Skilda världar : specialisering eller integration i socialtjänstens individ- och familjeomsorg

Sammanfattning: The general objective of this dissertation is to describe and analyse how specialised respective integrated forms of organisation in the Swedish Personal Social Services (PSS) condition social workers’ interventions and client effects (outcomes). The three specific questions are: 1) How are structural conditions for social work with clients created in specialised versus integrated (generic) forms of organising PSS? 2) How do social workers carry out their work with clients in specialised versus integrated (generic) PSS-organisations? 3) How do different organisational models of PSS  influence the results for clients? The research was conducted in three Swedish municipalities with different organisational models within the personal social services: 1) specialised organisation, 2) integrated organisation, and 3) a “combined” organisation with a mix between integration and specialisation. The research had a complex design. It was carried on as comparative case study. Data was collected in several different ways: 1) by means of survey among social workers, 2) by interviewing politicians, mangers and social workers, 3) focus groups consisting of social workers, 4) by collecting official documents, guidelines etc. 5) by mapping of the organisation of social services in the municipalities by means of analyse of their homepages and additional interviews by telephone.  The data were analysed using both qualitative and quantitative methods. The main results in this dissertation are: 1) In the majority of Swedish municipalities the PSS are nowadays specialized. 2) The formal organizational structure of PSS is always challenged by the employees’ spontaneous organising process that goes in an opposite direction. 3) Only the integrated (generic) organisation emphasizes social workers professional competence and knowledge. 4) Social workers, as a professional group, have the collective power to (to a certain degree) influence political decisions on what kind of PSS organisation is chosen in their municipality. 5) Regardless of organisation model, social workers’ method use is more unspecific than specific. 6) Social workers, in general, place significantly more weight on working with clients’ relationships and aspects of trust than on (specific or unspecific) working methods. 7) A holistic (generic) view of a client can only exist in a direct relationship between social worker and the individual and a unique client. It seems difficult to build in holism into primarily specialised organisations. 8) One may question whether a specialised organisation leads to specialisation of its employees in a way that they become experts on specific problems. The three organisational models are not equally good. Neither the specialised organisation nor the combined organisation is able to create economic or organisational conditions for working with clients that are clearly experienced as good. This also holds true for assessment of need, possibilities to make relevant interventions, such as building relationships. Those two organisations show several deficits regarding work with clients.