Lars Evertsson

Currently there is an effort to make social workers act according to principles of evidence-based practice. This approach assumes that by supporting social workers with reviews of “what works”, or practice guidelines, decision-making, and knowledge use will improve.
Our paper discusses decision-making and knowledge use in social work practice. What kind of knowledge is used? How is decision-making conditioned by contextual contingencies? What are the implications for social work research?
The paper draws on two studies of social workers. From the study Social Workers and Doctors Use of Knowledge in Practice, written narratives describing problematic situations where decision-making were hampered were collected. The participants (29 social workers) were experienced and came from different areas of the Swedish social services.
The project “Specialization or integration in the Personal Social Services?” studied how specialised respectively integrated organisations condition interventions and outcomes. We studied three organisational models using several research methods: 1) survey among social workers, 2) interviewing politicians, mangers and social workers, 3) focus groups with social workers, 4) analysing official documents, guidelines etc.
Decision-making and knowledge use proved to be more complex than usually assumed within the EBP paradigm. It is seldom just a matter of rational decision-making and matching specific interventions and well-defined social problems. The character of the interaction with clients conditions social workers’ decision-making and use of knowledge. Interaction with clients, perceived as being “problematic”, causes a rupture in social workers’ professional routine practice, which affects decision-making and knowledge use.
The predominant discourse on decision-making and knowledge use focuses on "the best” kind of knowledge, how knowledge should be implemented, as well as professionals’ motivation and competence. Professional action is largely viewed as a rational cognitive process. However, this is insufficient and policy-makers and social work researcher should focus more on social and relational aspects (i.e. client encounters) of decision-making and knowledge use.

In this article we explore how Swedish welfare politics within health-care and rehabilitation has opened up a space for nurses' and occupational therapists' professional projects. Using historical data, an analysis of the policy-making process behind welfare programs central to the professionalization of nursing and occupational therapy is presented. The time period covered is, in the case of nurses, the larger part of the twentieth century, while the modern history of occupational therapists first began in the 1940s. Special emphasis is placed on the corporative nature of the Swedish welfare state and the professional strategies utilized by nurses and occupational therapists in their struggle for jurisdiction. In the article, politicization is identified as a core strategy by which female-dominated welfare state occupations in Sweden have tried to gain influence over the welfare policy-making process and their occupations' jurisdiction.

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

ATT VARA UTSATT FÖR RISK OCH/ELLER UTGÖRA RISK ........................................................... ................................................. 5 Professionella ”at risk”: risk för egen del .......................................... ............................. ... ... LIKARTADE MÖNSTER I FORSKNINGEN OM ...

Bakgrund: Dagens samhälle beskrivs ofta som ett risksamhälle. Karaktäristiskt för risksamhället är ökad komplexitet, eskalerande osäkerhet och minskat eller brutet förtroende för professioners kompetens och förmåga att handskas med den ökande komplexiteten och osäkerheten. Närmare bestämt handlar det urholkade förtroendet för professioner om ett ifrågasättande av deras definitionsmakt, autonomi och diskretion. Idag är det i hög grad kraven på riskreduceringstekniker, exempelvis evidensbaserad praktik och standardiserade riskbedömningsinstrument, som står för kontroverserna om professionsutövningens natur, villkor
och utmaningar.

Syfte: Att undersöka hur risk påverkar (icke-)användning av kunskap i professionell praktik i
socialt arbete och allmänmedicin, samt att belysa hur de två professionerna förhåller sig till
riskteknologins imperativ.

Résumé

La négociation est devenue un aspect presque indissociable de la recherche sur les relations intimes. Dans le présent article, nous mettons en question la négociation en tant que concept efficace lorsqu’il s’agit de comprendre comment les couples organisent leur vie en commun, plus particulièrement la façon dont les couples suédois gèrent leurs finances. L’utilisation de la négociation tend à dissimuler certaines inégalités structurelles, puisque le quotidien est alors perçu comme le résultat d’une entente préétablie. Ceci nous porte à conceptualiser les relations de couple comme s’il n’y existait aucun rapport de pouvoir. Nous soutenons qu’un moyen plus efficace d’étudier l’organisation financière et la vie en commun des couples serait d’aborder ces sujets en tenant compte des rôles de genre dans la vie de tous les jours.

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Abstract

Negotiation has become an almost given aspect of research on intimate relationships. In this article we question negotiation as a fruitful concept for understanding how couples organize their lives together, more specifically, how Swedish couples organize their finances. The use of negotiations tends to conceal structural inequalities since everyday life is seen as a worked out agreement. This leads to a conceptualizing of relations in couples as void of power. We argue that a more fruitful way of studying how couples organize their finances and lives together is by regarding this from the perspective of the gendered nature of everyday life.