Frontline implementation of welfare conditionality in Norway: A maternalistic practice

Welfare conditionality is both ambitious and ambiguous for the frontline workers who put policy into practice. Since January 2017, the Norwegian frontline service should require social assistance benefit recipients under the age of 30 to participate in some sort of work-related activation, so-called mandatory activation. Drawing on qualitative interviews with frontline workers at local offices in the Norwegian Public Welfare Service (NAV), we investigate how the requirement is implemented in a context of a professionalised social welfare service. Mandatory activation is arguably a paternalistic measure. Drawing on Bernardo Zacka's concept of moral dispositions and Laura Specker Sullivan's concepts of maternalism, our findings indicate that at the frontline, mandatory activation policies are implemented by maternalistic decision making, emphasising the interpersonal relation between trained caseworkers and clients. The caseworkers use their discretionary powers in the implementation of conditionality and sanctions by emphasising care and support as embedded in the strict rules.     

‘Street‐level Bureaucracy’ Revisited: The Changing Face of Frontline Discretion in Adult Social Care in England

This reassessment of the continuing significance of Lipsky's (1980 ) work on ‘street‐level bureaucracy’ for frontline decision making is based on a retrospective review of the author's research on assessment practice in adult social care in England. The studies span the past two decades during which time successive governments have restructured and modernized social services departments. When these were established in 1970, they represented the high watermark of bureau‐professionalism – a mode of administration which dominated social welfare at the time Lipsky was writing. The subsequent dismantling of bureau‐professionalism calls into question the validity of his findings, and the author draws on her own research to assess conflicting views about the impact of social care reforms on the discretion which social workers exercise as street‐level bureaucrats. She concludes that the distinct types of discretion to emerge from her findings, represented in a taxonomy, are shaped by the differing micro environments of frontline practice which, in turn, affect the relative force of managerialism, professionalism and user empowerment in countering the defensive exercise of discretion described by Lipsky. Whilst her analysis affirms the continuing significance of Lipsky's analysis, it also points to the need for some revision to accommodate major shifts in welfare administration since the publication of his work. She highlights the potential relevance of these insights for investigating the next planned transformation of adult social care, personalization, as well as for the implementation literature more widely.     

When standardization becomes the lens of professional practice in child welfare services

This paper examines the relationship between professional work and standardization. There has been an increase in the use of standardized programmes in child welfare services (CWS) in Western society. Some researchers have criticized standardized programmes suggesting that they undermine professionals expertise and threaten their position, whereas others argue that such programmes strengthen professional practice. In this paper, we examine how standardized tools, in this case, a standardized parenting programme and a standardized Norwegian assessment tool, influence professional roles as experienced by child welfare workers (CWS professionals) in Norway. Semistructured individual and group interviews were conducted with 31 frontline workers in two CWS agencies. Our findings suggest that standardized tools increase the social workers experienced professional competence but challenge their professional knowledge base, reflective practice, and professional accountability. Professional and practical implications for CWS work are discussed in the light of these findings.     

Developing practice tools for social workers in end-of-life care

This article describes the National Association of Social Workers' (NASW) strategies for providing social workers with important practice and policy information about palliative and end-of-life care. With funding from a Soros Foundation's Project on Death in America grant, NASW developed practice standards, a Web-based continuing education course, and drafted a new policy statement to guide social workers in end-of-life care practice. The article provides an in-depth view of the development and scope of these resources for professional social workers.     

Developing Practice Tools for Social Workers in End-of-Life Care

Abstract

This article describes the National Association of Social Workers' (NASW) strategies for providing social workers with important practice and policy information about palliative and end-of-life care. With funding from a Soros Foundation's Project on Death in America grant, NASW developed practice standards, a Web-based continuing education course, and drafted a new policy statement to guide social workers in end-of-life care practice. The article provides an in-depth view of the development and scope of these resources for professional social workers.     

Citizen‐agency versus state‐agency at the frontline in prisons and probation services: A systematic literature review

Street‐level bureaucrats play a key role in the delivery of public services to the citizens with whom they interact. Using the Preferred Reporting Items for Systematic Review and Meta‐Analyses approach, we rely on a street‐level perspective to report a systematic review of 46 studies about officer–offender interactions in prisons and probation services. In doing so, we examine how correctional officers articulate state‐agency – whereby they focus on the implementation of rules and policies – and citizen‐agency – whereby their decisions regarding offenders are based on judgements of offenders' worth. Our results provide evidence that frontline work in prisons and probation services stems from a mix of citizen‐ and state‐agencies in which the former is prioritized over the latter: when rule enforcement allows it, correctional officers often make discretionary decisions based on professional judgements rooted in professional norms. In this respect, the managerial and actuarial approach to risk management and public protection involved by contemporary correctional reforms comes with new role expectations that conflict with correctional officers' rehabilitative ideals. At the same time, the literature provides many instances of officers coping with workload in order to meet policy objectives and organizational demands while maintaining satisfactory working conditions. In other words, there is an increasingly elaborate and fragile articulation of state‐ and citizen‐agencies at the frontline, in prisons and probations services. We conclude with some implications and an agenda for future research.     

Room to move? Professional discretion at the frontline of welfare‐to‐work

Outcomes of social policies have always been mediated by the discretionary agency of front‐line staff, processes which nevertheless have received insufficient attention in policy evaluation and in the social policy literature more broadly. This article takes the case example of the policy reforms associated with the Australian government's welfare‐to‐work agenda. Drawing on two discreet research projects undertaken at different points in the policy trajectory, the practices of social workers in Centrelink – the Commonwealth government's primary service delivery agency involved in welfare‐to‐work – is examined. Centrelink social workers have been and remain one of the core groups of specialist staff since the Department's inception in the late 1940s, working to improve the well being of people in receipt of income security. Their experiences of the recent past and their expectations of the future of their professional practice as welfare reform becomes more entrenched are canvassed. In summary, the discretionary capacity of the Centrelink social workers to moderate or shape the impact of policy on income security recipients is steadily eroding as this group of professionals is increasingly captured by the emerging practices of workfare.     

Professional Perspectives on Decision Making about the Long-term Care of Older People

With the increasing pressure on social and health care resources,professionals have to be more explicit in their decision makingregarding the long-term care of older people. This groundedtheory study used 19 focus groups and nine semi-structured interviews(99 staff in total) to explore professional perspectives onthis decision making. Focus group participants and intervieweescomprised care managers, social workers, consultant geriatricians,general medical practitioners, community nurses, home care managers,occupational therapists and hospital discharge support staff.The emerging themes spanned context, clients, families and services.Decisions were often prompted by a crisis, hindering professionalsseeking to make a measured assessment. Fear of burglary andassault, and the willingness and availability of family to helpwere major factors in decisions about living at home. Serviceavailability in terms of public funding for community care,the availability of home care workers and workload pressureson primary care services influenced decision ‘thresholds’regarding admission to institutional care. Assessment toolsdesigned to assist decision making about the long-term careof older people need to take into account the critical aspectsof individual fears and motivation, family support and the availabilityof publicly funded services as well as functional and medicalneeds.     

Working in Multidisciplinary Community Mental Health Teams: The Impact on Social Workers and Health Professionals of Integrated Mental Health Care

Correspondence to Professor John Carpenter, Centre for Applied Social Studies, University of Durham, Elvet Riverside II, Durham DH1 3JT, UK. E-mail: J.S.W.Carpenter{at}dur.ac.uk Summary This study investigated the relationships between the organizationof community mental health services and professional and teamidentification, team functioning and the psychological well-beingand job satisfaction of staff working in multidisciplinary communitymental health teams (CMHTs). Staff in four districts in theNorth of England completed anonymous questionnaires on two occasions,twelve months apart. There were systematic differences in teamfunctioning, favouring teams in districts where mental healthand social care services were integrated. However, service organizationhad no evident impact on professional or team identificationor on outcomes for staff in terms of stress or job satisfaction.There were differences between social workers (n = 31) and healthservice professionals (n = 82) indicating that social workershad poorer perceptions of team functioning and experienced higherlevels of role conflict. Controlling for other factors includingthe study districts, role conflict was a significant predictorof stress and of job dissatisfaction, while role clarity promotedjob satisfaction. We conclude that support and supervision aimedat ensuring a social work contribution to multidisciplinaryworking should be provided in the course of establishing CMHTsand integrated health and social care services.     

Community Mental Health Services in a Remote Rural Area

A programme was developed by the authors to provide community mental health services to an isolated rural region situated within the large catchment area of a state psychiatric hospital. The programme functioned without psychiatrist or medical officer in the team. The authors believe their programme to be effective and economical both of monetary cost and of the scarce services of psychiatrically trained professional workers. They hope it will serve as a model for other community mental health workers.     

“Unexpected and Distressing”: Understanding and Improving the Experience of Transferring Palliative Care Inpatients to Residential Care

The survival of patients with advanced cancer, coupled with the increased presence of end-stage chronic illnesses in an aging population, is leading to a demand in palliative care. Due to the ongoing need for acute-pain and symptom control in hospice/palliative care units, few are able to offer long-stay admission for those whose symptoms have stabilized. When a patient no longer requires specialist palliative care services, transfer from an inpatient palliative care facility may then be necessary. A core component of the role of palliative-care social workers involves working with patients and their families/carers when the care pathway shifts and the option of residential aged care facility (RACF) needs to be considered. This research explored several issues, including the impact of this transition on the patient and their families and on the interdisciplinary health care team treating the patient. An investigation was undertaken to identify concerns and barriers regarding the transition from hospice care to RACF and opportunities were highlighted to improve clinical practice in this area. A tripartite approach was adopted conducting face-to-face interviews with patients, their families/carers, and health care professionals. Members of the interdisciplinary team were interviewed and social workers working in similar inpatient palliative-care facilities undertook telephone interviews to gauge their experiences. A thematic analysis discerned a number of themes highlighting the impact of this transition on key stakeholders and incorporated recommendations to improve or best manage this process. The research has highlighted the difficulties that patients/families encounter in this transition, as well as the emphases of protecting the integrity of the patient and family. This is achieved by holding open and ongoing dialogue, particularly through family meetings and working in collaboration with the patient, the family, and the team. Understanding the experience and impact of this transition on key stakeholders is helpful in building up a knowledge base and to ensure a more effective relationship occurs. This research incorporated the voices of terminally ill patients, families, and members of the health care team in order to understand their views and recommendations for best managing the transition from a hospice/inpatient palliative-care facility to a RACF. This enables their input to have some real impetus in clinical practice and service delivery.     

应对地震灾害的社会工作的方法与开发——借鉴阪神淡路大地震、中越大地震、东日本大地震的经验教训

日本3.11大地震后,各种专业组织、社会福利组织致力于灾后重建的社会工作,有力佐证了日本护理保险制度中的护理管理在震灾救援中的巨大威力。针对震灾的社会工作,需要注重以个人援助为主的护理管理,与以地域社会为主的网络相结合。在灾害社会工作的发展方向上,需要社会工作把医疗和团队结合起来,通过加深相互之间的配合,建立在灾害医疗援助小组(DMAT)或日本医师会灾害医疗团队(JMAT)进行治疗后开展生活援助的机制。在社会工作中导入与灾害医疗援助小组同样的体系,平时就要培养好应对震灾的社会工作者。注重培养社会工作者应用现存的社会资源的能力,以及动员、调动灾区以外地区的社会资源的能力。重建受灾者的社区,非常有必要保持并进一步强化以往的居民间的关系。需要建立区域综合援助中心,配有保健师、社会福利士(社会工作者)、主任护理经理。以区域综合援助中心为主来开展灾区和灾区以外地区的社会工作者互相合作的"区域综合照顾"。在生活圈里重建各种组织机构的网络,社会工作者在各自的生活圈内,以地区的需求为基础,制定解决这些需求的计划,动员灾区居民参加,力求实现正式和非正式组织、机构的组织化,并在各种组织、机构的合作下进行实施推广,为社区复苏提供援助,促进地域社会中的各种组织的网络建设,从而形成地区的组织化。     

The FACES Project: an academic-community partnership to improve end-of-life care for families

This article reports on a research partnership between a community-based hospice and a graduate school of social work. The purpose of the collaboration was to design and test a tool for assessing caregiver strain and resources in families caring for older adults receiving hospice home care services. Eighteen hospice home care social workers interviewed 162 caregivers for the study and provided their own assessment of the tool's clinical utility. Both strengths and challenges of the collaboration are evaluated and implications are discussed for social work practice and research, particularly academic-community research partnerships.     

回应需求:社会工作专业教育发展的契机与策略

政府相关文件的出台为社会工作专业教育发展带来了机遇。随着社会服务需求市场的逐步形成,社会将迫切需要大量合格的社会工作者。专业教育体系要积极回应这一需求,通过明确培养目标和办学特色、加强师资队伍建设、完善课程体系和教材建设、优化教学过程等,促进人才供给与社会需求之间的对接。     

Implementation of Active User Principle: Learning from the Czech Social Services Reform

ABSTRACT

The active user principle introduced in Czech social services by the new Act on Social Services (2007) was expected to induce change of the prevalent paternalistic nature of social service provision. This study examines the relationship between clients and social service workers in social service facilities designed for people without shelter. From 2001 to 2008, instrumental case studies were examined from three different shelter facilities using qualitative interviews (with 17 members of staff) and document analysis. The findings indicated that neither the frontline workers nor the managers could always understand how to implement this principle. Response patterns and the effect it had on recipients are examined. These findings imply that such a profound change needs to be supported with proper explanation, professional training, and practical application skills. Directions for further application and future research are suggested.     

Local worker discretion within non-governmental organisations: social integration,social control,or innovation?

Abstract

This paper focuses on the dynamics of frontline organisational practice and examines how non-governmental organisations (NGOs) act as an intermediary between people and the state. It explores how workers in NGOs in the Pearl River Delta are responding to the needs of local migrant populations including rural-to-urban migrants and foreigners within mainland China, cross-border ‘new arrival’ Chinese and ethnic minorities in Hong Kong. We examine how government policy imperatives that relate to (im)migrants within the wider region are operationalised in strategic and direct practice, drawing on the theory of street-level bureaucracy to guide the analysis of primary data collected in two cities (Hong Kong and Guangzhou) during 2014. Key findings provide evidence of discretionary agency in both locations although the broader scope for an agency is evident in Hong Kong than Guangzhou. Implications for future practice are discussed within the context of increasingly restrictive political and social environment within the region.     

浅谈青年社会工作者心理压力

本文从社会工作的工作情境、工作对象、工作方式、工作过程、工作考核、工作风险、工作伦理、工作晋升等方面梳理了当前社会组织中青年社会工作者的压力来源,并从专业团队建设、社会服务推广、交流平台建立、专门人才培养等方面提出建议。     

Nonpharmacological Pain Management by Ethnically Diverse Older Adults With Chronic Pain: Barriers and Facilitators

As key players in multidisciplinary health care systems, geriatric social workers must understand the dynamics of pain management among older adults with chronic pain. This study identified perceived barriers to, and facilitators for, utilizing nonpharmacological pain management through face-to-face interviews with 44 ethnically diverse community-dwelling older adults. Constant comparative analysis identified barriers not recognized in prior studies: (a) embarrassment/self-consciousness, (b) unavailability of certain treatments, and (c) lack of faith in effectiveness of nonpharmacological treatments. Most frequently reported facilitators were (a) social support, (b) positive attitude, and (c) available resources. Social workers can provide counseling to motivate older adults to exercise to manage chronic pain and refer them to exercise programs tailored for older adults. To resolve the most frequently reported barrier—transportation—social workers can link older adults with transportation services offered by senior centers or other nonprofit agencies.