmanen, Petra
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Omsorgens pris i åtstramningstid: Anhörigomsorg för äldre ur ett könsperspektiv2015Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    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.

  • 14.
    Samuelsson, Eva
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Use or Misuse?: Addiction Care Practitioners’ Perceptions of Substance Use and Treatment2015Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The aim of this thesis has been to study boundary-making in addiction care practitioner’s perceptions of substance use and treatment. The four papers are based on three data collections in Swedish outpatient addiction care: a) a survey conducted in 2006 (n=655), b) a factorial survey using randomly constructed vignettes conducted in 2011 (n=474), and c) a focus group interview study from 2013 (n=30) with a sample of the respondents from the factorial survey.

    The analyses show that practitioners tend to draw boundaries between various forms of substance use, with alcohol use being perceived as a less severe problem than narcotics use and requiring less extensive treatment measures. There are also partially varying perceptions in different parts of addiction care. By comparison with social services staff, regional healthcare staff generally see a greater need for treatment, recommend medical treatment to a greater extent, and display less confidence in the possibility of handling problematic use without professional treatment. Despite an ongoing medicalization at the policy level, psychosocial treatment interventions appear to have legitimacy in both regional healthcare and social services settings.

    Boundary-making processes are also found in relation to the specific user’s age, family situation, socio-economic status and in some cases gender, with young women’s drinking being seen as more severe than young men’s drinking for example. The boundary-making between different substance users may be interpreted as a sign of an approach based on a professional consideration of the person’s socially exposed situation, which might require more comprehensive support. At the same time, it may be an expression of a stereotyped approach, involving a normative evaluation of women’s behaviour as being more deviant than men’s, thereby having a limiting effect on the conduct norms that regulate women’s behaviour and making the problems of men invisible. To avoid disparities in addiction care delivery, it is of major importance that practitioners are given room to reflect upon the assumptions and values that underlie the assessments they make in practice. Combining a factorial survey with focus group interviews is proposed as one means of facilitating this type of reflection. 

  • 15.
    Erlandsson, Sara
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Hjälp för att bevara eller förändra?: Åldersrelaterade diskurser om omsorg, stöd och service2014Doktorsavhandling, monografi (Övrigt vetenskapligt)
    Abstract [en]

    This thesis analyses the categorisation of adult persons who need help to cope in everyday life as either older persons or persons with a disability. Despite the development of social services in the Scandinavian countries being guided by the principles of universalism and equality, adults in need of care have different rights to support depending on their current age and at which age disability occurs. This thesis aims to explore how age-based differences in access to care, support and service are legitimised. In the thesis, the concept of help is used to refer to care, support and service.

    Using a discourse analytic approach, Swedish elderly and disability policies and websites through which providers of help market their services were examined. The analysis, inspired by the theoretical framework of governmentality, draws attention to how users of help and helpers are constituted in two age-related discourses on help. The first discourse, help to maintain, is used mainly in relation to older persons. In this discourse older persons are constituted as subjects in need of safety, comfort and company while the helpers are represented as caring and knowing. The second discourse, help to change, constitutes younger persons with a disability as citizens in becoming. Help aims to improve the situation for younger help users in varying ways: the opportunity to fully determine the tasks performed by helpers is essential to users of personal assistance whereas personal development as regards both practical and social skills is the key to change for persons with an intellectual or mental disability. While help for younger persons is represented as a means to enhance the individual’s self-determination and ability to participate in society, help for older persons is represented as aiming to maintain past patterns of life, not aspiring towards change or improvement. It is argued that these representations support a lower ambition for eldercare than for disability services.

  • 16.
    Kjellbom, Pia
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Påtvingad avflyttning från bostad: En rättssociologisk studie av socialtjänstens roll i teori och praktik2014Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The aim of the study was to analyse what the law is in social services work with people at risk of a forced move-out from a rented apartment. When processing an application for financial aid when a client is at risk of a forced move-out from a home, a discretionary interpretation of the criteria in the Social Services Act is assumed. The legal norm belt constituting the social services role in theory typically makes up the limits of the discretionary space. However, different workplace norms may also have significant influence on the discretionary space around the provision of assistance. Such standards emerging from expressions in local policies (municipal guidelines) and procedures, and interactions with managers, colleagues and clients, are shaping the role of social services in practice. On top of this, differing standards regarding the role of law may have an impact.

    Key conclusions of the study are: (1) In the vast majority of landlord applications to the enforcement authorities, financial assistance from the social services had no bearing on the outcome of the case.  (2) The rental law sometimes has a decisive influence over what is and can be the law in social services’ work for clients at risk of a forced move-out due to payment difficulties. ((3) There is a relatively high degree of consistency between norms in legal materials and different workplace standards. (4) Most of the standards identified in legal material and in social work practice have been categorized as related to either need or behaviour. Generally, it is concluded that need-related norms sometimes strongly imply protection not only for an existing home, but also for individual housing needs in general. In contrast, behaviour-related norms imply indifference in relation to not only an existing home but sometimes also to the applicant’s housing needs in general. These conditions create tensions in the social services’ decision-making and confusion about the aim of the individual needs assessment.

  • 17.
    Hammare, Ulf
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Mellan löften om särart och krav på evidens: En studie av kunskap och kunskapssyn i socialt inriktade ideella, privata och offentliga organisationer2013Doktorsavhandling, monografi (Övrigt vetenskapligt)
    Abstract [en]

    Between the Promise of Specificity and the Demand for Evidence –

    A study of knowledge and the approach to knowledge in socially oriented non-profit, private and public sector organizations

    In the social work field it is possible to identify two parallel processes in time. On the one hand a qualitative developmental process―even towards a form of standardization―where central concepts are academisation, professionalization, scientifically produced knowledge, expertise and evidence based methods. Simultaneously, there is a drive to create the conditions for increased diversity, where hopes are especially being pinned on the non-profit sector. In spite of representations and expectations concerning the non-profit sector and its so-called specificity, however, much of existing research lacks a comparative perspective, i.e., studies where non-profit organizations are related to comparable activities in the private and public sector.

    The aim of the study―with special focus on issues concerning evidence based knowledge in social work―is to compare and analyse whether and in that case how employee conceptions differ between the sectors, and whether and in what way non-profit employees and their activities can be said to fulfil the expectations of contributing to increased diversity. Data is from a questionnaire directed to about 1300 social work employees.

    The results show a greater interest in research and more marked efforts at professionalization in the public sector, while above all in the non-profit sector there was skepticism about science paired with reservations about work carried out in a professional way. In the non-profit, but also in the private sector, issues of ethics, views of humanity and values were paid greater attention. Also stressed here was the importance of creating relationships, the unique human encounter, genuine commitment, and human kindness.  However, there was significant uniformity across all sectors in the use of methods, where three dominated: solution focused measures, network support/therapy, and psychosocial work.

  • 18.
    Stranz, Anneli
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Omsorgsarbetets vardag och villkor i Sverige och Danmark: Ett feministiskt kritiskt perspektiv2013Doktorsavhandling, monografi (Övrigt vetenskapligt)
    Abstract [en]

    The present study analyses the welfare state as employer by studying eldercare workers’ experiences of their work in Sweden and Denmark.  The Nordic welfare states are often described as potentially women-friendly due to the availability of publicly provided services that enable women to combine paid work and caring responsibilities.  Whereas this might be empowering for a large group of women, paid care workers are often neglected in the discussion. The theoretical point of departure is Nancy Fraser’s dualistic model of gender justice, which encompasses redistribution (of material resources) and recognition (in the form of social status).

    By utilising survey-data (NORDCARE) on Swedish (n=532) and Danish (n=732) eldercare workers, the study shows that care recipients have larger needs and working conditions are more arduous in Sweden. However, in both countries workers report deficiencies with regard to insufficient resources, such as lack of staff, limited opportunities for development and training, and lack of necessary equipment for lifting service users, of support from managers and of reasonable time for the tasks to be performed. The pressure at work makes the care workers feel inadequate in relation to quality of care they are able to offer.

    The differences in job strain between the countries turn out to be of little importance when the care workers’ experiences of bodily and mental fatigue are compared. The bodies of the care workers are their main working tool and thus the bearer of the working conditions. More than 60 per cent of the respondents state that they often are physically tired after the day's work, and two-fifths of the respondents have seriously considered leaving their job during the past year. In both countries, the experience of physical and mental fatigue and the number of sick days over the past year are important factors behind thoughts about quitting the job.

    Using a dualistic model of gender justice, where redistribution and recognition are theorised as overlapping analytical dimensions, the results are interpreted as continuous organisational shortcomings which make the care workers’ everyday work invisible, and in the long run imply a risk for their health.

  • 19.
    Nybom, Jenny
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Aktivering av socialbidragstagare - om stöd och kontroll i socialtjänsten2012Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The aim of this thesis is to examine activation, including support and control, among different groups of social assistance (SA) recipients. Assessments and activation related decisions during one year are analysed for 372 social randomly selected assistance claimants from four municipalities. Data was collected 2002-2003 through structured interviews with the clients and their social workers. Income from work and social assistance was followed up with national register data after two years.

    The first study focuses on social workers conception of their claimants work barriers. Conceptions vary systematically across groups of claimants. The second study examines elements of activation, finding that extent and content of activation, and use of support and control, vary between municipalities and programs. The third study analyses associations between participation in activation programs and exposures to sanctions and exemptions (indicators of support and control) on the one hand, and claimants’ characteristics on the other hand.  Traditional work-test logic seems to be common in social work, and linked to stereotypic gender logic. This implies a systematic selection to activation based on sex, and on social workers opinion about the claimants work motivation. The results question the linkage between work barriers and activation, since claimants without formal resources (education and work experience) do not participate in resource activation (aiming to increase formal resources) more often than others. The fourth study analyses association between combinations of activation programs and sanctions and self support outcomes for SA claimants. Results suggest that a combination of resource activation and sanctions has a positive association with income from work, and that a combination of job activation and sanctions is associated with continuing SA.

  • 20.
    Grosse, Julia
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Kommer tid kommer tillit?: Unga vuxnas och medelålders erfarenheter2012Doktorsavhandling, monografi (Övrigt vetenskapligt)
    Abstract [en]

    Even though Sweden is considered a high trust society, research on this topic is primarily based on a few standardized survey questions. It is also known that there is a robust pattern of less trustful young people compared to older ones. Still, a satisfactory explanation of this fact is lacking. Thus, the first aim of this dissertation is to map trust among young adults and middle-aged individuals. The second aim is to examine by which factors and in what way different dimensions of trust are determined, focusing on individuals’ life course and consequently experiences. Analytical principles from the life course tradition are used as a theoretical framework.

    Data is derived from a Swedish cross-sectional nationally representative postal survey on trust, and qualitative interviews using a mixed-methods approach.

    A multi-dimensional concept of trust is suggested. Participants report relatively high levels of trust in known and unknown people, confidence in institutions, normative notions of trust, security, and trustful behaviour. Trust also seems to be structured according to a closeness principle. Young adults display lower trust levels in general. However, in some respects the pattern is reversed, particularly regarding domains they are expected to be more familiar with.

    Contrary to the well-established idea of generalised trust derived from predispositions and primary socialization, and particularised trust originating from experiences in adulthood, the results of this study suggest that unique combinations of factors, both individual characteristics and experiences, might explain each of the different dimensions. Often there is a sphere-specific relationship between experiences and later trust, i.e. experiences from one sphere of life seem to exclusively affect trust within the same sphere. It is suggested that as people grow older they accumulate what is called experience capital, which might benefit trust and contribute to an explanation of the age differences.

  • 21.
    Lagerlöf, Hélène
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Samhällsvård och välfärdsresurser: En studie av skolgång, fritid och kamratrelationer bland unga i familjehem och institutioner2012Doktorsavhandling, monografi (Övrigt vetenskapligt)
    Abstract [en]

    The dissertation analyses access to welfare resources within the areas of schooling, leisure and peer relations for youth in out of home care. The study was conducted in three counties in mid Sweden and is a replication of the recurrent Swedish surveys of living condition of children in general populations. By using the same design, children aged 13–18 (n=272) in foster care and residential care were approached. Throughout the analysis results are compared with conditions for peers living at home, based on data from the 2004/2005 survey on living conditions for children (Child-ULF). Furthermore the results are linked to the young people’s experience of psychosomatic complaints and emotional wellbeing and discussed within the theoretical framework of childhood sociology. Questions regarding society’s ability to convey resources to youth while in care as well as young persons’ potential to exercise determination while in care are also discussed. The study shows that youth in care in general have access to fewer resources than those in general populations in the studied areas. For youth in residential care the differences compared to peers living at home are substantial, while conditions for youth in foster care are more alike those of young people in general. Youth in residential care have fewer school related resources and fewer contacts with friends than peers living at home. Youth in foster and residential care are more subjected to bullying than the general population.

    The overall conclusions are that society, in the form of foster parents and residential staff fails in certain areas to convey resources to youth in care. The young people’s lack of resources poses limitations to their potential to exercise self-determination while in care. The study points out areas where targeted efforts might be needed to improve the living conditions for youth in out of home care and perhaps broaden their potential to exercise self-determination while in care as well as after.

  • 22.
    Andersson Vogel, Maria
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Särskilda ungdomshem och vårdkedjor: Om ungdomar, kön, klass och etnicitet2012Doktorsavhandling, monografi (Övrigt vetenskapligt)
    Abstract [en]

    This thesis follows a group of youths placed in secure unit care who have participated in a chain-of-care project aiming to better plan their discharge and aftercare. The overall aim of the thesis is to link a detailed description of these young people with an analysis of the project they participated in, and to undertake one- and two-year follow-up studies. Analytic focus is on the significance of gender, class and ethnicity. The study is mainly based on structured interviews performed at the secure units upon entry into care, discharge and at a one-year follow up. Data have also been used from criminal records and interviews with project staff.

    When entering care, these youths exhibited extensive problems in both family conditions and own behaviour. The major problem in boys was criminality while girls reported poor mental health. Professionals judge youth of foreign background as more criminal than youth of Swedish background despite a lack of difference in self-reported data. Some difference is also noticeable regarding class.

    Analysis of the project shows that out-of-home care was the most frequent intervention after leaving secure unit care, while other interventions were difficult to uphold over time. Few girls received help with their mental health problems. At the one-year follow up, the youths reported an overall better situation, although extensive problems still remained. Above all, girls’ mental health problems remained as before. At the 2-year follow up the study group was compared with a control group in order to investigate effects of the project regarding criminality and recommitment to secure unit care. The comparison shows that the project had no effect. This is discussed in relation to poor organization and the difficulty of adjusting a project like this to the target group, along with the substantial part played by gender, class and ethnicity in how the youth are construed and treated.

  • 23.
    Schön, Pär
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Gender Matters: Differences and change in disability and health among our oldest women and men2011Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    This thesis investigates gender differences in health and how they have changed between 1992 and 2002 among very old people. It explores gender differences in the association between disability and health, and gender differences in care utilization among our oldest old people. The studies are based on nationally representative data of the population in Sweden aged 77 and older (SWEOLD).

     Results from Study I showed that women generally had more health problems than men. Analyses of change between 1992 and 2002 showed increased prevalence rates for both sexes, especially women. However, women’s reporting of poor global self-rated health did not increase. There were no gender differences and there was no change over time in activities of daily living (ADL). Several health indicators seem to be developing differently for women and men.

     Study II showed that associations between ADL disability and other health indicators changed between 1992 and 2002, with several health problems and functional limitations becoming less disabling over time. This trend was especially true for women, while for men, the findings were mixed.

     Study III found no gender differences in physician visits and dental visits, despite women’s worse health and dental status. Marriage was associated with more physician visits for men and dentist visits for women. Results imply that women and unmarried older adults may have unmet health-care needs.

     Study IV examined whether the increase in life expectancy at age 65 observed between 1992 and 2002 consisted of years with or without musculoskeletal pain. Results showed that total years without pain decreased for both women and men, but more so for women. Women also had more years with pain added to life.

     The results of this thesis suggest an increase of health problems, but not disability, in the oldest Swedish population. However, gender variations in the findings highlight the importance of analyzing health trends separately for women and men.

  • 24.
    Ljungwald, Carina
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    The Emergence of the Crime Victim in the Swedish Social Services Act2011Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    This study sought to explain how crime victims emerged as a target group in the Swedish Social Services Act in 2001. The findings, derived from legislative documents, a literature review, and focus group interviews with social workers, showed that the 2001 provisions both duplicated and undermined pre-existing provisions of the Social Services Act. The explicit aim of the reform was to improve services to crime victims. The provisions did not, however, change the legal responsibility of the social services, nor did they strengthen the social rights of crime victims. The social services already assumed responsibility for crime victims according to other provisions of the act. To some degree, the reform can be explained symbolically. Support for crime victims was a complicated issue for the social democratic government. The economic crisis of the early 1990s ruled out reforms that might bring high increased costs. Yet expanding crime victims’ rights at the expense of the offender (e.g. toughening penal law and promoting victim impact statements) was not in line with social democratic ideology. By enacting the 2001 provisions, the government showed its commitment to providing support to crime victims. At the same time, the provisions did not increase costs or strengthen crime victims’ rights. In this way, the provisions solved a political dilemma for the government. Incorporating the 2001 provisions in the Social Services Act may seem to have been a modest reform. Symbolic politics, however, are not empty; rather, they reflect attitudes and beliefs. This study proposed that the reform revealed the state’s increasing concern with violence against women and individual responsibility. Furthermore, the provisions may have constituted a normative reorientation of the Social Services Act, in which individual responsibility increasingly replaced solidarity, the holistic view, and a right to assistance according to need.

  • 25.
    Spånberger Weitz, Ylva
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Ungas erfarenheter av skola, samhällsvård och vuxenblivande: En studie av fem livsberättelser2011Doktorsavhandling, monografi (Övrigt vetenskapligt)
    Abstract [sv]

    Avhandlingens syfte är att fördjupa kunskapen om skolsituationen för barn och ungdomar i samhällsvård samt att fördjupa kunskapen om de processer varigenom de unga finner vägar genom skolan och samhällsvården mot ett självständigt liv som unga vuxna. Studien har genomförts i fem svenska storstadskommuner. Materialet består huvudsakligen av upprepade intervjuer med unga som själva har erfarenhet av att vara placerade i samhällsvård. Som en bakgrund genomfördes en kartläggande aktstudie gällande alla de ungdomar från dessa kommuner, som under 2003 hade placerats i samhällsvård. Intervjudeltagarna valdes ut från denna kartläggning. I analysen av intervjuerna användes en narrativ livsberättelseansats. Fokus i analysen har riktats både mot att förstå de ungas erfarenheter av att leva i skola och samhällsvård och mot att förstå hur de unga, genom sina berättelser, tolkar dessa erfarenheter och på så sätt skapar en meningsfull berättelse om sig själva och sina liv. Resultatet visar att livet i samhällsvård för de unga är präglat av utsatthet på flera nivåer. Socialtjänstakterna pekar mot ett samband mellan svårigheter i hemmet och svårigheter i skolan för de ungdomar som placerades i samhällsvård. Livsberättelserna synliggör hur skolan, familjen och samhällsvården utgör en komplex helhet i de ungas vardag och hur utsatthet inom någon av dessa praktiker därmed tenderar att spridas vidare i en process av överförd utsatthet. I sin kamp för att undkomma denna utsatthet navigerar de unga mot arenor där de kan finna hemmatillhörighet, det vill säga en upplevelse av att förstå och ”höra hemma” i en socialt delad vardagsverklighet. Ett viktigt redskap i de ungas strävan efter hemmatillhörighet är deras förståelsearbete, det vill säga det kontinuerliga tolkningsarbete varigenom de – inom ramen för socialt delade hemmatillhörigheter – knyter ihop sina erfarenheter till en sammanhängande förståelse av sig själva och sina liv.

  • 26.
    Östberg, Francesca
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Bedömningar och beslut: Från anmälan till insats i den sociala barnavården2010Doktorsavhandling, monografi (Övrigt vetenskapligt)
    Abstract [en]

    The focus of this thesis is on social workers’ role in assessing and making decisions in child welfare cases. The primary aim is to identify factors that influence decisions concerning reports assessed, investigated, dismissed or processed to intervention within child welfare agencies in Swedish municipalities. Social policy, professional and organisational factors are perspectives considered in the analysis.

    All reports and requests for support for children and adolescents in the 0–19 age group were collected during two months in two local agencies, in 2003 (n= 260) and followed by interviews with social workers. Factors connected to social workers’ assessments at different stages in the process were tested in regression models and grounds for their assessments explored.

    Main results: two-thirds of reports are sorted out without investigation. One-fifth led to interventions. The highest probability for a report to be investigated was if it was assessed as acute, concerned abuse, came from a professional (not the police) concerned a girl and handled in the integrated agency. The most common problems, such as family conflicts and antisocial behaviour were investigated the least. A majority of the children came from underprivileged families, mainly poor single mothers.

    The process draws the pattern of a heavily tapered funnel with few interventions at the end. Children are not in focus and the attitude is to keep them out of the system for their own good. Social policy and organisational factors restrict social workers’ discretion. Contradictory demands are solved by a ‘consensual ideology’. Parallel tracks appear on risks in a narrow perspective and on voluntary counselling mainly directed to mothers. This forms child welfare into a rejecting practice, where hard social conditions are individualized. Legislation gives municipalities considerable leeway to produce a variety of services and interventions, but practice works on the basis of another kind of rationality.

  • 27.
    Fors, Stefan
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Blood on the tracks: Life-course perspectives on health inequalities in later life2010Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The overall aim of the thesis was to explore social inequalities in: a) mortality during mid-life, b) health in later life, and c) old-age mortality, from a life-course perspective. The studies are based on longitudinal Swedish survey and registry data.

    The results from Study I showed substantial inequalities in health, based on social class and gender, among older adults (aged 55+). Moreover, the magnitude of these inequalities did not change during the period 1991-2002.

    The results from Study II revealed social inequalities in cognitive functioning among the oldest old (aged 77+). Social turbulence and social class during childhood, education and social class in adulthood were all independently associated with level of cognitive functioning in later life.

    In Study III, social inequalities in mortality during mid-life (i.e., between ages 25 and 69) were explored. The results showed that childhood living conditions were associated with marital status and social class in adulthood and that, in turn, these conditions were associated with mid-life mortality. Thus, the results suggested that childhood disadvantage may serve as a stepping stone to a hazardous life-course trajectory.

    Study IV explored the association between income in mid-life, income during retirement and old-age mortality (i.e., mortality during retirement). The results showed that both income during mid-life and income during retirement were associated with old-age mortality. Mutually adjusted models showed that income in mid-life was more important for women’s mortality and that income during retirement was more important for men’s.

    Thus, the results of the present thesis suggest that there are substantial social inequalities in the likelihood of reaching old age, as well as in health and mortality among older adults. These inequalities are shaped by differential exposures throughout the life-course that affect health in later life both through direct effects and through processes of accumulation.

  • 28.
    Berg Eklundh, Lotta
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Kontaktfamilj: En förebyggande stödinsats eller mellanvård?2010Licentiatavhandling, monografi (Övrigt vetenskapligt)
    Abstract [en]

    The contact family is a special intervention for supporting children in families with social problems. The child receives an ‘extra family’ with whom he or she can spend limited periods, like one or two weekends every month, one or two weekday nights and some holiday weeks during the year. The concept is that sharing this ‘extra family’s’ everyday life helps the child to build up resiliency and become better able to handle everyday life in the biological family. The members of the contact family can serve as role models and provide good examples of how to handle such situations as family and sibling conflicts. Sometimes the child finds ‘a significant other’ in the contact family, i.e. an adult who understands the child’s needs, listens to the child’s thoughts and worries and assists in evaluating the child’s cognitive abilities. This form of social support is decided on and paid for by the Social Welfare Service in the community where the child lives with the biological family.

    This study concerns 50 children living in four municipalities in Sweden who had received contact families in year 2000. It is a longitudinal study conducted over a period of seven years comprising both interviews and analysis of the social service offices’ documentation on each of the 50 children in the study. The empirical material was collected on four occasions (2000, 2003, 2005 and 2007. Interviews were conducted with a number of social workers involved in the cases, 15 of the children, their biological parents and the contact parents.

    The theoretical foundation for the study is the ecological model of human development, which places the child in the centre surrounded by the four systems and  with the contact family as a possible ‘proximal process’. The analyses were made from the perspective of the social workers’ scope of action and that of the participating children’s perspectives.

    The results showed that the parents who applied for a contact family (often a single parent, usually the mother) did so in order to obtain some relief from their parental duties and/or because they lacked a social network. The majority of the children had parents with social problems, such as substance addiction, a mental disorder or other health problems. As many as 30 of the children had experienced domestic violence. Nearly 40% had also experienced being placed with a contact family that in periods functioned as a short-term emergency children’s home or foster home.

    Only two of the children had the possibility to participate in choosing whether or not to have a contact family. Several of the children participated in the ongoing process of arranging for the contact family and in making the decision to terminate the arrangement, or to move in with the contact family as foster children or with the contact family functioning as a form of supported housing.

  • 29.
    Holmdahl, Johan
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Hot om vräkning: Tre aktörers perspektiv2009Licentiatavhandling, monografi (Övrigt vetenskapligt)
    Abstract [en]

    From the filing of an application to evict to the final execution of an eviction order is a long and complicated process. This raises questions about how the actors involved experience and act during this process. The general aim of the study was to describe and analyse this process from the respective perspectives of the landlords, the social services and the individuals (families) facing eviction in three municipalities in the county of Stockholm. The issues discussed are how the landlords and the social welfare offices are organised, their work procedures, respective scopes of action and resources, and how individuals facing eviction cope with their life situation.

    The material for the study consists of qualitative interviews with nine handling officers at six landlord offices, fifteen social workers at three social welfare offices, twelve individuals who were facing eviction and fifteen observations of conversations between social workers and individuals who were facing eviction. The analytic framework used consists of perspectives and concepts derived from organisation theory – Human Service Organizations and street-level bureaucrats – and theories on coping. A main result of the study is that the work procedures of the professionals are standardised in many ways and are characterised by similar procedures for classifying and categorising the individuals facing eviction, irrespective of how the three municipalities have organised their work. Another main result is that the primarily interests of the individuals facing eviction are to meet what they experience to be their children’s needs, and to avoid eviction. Further, the individuals experience as stressful their life situation marked by the threat of eviction in combination with reduced financial resources that make it difficult for them to meet their children’s needs. The study has identified two types of strategies that individuals facing eviction use in order to cope with their life situation and to achieve their interests. These are emotion-focused strategies and problem-focused strategies, which are described and discussed.

  • 30.
    Schön, Ulla-Karin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Kvinnors och mäns återhämtning från psykisk ohälsa2009Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The overall aim with this thesis is to describe and analyze women’s and men’s recovery processes. More specifically, the aim is to determine what women and men with experience of mental illness describe as contributing to the personal recovery process. The point of departure for the studies was 30 in-depth interviews conducted with 15 men and 15 women. The selection of interview subjects was limited to individuals who had been treated in 24-hour psychiatric care and diagnosed as having schizophrenia, psychosis, a personality disorder, or a bipolar disorder.


    Four studies have been carried.  Study 1 was a baseline article that examined what people in recovery from mental illness outline as facilitating factors to their recovery. The results that emerged from that study indicated areas for further analysis to condense the understanding of the recovery process. In study 2 the similarities and the differences in recovery described by women and men were examined. In Study 3 women’s and men’s meaning-making with reference to severe mental illness facilitate the recovery process were studied. The forth study explored how peer-support contribute to women’s and men’s recovery from mental illness.


    The results emphasize recovery from mental illness as a social process in which relationships play a key role in creating new identities beside the mental illness. For a majority of the participants meeting peers facilitated the recovery process. The participants described how peer support meant an end to isolation and became an arena for identification, connection, and being important to others. Throughout these recovery processes the impact of gender has been emphasized. The results from this thesis provide new insight into gender as an important factor in understanding the recovery processes. The results from the four studies emphasize the mental patient, the psychiatric interventions and the individual recovery strategies as being influenced by gender constructions.

  • 31.
    Andersson, Gunnel
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Vardagsliv och boendestöd: En studie om människor med psykiska funktionshinder2009Doktorsavhandling, monografi (Övrigt vetenskapligt)
    Abstract [en]

    In the wake of deinstitutionalization, people with psychiatric disabilities are, to a great extent, living in the community. In this thesis everyday life of people with psychiatric disabilities, living in independent housing with community-based social support to manage their daily life, is investigated. Special attention is paid to the characteristics and meaning of community-based social support. Through participating observational studies, interviews and time-geographic diaries, data have been gathered about everyday life of seventeen men and women. It is the interpersonal social conditions that have been the main target of the study, addressed as social networks and social support. Everyday life conditions are dependent on social as well as physical and material circumstances. Although the social conditions are emphasized in the study they are not looked upon as isolated dimensions but as part of everyday life circumstances. The everyday life perspective offers an opportunity to reveal the structures within which everyday life takes place. The time-geographic concepts “community-organized projects” and “individual-organized projects” were used to investigate the structures of everyday life, resulting in four substructures. Four types of everyday life and four patterns of networks connected to the different substructures were identified, showing great variations. The characteristics of community-based social support can be summarized as “the doing”, “the talking” and “the being with” in a reciprocal type of relationship. The meaning of support is shortly described as solution of and relieving problems, social companionship, security, protection and control. Community-based social support show similar importance regardless of the type of everyday life when it comes to solution of problems and different importance when it comes to aspects of support such as social companionship.


  • 32.
    Tham, Pia
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Arbetsvillkor i den sociala barnavården: förutsättningar för ett kvalificerat arbete2008Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    This thesis describes and analyzes the working conditions of child welfare social workers who responded to a comprehensive questionnaire (n=309, dropout rate 3 per cent).

    In Study 1, the working conditions of social workers new to the profession (0-2 years) were compared with those of social workers with longer experience. The study shows that less experienced workers were more often found working in areas characterized by worse socioeconomic conditions and in workgroups where many others were also new and inexperienced. Although they described some aspects of their working conditions more positively they tended to report more health problems.

    In Study 2, working conditions of the child welfare social workers were compared with those of other professional human service workers. The study shows that although social workers in general and child welfare social workers in particular made positive assessments of their working lives, social work was unusually demanding among human service professions on several measures of workload, complexity of tasks and quality of management.

    In Study 3, the associations between the child welfare social workers’ working conditions and their health and well-being were investigated, controlling for background variables. The negative consequences of high job demands, especially for psychological health and well being emerge.

    In Study 4, factors associated with the social workers’ intention to leave the job were investigated. The study showed that lack of human resource orientation within the organization was of greatest importance.

    The results are analyzed from two different perspectives; the effort/reward model and new institutional theory. The main conclusions are that improvement is needed of the introduction to the profession at the workplace, that the status of child protective work needs to be raised and that social workers need help to limit their responsibility load, more time and space for reflection, and greater valuation of their work.

  • 33.
    Meinow, Bettina
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Capturing health in the elderly population: Complex health problems, mortality, and allocation of home-help services2008Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    This thesis investigates health trends among very old people and the allocation of public home-help services. A further aim is to examine methodological issues in mortality analysis. Three data sources are used: (1) The Tierp study of community-dwelling persons (n=421, ages 75+), (2) the SWEOLD nationally representative samples (n=537 in 1992 and n=561 in 2002, ages 77+), and 3) SNAC-K comprised of home-help recipients in a district of Stockholm (n=1108, ages 65+).

    Study I suggests that the length of the follow-up period may explain some of the differences found in predictor strength when comparing mortality studies. Predictors that can change rapidly (e.g., health) were found to be strongest for the short term, with a lower average mortality risk for longer follow-ups. Stable variables (e.g., gender) were less affected by length of follow-up.

    Studies II and III present a measure of complex health problems based on serious problems in at least two of three health domains. These were diseases/symptoms, mobility, and cognition/communication. Prevalence of complex health problems increased significantly between 1992 and 2002. Older age, female gender, and lower education increased the odds of having complex problems. Complex problems strongly predicted 4-year mortality. Controlled for age, gender, health, and education, mortality decreased by 20% between 1992 and 2002. Men with complex problems accounted for this decrease. Thus, in 2002 the gender difference in mortality risk was almost eliminated among the most vulnerable adults.

    Study IV revealed that physical and cognitive limitations, higher age, and living alone were significantly related to home-help allocation, with physical and cognitive limitations dominating. Psychiatric symptoms did not affect the assessment.

    The increased prevalence of complex health problems and increased survival among people with complex needs have important implications concerning the need for collaboration among service providers.

  • 34.
    von Greiff, Ninive
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Ungdomsinriktad alkohol- och drogprevention: förutsättningar, evidens och legitimitet2008Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The aim of this thesis is to elucidate different aspects of Swedish adolescents’ use of alcohol and drugs and how society deals with problems related to their use. The subject has been analyzed in four studies. The first study was based on focus-group interviews with adolescents and aimed at elucidating the meaning of alcohol and intoxication for adolescents. The participants’ discussions contained two levels - one superficial (an ideal presentation of themselves) and one deep (which mediated cultural ideas of how to think and act). This is interpreted as a way to express the maturity process they are going through, at the same time as it symbolizes difficulties to unite external norms and values with their own need for devotion. The second study was based on project applications, evaluations and economy accounts for preventive work from 150 projects conducted by non-profit organizations. The results show that type of organizations and the methods used were based on tradition rather than on efficiency. These results are discussed in relation to growing demands for evidence based practice in the field of prevention. The third and the fourth study are based on the ADAD-interview (Adolescent Drug Abuse Diagnosis). In the third study, comparisons of different judgements concerning the extent of drug abuse among adolescents in institutional care, were made and results show large differences between the different judgements, concerning both occurrence and extent of abuse. In the fourth study, the significance of ADAD was discussed in relation to matching drug abusing adolescents to treatment institutions. The results show that only a limited number of institutions specializes on drug abusing adolescents and that a majority of the adolescents institutionalized for drug problems never visit an institution specialized on drug abuse treatment.

  • 35.
    Tärnfalk, Michael
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Barn och brott: - En studie om socialtjänstens yttranden i straffprocessen för unga lagöverträdare2007Doktorsavhandling, monografi (Övrigt vetenskapligt)
    Abstract [en]

    The aim of this thesis is to scrutinise the statements from the social authorities to the criminal courts in the juvenile justice process, and to analyse in what extent these statements influenced the criminal courts in their penalty sentencing for boys aged 15-17 years, suspected and convicted for assault and battery and grand assault and battery, in Stockholm County the years of 1998 and 2000.

    In 1998 a child’s perspective and the concept of the best interest of the child was introduced in the Social services act. A legal reform in 1999 in the criminal code introduced the concept of just desert for juvenile offenders, to make the juvenile justice system more predictable and fair and to make the statements more clarifying to the courts. Laws, preparatory documents and legal doctrine are studied. Theoretically, discourse analysis and neoinstitutional organisational theories are points of departure. The empirical material consists of criminal statistics, 103 statement from the welfare agencies and 103 criminal court records. The social authorities statements are scrutinised to discern specific patterns of intervention and then analysed together with criminal court records. The result indicates that the juvenile justice system seems to be unpredictable and unfair due to several factors linked to each other. There is a striking uncertainty in the statements because of great variations. The concept of the best interest of the child is hardly expressed as an interest in the statements. Social interventions are proposed both on the behalf of the child’s needs and to punish the child in a criminal justice mode. The statements seem to influence the courts sentencing in a great extent but there are difficulties to discern the grounds for differences in criminal sentencing. The juvenile justice system and the social services laws seem to be incompatible by contradictions in terms.

  • 36.
    Karlsson, Lis Bodil
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Berättelser om inre röster: Ett fenomenologiskt och kommunikativt perspektiv2007Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The phenomenon of hearing voices is examined in a communicative way and with a phenomenological perspective. Data consist of talks in focus groups and of written autobiographical texts.

    (I) The aim of the first article, “More real than the reality”- A study of voice hearing, is to describe and analyse how participants in focus groups account for and understand their voice hearing experiences. Voice hearing can be understood as a continuum of various experiences, including thoughts about the self and the inner and the outer world. Voice hearing can be experienced as ‘more real than the reality’.

    (II) The aim of the second article, Från rösthörarnas värld - en analys av självbiografiska brev om hörselhallucinationer [From the world of the voice hearers - en analysis of personal letters on auditory hallucinations], is to analyse how people can describe and interpret inner voices in texts. The terms monologue, dialogue, polyphony and cacophony characterise variations of voice hearing.

    (III) The aim of the third article, ‘Schizophrenic or occult harassed?’ A narrative study of an autobiographical text about auditory and visual hallucinations, is to show that important insight into voice hearing can be gained when one describes and analyses how a subject writes. The analysis showed how writing was a way of adapting to inner voices and to the psychiatric diagnosis the author had received.

    (IV) The aim of the fourth article, Leva med inre röster. Utforskande av röstupplevelsers mening [Living with inner voices. A quest for the meaning of voice experiences], is to describe and analyse some methods and attitudes that the subjects use in order to cope with inner voices. It was important that the participants accepted their voices as a part of life. The participants also must cope with being stigmatised.

  • 37.
    Batljan, Ilija
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Demographics and Future Needs for Public Long Term Care and Services among the Elderly in Sweden: The Need for Planning2007Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Long term care and social services (LTCaS) for older people are an important part of the Scandinavian welfare state. The fast growing number of elderly people in Sweden has caused many concerns about increases in future needs (and particularly costs) of age-related social programs such as LTCaS. The general aim of this dissertation is to examine how projected demographic changes may affect future needs for long-term care and services in Sweden assuming different trends in morbidity and mortality. The following data sources are used: national population registers, register data on inpatient/outpatient health care from region Skåne, the Swedish National Survey on Living Conditions (SNSLC) for the period 1975-1999. Three alternative methods to inform simple demographic extrapolations of needs for health and social care for the elderly are presented. Furthermore, a new method for demographic projections has been developed. According to our studies, the health of older people (measured as the prevalence of severe ill-health) has improved during the study period. Taking into account health status, when projecting future needs for LTCaS, will result in a fairly substantial reduction of the rate of the demographically influenced increase in projected LTCaS needs. The changes in population composition regarding education and mortality differentials per educational level may have a significant impact on the number of the elderly in the future. On the other hand, the projected increase in the number of older people suffering from severe ill-health, as a consequence of population ageing, may be counterbalanced to a large extent by changes in the educational composition towards a higher proportion of the population having a high educational level and lower prevalence of severe ill-health. We need to improve our planning tools in order to support policy-makers to plan for uncertainty concerning future needs and demand for LTCaS.

  • 38.
    Backlund, Åsa
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Elevvård i grundskolan: Resurser, organisering och praktik2007Doktorsavhandling, monografi (Övrigt vetenskapligt)
    Abstract [en]

    The aim of the thesis is to describe and analyse the organization, resources and practice of pupil welfare work in municipal compulsory schools. In one study, telephone interviews with head masters from a random sample of 100 municipal compulsory schools have been carried out. A second study is based on material from two case studies, where the work of the pupil welfare team members and the everyday organizing of pupil welfare, are scrutinized.

    The distribution of special pupil welfare resources varied considerably. Almost one-third of the variation could be explained by organizational and structural variables included in a regression analysis. Practically all schools in the sample had a school nurse, while school social workers and in particular school psychologists, were available to a lesser extent. Regarding the latter two professions, the results indicate that these resources are allocated to pupils of different age groups. The involvement of different kinds of municipal service in pupil welfare work is becoming a common form of organization. The case studies show that these service units can become influential actors in the organizing of local pupil welfare work.

    School nurses appear to be an institutionalized resource, with regard to their presence in schools and the content of their work. The school social worker lacks a specific technology of her own that distinguishes her work from other professions. School social work is performed by several professions and for some tasks domain conflicts can arouse. These conflicts can to a certain degree be rooted in the enhanced consultative role of the pupil welfare specialists, which affects the division of labour between the actors. The pupil welfare meetings studied in the case studies where characterized by asymmetrical relationships, where little space were given for pupils and their parents to be actively involved in the decision-making process.

  • 39.
    Skogens, Lisa
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Hur bemöts manliga socialbidragstagare med alkoholproblem?: -regler, kunskap och kontext i socialt arbete2007Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Several Swedish studies have suggested that within the group of clients contacting social welfare offices for social assistance, approximately one third are having problems with heavy drinking. The overall aim of the dissertation was to study how social workers approach these problems in single, male clients. That is; are the drinking problems of these clients approached and if they are, when and why does this happen? The subject has been investigated in four studies. In study I (n=66) and II (n=103) social workers were to respond, in a written questionnaire, on how they would act on a hypothetical client described in vignettes. The results from these studies suggest that there is no consensus among social workers of how to act towards the clients drinking problem and that social workers personal values seem to influence their choice of action taken. In study III, data was collected from case files on male single clients in nine municipalities. Case files in which alcohol related notes were present (n=297) were investigated. The results indicate that social workers are more active as regards demands on clients to moderate or stop their alcohol consumption if the clients are able to work, than if they are not. Study IV was based on focus-group interviews in eight municipalities. In each municipality, a work group of social workers dealing with social assistance were interviewed on one occasion. The social workers approach to the client’s problems was described as a mobile point within a two-dimensional system. The legislative dimension concerned the clients’ right to be equally treated versus the right to have their application judged individually with every circumstance considered. The other dimension was related to traditional social work with the client’s integrity versus the need for support and control. The results were contextualised mainly from three aspects, the influence from raised demands on a “knowledge-based” practice, the prerequisites consistent of the specific frames for social work and changes in the public discourse constituting the frame of socially acceptable drinking habits.

  • 40.
    Kejerfors, Johan
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Parenting in Urban Slum Areas: Families with Children in a Shantytown of Rio de Janeiro2007Doktorsavhandling, monografi (Övrigt vetenskapligt)
    Abstract [en]

    This is a study of parenting and child development in a slum area in a developing part of the world. The aims of the study were threefold. The first aim was to explore the physical and social contexts for parenting in a shantytown in Rio de Janeiro using an ecological perspective. The second aim was to examine parenting and subsequent child outcomes among a sample of families living in the shantytown. The third aim was to explore what factors contribute to differences among parents in how they nurture and protect their children. The theoretical framework of the study was an updated version of Bronfenbrenner’s bioecological model of human development. Using self-report questionnaires developed by Rohner, data on perceived parental acceptance–rejection were collected from 72 families with adolescents 12–14 years old, representing approx. 75% of all households with children in this age group in the shantytown. Besides self-report questionnaires, each adolescent’s main caregiver replied to several standardized questionnaires developed by Garbarino et al., eliciting demographic and social-situational data about the family, neighborhood, and wider community. The results of the study paint a complex portrait of the social living conditions of the parents and children. Despite many difficulties, most parents seemed to raise their children with loving care. The results from the self-report questionnaires indicate that the majority of the adolescents perceived substantial parental acceptance. The adolescents’ experience of greater or lesser parental acceptance–rejection seems to influence their emotional and behavioral functioning; it also seems to be related to their school attendance. Much of the variation in degree of perceived acceptance–rejection seems to be related both to characteristics of the individual adolescents and their main caregiver(s) and to influences from the social and environmental context in which they and their caregivers interact and live their lives.

  • 41.
    Högdin, Sara
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Utbildning på (o)lika villkor: Om kön och etnisk bakgrund i grundskolan2007Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The aim of this thesis is to examine children’s educational conditions in senior compulsory school. The purpose is to compare girls and boys’ conditions on the basis of ethnical background. The thesis includes four articles. The first three are based on questionnaire data from 1,193 children, 13 to 15 years old, at four Swedish municipal schools. The last article includes two studies: A study conducted among the headmasters at the four schools and a study of the compulsory school attendance law.

    The first article introduces a study concerning parental involvement in their children’s education. The aim is to examine the children’s experience of their parents’ assistance in their homework, participation in school meetings and interest in their education. Finally, these topics are analysed in relation to the children’s own involvement in their education. The second article introduces a study concerning schoolchildren’s involvement in their own education and factors that correlate, beside parental involvement. The implicit aim is to study the children’s experience of teacher support, their situation in school and attitudes towards university education. The third article introduces a study concerning parent’s directives regarding their child’s participation in social activities. The aim of the study is to examine how many children that are not allowed to participate in social activities and some educational elements at school, for example psychical education and school journeys. The results of the questionnaire show great complexity concerning how the children experience their conditions, where sex/gender and ethnicity correlate. The last article examines the conflicts that may arise between the educational system and the parents regarding specific elements in their child’s education. This study examines the attitude of the schools towards allowing children to refrain from compulsory attendance at the family’s request. Results show that the attitude towards the families varies between the schools. The compulsory attendance law is indistinct, but legal cases show that it is illegal to allow children to refrain from specific elements within the education to fulfil the parent’s wishes.

  • 42.
    Stranz, Hugo
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Utrymme för variation: - om prövning av socialbidrag2007Doktorsavhandling, monografi (Övrigt vetenskapligt)