Learning a shared language – theoretical concepts as tools for enhanced well-being in social work interventions

ABSTRACT

The aim of this article is to explore the opportunities of using theoretical concepts as way of gaining a shared language for people participating in an active labour market program (ALMP). The investigated programme offered vocational education preparing for work in eldercare to unemployed individuals. Data was collected through interviews with ten participants and two teachers, and through observations. All participants had experienced social problems such as homelessness, indebtedness, criminality. Half of the group had Swedish as their first language. In the other half of the group, several languages were spoken. Some spoke Swedish without difficulties, whereas others had big difficulties speaking, reading, and understanding Swedish. The programme included an introduction to Aaron Antonovsky’s theory Sense of Coherence (SOC). This article reports from, and reflects on, the acquisition of a theoretical vocabulary serving as a pedagogical short-cut for the participants. By filling the concept of SOC with meaning, participants got access to a new language, a language that was surely not ‘plain Swedish’, but rather a language of abstract theory. The pedagogical work created literacy – and a shared platform for increased understanding of one’s own life story and current situation. Using the empirical case of an ALMP serves as an attempt to cross-fertilize the theory of SOC and educational ideas in a way that is not conventional in social work research. We suggest that introducing a theoretical language relevant for one’s own personal story might enhance well-being and thus prime learning in social work interventions.

KEYWORDS:

• ALMP
• SOC
• learning
• well-being

Introduction

This article aims to shed light on a specific phenomenon studied in a local labour market programme (ALMP). We use theories from Aaron Antonovsky’s (1988) sense of coherence (SOC) to deepen our understanding and explore the role abstract theoretical concepts can play in health pedagogics classes for participants who are struggling to master the Swedish language. The concept of SOC plays a ‘double role’ in the article: it is both a theoretical concept within the educational plan on the labour market programme and an analytical tool to deepen participants’ understanding of their experiences.

The ALMP in focus in this article has previously been analysed as a classroom practice steered by street-level bureaucrats (Hultqvist and Hollertz 2021a) and as social policy. It is thereby hybrid in nature, combining seemingly contradictory principles such as universalism and selectivism (Hultqvist and Hollertz 2021b). With the above reported analyses as a base, this article focuses on a specific experience that we have consistently returned to when discussing a phenomenon within the ALMP. This phenomenon can briefly be described as the appropriation of vocational knowledge through abstract theory, despite language barriers.

We prescribe to a view on learning as embedded in cultural practice. In learning sciences this view is part of the so-called situated turn inspired by anthropology (Säljö 2021). Learning and cognition are situated in, and intrinsic to, human practice. In accordance, identity and identity transformations are central elements in how learning as a concept is understood. Learning in a community is a matter of identifying with its values and practices and of changing one’s participatory status as a citizen. The Vygotskian concept of appropriation implies that people familiarize themselves with cultural tools, sign systems and artefacts and learn to use them in a contextually relevant and productive manner. Appropriation does not mean copying; the use of cultural tools requires adaptation on the part of the user (Säljö 2021).

The empirical case of an ALMP serves as an attempt to cross-fertilize educational ideas and Antonovsky’s theory on SOC in a way that is not conventional in social work research. In this article we explore how vocational learning can take place in spite of disadvantageous conditions, and how theoretical concepts can be valuable in providing participants with a deeper understanding of their experiences.

Setting the scene for the ALMP

Swedish eldercare is organized as part of the public sector, and municipalities play a key role in its delivery. A pressing situation, characterized by labour shortages and national initiatives such as ‘fast tracks’ to the labour market for disadvantaged groups, has led to a situation in which municipalities offer tailor-made vocational training programmes targeting unemployed individuals, with the aim of making them more attractive on the labour market. In the City of Gothenburg, an ALMP aimed at the long-term unemployed, ‘the stepwise work and knowledge ladder’, was introduced in 2018. The purpose of ‘The Ladder’ is to supply employers struggling with labour shortages with a qualified workforce, thus reducing unemployment rates. Eldercare was one of four identified sectors, and the goal was to equip the long-term unemployed with skills and knowledge to perform ‘easy tasks’, such as cleaning, folding and supporting care staff, within eldercare.

The recruitment process followed several steps. The Municipal Administration for the Labour Market and Adult Education in Gothenburg organized a voluntary information meeting inviting people in long-term unemployment receiving means tested social assistance to attend. The ALMP, a path towards the job of ‘service assistant in eldercare’ was presented. About 80 people attended the open information meeting. Participants who expressed interest in the one-year programme were offered a two-week introduction course to the eldercare sector. In total, 40 participants took part in this introduction course. Of these, 12 candidates were selected to participate in a programme to become service assistants. Motivation for care, suitability for work in eldercare and capacity to follow the course were central aspects in the recruitment process. In this regard the programme deviated from regular ALMPs in one crucial way. Usually, participation is a prerequisite for receiving financial support and participants are referred to an ALMP by case workers. Here, recipients who showed an interest in care work were invited to take part in the programme. The programme would last one year, combining vocational education and practice in residential eldercare. During the programme period, participants received 75% of the negotiated salary for the sector, thereby making clients paid (temporary) employees with social rights and benefits. There was a stated ambition to employ the service assistants after they completed the programme. Given these conditions, the programme more closely resembles traditional state-funded ALMPs in which the state takes responsibility for upskilling workers to meet the demand for labour than those ALMPS that rest on the principles of conditionality and disciplining (Caswell 2020; Hultqvist and Hollertz 2021b).

Aim

The aim of this article is to explore the opportunities of using theoretical concepts as a way of providing a shared language for participants in an ALMP. The empirical material is comprised of classroom observations and interviews. The article provides illustrative examples that highlight the phenomenon of the appropriation of new vocational knowledge through abstract theory. We explore how vocational learning can take place in spite of disadvantageous conditions, such as the presence of language barriers, and how theoretical concepts within a teaching context can become tools for improved well-being.

Background

The ladder, a social policy hybrid rooted in the Swedish Model

To contextualize the ALMP that is the focus of this article, we provide a brief background to Swedish labour market policies. Sweden has a long tradition of active labour market policy, strongly influenced by the English economist John Maynard Keynes’ ideas of nationally funded stimulus packages for job creation and investment in public work (O’Connell 2016). Rudolf Meidner and Gösta Rehn, both representatives of the Swedish Confederation of Trade Unions (LO), were the architects behind Swedish reforms from the mid-20^th century (Erixon 2010). The Rehn-Meidner model aimed to compensate for a lack of skills among the least employable jobseekers and has been referred to as compensation logic, in contrast to competition logic, which targets those jobseekers who are easiest to employ (Auer and Fossati 2019). The Rehn-Meidner model together with the general welfare state constituted what was known as the Swedish Model (Erixon 2010). However, since the 1990s ALMPs in Sweden have increasingly linked mandatory participation in specific programmes to the right to income security (Govender 2023; Hollertz 2016; Hultqvist and Nørup 2017; Nybom 2011). In the light of this development, the compensation logic that distinguishes Sweden’s active labour market policy has been ‘diluted’.

Today, when long-term unemployed citizens participate in an ALMP, financial compensation is usually attached to activity. As a result, receiving income is generally conditioned, regardless of whether participation is linked to state-funded activation support or to municipal social assistance (Filges et al. 2015).

In a previous study (Hultqvist and Hollertz 2021b), we characterized The Ladder as a social policy hybrid that blurs the boundaries between universalism and selectivism. In contrast to many ALMPs, The Ladder transforms the status of participants – from unemployed to employed. By virtue of this, participants gain access to workers’ rights from day one.

The participants

Twelve participants were selected for the programme. They all lived in Gothenburg and had all experienced long-term unemployment. Some were born in Sweden, while others were migrants from Asia or Africa. The classroom context was multilingual. While some held an academic degree, others had dropped out of secondary school. Some had worked in the healthcare sector and others had no experience of working in any kind of care service. All participants had experience of paid work: while some had spent their working lives constantly alternating between temporary jobs, others had previously held both temporary and long-term positions. In these ways the participants represented a mixed group, presenting a unique set of life stories. As well as their shared experiences of struggling to attain and keep a secure job, during the interviews and in conversations between sessions the participants all spoke of having experienced difficult personal circumstances. Their stories included war, flight, trauma, loss, long-term somatic illness, addiction, mental illness, poverty, indebtedness, status as undocumented migrants, homelessness, criminality, experiences of being in the care of the community as a child, school failures and intrafamilial violence. These various circumstances had affected them and/or their loved ones and contributed to shaping the courses of their lives. The two female teachers who led the course were experienced and qualified. One had a degree in teaching Swedish as a foreign language and the other was a licenced nurse taking academic courses to become a vocational teacher.

Methodology

Ten of the twelve participants and both teachers agreed to be interviewed. Interviews were carried out on the premises of the school during the scheduled course hours, between 8:00 and 15:00. The participants’ willingness to be interviewed was directly linked to the fact that we did not request their time outside scheduled hours. Four of the participants spoke Swedish as a first language and six had migrated to Sweden and spoke Swedish as a second language. All of those who had migrated were offered extra language support within the programme, meaning they spent three days a week in school and two days at an assigned workplace, an eldercare home. The native Swedish speakers spent three days a week at their assigned workplace and two in school.

We conducted observations in the classrooms and corridors over approximately 60 hours. We took on the role of active observers, in the sense that we also contributed to discussions and were open about our lives and experiences as researchers as well as social workers, mothers, teachers and any other roles we occupy in our everyday life. This was an intentional strategy. In social work education, this approach is known and as a gap-mending strategy (Askheim, Beresford, and Heule 2017). We argue that building relationships with those whose experiences we want to explore and understand is crucial to the validity and reliability of the research undertaken. Hence, we suggest gap-mending being valid not only in education but also in research with socially marginalized groups.

Service assistant as a vocational role and the health pedagogics course

The job description for service assistants defines the duties of the role, which are oriented towards providing service rather than care. Cleaning, doing laundry, helping with deliveries and waste disposal were examples given in the description of the vocational role. One of the explicit aims of introducing the role of service assistant was to relieve care staff and enable them to spend working hours on providing care rather than services. The role of service assistant – as indicated by the job title itself – was defined in contrast to the that of a care worker. The service assistant should facilitate the care worker to provide care.

The Ladder consisted of courses delivered within the system of municipal adult education, in combination with a placement in an eldercare home. Participants were placed in the same homes for the entire year-long programme. The course participants in the study were selected by the steering committees of The Ladder. For service assistants in the field of eldercare, some courses were identical in terms of content to those offered within the regular training for care workers. One of these was a course in health pedagogics,¹ which is also the focus for this article. The course was given halfway through the first semester of the programme and had the same goals as those stated for care work. It was during this course that we conducted the observations and interviews. The content of the course in health pedagogics is briefly described below:

• Human health, health-related lifestyles and health outcomes from an environmental, historical, international, social and cultural perspective

• Different forms of public health work and health promotion approaches at individual, group and community levels

• The meaning of a salutogenic approach

• The impact of work, the working environment and leisure time on human health

• The impact of empowerment, participation and equality on human health

• The impact of health and risk factors on human health, such as exercise, recreation and nutrition, as well as drugs and stress

• Crises and crisis management

• Laws, targets, other regulations and agreements for public health work at international, national and local levels

• Methods for analysing people’s health status

• Critical processing of information from different sources

• Interaction and communication in cooperation and encounters with people

Research has shown that the term ‘care’ implies instrumental aspects (care-as-service), affective aspects (care-as-relating) and repetitive adjustments in response to the bodily cues of the dependent person (care-as-comfort; Bowers, Fibich, and Jacobson 2001). Referring to classical care theory, Storm and Stranz (2021) use Waerness’ (1984) concept of a ‘rationality of care’, focusing on the well-being of the dependent person. Knowledge, experience and skill are all aspects of care work. The concept of rationality of care can be used when investigating the relationship between hands-on paid care work and the administrative and scientific authority that determines the conditions of the work. The tension between care and work has been described as encompassing both instrumental tasks and affective relations (Abel and Nelson 1990). The caregiver is expected to provide both love and labour (Säljö 2021). This multifaceted definition of care aligns with the course content list above, which covers topics far beyond care-as-service. For the aim of the article, it is useful to highlight the content of the course in health pedagogics as well as the underlying concepts of care. In the analysis, we elaborate on how the course content was understood, interpreted and made relevant to work in eldercare. In our analysis, we explore how theoretical concepts prevalent in the course syllabus can, as we see it, be understood as ‘a vehicle for enhanced well-being’ for the participants, rather than merely an exercise in learning ‘abstract words’ in a classroom context. This was especially noticeable amongst the group of participants who were not native Swedish speakers and were not yet comfortable communicating in Swedish. Contrary to our expectations, the language barrier did not seem to hamper the participants from comprehending abstract theory and even developing it by coupling it to their lived experiences. Appropriation of vocational knowledge seemed to occur when theoretical concepts were related to an individual’s lived experiences. We argue that engagement and motivation are interesting factors for grasping the phenomenon of appropriating vocational knowledge through theory for those also struggling to learn a second language. As we will see, these are related to meaningfulness, one of the core components in Anotonowsky’s theory on ‘Sence Of Coherence’ (SOC).

The salutogenic approach

In the following, we describe the salutogenic approach before we illustrate how SOC as an abstract theory was not only understood but developed on. In the interviews and observations, we could see how the concept was understood, interpreted, linked to personal experience and used as a tool for vocational learning during the class in health pedagogics.

Nearly 50 years ago, the medical sociologist Aaron Antonovsky noted that over one-quarter of respondents in a group of concentration camp survivors were judged to be of satisfactory mental health. Why was it that a significant proportion of a group that had undoubtedly been exposed to extreme biological and social stressors was, nevertheless, in a better mental state than would be expected? The salutogenic approach (Antonovsky 1988) is based on the question: what factors determine an individual’s position on the positive pole of the health – ill-health continuum, and what influences them towards this pole at any given moment? Antonovsky concluded that if we ignore stressors that have a direct degrading effect on the human being as an organism, it is difficult to predict the consequences of various stressors on human health. Experiencing a stressor leads to a state of tension that must be managed. This tension management determines whether the effect of a stressor is illness, health or something in between. This way of thinking has inspired a wide range of scholars interested in issues of mental health, quality of life and well-being for certain groups (Del-Pino-Casado et al. 2019; Schäfer et al. 2019). During the last two years, Antonowsky’s ideas on well-being have been frequently used for measuring mental health maintenance during the COVID-19 pandemic (Ruiz-Frutos et al. 2021; Tanaka et al. 2021).

In the working hypothesis developed by Antonovsky, general resistance resources became a central concept. Money, social support and cultural stability are examples of general resistance resources that can mediate stressors. The common denominator of all general resistance resources was that they helped to make stressors understandable. By repeatedly making impressions and experiences understandable, these resources contributed to a sense of coherence. SOC is the central concept of the salutogenic approach. SOC is a global attitude expressing the extent to which a person has a pervasive and enduring but dynamic trust that: 1) the stimuli emanating from one’s inner and outer worlds are structured, predictable and understandable; 2) the resources needed to meet the demands of these stimuli are available and 3) these demands are challenges worthy of engagement rather than burdens (Antonovsky 1988, 18).

Research exploring salutogenesis in an educational context is uncommon (Lindström & Eriksson, 2011; Wallerstein and Bernstein 1988). Elaborating on salutogenesis in research on ALMP is probably even more rare. However, looking at learning as transforming the identity or changing the participatory status of citizens (cf. Säljö 2021), it does seem uncontroversial that learning can be health promoting and strengthen individuals in disadvantaged life situations.

Sense of Coherence (SOC) has three core components: comprehensibility, manageability and meaningfulness.²

Comprehensibility is the first well-defined, explicit core of the original definition. It refers to the extent to which a person perceives confronting stimuli from their internal and external environments as making cognitive sense, i.e. as information that is ordered, consistent, structured and clear. A person experiencing a high level of comprehensibility would expect future stimuli to be predictable or otherwise orderable and explicable. It is important to note that nothing is implied about the desirability of stimuli; death, war and failure are all possible occurrences, but sense can be made of them.

The second component of SOC is manageability. Manageability refers to the extent to which a person perceives the resources at their disposal to be adequate to meet the demands posed by confronting stimuli. This may refer to resources within their direct control or those controlled by legitimate others – a spouse, friend, colleague, God, party leader, physician – representing a trusted person or institution. A person who is experiencing a high sense of manageability will not feel victimized by events or that life treats them unfairly.

Meaningfulness is the third component – the driving force or motivational component. Formally, it refers to the extent to which a person feels that life makes sense emotionally and that at least some of the problems and demands posed by living are worth investing energy in and deserve commitment and engagement, rather than simply being burdens that they would much rather do without. This does not mean that someone experiencing a high level of meaningfulness is happy about the death of a loved one, the need to undergo a serious operation or being fired, but when these unhappy experiences arise they will willingly take up the challenge, be determined so seek meaning in it and do their best to overcome it with dignity.

To summarize the SOC theory, dealing with a stressor requires the sense of having a clear understanding of the character of the current problem. Inspired by Julian B Rotter and the concept of locus of control, Antonovsky underlined that the crucial aspect of manageability is the sense that adequate resources to cope with stressors are available. These resources can be available directly or through a significant other. Inspired by Victor Frankl, the emotional sense that life is worth living is central to the component of meaningfulness; it provides motivational force. However, meaningfulness also assumes a cognitive perception of order (Vinje, Langeland, & Bull, 2017). As stated previously, SOC plays a double role in the article. It is a theoretical concept taught to students in the ALMP, as well as being used as an analytical tool for structuring data. It could be argued that such an unorthodox way of conducting an analysis precludes clarity, and even intellectual independence, in relation to the studied ALMP (cf. Govender 2023, 47). However, we argue that it is the very rationale of Antonovsky’s theory that makes it possible to cross-fertilize educational ideas with his theory on SOC and thus notice new aspects of the studied ALMP.

Glimpses from the field: illustrations of theory as a tool for enhanced well-being

In this section, we give examples of how the content of the course syllabus, including concepts of SOC, were given meaning when anchored in participants’ own experiences. We propose that learning theoretical concepts can serve a double purpose. Health pedagogics is taught prescriptively in relation to how service assistants’ work tasks are related to promotion of well-being and management of crises etc. However, for participants, learning is not only instrumental; it can serve to provide them with an understanding of their own lives – and is therefore closely linked to enhanced well-being (cf. Wallerstein and Bernstein 1988). Moreover, much of this learning takes place as a result of collective sharing within the group. Hardships and setbacks experienced by participants are used to link abstract concepts to lived experience. In the following sequences, we will illustrate how three core theoretical concepts within SOC – comprehensibility, manageability and meaningfulness – were understood, interpreted and given personal meaning by participants. By doing so, we argue that theoretical concepts become valuable tools for enhanced well-being within the settings of vocational learning in a class in health pedagogics.

Observation: theoretical concept – comprehensibility

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The morning class starts at nine. The participants start to arrive shortly before nine. Some are short of breath as they enter, and they joke about the physical challenge of climbing the stairs – this is something that unites them. The classroom is on the fourth floor in an old building and the elevator is not to be used. The teacher welcomes the students and jokes about the importance of physical exercise, ‘if you want to work in eldercare, you need strong legs’. Six out of the twelve participants are in the room when the clock strikes nine. The class starts. It is Wednesday, and the participants have spent the previous two days at their field placements in care homes. The atmosphere is open and welcoming, the participants seem to know each other and the teacher, and they are chatting informally. The participants are asked to arrange themselves in a circle and the teacher takes the lead. She asks all the participants, one after the other, about their experiences from the two days in the field placements. One participant starts recounting her experiences. She is content and was able to assist staff by preparing breakfast for the elderly residents. This made her feel useful, she tells the group, and she is content with the feeling she gets from having contributed to the workplace The teacher and the other participants confirm these feelings. The participant goes on and explains that she has also been given the task of feeding the elderly residents. This triggers a discussion in the room. Several participants had been asked to do this during their placements, but feeding is not included in the tasks of a service assistant. The teacher listens and says that she has tried to convince the management that feeding should be included in the syllabus but without success. ‘However’, she says, ‘if you are ever in the situation where you do feed anyway you should think of the following (…)’. The teachers goes on to describe in detail how feeding should be performed. She explains that feeding can be risky, and feeding elderly people is different to feeding infants. She says that she does not want to scare them but explains that when feeding elderly individuals there is a risk of them choking. By explaining the feeding procedures, the teacher has clearly gone beyond the tasks assigned to her. However, instead of adhering to a strict interpretation of the syllabus, she confirms that the participants are capable of care constituting a range of tasks – not only those defined in the curriculum. Everyone was placed in the circle. All the participants were actively listening and taking in each other’s experiences, while also taking in the straightforward tips of the teacher.

In the sequence above, the teacher invites the students to actively contribute to the teaching situation. By organizing them in a circle, with all participants given time and space to share their experiences, her intentions were to create a welcoming and accepting atmosphere in the classroom. All participants were given time to talk about and reflect on their experiences from their field placements in care homes. These reflections were expressed as feelings of pride and contentment but also insecurity and difficulty knowing what to do and how to behave in the workplace. The teacher took the time to give explanations and went beyond the set curriculum for service assistants to guide and reassure the participants about their role and work tasks in the eldercare homes by explaining the risks of feeding older people – and highlighting that this type of feeding is different from feeding children (something many of the participants may have experienced as parents). The teacher highlighted a mistake made when one of the participants fed an elderly resident, which was against the regulations for service assistants. However, the critique was constructive, and she acknowledged a desire to engage in the topic, admitting that she had tried to have feeding included in the curriculum. In this way, she also implicitly declared her opinion that they were all capable of learning and fulfilling caring tasks as well as service tasks, or care-as comfort rather than care-as-service (Bowers, Fibich, and Jacobson 2001). The situation – feeding an elderly resident – was reflected upon and promoted learning. More importantly, if the situation occurred again (which was likely given the need for ‘extra hands’ in eldercare homes during feeding times), the situation would be less insecure, more predictable and comprehensible for the participant. We could see how the concepts were understood, interpreted, linked to personal experience and used as a tool for vocational learning during the class in health pedagogics. From the discussion and the reaction of the participants, we conclude that the shared reflections reduced insecurity and increased the level of comprehensibility. The participants were given information on the role of a service assistant, as well as how feeding should be performed. In this way, their understanding of what could be expected from them increased, while also providing security to make a choice when asked for help in a similar situation in the future.

The nomenclature of SOC was sometime used explicitly during the interviews with participants. Below, one participant who had been working in eldercare in her former home country, but not since she came to Sweden, says:

Interview: theoretical concepts – manageability

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‘I have heard many words in the class – theoretical words – such as sense of coherence. These are new words for me. I have not been to school in Sweden. In my own country I would understand much more, but here I don’t. But right now, on this course, I have learned a lot. I have learned about special diets and theoretical concepts. I have learned new words, like “sense of coherence” and all these kinds of words. They are important to me, the theoretical words I learn on the course. I know that if you have worked with one thing in one culture and you go to another culture to work with the same thing you need to understand more. You need to learn more. And things differ between cultures. When we are done with this course, I will have so many words that I can use to work here’.

The participant tells us that she recognizes that even though she has done care work before, being in another country requires further learning. In her opinion, cultural difference requires her to become familiar with new ways of thinking. It is striking how she describes eldercare in Sweden as being different from eldercare in her home country. She refers to ‘culture’ when describing these differences and why she has to ‘learn more’. At the same time, her reasoning seems to confirm that education is an investment in herself. Learning new things increases her value. Suffice to say that in a capitalist society, the aspiration of becoming gainfully employed permeates the adult population. She explicitly links vocational learning to the learning of new Swedish words. The nomenclature of SOC is described as ‘theoretical words’ that will help her in her work and to become a skilled service assistance in eldercare. Her understanding of what she learns relates directly to an increased understanding of not only the care context but her own path to becoming ‘employable’ in a Swedish context – she expresses a more manageable situation in which she knows what is needed on the Swedish labour market. We will elaborate further on the concept of manageability – and the third concept of meaningfulness – in the excerpt below.

Interview: theoretical concepts – manageability and meaningfulness

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Another participant tells us that only 12 out of 48 persons were selected to join the programme. She is very proud and happy that that she was one of them. She says that she wants to work, and that she has previously been part of many different programmes. She is in financial dept and has lived without a legal permit in Sweden with her children. She explains that this programme provides her with real work, and a salary, for an entire year. She is very hopeful that the programme will lead to a stable job, and she wishes to stay at the eldercare home where she is now placed; she wants to stay there for many years to come. On being part of the programme, she concludes: ‘I don’t know, but I think previously I have not had much luck (in life). But now – I have been very fortunate. And my SOC has increased a lot. I am lucky’.

Above, the participant refers to having had ‘not much luck’ in her life, and now describes how the programme has led to increased hope of employment after the programme ends. That she was selected for the programme gives her a sense of pride, and she concludes – using the words of Antonovsky – that her sense of coherence has increased. Being selected for the programme, having a salary and the prospect of regular employment give her manageability to control her life, but also meaningfulness and hope. She expresses this with reference to the concept of coherence, as taught on the course. She predicts that her future will, indeed, be brighter. She expresses this using the theoretical concepts learnt in the classroom, indicating that these concepts give her a way of describing and theorizing about her own situation.

The excerpts from the observations and interviews above show that the learning of theoretical concepts can indeed serve as a tool for empowering individuals in an ALMP, increasing the sense of coherence among participants in adverse life situations. Empowerment in this sense should be understood as increased power and strength as individuals move from a position characterized by a lack of power and control over their situation (Askheim 2007). Motivation, being a driving force for learning a second language, seems to be promoted when feelings are connected to learning by drawing on personal experiences. We suggest that this process of collective learning can occur when an atmosphere of trust is created. This means a conviction that: 1) everyone in the room has something to learn from those around them, 2) diversity, in terms of language, gender, age and religious affiliation, is a resource and 3) individual shortcomings can be compensated for if participants collaborate in building a base. The focus in this article is participants struggling to learn Swedish as a second language, but this research could also be applicable as a tentative framework for analysing activation programmes for those who speak Swedish as a first language.

Enabling the usage of all available knowledge as a collective good

The Ladder represents both historical continuity and innovation. The ambition to kill two birds with one stone applies to active labour market policy as it was launched in Sweden in the middle of the last century and as it has been resurrected in Gothenburg today. Its contemporary iteration, studied here, aims to combat unemployment and provide the labour market with a workforce by means of public spending. However, The Ladder stands out as having transformed the status of participants from unemployed to employed during their participation in the programme. What we have focused on in this article is how hardships were acknowledged but also used by participants to fortify vocational learning. First, and as an important prerequisite for the learning process, the participants were motivated for care work. Caring seemed to be seen as meaningful, as was expressed by participants. Though the job title pointed to service rather than care, the tasks affiliated with care-as-relating and care-as-comfort were referenced just as frequently as care-as-services tasks in interviews and during observations. Moreover, the education programme is a shorter, condensed version of the one that prepares assistant nurses for work. For example, the course on health pedagogics that we observed during our fieldwork focused on public health mental well-being in the abstract rather than practical skills required to provide concrete services. Moreover, the main teacher S, was a trained nurse. That S shared her experience of migrating to Sweden and learning Swedish as a second language might also have served as inspiration.

In essence, it seems the course in health pedagogics not only served to provide knowledge in relation to the tasks that are part of the role of a service assistant. Giving theoretical concepts personal and collective meaning also created a sense of motivation in a more comprehensive way, as if striving to become a service assistant pushed the participants to overcome the fear of using a word incorrectly or making grammatical mistakes. Theoretical concepts were understood not only as working tools, but as a way to promote a feeling of being in command, important and an asset to the placement eldercare organization. The teaching in the programme provided an opportunity for participants to take command of language or theoretical concepts that helped them perform better at work and to create a deeper sense of coherence in their role as employees and citizens. Their experiences in life and the application of SOC shed light on the differences between this experience and the feeling of internal and external stimuli being incomprehensible, not manageable and without meaning. The participants explained that they previously had taken part in ALMPs without understanding their purpose and that they had seemed pointless as a result. We argue that these experiences – and the opposite when participants argued that their sense of coherence had increased – represent fertile ground for gaining knowledge that is valid to those concerned. The concepts learnt about in the classroom were made useful to the participants themselves, and therefore also served as strengthening tools. Possibly, one could also argue that their personal experiences and expression of an increased sense of coherence enhanced their readiness to take on work with other individuals in vulnerable positions, i.e. frail older people with multiple needs in care homes. After all, salutogenesis is promoted by authorities as a source of guidance in Swedish eldercare (National Board of Social Affairs and Health 2012). It seems promising that this approach is embraced and embodied by participants training to work in this sector of the labour market.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1. The list is our translation of the course content listed for the course Health Pedagogics, Course code HALHAL0 by the Swedish National Agency for Education.

2. The three core components referred to here are defined in Chapter 2 ‘The “Sense of Coherence” Concept’ in Unraveling the Mystery of Health. How People Manage Stress and Stay Well (Antonovsky 1988).