Street-level bureaucracy and categorization processes in social workers’ encounters with parents who have financial and cognitive difficulties

ABSTRACT

In the Swedish welfare state, assessment of applications regarding benefits for rent costs varies greatly between municipalities which could partly be explained by the inherent discretion in social work practice. This study focuses on practices of categorisation in processes of eviction risk among families, where there are indications of parental cognitive difficulties. The present article aims at exploring social workers’ discretionary approaches in these client interactions, and specifically how indications of cognitive difficulties are handled in relation to financial problems. This paper highlights how they, as street-level-bureaucrats, define and assess these particular clients’ needs of support but also how they view their professional role and the scope for interventions regarding parental impairments in relation to need for income support.This qualitative analysis is based on interviews with 10 social workers in different units of the social welfare agency, who in their work encounter families in eviction risk due to financial problems. The findings show that although the interviewees note that cognitive difficulties may partly explain the need for income support on a general level, the strategies to address indications of such difficulties and adjust the process and/or offer alternative interventions to suit the clients needs vary.

KEYWORDS:

• Interview studies
• marginalization
• practice research
• social welfare

Introduction

” I think there are many unknown cases when you don’t really know what it is all about. There is a great risk that we all become confrontational, that it’s just a hopeless person that doesn’t understand”

(Social worker N)

In Sweden, as in many other countries, financial aid is viewed as a last resort and the client is regarded as eligible only when all other means of support and assets are exhausted. The individual who receives financial aid is often expected to strive towards being self-sufficient and show an active approach in relation to the job market. But what if the client seems unable to respond to these demands, or accommodate to the routines that govern financial aid processes? This article explores discretionary practices used by social workers and more specifically how these are utilized in relation to clients with diagnosed or suspected cognitive difficulties.¹ In general terms, ‘discretion’ may be defined as the freedom that organizations and, more relevant in this context, professionals within organizations are granted ‘when they choose among a number of possible actions to take or not take when interacting with policy targets’ (Thoren 2008, 23). The correlation between financial and cognitive difficulties has been addressed by research as well as professionals in relevant sectors and it has been argued that families where the parents have cognitive difficulties may experience several dimensions of marginalisation, since financial hardship may aggravate the social situation (cf. Cleaver, Unell, and Aldgate 2011; Emerson 2007; McConnell et al. 2011; Fernqvist 2015). Little is however known about how this problem complex, and these clients, are understood and managed by social workers. A recent study based on interviews with parents with cognitive and financial difficulties (Fernqvist and Näsman 2016) suggest that the correlations between cognitive and financial difficulties are perceived as linked together also by the informants in the study. Nevertheless, and in spite of evidence in previous research that support this correlation, the parents felt that the access to support often relied on their own ability to find it and that more systematic and convenient measures focusing on economic issues were rather absent. Furthermore, McConnell et al (2011, 622) note that poverty and the social exclusion that may follow highlights the risks for i.e. child neglect and aggravates the effects of the disability. Cleaver, Unell, and Aldgate (2011) argues that, in addition to often living under poorer conditions than other parents, the social networks and possibilities for financial and social support are often smaller for these parents, which may make their situation particularly vulnerable (see also Sigurjónsdóttir and Traustadóttir, 2010). It is therefore relevant to address and empirically investigate how these clients’ specific situations are handled by social workers, since financial aid in its conventional form may not be suitable for clients with these difficulties, or that the process of distributing financial aid ought to be adjusted to conform to these clients’ needs.

In spite of the abovementioned correlations between poverty and disability, previous research on economic hardship in the welfare state suggests that poverty is often understood as a consequence of individual failure, often linked to notions of morality (see Hasenfeld 2010; Moffatt 1999). The distinction between deserving and undeserving poor has been used for centuries to differentiate between individuals who are unable to work and become financially self-sufficient, and therefore deserve support from society, and those perceived as able to work but who receive support anyway (Handler and Hasenfeld 1991; Moffatt 1999; see also Marston 2008). Individuals in the latter category become regarded as undeserving poor, i.e. not morally entitled to financial benefits which, in turn, may make the possible impact of other contributing causes of poverty less likely, or perhaps even controversial, to address. Here, this is highlighted by discussing how disabilities such as cognitive difficulties are understood by social workers in relation to financial problems resulting in the risk of eviction. Based on the discretion embedded in their work and their organisational location between management, government norms and regulation and the direct and often long-standing contact with the clients they encounter, these social workers are here defined as street-level bureaucrats (see Lipsky 2010).

The main aim of the article is to make visible and analyze how the social workers understand and conceptualize possible connections between cognitive and financial difficulties, how a disabling condition may call for adjustments in the processes and also how they view their own professional role in relation to these clients. In this context, the issue of the social worker’s acting space, in terms of room for discretionary practice in relation with the clients, becomes highly relevant. In social work, discretion may be defined as a necessary part of the job due to the complexity of the processes that are handled and also because of the interventions that social workers do in people’s lives that ‘call for sensitive observation and judgement, which are not reducible to programmed formats’ (Lipsky 2010, 15). Drawing on interviews with social workers in four Swedish municipalities, the professional role and discretion associated with it is discussed in light of the following questions: how is the possible link between financial and cognitive difficulties understood and handled? How can suspicions or indications of cognitive difficulties be documented in financial aid case records? How do the social workers themselves reflect upon the discretion that their professional role entail in relation to this specific client group, in relation to client encounters as well as the administrative work that follows? In general, social workers who administer financial aid seldom have special training in handling clients with disabilities, much less intellectual or cognitive disabilities, which can make these client encounters challenging in several ways.

Categorization processes and street-level bureaucracy in social work practice

This paper is a part of a larger study which aims at analyzing processes of categorization within a specific field of Swedish social work practice. The primary focus has been to study normative assumptions regarding financial propriety, e.g. the ability to handle money properly, but also aspects of performativity and self-presentation in relation to these processes, such as willingness and/or shown ability to adapt to social services, norms and regulations (see also Fernqvist 2018). In this article however, the focus lies solely on how social workers use discretionary approaches when meeting with clients and making decisions, with an emphasis on how a possible disability is viewed and handled in relation to financial problems. The presence of a diagnosis, or at least a discussion of a possible diagnosis, is likely to be relevant here as it represents legitimacy in relation to deservingness and claims in relation to social benefits. A diagnosed disabling condition, such as cognitive difficulties, is likely to frame the client as more deserving since ‘[a diagnosis] can pin down the boundaries between welfare politics, medical interventions and the responsibilities of the individual. It fixates the norms for health and sickness, normality and deviance and for the expected or accepted behaviour’ (Johannisson 2006, 30, authour’s translation). Cases involving these clients thus highlight social workers’ negotiations of normality when handling financial issues and social benefits, which among other things emphasize the client’s ability to follow tacit or explicit agreements with the social service agency and to strive towards financial self-sufficiency.

As in other social work contexts, it may be challenging for the social worker to both exercise public authority in personal social services and at the same time trying to help and motivate clients to change, often aiming at improving their behaviour in different matters (Börjesson and Palmblad 2008; Hasenfeld 2010; Rexvid and Evertsson 2016; see also Lipsky 2010) is ever-present. In Sweden, financial aid is governed by the Social Services Act but also partly adapted to local regulations in the municipality where the client resides (cf. The National Board of Health and Welfare 2013). It is primarily the social worker who has to make decisions based on individual needs, but also conform to policy and practice which may vary between municipalities. In her work on street level bureaucracy in activation policy and practice, Thorén (2008, 23) argues that the often ‘heterogeneous and case-specific’ situations that are administered by welfare policies as well as social workers make more all-embracing policies and guidelines almost impossible to achieve, hence the need – or rather inevitability – for discretion in social work practice. Previous research has highlighted how officials within people-processing organisations, e.g. teachers, police officers and social workers, can use a varying degree of discretion in their work and how tensions between this discretion and institutional norms, demands and regulations can be understood (e.g. Lipsky 2010; Hasenfeld 2010; Nothdurfer 2016). The work in a people-processing organisation is thus not only about meeting individual needs, but is also about relating to a more or less explicit ambition of improvement where the client is ideally being motivated to self-improvement, in a wide sense (e.g. Börjesson, Palmblad, and Wahl 2005; Hasenfeld 2010; Moffatt 1999). Lipsky (2010) argues that social work practice is characterised by classification processes whereby the client’s suitability in relation to specific interventions are assessed; or in other words, who is regarded as deserving or undeserving of support. As Epstein (1999) and many others have emphasized, the aspect of governing the client is a crucial feature in modern social work practice whereby the social worker has to balance strictly institutional demands and discursive practices, often based on notions of morality, as well as what is best for the individual client (see also Hansen and Natland 2017).

Furthermore, Hasenfeld (2010, 10ff) suggests that the distinction between deserving and undeserving poor, and its connection to wage labour and individual self-sufficiency, may lead to a compartmentalization of a client’s needs whereby the increased specialization among social workers tends to obscure how different problem areas in the client’s life affect the situation at hand. Factors such as substance abuse problems, physical or psychological ill-health, etc. can therefore be regarded as more or less relevant in relation to the financial situation. This may result in an exclusive focus on issues directly linked to the ability to provide for oneself financially, and a tendency to put less focus on the aspects that are regarded as irrelevant in relation to financial problems. In the context of this article, this could mean that financial and cognitive difficulties are regarded as separate issues from the social worker’s point of view – which they are of course, but the previously noted correlation between them (Cleaver, Unell, and Aldgate 2011; Emerson 2007; Fernqvist 2015, Fernqvist and Näsman 2016) suggest that they could be regarded as parts of the same problem complex which in turn could affect the outcome of the financial aid investigation. In a similar vein Rexvid and Evertsson (2016) note in their study on social workers´ perceptions of financial benefits clients that clients afflicted by sudden and unforeseen events, which had a negative impact on the economy to a higher extent were regarded as ´victims´ by the social workers. These clients´ situations were more often perceived as unproblematic and easy to handle in comparison with clients who showed a more long-lasting, and to some extent unexplainable, need of financial support. Given the findings in previous studies, it is likely that clients with cognitive difficulties which may affect the ability to handle money for longer periods are perceived as particularly challenging or ‘problematic’ within this institutional logic.

Data and method

In this study, 10 social workers working in social services agencies in four Swedish municipalities of varying sizes have been interviewed individually during 2015–2016. The interviewees have been recruited through contacts with their professional superiors, who provided them with information about the study, which was controlled and partly repeated verbally prior to every interview. In this information, it was stated that participating in the interview is voluntary and that the participation could at any point be discontinued by the interviewee. The interviewed social workers work primarily with administration of benefits, but the selection also comprise of one administrator working with child protection and one administrator who has previously worked with financial aid but is now engaged in eviction prevention work. Thus, the organisational location of these two interviewees was outside the financial aid unit and their work tasks differed from the other interviewees. However, the topics addressed during the interviews with them was analytically relevant for the research questions guiding this study and given that the vast majority of the interviewees worked in financial aid units during the time of the interviews, it was viewed as relevant to include all interviews in the analysis. After each interview, the interviewee was offered to read and comment upon the interview transcript, which one of them did. Their identity and the municipality where they work have been anonymised throughout. The study has been audited and approved by the Regional Ethical Review Board according to the Ethical Review Act (dnr 2015/154).

The interviews were semi-structured and each interview lasted for 45–60 minutes. Most of them were conducted over the telephone, for pragmatic reasons: it allowed more interviews during a shorter time span. Doing research interviews over the telephone can however have both drawbacks and advantages from an ethical and methodological point of view, depending on the study design and the research questions guiding it. Non-verbal expressions, like body posture and language, are impossible to observe and a personal encounter is perhaps preferable when the interview deals with sensitive topics and the researcher can observe more closely how the respondent reacts and responds. The distance that the telephone interview creates, when the interviewer is not physically present, may on the other hand make the respondent feel more comfortable when discussing delicate matters (see also Bryman 2008). Since the analysis of these interviews would not entail discussions about non-verbal expressions, and that the content of the interviews was regarded as less likely to evoke feelings of discomfort from the respondent’s point of view, it was considered fairly unproblematic to conduct some of the interviews over the phone.

The questions asked during the interviews have mainly evolved around the general issue of boundary work and how to raise the issue of possible disability when meeting clients (e.g. ‘what indications of cognitive difficulties can you spot in client meetings? How do you address it to the client’), categorisation in practice (e.g. ” how do you handle the matter when the client has or is suspected to have cognitive difficulties?”) and how the social worker view his/her professional role in relation to this specific client group (e.g. ‘ what resources do you have to support these particular clients? What room for cooperation with other agencies would be fruitful?’). The interviews have been transcribed verbatim and the transcripts were closely read and broken down into codes, such as ‘adjustments’, ‘client agency’, ‘professional role’ etc. Using a content analysis approach, these codes were then reworked into broader themes that have been regarded as relevant on the basis of previous research and the theoretical framework (see also Graneheim and Lundman 2004). These themes structure the discussion on the following pages: the first section briefly explores if and how cognitive difficulties are made visible in interaction with clients, and how the social worker uses the information conveyed in this interaction to determine how the investigation regarding financial aid will be carried out with this in mind. The second section addresses how the social worker uses different discretionary approaches to adjust to confirmed or suspected disabilities, both in the joint planning in relation to, e.g. job activation with the client, but also in relation to documentation. The concluding section focuses on reflections on the role of a social worker in relation to this specific client group, with emphasis on professional limitations and possible areas for improvement.

Defining normality and propriety in client encounters: establishing required interventions

In most interviews, the presence of a disability such as cognitive difficulties is framed as an aspect of the client’s life situation that makes him/her more deserving in relation to obtaining social support. All interviewees, but one, acknowledge that there often can be a correlation between cognitive difficulties and longstanding and/or recurring financial problems. In relation to this, they stress the importance of not assuming that these problems are always caused by carelessness and negligence. The aforementioned moral dimension of social work, particularly in relation to economic issues and poverty management, where it becomes central for the social worker to clarify whose need for support is justified is often referred to by the informants:

If there are difficulties with perseverance and the ability to care for children, the household, the economy and work…It is a lot to deal with for someone who lacks the prerequisites, which is why it is so important to support, and not punish, that individual. It is a long-term thing, it can take years sometimes. (Social worker P)

There are these ideas that some people do this systematically. They know or think that they won’t get evicted because they have children and these children become sort of a hostage, they don’t give a damn about paying rent because they know that we will save them. I don’t believe that to be true because if you’ve thought up a strategy like that…there has to be some reasons behind that. A normal person wouldn’t do that, it would be some kind of survival strategy because you can’t make it work otherwise. (Social worker V)

In these quotations, stereotypes and sanctions linked to financial negligence – and that perhaps otherwise would be relevant in these cases – are addressed. The interviewees, particularly V, seem to resist such notions and do not necessarily conform to them. Yet, these representations are nonetheless used as a discursive frame in the discussion of financial benefits in general, through wordings like ‘punish’. The second quotation draws upon common stereotypes where people who obtain welfare benefits are regarded as ‘welfare cheats’, a concept that refers to clients who behave inappropriately in relation to the distribution of benefits and thereby ‘do not fit in within the network of relations in the social assistance office’ (Moffatt 1999, 220). The clients we primarily discuss, who according to the normative welfare logic could be classified as deserving, are not labelled as such by the respondents, but are neither perceived as typical, or ‘normal’, clients. It therefore becomes relevant for the social workers to define the clients’ predisposition and ability to perform in accordance with both normative assumptions regarding financial propriety and social services policies and regulations. These practices of categorisation and negotiations regarding normality, propriety and deviance may be viewed as a form of boundary work (e.g. Johansson and Lundgren 2015), whereby it becomes important to label or define certain individuals, in this case as members of the category ‘disabled’, to follow the demands from social services. In relation to clients with obvious cognitive difficulties, several of the respondents describe the delicacy of caring for the client by adjusting central aspects of the encounter, but without stigmatising the client by behaving in a paternalistic manner. Börjesson and Palmblad (2008) note in their analysis of Swedish social services records that this tension between a rather outdated perspective on the client as inherently problematic and/or passive and a more modern subject-oriented view of him/her as inherently capable through empowerment is salient. The balance between these client perspectives also emerges in these interviews, like in this quotation from social worker N:

I had this client who didn’t know what a receipt was, he kind of didn’t have that knowledge. There are certain things you assume are basic knowledge, but in some cases it isn’t…I would probably have known that here, but it is hard, you don’t want to ask the question “you know what a receipt is, right”?

N here raises the difficulties of assessing cognitive difficulties and how special needs may call for special measures, and also how some clients may lack taken-for-granted abilities and therefore need more concrete support than just motivation through empowerment. This is a delicate issue due to the obvious risk for misinterpretations and inaccurate conclusions, especially if the social worker is unfamiliar with manifestations of cognitive difficulties and how it often may be connected with financial difficulties. A performative aspect of financial propriety is therefore likely to be a relevant, yet rather unexplored, aspect when highlighting correlations between cognitive difficulties, poverty and financial aid processes in the context of welfare state interventions. Previous research (e.g. Börjesson, Palmblad, and Wahl 2005; Kullberg and Cedersund 2001) has noted that the dynamic between the client and the social worker is often affected by the client’s manifested will to improve the situation. Given the demands often posed by social services on the clients’ ability to plan economically and show initiatives in relation to finding work (or other means of self-sufficiency) and not least to propriety and conscientiousness in financial matters, there is a risk that cognitive difficulties, which often affect executive functions, memory and concentration, can be misinterpreted as lack of attention or negligence which in turn may reduce the possibility to obtain proper support (see also Jones 2013; Fernqvist 2018). The first meeting between the client and the social worker, and the latter’s perception of the client and how this may govern following interventions, is therefore a crucial part of the process. The following section explores how several aspects of both client interaction and the process itself often has to be modified to accommodate to these clients.

Adjusting to the atypical client

In several interviews, there is an apparent and often outspoken awareness that financial problems can be linked to other difficulties and that a more holistic view of the client’s situation is important in order to provide accurate support, which in part run counter to the previously mentioned discourse of compartmentalisation (see Hasenfeld 2010). As stated previously, most of the interviewees have experienced that financial difficulties and cognitive difficulties often are connected in some way, and acknowledge that such disabilities affect the client’s ability to stick with the social contract that accompanies the financial aid investigation. One central aspect of this is the joint plan that is made up in cooperation between the client and the social worker and is the foundation of the financial aid investigation; if the client does not conform to what is agreed, s/he runs the risk of losing the plan’s cash benefits. Several of the interviewees state that when the planning with the client does not work, and where a cognitive disability or a similar condition might explain the situation, it could result in adjustments in order to facilitate the cooperation with the client:

It may be rather chaotic in the family and they have to attend meetings in different places…well, then one can’t demand more from them really. They can have meetings with the school and psychiatrists several times a month, they have a lot of people to see. That can be enough as we see it, their planning with us is to attend the meetings that they are asked to attend. (Social worker S)

A certain amount of adjustment, which takes into consideration problems besides the economy and motivates deviations from the job activation paradigm, is by several interviewees regarded as an unproblematic discretionary strategy embedded in the daily job. Returning to the interplay with clients who do not seem to be capable of adapting to the social services norms and regulations, here discussed in relation to cognitive difficulties, it became relevant to discuss how possible indications of such disabilities are put forth and handled on an interpersonal level. Several of the interviewees address the notion that a more or less diffuse inability where the handling of the economy on a day-to-day basis is not functioning adequately may indicate cognitive difficulties. However, the clients may present themselves in a way that they assume is correct and desirable in the context of social services practice. These clients can state that they understand the planning and the social worker’s instructions. When the planning falls through anyway, this may serve as an indication for the social worker that a different approach is needed:

The language and use of words is…even if it is supposed to be easy it often is not. I have had several clients who don’t understand the meaning of what is being said. In that position, the client becomes very exposed and vulnerable (…) I think that it is very much up to the individual social worker to get the skills to become more observant, and courageous enough to ask the right questions and not settle with a simple ‘yes’ when asking the client if s/he understands (Social worker B)

This quotation also highlights the aforementioned aspect of consensus and dialogue in social work practice, which is often contrasted against the more paternalistic perspective on the client that historically has dominated the relationship between citizen and governmental practice (Börjesson, Palmblad, and Wahl 2005; Juhila et al. 2003). Here, the inherent tension in the social worker’s role in general becomes visible: to explain, support, motivate and enable the client to be an actor and a subject in the client-social worker relationship and at the same time governing the client by mediating ‘the normative views inherent in the intentions of social work practice’ (Epstein 1999, 8), in this case norms regarding financial propriety. In the cases discussed here, the possible presence of cognitive difficulties problematizes this tension even more and emphasizes the social worker’s presumed resistance towards a more governing and paternalistic position.

Assessing and defining disability

The problematic duality in addressing possible disabilities without risking to offend the client, or taking over the situation by offering ‘too much’ help and control over the situation and thereby reducing the client’s agency, is a recurring theme in several interviews. This can partly be understood in relation to the formulations in the Social Services Act which stresses the voluntariness in relation to interventions governed by the act and how ‘social services operations should build upon respect for the individual’s right to self-determination and integrity’ (Social Services Act 2001:453 1 §, authour’s translation) and which also highlights the inherent notions of non-paternalism and cooperation between social worker and client. In cases where the client does not have a diagnosis, but where cognitive difficulties may be suspected on the basis of financial and social problems and/or incomplete school records or job instability, most of the interviewees agree that the situation is complicated. The question then arises in what way the individual social worker has to clarify if the client has a disability that would qualify for other forms of support – how far and how detailed can such suspicions be documented in the case records, by a social worker without special training in these matters? According to the official guidelines regarding social workers’ administration policy, everything that is deemed relevant in relation to the investigation should be documented, with the social worker’s own assessment of the situation clearly marked (The National Board of Health and Welfare 2014). Consequently, it is up to the individual social worker to decide how – or if – such suspicions should be mentioned in the written documentation and the interviewees’ attitudes regarding this matter differ somewhat. Social worker L’s position is that the professional role acknowledges that such information could, and perhaps also should, be put forth, both when meeting with the client and in the following investigation:

In our work description, it just says that we should investigate the right to financial benefits – what is the meaning of ’investigate’ here? It is all a matter of competence. I have much experience in working with different people and financial aid, I can discuss this, I pick up on it a bit faster. I don’t think that it is something that works automatically with anyone, it can be missed completely (…) It is so important to be able to address a possible disability with the client. I rarely feel attacked or questioned when I do that, they are often very ardently seeking help and financial benefits are the last resort.

Social worker B discusses the matter in a similar way, but puts more emphasis on the complexities that often follow:

In my assessment, I can note if they have apparent difficulties, whether these are cognitive or not…I’m no doctor, so I can’t really make that judgement, but I can see if that person based on his/her behaviour and the situation they have ended up in have apparent difficulties.

The complexity and challenge in making such an assessment, and the limitations of their professional role associated with it, is addressed on several occasions. Below, social worker V gives room for a more restrictive view in relation to documented suspicions of disability:

In the case record, I can write…if one writes that it is a messy situation in the family, I can note that due to these circumstances, it is apparent that certain things aren’t working so well. One can write it in a nice way, you can’t speculate. It is better to put too little than too much on record regarding these things, to be a bit cautious and establish a solid contact because obviously my first impression can be wrong.

The social workers’ discretion in financial aid investigations thus enable a certain variation in relation to how or if a possible disability should be handled, both in the physical encounter with the client but also in the written documentation. This is nothing remarkable as such; rather, it could be viewed as a prerequisite to treat the individual and specific client on the basis of his/her situation, ability and preconditions (see also Thorén 2008). However, it may be of great importance that all relevant circumstances that affect the client’s possibilities to get proper support become visible, which social worker L also stresses: ‘Yes, we work with issues regarding the economy, but we also have to acknowledge the bigger picture and pay attention when we see that something is not right, that is our obligation.’ This view opens up a more extensive discussion of whether the awareness of, and willingness to, addressing and documenting indications of cognitive difficulties is connected to a self-reflective view on the professional role as a social worker specialised in financial aid – what is the main focus, the financial situation or the ‘bigger picture’? This issue is probably relevant when discussing assessments as categorisation practices and boundary work in social work practice in general and this client group in particular, where the disabling condition may be an underlying circumstance that affect domestic finances rather than an isolated event that may explain the need for financial aid.

Reflecting on one’s professional role: limitations and challenges

The concluding section addresses how the position as a social worker in a financial aid unit is viewed upon by the respondents with a focus of acting space and discretion, and also how this discretion may be utilized in relation to other agencies and actors involved with these particular clients. Several of the interviewees addressed how their competence and insight in the client’s situation was often overlooked; that their work with ‘just the money issues’ often entailed much more than just handling and distributing social benefits. Working with clients who had diagnosed disabilities and long-term contacts with the financial aid unit was often described as a joint effort between other units within and outside the social services as well as, e.g. the habilitation team and the unemployment office. Contacts with the child protection unit are also an important part of working with families at risk of eviction in general which makes this issue relevant to highlight briefly here. In Sweden, public officials working near children, such as social workers, school staff and hospital staff, are obliged to report to social services if they suspect that a child is neglected in some way. The child protection unit then decides whether the notification will lead to a child protection investigation (e.g. Svärd 2016). In relation to the risk of eviction, almost all of the interviewees stated that this is a definite cause for concern and notification to the child protection unit, particularly if the financial difficulties are recurring and where previous interventions led nowhere:

If they have gotten information about the severity of the situation, both from myself and the landlord, that it cannot happen again, but it happens anyway and when it, on top of everything else, becomes apparent that they have money but not payed rent, I have notified on the basis of lacking parenting ability. They have chosen not to prioritise rent even though it has happened several times before. (Social worker N)

In this quotation, as in several of the interviews, the recurring wordings regarding the client’s ability to choose and make financial priorities can be interpreted as tokens of the moral dimension of poverty (e.g. Handler and Hasenfeld 1991; Moffatt 1999). However, based on previous knowledge regarding poverty in this client group (cf. Cleaver, Unell, and Aldgate 2011; Fernqvist 2015), it may be questioned to what extent bad priorities are the cause of financial problems and eviction risk. Previous studies have shown that planning the economy can be an area of particular challenge and difficulty among people with cognitive difficulties (Emerson 2007; Levinsson and Jiborn 2013; Fernqvist and Elisabet 2016). Although recurring problems with rent payments are considered to be a non-questionable ground for a notification to the child protection unit, there are differences of opinion in the data whether such problems are enough to question parenting abilities. This is often mentioned in relation to an awareness of how the notification will be handled by the child protection unit, whose primary interest and grounds for investigation is (lacking) parenting abilities:

There are really no reasons not to notify I think…one should always make a notification of concern when children risk eviction (Social worker L)

In most cases, the parents won’t pay rent and when that happens we look into the parenting abilities in general: if the children’s needs are met, if they are not beaten up, if the parents aren’t on drugs, they are clothed and fed…if so, the child protection unit won’t do much about it. (Social worker V)

Previous studies have however shown that eviction of families usually does not lead to child protection investigations in Sweden, which may partly be explained with weak – or rather, non-existing – perspectives on children’s rights in the legislations that govern eviction processes (see Kjellbom and Alexius 2012; Stenberg et al. 2010). Several of the interviewees state, not without frustration, that financial hardship in families rarely lead to child protection investigations. This is viewed as problematic by the interviewed social workers since the social service’s involvement in financial problems, i.e. the work that they do, may highlight and enable access to other problem areas in the family, such as parental disabilities, which may possibly contribute to child neglect or other problems that would lead to an investigation at the child protection unit. Financial aid work should therefore, according to the informants, be regarded as a wider area of expertise.

Furthermore, some of the interviewees touched upon the fact that there is a lack of competence within their own field of financial aid and that more learning and knowledge about cognitive disabilities is needed:

I can try to not to give too much information at once, write it down, tell the client to call me at a specific time and if they don’t do that, I’ll call them. It has to be more structured with these clients. You can’t sit there afterwards and think it’s weird that they never handed in the papers. (Social worker S)

In the concluding sentence, it is implied that it is not that unusual for the social worker to take a somewhat laidback position with confidence that the client has the ability to stick to what is planned and do what s/he is told. Above, S stresses that this approach does not work with these clients, where the social worker often needs to be more proactive. The economy is in many interviews referred to as a rather invisible or neglected area in these clients’ life situation on the whole, which often involves contacts with several supporting agencies and persons that rarely focus on the financial problems since other problems are regarded as more severe and/or acute. Some describe how a financial aid investigation process may lead to other measures being taken, such as psychiatric evaluations, since it becomes clear for both social worker and client that there is an underlying problem that needs to be investigated further. As in the cases of possible child neglect addressed previously, financial problems can, according to the interviewees, lead to the acknowledgement of other problems that require alternative measures more suitable for these particular clients. Social worker L stresses that the insight she has in her clients’ life situations by working with financial support should be acknowledged and accounted for to a greater extent by other actors involved. She calls for more extensive cooperation with these clients, preferably on the initiative of others:

My role in these cases has a lot to do with coordinating contacts and building professional networks around these clients, which can be really difficult. Even if there is an administrator somewhere, it always ends up in my lap since I have to initiate coordinated meetings with everyone involved, including the client. I feel very alone in that. Social workers in financial aid units, we are just supposed to fix everything. (…) I think that much more cooperation is needed, I feel like I’m the only one calling everyone, trying to set up meetings and what not – no one ever calls me! I have an endless amount of information and knowledge about these clients, I see them at least twice a month.

The contacts with the social services are described as very significant for these clients, which can be challenging given the social workers’ often stressful work situation – ‘you wish that there were more support for them, sometimes they have no one and we are the only ones they’ve got’ as one of the interviewees puts it. The social workers note, in line with the results from several studies (e.g. McConnell et al. 2011; Sigurjónsdóttir and Traustadóttir 2010) that even though it is often mentioned as an important resource, parents with cognitive difficulties often lack supporting social networks of their own which can make the situation even more vulnerable, not least for the children.

Discussion

In the interviews, the social workers stress the importance of making these clients and their disabilities visible in order to provide adequate support, but at the same time pointing out the dilemma of doing so without the running the risk of treating them as less knowledgeable. A perspective on financial problems that acknowledges aspects such as cognitive difficulties that might contribute to them, is often stressed as crucial. At the same time, the work of social services agencies in Sweden has gradually been characterised by an increased level of specialisation (e.g. Thorén and Salonen 2014) which can be seen as the practical implementation of the aforementioned process of compartmentalisation (Hasenfeld 2010). Cognitive difficulties, as in this case, may therefore have been primarily viewed and treated as a feature of the psychiatric/medical domain, making the connection to socio-economic matters less prominent. Based on the findings in this study as well as in previous research, there is a possibility that this is difficult to combine with more holistic ambitions, both on an organisational as well as an individual level.

These cases also highlight how social workers have to engage in categorization work outside of their ’comfort zone’, i.e. how possible disabilities affect the client’s suitability in relation to financial aid processes, since a diagnosis often makes the client eligible for other forms of support. This discourse of medicalization that becomes an inevitable part of the process of sorting between clients who are perceived as deserving or undeserving of support, or where the process needs to be adjusted to conform to the clients’ needs, is described as complex and problematic by several of the informants. In most cases they do not perceive themselves as qualified to make such assessments, which are crucial since it may affect the outcome of the investigation. In the data, the importance of an early detection of these clients’ situations and preconditions, partly due to the general focus on cooperation and dialogue with the client (e.g. Börjesson, Palmblad, and Wahl 2005; Epstein 1999), is also put forward. This may be particularly important here since these clients otherwise often may fail to conform to the norms and regulations guiding the handling of financial aid.

The importance of the client understanding the meaning of, for example, consent in contact between the social worker and other actors involved in the financial aid process is therefore described as crucial in the interviews, but at the same time, it appears to be some uncertainty how the social worker makes sure that this is done. Even though several interviewees in different ways reject notions of moralising the clients’ financial shortcomings, this dimension is nevertheless visible as a discursive frame: it is emphasised that these particular clients should not be punished for their behaviour and that is important not to moralise. Another aspect is how the social worker, through their insights on the financial situation and related problems, often tells a lot about the client’s situation as a whole and that this perspective and competence could be better utilised by other actors and agencies involved in these processes. The possible correlation between financial and cognitive difficulties is self-evident for almost all of the interviewees, which imply that the financial problems in these cases are likely to be understood on the basis of inability rather that negligence. It is possible that this may affect the perspective on these clients in a wider sense since the aspects of their life situation that make them ‘deserving’ – such as a disabling condition like cognitive difficulties – needs to be placed at the forefront and articulated, and the client is often expected to be the one to do it. It is therefore of relevance to shed more light on the connection between financial and cognitive difficulties, and this client group, which in other contexts has been described as a ‘silent group’ (Fernqvist and Elisabet 2016), in research as well as in social work practice and to increase the knowledge and competence about this client group in financial aid processes.

Disclosure statement

No potential conflict of interest was reported by the author.

Additional information

Funding

This work was supported by Forskningsrådet om Hälsa, Arbetsliv och Samhälle (FORTE), [2014-0410]

Notes

1. This concept is used here to describe difficulties in everyday life regarding, e.g. memory, problem solving and ability to concentrate, which are linked to neuropsychiatric disorders (such as ADHD, ADD and Asperger’s syndrome) and/or intellectual disabilities (e.g. Azar and Read 2009).