Health care,social care or both? A qualitative explorative study of different focuses in long-term care of older people in France,Portugal and Sweden

Challenges with an ageing population are increasingly becoming a reality in the Western world. Since cognitive impairment increases with age, we can expect an increasing number of older people in need of care. The aim of this article is to describe, analyse and compare different focuses on care of older people with dementia, using examples from France, Portugal and Sweden. The questions are principally focused on the participants’ view about their tasks, the organisation of work, the professional role and cooperation with other professions. Everyday care was studied through observations and participant observations and the staff's opinion was explored by means of interviews. Twenty-two care settings for older people were included. The findings showed that France provided mainly ‘health care’, Sweden ‘social care’ and Portugal an integrated ‘health care and social care’. In a comparative perspective the Portuguese general care of older people, which focuses on integration of health care, social care and social work, also seems to provide care for older people suffering from dementia which best corresponds to the previously developed group living model.     

Exploring emotional aspects of care and control in social work with children and families - a single case analysis of conversation

ABSTRACT

In this article, I explore how emotions are displayed and dealt with on a communicative level in face-to-face encounters between social workers and parents in a child welfare setting. The analysis draws upon detailed analysis of a whole encounter between a social worker and a parental couple who have recently had their new-born daughter placed in foster care. By examining the way emotional stances are expressed and responded to I discuss how orientations toward institutional tasks and goals create constraints for the display, recognition and validation of clients’ emotion displays. I consider the communicative challenges this poses for the parents and the social worker and the implications these may have for the client–worker relationship.     

Interactional perspectives on the mistreatment of older and vulnerable people in long‐term care settings

This article draws on a study aimed at developing theoretical and methodological understanding of the abuse and neglect (mistreatment) of older people in long‐term care settings such as care homes and hospitals. It presents an interactionist account of mistreatment of older people in such establishments. Starting with an outline of definitional issues surrounding the topic, the allied concept of dignity is also briefly explored, and one important model described; we present dignity as the converse of mistreatment. The article argues for the potential of a positioning theory analysis of mistreatment. Positioning theory proposes that interactions are based on taking of ‘positions’, clusters of rights and duties to act in certain ways and impose particular meanings, which enable or prohibit access to certain storylines. It is argued that ‘malignant’ positioning can contribute to the creation of a climate that allows mistreatment to take place, or fails to prohibit its development. Mistreatment of people with dementia is used as an illustration, and it is argued that this is potentially generated by negative feedback loops of behaviour patterns, interpretations and malignant positioning by staff or family carers and subsequent response to these interpretations by the person with dementia. Positioning theory also allows for an explanation of the importance and impact of organizational cultures and social factors such as ageism. Individual staff members take positions, use meanings and develop storylines imbued with such factors. This understanding therefore overcomes some of the potential confusions created by concepts such as organizational or institutional abuse, removing the need to ascribe intentions and personal responsibility to such constructs. The article concludes with some suggestions for further research to develop an understanding of the kinds of cultures that allow mistreatment and consequently to inform the development of protective measures.     

The role of child care social work in supporting families with children in need and providing protective services—past,present and future

This article examines the way in which child care social work with deprived families has changed and developed since the inception of Children's Departments in 1948. It is argued that between 1948 and 1970 child care social workers enjoyed a fair measure of social support. A variety of reasons are considered for explaining this—specialization, smallness of size, privacy and a consensus about the needs of children. From the early 1970s it is argued that broader societal changes, including a shift away from social solidarity towards individualism, organizational changes and the advent of child abuse as a public concern, resulted in con?icting demands on child care social workers and a subsequent loss of credibility and con?dence. The 1990s have seen a return to emphasis on family support policies which has been further accelerated in the new millennium by New Labour's stated commitment to eliminating child poverty and creating better life opportunities for all children. The implications of these new developments for child care social workers engaged in meeting the needs of children living in highly disadvantaged families are considered. Copyright © 2006 John Wiley & Sons, Ltd.     

Estonian social policy: from Soviet heritage to understanding the principles of deinstitutionalization

Deinstitutionalization is a key issue in the field of social policy. The community-based services movement has challenged the role of institutions as far back as the 1950s, but it is a relatively new development in Central and Eastern Europe. EU membership and the use of structural funds have been key elements of change in many countries; however, the Soviet heritage still overshadows progress and decision-making in social policy. Though deinstitutionalization’s overall meaning and aims are generally well known, less information is available about the processes and policies underlying deinstitutionalization. In post-communist countries, deinstitutionalization is often narrowly associated with large institutions, but its embedment in the social welfare policy framework is less discussed. Nevertheless, first attempts to change the design of social services to more participatory and integrated solutions are evident. For more than 20 years, developments in the field of social-welfare policy have aimed to reduce the gap between Estonia and other developed countries. This article reviews relevant documents in Estonia’s social welfare policy reforms from re-independence to the present. The article discusses the prospects and challenges for achieving deinstitutionalization’s intended goals in Estonia.     

The importance of the size of the social network and residential proximity in the reception of informal care in the European Union

This paper explores which factors affect the reception of informal care among those dependent people aged 65 and over in Europe, starting from the so-called Behavioural Model of Health Service Use introduced by Andersen. The data employed are drawn from the fourth wave of the Survey of Health, Ageing, and Retirement. The final sample consists of a total of 17,284 older dependent people of which 4529 (26.2%) received informal care. The main novelty is the incorporation of different characteristics of the social network of the individual (presence of children, size and residential proximity) among the factors that enable the reception of informal care. In particular the two latter aspects are combined in one sole indicator of distance to the social network. In addition to ‘traditional factors’ like age or degree of dependency, all the characteristics of the social network are found to influence the likelihood of receiving informal care. This reveals the need for taking into consideration the role played by social networks when governments design care programmes, especially in the current scenario of rising demand for care.     

Social work for critical peace: a comparative approach to understanding social work and political conflict

ABSTRACT

This paper uses a case study approach to explore issues of social work policy and practice in three sites of political conflict in Europe: Northern Ireland; Bosnia and Herzegovina; and Cyprus. It begins with a review of the international literature on social work and political conflict and then discusses the strengths and limitations in engaging with comparative case study approaches. The authors explain how they view the writing of the paper as an intellectual encounter that helped establish the beginning stages of their comparative analysis. This starts with an analysis of the existing knowledge base about the three case studies that each share similar patterns of colonial histories, political and community conflict and the social work response. The second part of the paper extends this analysis to a critique of the impact of neo-liberal social and economic policies that often adversely impact upon the role of social workers in resolving conflict and building peace. The paper concludes with an appeal for social work to rediscover its rights-based role in working with victims and survivors of political conflict, what the authors describe as: ‘social work for critical peace’.     

Hospital social workers' assessment processes for children at risk: positions in and contributions to inter-professional teams

This article explores hospital social workers' assessment processes for children at risk within the context of inter-professional teams working in child hospital care in Sweden. Based on qualitative interviews, the study discusses how assessment processes for children at risk can be understood from a professionalism perspective. Three institutionalized norms—juridical, therapeutic, and medical, building on different knowledge systems—are analyzed in relation to the three positions taken by hospital social workers as team members—active, reflective, or passive—leading to different kinds of actions in the assessment processes. The outlined norms and the positions taken involve consequences for the children and their families, but also pose questions for the future professionalization efforts of hospital social work.     

Young people and social networking sites: exploring the views and training opportunities of CAMHS social workers in Ireland

ABSTRACT

Social Networking Sites (SNS) (e.g. Facebook, Instagram) have become a fundamental part of the daily lives of many young people. SNS engagement has been associated with a number of risks and benefits, some of which are particularly relevant to young people who access child and adolescent mental health services (CAMHS). Consequently, understanding how and why young people engage with SNS, and the associated risks and benefits, may become an increasingly important part of CAMHS social work.

This small-scale study (n = 15) utilised an online survey to explore the importance that a sample of Irish CAMHS social workers attribute to maintaining an awareness of how young people use SNS, whether they, in their professional lives, have been offered the opportunity to learn about SNS engagement among young people, and whether they have taken it upon themselves to learn about this topic.

Findings suggest that participants consider an understanding of SNS to be an important part of CAMHS practice. However, participants report that they do not feel sufficiently aware of SNS trends among young people, suggesting that there is scope for SNS-focused training/learning opportunities among this sample of CAMHS social workers. Implications for practice and suggestions for future research are outlined.     

Catering to sex,sexual, and gender diversity: An exploratory study on the effects of LGBTI awareness training on aged care staff in Tasmania,Australia

The Australian National LGBTI Ageing and Aged Care Strategy seeks to address the lack of recognition of older lesbian, gay, bisexual, transgender, and intersex (LGBTI) adults living in aged care. Awareness training for aged care staff forms a crucial part of this strategy, but the impact of such educational programs are yet to be examined. In this article, we examine the effects of LGBTI awareness training on staff working in an Australian aged care facility. These staff perceived the awareness training as valuable, but the outcomes from it were limited. Therefore, we indicate changes that are necessary to support the translation of training into practice.     

Using photography to understand change and continuity in the history of residential care for older people

The Last Refuge by Peter Townsend is a seminal study of residential care for older people. The fieldwork was carried out in the late 1950s and the data are now deposited in the National Social Policy and Social Change Archive at the University of Essex. We have undertaken research, funded by the ESRC, which has revisited Townsend's work and some of the homes he studied in order to conduct an overtime comparison. In this paper we focus on Townsend's use of photography and our subsequent use of photography in our revisiting study. We argue that although Townsend did not analyse his photographs, they were significant data for use in his arguments critiquing residential care. They were, however, the product of a different socio‐historical context to our own and as such posed considerable practical and ethical challenges for us when attempting to use this aspect of his methodology for an overtime comparison. We argue that despite the resulting constraints, photography was an important part of our methodology, enabling comparisons and illuminating historical patterns in residential care for older people.     

The psychological goods on clinical social work: a content analysis of the clinical social work and social justice literature

The purpose of this content analysis was to evaluate the extant literature on clinical social work and social justice. In July 2009, an online search of the university databases EBSCO Host (1988–2009) was conducted to identify articles on clinical social work and social justice. Thirty-six peer reviewed journal articles were identified and extracted. The majority were non-empirical articles (75%) published in the United States (94%) over a 21-year period from 1988 to 2009. Overall, clinical social work practice was described as psychological and/or sociopolitical interventions that had a direct and/or indirect effect on psychological and sociopolitical level social justice outcomes. Theories and practices consistent with social justice were advanced. These findings suggest that clinical social work's promotion of psychological well-being remains an underdeveloped area in the scholarly and research literature. In this era of professional educational reform, additional research and professional training on social justice based clinical social work practice is warranted.     

Pedagogy of international social work: a comparative study in the USA,UK, and Georgia

The social work profession worldwide has been increasingly influenced by globalization and its effects on social issues that require social workers to be responsive and knowledgeable in addressing them. In recent years there has been an increased emphasis on the internationalization of the social work profession and education. With limited examples of international social-work-teaching methods discussed in the literature, there is also a lack of information obtained directly from students on methods of instruction that they most prefer and find beneficial. This collaborative, comparative project examined students' perceptions of methods that make teaching international social work successful at three universities in the United States, United Kingdom, and Georgia. While there were different preferences for content- and process-driven approaches in teaching, students' common interest was in gaining practice examples and exposure to real-life practice of international social work in their own and other countries. The findings suggest that international social work education needs to be more experiential and practice-based.     

Retraining programmes in social work: career considerations,factors influencing the decision to study social work and professional preferences among students

The current study sought to examine the differences between retraining programme (RP) students in social work (SW) and mainstream programme (MP) students regarding career considerations, factors influencing the decision to study SW and professional preferences. RPs are similar to fast-track training programmes known in the UK, as they offer graduates from other disciplines a qualification in SW. This study was conducted among 125 SW students in Israel: 56 in the RP, where studying SW was their secondary choice (after graduating in a different academic discipline) and 69 MP students for whom SW was their first choice for a profession. Both groups were examined in their final year of studies. When choosing their profession, RP students attributed greater importance to considerations such as personal development, satisfaction and interest in treating people, while for MP students, working conditions were more important. In addition, RP students also preferred to engage in individual therapy and policy practice. Furthermore, there were several differences between the groups’ preferences regarding types of populations, services and sectors. Correlations were found between various preferences of populations, services and fieldwork training. Lastly, a higher percentage of RP students compared to MP students had expressed their intention to work as social workers once they complete their studies.     

The evolution of spirituality and religion in international social work discourse: Strengths and limitations of the contemporary understanding

ABSTRACT

As the profession’s interest in spirituality and religion has grown, new understandings of these two constructs have emerged. As in other areas of academic discourse, it is important to be informed about diverse understandings. Toward this end, the present article describes the emergence of the contemporary understanding of spirituality and religion in social work discourse and, perhaps more importantly, the strengths and limitations associated with the contemporary perspective. By illuminating some of the diverse arguments in favor of and against contemporary conceptualizations, the profession is better equipped to understand and work with these concepts in a professional and ethical manner.     

Social work and artefacts: social workers' use of objects in client relations

Social workers' use of physical objects—i.e. artefacts such as paper, computers and plastic models—in client relations is rarely investigated. Most often, research focus is on interpersonal relations, user groups, professional skills and treatment methods in social work. In a study of decision-making tools and their impact on caseworkers' decision making, examples were found of caseworkers using artefacts in client relations. This paper presents these findings and discusses the purposes for which the caseworkers use artefacts. The empirical data consist of 30 qualitative interviews with caseworkers from a study of three different decision-making tools used in eldercare, employment services and child protection in Danish municipalities. The analysis shows that the caseworkers are concerned with the issue of how to justify the questions they ask clients and their assessment of clients. Job counsellors use artefacts to justify sensitive questions, for instance, questions concerning substance abuse. Family counsellors use artefacts as proof that they are guided by a model rather than making up the questions themselves. The caseworkers who grant homecare service use artefacts when rejecting an application.     

Idealist thought, social policy and the rediscovery of informal care

Recent work in the history of welfare has suggested a need to reconsider the status of some conceptual frameworks within sociology and social policy studies regarding the meaning of 'social welfare' and the 'welfare state'. In this context, the present article argues in particular that the marked upswing of interest in informal care in the UK beginning in the 1970s reflected, at least in part, a reaction, itself not so far adequately understood, to some features of the work of Richard Titmuss and 'traditional social administration', work which, on examination, reveals a distinctive 'idealist' core, unsympathetic to research into familial patterns of caring. Similarities with 'classic' British idealism, broadly defined, at the end of the nineteenth and beginning of the twentieth centuries are reviewed. This idealist thought emerges too as unresponsive to informal care, even though contemporary non-idealist thought had discussed it. The article concludes that the (unacknowledged) persistence and influence of idealist modes of social thought diverted attention away from informal care; informal care was in fact not 'discovered' in the 1970s, it was rediscovered as idealist preconceptions about the nature of 'real' welfare were discarded. The sense of 'discovery' reflected prevailing and dubious historigraphical interpretations of the meaning of 'social welfare' and the status of the ('classic') 'welfare state'.     

An investigation of mental health and personality in Swedish social work students upon entry to university training

The aims were to describe Swedish social work students' personality characteristics upon entry to their training and to analyze relationships between personality traits, mental health, and some sociodemographic variables. One hundred and twenty-one female social work students completed a sociodemographic form, the Temperament and Character Inventory, and the Symptom Checklist. They scored significantly higher on harm avoidance, reward dependence, and self-transcendence and reported more somatization, obsessive compulsive, and phobic-anxious symptoms, and less hostility, than Swedish individuals from the general population of the same age. Personality traits significantly predicted the various mental symptom scores. It is recommended to implement modules or training courses within social work training in Sweden that bring an improvement of self-directedness and cooperativeness character trait into focus.     

Young people,social workers and social work education: the role of digital skills

ABSTRACT

This paper addresses a key issue in the development of youth-focused social work: the role of digital skills in the relationship between young people and social workers who work with these native digital users. To this end, we analysed data from the International Digital Economy and Society Index 2019 and Eurostat. Information from the sixth European Working Conditions Survey and a survey conducted by the Social Care Institute for Excellence and the British Association of Social Workers supported the empirical analysis. The main findings reveal a gap between the level of digital skills required in the labour market and the actual level of digital skills in both young people and social workers, despite efforts by both groups to improve their skills. Initiatives to foster digital skills are therefore recommended to bridge this digital divide. Lastly, it was concluded that both groups could act as mutual drivers of digital transformation.     

Foster fathers performing gender: the negotiation and reproduction of parenting roles in families who foster

ABSTRACT

Foster care research and social work practice tend to focus on how women look after children living in foster care. This focus has limited our understanding of what it is that men do within foster caring families and they are automatically assigned secondary or breadwinning roles. Families who foster involve some form of renegotiation of roles to care for children they foster. While foster caring arrangements are internationally diverse, foster carers often work with social workers. It would therefore seem important for social workers to understand how foster carers negotiate their parenting roles. This paper reports findings from seven main caring foster-fathers who took part in a wider study involving twentythree foster-fathers. The evidence provided by these foster-fathers demonstrate they are highly motivated to care for children and, alongside delivering traditional parenting roles, they negotiate new, non-traditional parenting roles as foster-fathers. These new roles, taken on by foster-fathers, often challenge stereotyped masculinity while they also concurrently enact parenting norms. This study applied Judith Butler’s work on performing gender to foster caring families to theorise on the process whereby foster-fathers negotiate diverse masculinities and continue to reproduce gendered relations in foster caring families.