Approaching drinking problems in single male clients receiving social assistance

Abstract

How are drinking problems in single male clients receiving social assistance approached? This subject has been investigated in two studies. In Study I, 103 social workers responded to a questionnaire on how they would act towards a hypothetical client. The results suggest that there is no consensus among social workers as to how to act towards their clients' drinking problems and that personal values more than anything else are what seem to influence the choice of action taken. Study II is based on focus group interviews with social workers. The social workers' approach to the clients' problems is described as a mobile point within a two-dimensional system. One dimension concerns the client's right to equal treatment versus the right to have their application judged individually with special circumstances considered. The other dimension is related to the client's integrity versus the need for support and control. The results are contextualised mainly from three aspects: the demands on ‘knowledge’ in social work, the specific framework of social work, and changes in the public discourse regarding socially acceptable drinking habits.

Hur bemöts manliga socialbidragstagare med alkoholproblem? Detta studeras i två studier som presenteras i artikeln. I den första studien svarar 103 socialsekreterare i en enkät på hur de skulle agera gentemot en fiktiv klient. Resultaten visade stora variationer i hur de säger sig agera samt indikerar att bland annat socialarbetarnas personliga värderingar kan ha betydelse för val av agerande. Den andra studien baserar sig på åtta fokusgruppsintervjuer med socialsekreterare. Socialsekreterarnas resonemang beskrivs som en rörlig punkt inom en tvådimensionell modell. Den ena dimensionen anger socialsekreterarnas rättsliga ram, det vill säga klienters rättigheter till individuell bedömning samtidigt som rättsäkerheten ska tillgodoses i form av likvärdiga bedömningar och beslut. Den andra dimensionen berör överväganden om å ena sidan klientens integritet och å andra sidan dennes behov av omsorg och stöd. Resultatet kontextualiseras ur tre aspekter; kravet på ‘kunskap’ inom socialt arbete, professionsspecifika ramar samt föråndringar i synen på alkoholbruk.

Keywords:

• Social Assistance
• Alcohol Problems
• Social Workers
• Vignettes
• Focus Groups

Nyckelord:

• Socialbidrag
• Alkoholproblem
• Socialsekreterare
• Vinjettstudie
• Fokusgrupper

Notes

1. The responsibilities within these domains are regulated in the Social Services Act (SFS, 2001, p. 453).

2. Employment as a social welfare officer in all three areas usually requires a bachelors degree in social work although it is possible, as is obvious in the first of the studies presented in the article, to work in social welfare even without a proper education. The degree covers studies in all three areas but the extent of each area varies between universities.

3. The right of all Swedish citizens to a ‘reasonable standard of living’ is expressed in the Social Services Act (SFS, 2001, p. 453). However, this right has restrictions and is individually applied for at the social welfare office situated in every municipality.

4. Published in Swedish (Skogens, 2005, 2009).

5. In Sweden, there are two main ways of organising the municipal social welfare offices, following two different principles. One is the comprehensive approach, asserting the principle that a client with multiple social problems will benefit more from dealing with his problems together with one social worker who ‘gets the whole picture’. The other principle is the specialist approach, meaning that a client with multiple social problems should have different social workers, each of them specialised in dealing with separate problems (for discussion, see Bergmark & Lundström, 2007b). While there is no clear evidence-based support in favour of either principle, the most common is to organise the social welfare offices in specialised units with separate departments for social assistance, addiction problems and child welfare. However, the comprehensive approach is more common in smaller municipalities for the simple reason that they are not large enough to divide the officers into separate units.

6. This text is a shortened version of the content of the vignettes in the questionnaire given to the social workers.

7. The vignette and the action alternatives were developed in steps. Three experienced social workers separately commented on the first draft to establish validity and credibility, that is, whether the client described ‘made sense’ and whether the action alternatives were appropriate. A questionnaire was then formulated and tested on a group of social workers before the final form was established.

8. The statements and the ranking list have earlier been used for this purpose in another Swedish study (Ekendahl, 1999).

9. The scale consists of 20 statements representing five value heuristics developed by Fisher (1998): individual need, deservingness, utility, fairness and ecology. Fisher used the scale in studies of how middle managers in health and local authorities decide about resource allocations. He argues that these value heuristics are used as rhetorical material and devices when forming decisions about resource allocation.

10. ‘Used the alternative at appointment nr 1–3’=1, ‘Used the alternative at appointment 4–6’=2, ‘Used the alternative at appointment 7–8’ or ‘Never used the alternative’=3.

11. ‘Alternative not used’=0, ‘Alternative used’=1.

12. Since the dependent variables are ordinal, the tests were conducted with gamma which is a chi-square based measure of association (Walsh, 1990).

13. These activities are according to welfare-to-work policies (Giddens, 2000) meaning that the unemployed individual should be offered some kind of work or training rather than solely be given financial support.