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‘Sometimes it’s really complicated!’: clients with complex needs on their encounters with specialised personal social service organisations in Sweden
Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för socialt arbete och psykologi.
Högskolan i Gävle, Akademin för hälsa och arbetsliv.ORCID iD: 0000-0002-2885-0635
Umeå University, Faculty of Social Sciences, Department of Social Work.ORCID iD: 0000-0002-5867-234X
2016 (English)In: Nordic Social Work Research, ISSN 2156-857X, E-ISSN 2156-8588, 1-14 p.Article in journal (Refereed) Epub ahead of print
Abstract [en]

Research in the field of human services has paid limited attention to the consequences of the international development toward organisational specialisation; the consequences for clients have been overlooked in particular. The aim of the article is to describe and analyse the consequences of organizationally specialised personal social services (PSS) in Sweden for clients with complex needs. Findings from a survey and an interview study addressing PSS clients show that clients primarily perceived their encounters with the specialised PSS negatively, and that they experienced several elements of service fragmentation. Implications of the findings are discussed in light of previous research and theory in the area.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2016. 1-14 p.
Keyword [en]
Personal social services, client perspective, specialisation, service fragmentation, service integration
National Category
Social Work
Identifiers
URN: urn:nbn:se:umu:diva-118351DOI: 10.1080/2156857X.2016.1156017OAI: oai:DiVA.org:umu-118351DiVA: diva2:912581
Available from: 2016-03-16 Created: 2016-03-16 Last updated: 2016-08-25
In thesis
1. Komplexa behov eller komplexa organisationer?: konsekvenser av specialiserad individ- och familjeomsorg ur ett klientperspektiv
Open this publication in new window or tab >>Komplexa behov eller komplexa organisationer?: konsekvenser av specialiserad individ- och familjeomsorg ur ett klientperspektiv
2016 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[en]
Complex needs or complex organizations? : consequences of specialized personal social services from a client perspective
Abstract [en]

Even though recent decades have seen a clear trend towards organizational specialization within Swedish personal social services (PSS), there is a lack of knowledge about the consequences of this, particularly from a client perspective. The aim of this compilation thesis is to describe and analyse the consequences of organizational specialization for clients with complex needs. The empirical material consists of a survey and an interview study, both addressing clients whose needs can be considered complex since they entail several parallel contacts with different specialized PSS units. Article one is a research review aimed at summarizing and discussing the research on organizational structures in the social services, and these structures' impact on work with clients. The review suggests that, to function adequately, social service organizations need to combine and balance aspects of both specialization and integration. Article two aims to describe and analyse how clients with complex needs perceive and value the service conditions of the organizationally specialized PSS. The main findings are that clients primarily perceive and value their encounters with the specialized PSS negatively, and that they experience several elements of service fragmentation. The aim of article three is to describe and analyse how clients with complex needs account for their handling of service conditions within specialized PSS. A key finding is that clients combine different approaches (categorized as consensus, resignation, fight, and escape) in a balancing act intended to promote their own best interests. Article four aims to describe and analyse how clients with complex needs perceive the conditions for helping relations in a PSS setting marked by organizational specialization. A lack of system trust, the people-processing dimensions of work, and an organizational and professional emphasis on formal organizational structures and boundaries were found to constitute unfavourable conditions. Conversely, the occurrence of individual trust, the people-sustaining and people-changing dimensions of client work, and the boundary-spanning efforts of both informal organizations and individual social workers constituted favourable conditions. The thesis concludes that there seems to be a substantial lack of fit between the logics and features of organizational specialization on one hand, and the complex and interwoven nature of clients’ actual needs and everyday lives on the other. It is also argued that organizational specialization means that the complexity involved in encounters between clients and the PSS is overlooked or obscured. Further research on the structural arrangements and service conditions that surround encounters between clients and the social services is suggested, especially research that adopts a client perspective.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2016. 82 p.
Series
Studier i socialt arbete vid Umeå universitet : avhandlings- och skriftserie, ISSN 0283-300X ; 83
Keyword
Organizational specialization, personal social services, complex needs, client perspective
National Category
Social Work
Identifiers
urn:nbn:se:umu:diva-124733 (URN)978-91-7601-537-7 (ISBN)
External cooperation:
Public defence
2016-09-16, Krusenstjärnasalen, sal 23:213, Kungsbäcksvägen 47, 801 76 Gävle, Gävle, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2016-08-26 Created: 2016-08-23 Last updated: 2016-08-25Bibliographically approved

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