Is there a field of social work?: Trainees evaluating social problems and social work

My aim was to study the experiences and priorities of two age groups of social work students practicing in client-centered social work. This article is based on the research on rationality and language games in social work. The target groups of the research project as a whole were the actors: the heads and social workers or activists in public social welfare and health care agencies and institutions and in voluntary associations and action groups, and finally, two subsequent classes of students from a school of social work, during their practicing periods. This article concentrates on the trainees. At first, the trainees wrote essays and kept diaries. Secondly, they marked their standings on graphs visualizing different types of information contents and social relation structures. Thirdly, they made their choices of reasons for and solutions to social problems on a problem wheel. The trainees' study, using different data gathering techniques, partly confirms the results of the research of the other actor groups, in which the data were derived using questionnaires and interviews. The trainees' study shows variation in the respondents' priorities within and between specified social problem categories. Qualitatively analyzed, however, the characterizations of social work, both those who currently act in and those aiming to enter this field, resemble one another.     

From State Security Model to Selective + Residual Security Model: Health care regime shift in urban China

Based on the study of welfare states, welfare regime theory (WRT) has been widely applied to international and regional welfare regimes and to specific‐policy comparative studies. However, the health care system has often been neglected in this area of study. The current study promotes a health care regime approach that is influenced by WRT and incorporates analysis of the level of health care de‐commodification and health equity. Three types of health care regimes were identified in the development of the health care system in urban China: the State Medical Security Model, the Selective Medical Security Model and the Selective + Residual Medical Security Model. This approach provides useful policy implications for the health care reform currently taking place in China. In addition, this analysis contributes to theories in the comparative health policy literature.     

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。     

Social investment effects of public education,health care,and welfare service expenditures on economic growth

The purpose of this study is to theoretically and empirically examine whether public spending in education, health care, and welfare service operates as a fruitful investment in welfare states, which has been implied in the literature of social investment arguments. Based on comprehensive review of existing literature, this study suggested a tripartite mechanism of social investment effect of such spending, that is “enhancement of human capital,” “support for labor force participation,” and “job creation.” To find the empirical evidence, a pooled time‐series cross‐section analysis was conducted with the data of 15 advanced welfare states from 1980 to 2015 using estimation technique of fixed‐effect model. The results confirmed that public spending in education, health care, and welfare service had a positive medium‐term as well as long‐term effect on economic performance, while cash‐type welfare spending had an obscure or no visible effect on economy. Government consumption that is a proxy and control variable of size of the welfare state showed a positive effect on real GDP in the medium term but a negative effect in the long run. In conclusion, this study suggests that reinforcing social services should be recognized and dealt with as essence of social investment strategy.     

To Coordinate Information in Practice: Dilemmas and Strategies in Care Management for Citizens with Dementia

ABSTRACT

This qualitative study, based on 19 interviews with care managers, explores the experiences of care-managers involved in assessing the need for social services for people with dementia. The study shows that social workers, as care managers, face several dilemmas in their practice concerning people with dementia, in relation to the exchange of information and in regards to conflicting interests between different actors involved in the assessment of the need for support for people with dementia. Strategies used to handle problematic situations that arise in their work are using other sources for information (e.g., relatives and actors from other professions), persuading, and pursuing creative forms of consent. However, the study shows that dilemmas and strategies used generate other, prominently moral, dilemmas for care managers in their practice, which relate to participation and self-determination by the person with dementia. The study shed light on the problematic situation for care managers in their work to coordinate information and further the new “realities“ that they encounter as well as on how to handle these new situations. This study suggests possible ways to improve the everyday work of care managers, as well as how policies concerning social work and people with dementia can be improved.     

Implications of Subsidiarity for the Care of Older People in Germany

This paper examines definitions and origins of the principle of subsidiarity and its application to welfare systems of the Federal Republic of Germany (FRG) with particular reference to the care of older people. The German corporatist welfare system is influenced by conservative views about status relations and Catholic teachings on family responsibilities. Since unification of Germany in 1990 new care systems based on the principle of subsidiarity have been imposed in eastern Germany. The FRG's social insurance system based on entitlement benefits those fully employed, while women and marginalized groups with low status in the labour market are poorly covered by insurance and may have to rely on stigmatizing means-tested social welfare based on subsidiarity. Access to pluralist, fragmented care services depends on eligibility for funding through insurance or social welfare or else on ability to pay. Social care is poorly developed because of the emphasis on insurance and the medical model as well as on the principles of subsidiarity and self help which place an explicit duty on the family, mainly women, to care.     

The Choice Revolution: Privatization of Swedish Welfare Services in the 1990s

During the 1990s, the Swedish welfare state was declared by some to be in a “crisis”, due to both financial strain and loss of political support. Others have argued that the spending cuts and reforms undertaken during this period did slow down the previous increase in social spending, but left the system basically intact. The main argument put forward in this article is that the Swedish welfare state has been and is still undergoing a transforming process whereby it risks losing one of its main characteristics, namely the belief in and institutional support for social egalitarianism. During the 1990s, the public welfare service sector opened up to competing private actors. As a result, the share of private provision grew, both within the health‐care and primary education systems as well as within social service provision. This resulted in a socially segregating dynamic, prompted by the introduction of “consumer choice”. As will be shown in the article, the gradual privatization and market‐orientation of the welfare services undermine previous Swedish notions of a “people's home”, where uniform, high‐quality services are provided by the state to all citizens, regardless of income, social background or cultural orientation.     

What social workers talk about when they talk about child care proceedings in the District Court in Ireland

Court proceedings are a fundamental and increasingly time‐consuming aspect of social work practice. However, to date, there is a relatively modest body of literature considering the experiences of social workers in instituting child care proceedings and giving evidence in court. This paper draws on data gathered as part of an in‐depth qualitative study of professional experiences of District Court child care proceedings in Ireland and presents findings regarding the experiences of social workers in bringing court applications for child protection orders. It seeks to answer 2 key questions: First, how do child protection and welfare social workers experience the adversarial nature of child care proceedings in the District Court? Second, what are the views of child protection and welfare social workers on the strengths and weaknesses of child care proceedings as a decision‐making model for children and young people? The main findings are that social workers expressed significant reservations about the predominantly adversarial model that currently operates in Irish child care proceedings and about the level of respect that social workers are afforded within the operation of the system.     

Work barriers perceived by welfare recipients of a community employment program in Beijing,China

This research adopted a qualitative research method to explore work barriers perceived by 36 welfare recipients of a community employment program in Beijing, China. The barriers identified included personal and family factors of low education, lack of working skills, poor physical health, mental health problems and family care burden, along with interpersonal factors of weak social networks and social factors of high competitiveness in the job market and age discrimination. The findings were discussed in Chinese social contexts. The practice and policy implications of the study were noted and further research was recommended.     

Local perspective and practical knowledge: Social work practice research on chronic diseases of the nomadic area in China

Taking a nomadic community in Inner Mongolia autonomous region of China as an example, this paper analyzes the local characteristics of chronic diseases suffered by families and nomads in the nomadic area of Inner Mongolia and puts forward the problem of ignoring the local cultural and ecological factors in the social welfare system dealing with the chronic diseases of nomadic area. The paper describes disregard of the welfare system, institutions, communities, families, and individuals of chronic diseases in the nomadic area and points out that social work practice research should be carried out based on the cultural and ecological relevance and local knowledge of the nomadic area. It is believed that the family healthcare model suitable for nomadic area has practical significance for effectively dealing with chronic diseases in the nomadic area.     

Public health care in the balance: exploring popular support for health care systems in the European Union

Which factors explain intra‐ and inter‐country variations in levels of public support for national health care systems within the European Union, and why? We propose that public opinion towards public health care is dependent on (1) the type of welfare state regime to which the various European welfare states belong, (2) typical features of the national care system and (3) individual social and demographic characteristics, which are related to self‐interest or morality oriented motives. To assess the explanatory power of these factors, data from the Eurobarometer survey series are analysed. Support for public health care appears to be particularly positively related to social‐democratic attributes of welfare states, whereas support drops with increasing degrees of liberalism and conservatism. Further, support for public health care proves to be associated with wider coverage and public funding of national care services. We also find higher levels of support in countries with scarce social services for children and the elderly, and larger proportions of female (part‐time) employment. Lastly, with respect to individual characteristics, we find remarkably little evidence for self‐interest oriented motives affecting the preference for solidary health care arrangements.     

The evolution of the Georgian social protection system since independence: An unclear future despite recent expansion

In the first decade of transition, the Georgian social protection system experienced a major retrenchment as the government struggled to finance welfare provision in the face of massive economic contraction and the near collapse of public institutions. Since 2004, this trend has been reversed, with the economy returning to a fast growth path and public administration improving considerably. Recent reforms, including the notable introduction of universal public health insurance, are welcome steps towards building a modern welfare state. Major challenges still remain, however, especially in relation to the system's limited effect on widespread poverty. Decelerating growth, the lack of strong pro‐welfare actors, and the absence of positive external pull factors may stall or prevent future growth, but the changing nature of the social contract between the people and government, as well as Georgian politicians' growing recognition of the importance of the welfare system for inclusive growth, leaves ample space for optimism.     

Empirical Analysis of Fiscal Soundness and Public Social Expenditure: A Lesson for the Future Direction of the Korean Welfare State

The aim of this paper is to investigate the relations between fiscal soundness and public social expenditure in advanced welfare states so as to reconsider the conventional wisdom that welfare expenditure aggravates national finances. Through this, I propose the clues of building the sustainable Korean welfare state. I focus on the interdependent relationship between fiscal soundness and public social expenditure based on fiscal sociology. Considering this interaction, I form two sets of simultaneous equations models and employ a special statistical method, three‐stage least squares (3SLS). The results regarding the causal relationship between fiscal soundness and public social spending indicate that, if public welfare spending is increased, fiscal health is damaged. However, as many comparative social policy researchers have pointed out, outcomes of welfare states differ from country to country according to the composition of public welfare spending. Specifically, some welfare states with priority given to social services such as vocational training or childcare services have maintained the stability of public finance. By extension, we can say that public social expenditures have a positive influence on fiscal soundness based on the composition of social expenditures. Finally, it is possible to create financially sustainable welfare states.     

'Polyphonic' welfare: Luhmann's systems theory applied to modern social work

This article applies a series of concepts from Niklas Luhmann's systems theory in an analysis of modern welfare organisations. The point of departure is that social help in late modern welfare states has become 'polycentric' in that 'help' is today being defined by various different agents: public, voluntary and private care providers. Empirically, this article investigates re-housing work with homeless people, a kind of social work which involves several different welfare organisations. The case study shows how these organisations define themselves by making internal constructions of their surroundings, and how their self-enclosed nature creates a certain 'insensitivity' towards one another. How to coordinate and translate within this 'polyphony' of incomparable observations and values represents a major managerial challenge for present-day social workers.     

社会政策与社会工作的议题

社会政策与社会工作的研究共同点在于其目的是解决社会问题,从而改善和提高社会福利,一般的研究基于中国背景,更注重实务性;而本文则基于国外发展状况,旨在从理论层面探析影响二者发展的因素。     

英国医疗卫生体系问题与医疗卫生政策改革研究

健康是人们福利的重要组成部分,因此医疗卫生政策和体系是社会政策的重要领域。该项研究从贫穷、低收入和健康之间的关联中评估人们对医疗保健的需要;指出英国存在全科医生、医院医生及公共卫生医生是医疗卫生服务提供的主体;英国在医疗卫生政策改革方面的内容包括:(1)对英国全民医疗体系(NHS)多渠道的财政支持,(2)提高服务质量的机构管理改革,(3)实施提高服务质量的安全、有效、病人中心、及时、效率、和平的原则;英国存在的强大政治集团及其利益影响着改革;政府需要在减少医疗服务中不平等和提供及时有效的服务方面努力。     

Child welfare workers who are exhausted yet satisfied with their jobs: how do they do it?

In response to a study of Canadian child welfare workers that unexpectedly found participants scoring high on a measure of emotional exhaustion (burnout) and, at the same time, high on overall job satisfaction, this paper reviews research that has investigated these constructs in the social work literature as well as in selected studies from sociology, social psychology, management and women’s studies. The review reveals that some previous studies also report the coexistence of high levels of emotional exhaustion and strong job satisfaction in child welfare and social worker samples. Several studies have suggested that individual characteristics, including finding reward in helping others, having a commitment to the mandate of child welfare and believing that one’s labour is ‘making a difference’, contribute to satisfaction with child welfare work in spite of work overload and emotional exhaustion. Attributions regarding causes of exhaustion, coping strategies and goal orientation may also attenuate the expected negative effects of emotional exhaustion. Considerable evidence supports the positive influence of variables organizational managers can control, including job autonomy, supportive supervisors, workload, promotional opportunities and perception of personal safety. The degree to which this phenomenon is associated with female socialization and the ‘ethic of care’ underlying social work is discussed. Implications for child welfare research, practice and policy are offered.     

构建老人福利机构危险管理机制——日本经验之启示

"养儿防老"是中国传统的养老模式,长期以来老人的养老主要依靠子女来解决,但是随着生活方式的改变、家庭规模的日趋小型化,老人的长期照顾问题受到了社会的广泛关注。近年来国家制定了相关的政策、制度以及服务来满足老人及其家人的需求,然而老人福利机构及所提供的照顾服务,其服务质量离人性化照顾服务仍有一段距离。就现阶段而言,老人福利机构所提供照顾服务的质与量,均有提升与改善的空间。日本是亚洲第一个施行公共性长期照顾保险的国家,其施行之初也面临着一些与我国同样的问题,为提升长期照顾机构的服务质量,日本厚生劳动省在介护保险制度施行后的2002年,就开始倡导老人福利机构应建立危险管理机制的理念,并于2006年修订老人长期照顾福利机构管理规则,规定老人福利机构应建立危险管理机制,以提升照顾服务质量。有鉴于此,本文将对日本老人长期照顾福利机构建立危险管理机制的过程、基本架构,以及相关课题做系统说明,为我国老人福利机构经营管理提供参考,也可为我国未来在探讨老人长期照顾问题之际,提供必要的配套依据。     

Building state capacity for welfare governance: The pathway and development of child welfare system and social work in China

ABSTRACT

China’s dramatic socioeconomic transformation after the reform and opening up, coincided with changes in state-family relationship, has resulted in a large number of children at risk of care. In the past three decades, child welfare has been highly concerned by the government and society, and the child welfare system has substantially developed in the direction of establishing a moderately universal system. In this process, the development of child welfare and social work has shown a mutually reinforcing trend. This includes the professionalisation of child welfare services, the professional training of child welfare workers and the advancement of child welfare policies. The governance of child welfare is an essential component of national social governance. Its future development should be oriented towards a developmental and holistic approach of governance, and social work as an important institutional actor plays a critical role in promoting good governance of child welfare and beyond.