Change search
ReferencesLink to record
Permanent link

Direct link
Professionsutövning och kunskapsstyrning: en jämförelse av socialarbetares och allmänläkares klientarbete
Umeå University, Faculty of Social Sciences, Department of Social Work.
2016 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis is to study whether the Swedish state’s efforts to govern the professional practice of social workers (SWs) by knowledge to achieve an evidence-based practice, address the difficulties that SWs encounter in their practice. The Swedish state’s ambition is to govern the practice of social work by ideas and methods originating from medicine. The thesis therefore compares, through four different studies, the professional practice of SWs with general practitioners (GPs) as the most comparable sub-profession in medicine. The research questions that the thesis seeks to answer are:

  • What situations are perceived as problematic and non-problematic by SWs and GPs?

  • How does the professionals’ relationship with clients affect the performative aspects of these occupations’ enactment of their practice?

  • How do SW and GPs experience the state’s efforts to govern their professional practice by knowledge?

  • What problems can arise when the Swedish state builds its knowledge governance of social work practice on a comparison with medicine, even though these professional fields exhibit a number of important differences?

The empirical material in the first and second studies consists of 52 narratives, written by SWs and GPs on problematic and non-problematic situations. The third study is based on vignette-based focus group interviews with 25 SWs and GPs. And the fourth study is based on a literature review, consisting of 54 articles about SWs’ and GPs’ practice.

A first finding is that professionals rarely describe lack of knowledge or difficulties with knowledge use as problematic. A second finding is that non-problematic situations are connected to professionals’ control of the intervention process. SWs gained control of the relationship with the client either by use of coercive means or by the client’s active co-operation. GPs gained control of the intervention process by the use of professional knowledge. A third finding is that an understanding of professional practice as a linear process consisting of diagnosis, inference and treatment reflects GPs’ practice but not all aspects of SWs’ practice. A fourth finding is that both professions hold ambivalent positions towards evidence-based risk reductions technologies. The responses towards organisational risk reductions technologies differ in that GPs are sceptical, whilst SWs take a more pragmatic view.

A main conclusion is that the Swedish state’s efforts to govern the performative aspects of SWs’ practice by knowledge, runs the risk of becoming a insufficient strategy since they tend to exhibit two main blind spots. The first is that these efforts tend to ignore that the relationship with the client has a crucial affect on and conditions SWs’ and in problematic situations also GPs’ knowledge use. The second is that the efforts also tend to ignore that control of the intervention process is not always maintained through control of knowledge use. For SWs control of the relationship with clients represents another mode of professional control of the intervention process. 

Place, publisher, year, edition, pages
Umeå: Umeå universitet , 2016. , 128 p.
Series
Studier i socialt arbete vid Umeå universitet : avhandlings- och skriftserie, ISSN 0283-300X ; 84
Keyword [en]
Social workers, GPs, performative aspects of professional practice, relationship with clients, welfare state, knowledge governance, EBP
National Category
Social Work
Identifiers
URN: urn:nbn:se:umu:diva-127145ISBN: 978-91-7601-598-8OAI: oai:DiVA.org:umu-127145DiVA: diva2:1043815
Public defence
2016-11-25, Hörsal B, Samhällsvetarhuset, Umeå, 13:00 (Swedish)
Opponent
Supervisors
Projects
Hur använder socialarbetare och allmänläkare kunskap i praktiken?, FAS/FORTE dnr 2009-0251
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, dnr 2009-0251
Available from: 2016-11-04 Created: 2016-11-01 Last updated: 2016-11-07Bibliographically approved
List of papers
1. Risk reduction technologies in general practice and social work
Open this publication in new window or tab >>Risk reduction technologies in general practice and social work
2012 (English)In: Professions & Professionalism, ISSN 1893-1049, E-ISSN 1893-1049, Vol. 2, no 2Article in journal (Refereed) Published
Abstract [en]

General practitioners (GPs) and social workers (SWs) are professions whose professional autonomy and discretion have changed in the so-called risk and audit society. The aim of this article is to compare GPs’ and SWs’ responses to Evidence-Based and Organizational Risk Reduction Technologies (ERRT and ORRT). It is based on a content analysis of 54 peer-reviewed empirical articles. The results show that both professions held ambivalent positions towards ERRT. The response towards ORRT differed in that GPs were sceptical whilst SWs took a more pragmatic view. Furthermore the results suggest that SWs might experience professional benefits by adopting an adherent approach to the increased dis-semination of risk reduction technologies (RRT). GPs, however, did not seem to experience such benefits.

Keyword
profession, risk, social worker, general practitioner, risk reduction technologies, evidence-based practice/medicine
National Category
Social Work
Identifiers
urn:nbn:se:umu:diva-62233 (URN)10.7577/pp.409 (DOI)
Projects
Hur socialarbetare och allmänläkare använder kunskap i praktiken.
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2012-12-13 Created: 2012-12-12 Last updated: 2016-11-11Bibliographically approved
2. The precarious character of routine practice in social and primary health care
Open this publication in new window or tab >>The precarious character of routine practice in social and primary health care
2015 (English)In: Journal of Social Work, ISSN 1468-0173, E-ISSN 1741-296X, Vol. 15, no 3, 317-336 p.Article in journal (Refereed) Published
Abstract [en]

Summary: This article presents a description and analysis of the written narratives of problematic situations given by social workers and general practitioners (GPs) within the framework of the sociology of professions and organisations. The narratives were collected from 28 social workers and 24 GPs, working in several Swedish counties.

Findings: Our findings show that the professionals rarely described lack of knowledge or difficulties choosing the right intervention or treatment as problematic. Rather, the problematic situations contained encounters with clients perceived as disruptive to professional routine practice. We conclude that there were three different types of problematic situations where the professional routine practice was disrupted: (1) Situations related to ‘client-making work’, where the professionals perceived it difficult to, e.g., gather enough information about the client to make a diagnosis, set a timetable or decide on adequate interventions; (2) Situations related to ‘wicked work’, where the professionals experienced clients unable to articulate their problems or understand and follow the interventions suggested by the professionals; (3) Situations related to ‘dirty work’ were only present in GPs’ narratives and typically occurred when GPs perceived that they were dealing with clients who endangered their profes- sional status. 

Applications: Contrary to previous studies, this study indicates that problematic situ- ations are not necessarily connected with traits and characteristic of the client or a lack of professional competence. Instead, they might be connected to situations where professional routine practice is disrupted. Furthermore, it is questionable to what extent problematic situations connected to such disruption can be managed by evi- dence-based methods, manualisation and standardisation. 

Keyword
Social work, dirty work, wicked work, evidence based practice, critical incident analysis, decision making, human services
National Category
Social Work
Identifiers
urn:nbn:se:umu:diva-95035 (URN)10.1177/1468017314548121 (DOI)000353474000005 ()
Projects
Hur använder socialarbetare och läkare kunskap i praktiken? En jämförelse mellan två professioner
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, Dnr 2009-0251
Available from: 2014-10-20 Created: 2014-10-20 Last updated: 2016-11-01Bibliographically approved
3. Non-problematic Situations in Social Workers’ and GPs’ Practice
Open this publication in new window or tab >>Non-problematic Situations in Social Workers’ and GPs’ Practice
2016 (English)In: Professions & Professionalism, ISSN 1893-1049, E-ISSN 1893-1049, Vol. 6, no 3Article in journal (Refereed) Published
Abstract [en]

This study aims to describe and analyze written accounts of non-problem- atic situations by 28 social workers and 24 general practitioners (GPs). The results show that non-problematic situations were connected to professionals’ control of the intervention process. Non-problematic situations were described by social workers as situations where they had control of the relationship with the client either by the use of coercive means or by the client’s active cooperation. GPs referred to non- problematic situations as situations where they had control of the intervention pro- cess mainly by the use of professional knowledge. One main conclusion is that the ability to control the intervention process through control of the relationship with the client may be of significance to those professions where a central part of the profes- sional jurisdiction involves changing clients’ behaviors. This conclusion means that professional knowledge is not the only way to control the professional intervention process. 

National Category
Social Work
Identifiers
urn:nbn:se:umu:diva-126826 (URN)10.7577/pp.1520 (DOI)
Available from: 2016-10-15 Created: 2016-10-15 Last updated: 2016-11-11Bibliographically approved
4. Who is viewed as client by social workers and general practitioners?
Open this publication in new window or tab >>Who is viewed as client by social workers and general practitioners?
(English)Manuscript (preprint) (Other academic)
National Category
Social Work
Identifiers
urn:nbn:se:umu:diva-127211 (URN)
Available from: 2016-11-03 Created: 2016-11-03 Last updated: 2016-11-03

Open Access in DiVA

fulltext(1501 kB)90 downloads
File information
File name FULLTEXT04.pdfFile size 1501 kBChecksum SHA-512
63d256367901fab48bdfa32bb769069963a7bcdc5293f3a4cbe19a9b28b3ed887cffdabb6d8873b09af7b70391e9b906efa24f53c26175dba275776989600077
Type fulltextMimetype application/pdf
spikblad(108 kB)15 downloads
File information
File name FULLTEXT02.pdfFile size 108 kBChecksum SHA-512
0d6ecac656eab676ad287955149f41836a07183c1e4ff3a733c4f98731bd4e94841b78aa44f10f69cbe3ceea63defe31395c5847aedf5b282bec08373df77b0e
Type spikbladMimetype application/pdf

Search in DiVA

By author/editor
Rexvid, Devin
By organisation
Department of Social Work
Social Work

Search outside of DiVA

GoogleGoogle Scholar
Total: 109 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Total: 975 hits
ReferencesLink to record
Permanent link

Direct link