The aim of this dissertation is to describe and analyse how social workers in Swedish social services define “family” and handle complexity when they work with families, and especially “families with complex needs” as the target of their interventions. Whereas families with complex needs can be understood to involve one or more family members having two or more simultaneously occurring needs or problems (e.g. mental health issues, addiction, financial problems, dysfunctionality, child abuse, ageing, disabilities, and family violence), complexity in social work extends beyond that which exists in families. Therefore, to broaden our understanding of these complexities in social work, this research sought answers to the following questions:
• How do social workers define and set boundaries around the concept of “family” when they target their interventions? How do these definitions differ between different sectors of the social services – elderly care, disability care, addiction, child welfare, and financial assistance? (study I)
• How do social workers involve families and family members in the casework from intake and through the investigation process within different social service sectors? What happens to the conceptualisation of family through an investigation process? (study II)
• How do social workers in child welfare services describe and manage complexity in their work generally and when they work with families with complex needs? (study III)
• How then do social workers in different service sectors conceive of and manage complexities in their everyday work, especially when it comes to families with complex needs? (study IV)
The empirical material in studies I and IV consists of telephone interviews with 60 social workers working in five different sectors in four municipalities. Study II is based on five focus group interviews with social workers working in five different sectors in one larger municipality. Study III is based on focus groups with vignettes with social workers working in child welfare in three municipalities.
In the first study findings revealed that different mediating mechanisms were adopted by social workers in what can be understood to be a deconstruction of the family. These mechanisms included legislation (as a control mechanism), household composition (boundary mechanism) and service needs (professional mechanism), which were used in various ways and to differing degrees within each sector. The five unique and sector-specific conceptualisations of families are implicated in how interventions are constructed and work processes targeted at individuals and families.
In the second study findings showed that clienthood and family are interpreted in different ways. The family was brought into or kept out of service provisions in ways that were connected to social workers’ construction of the family either as expert, client or non-client. How social workers understood the role of the family changed during the casework process. In the third study, findings showed that social workers were challenged in their everyday work where they focused on immediate conditions for children while avoiding problems that were less amenable to being solved. Social workers tried to manage complexities related to families by either sorting prioritizing or oscillating between different child welfare orientations. In the fourth study, findings showed that there were different types of reported complex needs: deeprooted needs and broad-based needs. Complex family needs were transformed into complex cases by social workers, based on considerations of family composition, relationships between clients and social workers, and organizational contexts of practice. The boundaries between these three domains were not distinct, and the interconnectivity and complexities occurring in and between them contributed to the production of much of the “wickedness” that exists in social work practice.
A main conclusion is that the concept of family is understood and targeted differently in different sectors of social work. In some cases, the use of the family concept can be related to the clients' specific needs. Families who social workers meet often have combinations of needs and problems that result in numerous interventions from the social services. When social workers meet these families, they can feel ambiguity and uncertainty because of the complexity of the needs or other complexities. And, in individualised social services, a narrow focus on the needs of individuals can make it difficult to see the situation of the family as a whole. This research highlights the importance of bringing this web of complexities to the forefront of practice.