Background: This study critically examines the central policy documents that regulate care and support for people with disabilities in South Africa and Sweden.

Methods: The study critically analyses South Africa's White Paper on the Rights of Persons with Disabilities and the Swedish Disability Act. Utilizing the “What's the Problem Represented to be? (WPR)” framework developed by Bacchi, the problematization of disability in these policy documents is discussed.

Results: Both countries have shifted from a medical model of disability toward a more inclusive, rights-based approach. While South Africa focuses on addressing historical inequalities and promoting mainstreaming, Sweden prioritizes individual autonomy, personal assistance, and structural support for independent living.

Conclusions: The analysis reveals that South Africa relies more heavily on family and community support for individuals with disabilities. By contrast, Sweden promotes greater self-determination for individuals, reducing the burden on families by offering state-supported personal assistance.

Background: Experiencing a stroke disrupts the expected life course and can negatively impact cognitive, emotional, and physical functioning, making it a major source of disability globally. To support recovery, individuals can seek help by sharing their experiences in peer-to-peer support communities.

Objective: The objective of this study was to use discourse analysis to examine how members of a peer-to-peer online support community for stroke survivors construct their understanding of the condition and use narratives to reconstruct their identity into different subject positions.

Methods: The study context was a private Swedish peer-to-peer online support community created and administered by middle-aged people with lived experience of stroke. Data was collected through structured protocols that captured the content of posts and comments (n = 397). The analysis has followed the principles of Laclau and Mouffes discursive framework.

Results: Our findings suggest that identity struggles revolve around looking ahead and negotiating normative expectations with oneself and others. We identified five subject positions: survivor, pathfinder, mentor, struggler, and outsider. These positions highlight the plurality and fluidity of post-stroke identity processes. Members often shifted between these roles based on changes in health, emotional state, or community interactions.

Conclusions: The diversity of subject positions demonstrates that stroke recovery is not a uniform process, emphasizing the importance of recognizing identity work as a core aspect of post-stroke adaptation. The findings highlight the need for more flexible, patient-centered services that accommodate diverse narratives, including those shaped by long-term disability, emotional trauma, and shifting life priorities.

This article explores how mental health professionals narrate successful experiences of implementing shared decisionmaking (SDM) within coordinated individual care planning (CIP) for adults with severe mental illness in Sweden. Drawingon narrative theory and the concepts of master and counter-narratives, the study analyzes two in-depth interviews withprofessionals who adopted a new SDM-oriented CIP model. While previous research has highlighted barriers to implementation, this study focuses on stories of localized success. The findings show that professionals engage in narrativeidentity work to navigate and, at times, resist dominant institutional discourses centered on time scarcity, user passivity,and bureaucratic rigidity. Through reflective practice, relational engagement, and adaptive use of tools such as premeetings and informational media, the professionals reframe SDM as both feasible and desirable. These counter-narrativesreveal the importance of time, trust, and storytelling as enabling conditions for change. The study highlights the role ofnarrative as a tool of professional agency, offering insight into how small-scale innovations can challenge organizationalinertia and foster more participatory models of care.

Background: Many stroke survivors face disabilities that can have a substantial lifelong impact on both their own and their significant others' life situations. Online groups on social media can serve as forums for peer support among people sharing a common experience. However, there is limited knowledge about online peer-support groups for people living with the consequences of stroke that are initiated and managed by stroke survivors themselves. Objective: The aim of this study was to explore and describe what stroke survivors and their significant others share in posts and comments in a Facebook group for stroke survivors, initiated and run by stroke survivors. Methods: In this participatory, exploratory and qualitative study, three stroke survivors, engaged as co-researchers with no previous research experience, identified Facebook as an important context for sharing experiences and peer support. Data were collected by summarizing posts and comments from a Facebook group over 3 months and analyzed using the principles of inductive qualitative content analysis. Results: In total, 5 categories and 11 subcategories were created. The categories Narrating About Everyday Life with the Consequences of Stroke, Dealing with the Emotional Struggle of Poststroke Life, Making Progress and Enjoying Everyday Life, Navigating Societal Services and Societal Demands and Continuing Everyday Life describe narratives, questions and requests for other members' experiences related to challenges and situations that the group's members faced post-stroke. Conclusion: We conclude that there is considerable breadth in the topics and issues discussed in the online forum, reflecting that a stroke affects many areas of life for both stroke survivors and their significant others. Furthermore, online peer-to-peer support for stroke survivors have the potential to provide a context for sharing experiences and knowledge, and for developing experiential knowledge. Clinical implications are that rehabilitation professionals can inform stroke survivors about the existence of online peer-to-peer groups, include the ability to use social media in assessments of activity performance, and, if relevant, support stroke survivors' use of social media. Patient or Public Contribution: Stroke survivors identified Facebook as a context for the study. They collaborated in data collection, analysis, interpretation and discussion of findings and are co-authors.

Understanding the capacity of child welfare (CW) organisations to deal with child abuse is complex, and dependent on the specific CW context. Sweden occupies a unique position in trying to balance high demands for CW and protection with a strong family support focus, which carries a risk of overlooking children who need protection. Drawing on an understanding of social service organisations as street-level bureaucracies, this article explores discretion in child abuse cases by examining conditions affecting discretion and strategies for investigating child abuse, including police reporting. Thematic analysis of interviews with Swedish supervising social workers showed that staff's conceptions of the CW system influenced the exercise of discretion, leading to different strategies for dealing with child abuse. This resulted in different practices and potentially unequal access to child protection and support, highlighting the wide margin of discretion. This article concludes that the interplay between knowledge and governance is central to equal child protection. This article contributes to the discussion of discretion in CW organisations by underlining the importance of being particularly vigilant about discretion when both children and parents are considered clients, as the child risks being lost as a subject with individual needs and rights. Understanding the capacity of child welfare (CW) organisations to deal with child abuse is complex. Sweden occupies a unique position in trying to balance high demands for CW and protection with a strong family support focus, which carries a risk of overlooking children in need of protection. This article explores the handling of child abuse cases by examining conditions affecting discretion and strategies for investigating child abuse, including police reporting. Analysis of interviews with Swedish supervising social workers showed that staff's conceptions of the CW system influenced the handling, leading to different strategies for dealing with child abuse. This resulted in different practices and potentially unequal access to child protection and support, underscoring the importance of being particularly vigilant about discretion when both children and parents are considered clients: the child risks being lost as a subject with individual needs and rights. This article concludes that the interplay between knowledge and governance is central to equal child protection.

This article explores conditions for implementing shared decision-making(SDM) in coordinated individual care planning (CIP) with individuals withcomplex mental health needs. SDM in CIP are described as central,although such user centred collaboration still remains to be realised.Research underlines the need for a changed way of working, whereuser expertise is valued and a balance of power is promoted. The aimof the present study is to investigate the conditions for implementingSDM in connection with CIP for and with people with mental illness. Tobetter understand the context and conditions that can promote such animplementation, altogether 15 participants were interviewed in threeregions in Sweden within the scope of a stakeholder analysis. Bothhindering and supporting factors were identified with respect to animplementation process, such as staffturnover, differences in workculture and committed leadership. Further focus should be directedspecifically towards professionals working more closely with CIP andtowards in-depth analysis of the construct of culture in terms ofimplementation processes.

Background: Pediatric acute-onset neuropsychiatric syndrome (PANS) is a symptom-based and clinically heterogeneous condition characterized by an abrupt and dramatic onset of symptoms such as loss of motoric and cognitive abilities, anxiety, compulsion, tics, and eating disorders. PANS is a new diagnosis and the condition has gathered controversy in research and clinical practice. Aim: We aimed to investigate the process by which parents of children with PANS acquire knowledge about the condition; the causes that lead parents to search for knowledge; the ways in which they search for knowledge; and the manner in which this knowledge is received by medical care professionals. Method: The study employed in-depth semi-structured, individual interviews with 13 parents of children diagnosed with PANS. An inductive qualitative thematic analysis was used as a guide for analyzing the data. Results: Challenges to understand their child’s illness and receive effective care led the parents to search for knowledge about PANS and provide an explanation for their child’s symptoms. They used personal and social resources to search for knowledge. They felt trusted and encouraged when clinicians endorsed their knowledge. On the other hand, when they were dismissed as a source of knowledge, they experienced a lack of trust towards professionals. Conclusions: A driving force for parents’ search for knowledge is a perceived incapacity to give meaning to their experiences. Another reason is mistrust of healthcare staff’s existing knowledge.

This article explores subjective realities of being not in employment, education or training (NEET), with a specific focus on support needs and how labour market support fits these needs. A total of 23 semi-structured interviews were conducted with participants aged 18–29 who had just been recruited to a work support program aimed at increasing the availability, coordination, and individualisation of support in order to enhance the possibility of finding work. The results illustrate a clear yet fragile motivation to work among the respondents. The participants expressed optimism that they would find a job, but were also clear about the need for adaptations in the workplace to succeed. Through the lens of crip time, the participants expressed a need for flexibility and extra time to perform tasks such as finding a job and feeling comfortable in the workplace, compared to the needs of abled people. Rules and time limits at the Public Employment Service and the Social Insurance Agency reinforced the image of this normative time, making the participants express their needs as a deviation from what is considered normal. 

Den här artikeln utforskar erfarenheter och upplevelser av att stå långt ifrån arbete, sysselsättning eller studier, med ett specifikt fokus på subjektiva stödbehov och hur arbetsmarknadsstöd matchar dessa behov. Totalt genomfördes 23 semistrukturerade intervjuer med deltagare i åldrarna 18–29 år, som just rekryterats till en arbetsstödjande insats som erbjuds genom samordningsförbund. Insatsen syftar till att öka tillgängligheten till stöd, samordna och individualisera stödet för att öka möjligheterna att nå arbete eller studier. Resultaten illustrerar en tydlig men samtidigt skör motivation att arbeta, bland respondenterna. Deltagarna uttrycker en optimism om att de ska hitta ett jobb, men också en tydlighet kring behovet av anpassningar på arbetsplatsen för att lyckas. Genom perspektiv såsom att crippa tid illustreras deltagarna behov av flexibel och extra tid för att utföra uppgifter som att hitta ett jobb och känna sig bekväma på arbetsplatsen, jämfört med vad arbetsföra människor kan behöva. Regler och tidsgränser från Arbetsförmedlingen och Försäkringskassan förstärker bilden av hur denna normativa tid skapar en känsla av avvikelse bland deltagarna. 

Despite a strong emphasis on user participation in social services, scientific knowledge on how to achieve these goals is limited. The aim of this study is to explore what social work practitioners identify as challenging in implementing user participation and what solutions they propose to be necessary to meet these challenges. Future workshops were applied, combining data from brainstorming processes and from the participants’ analytical work, identifying current obstacles and co-creating solutions. The workshops took place at the Personal Social Services section in a suburban area outside a large city in Sweden with 95 participants. The findings are discussed in relation to a model of participation, where creating openings, opportunities, and obligations are essential. The participants highlighted the need to strengthen commitment to user participation, increased access to knowledge and methods that enhance user participation, and support from management, with increased resources to ensure continuous development and maintenance. Practitioners must be able to engage in user participation, and actions need to be taken at all organizational levels. To overcome a complex and intertwined set of challenges, an intertwined set of solutions is required.