The main theme emerging from the interviews concerned constraints in the provision of social services to long-term social assistance clients. Two sub-themes related to interaction with clients, and the societal context in which they operated. See Table .
The first subtheme included four categories: balancing the dual role, obligations vs. rights of the clients, recognising clients as individuals vs. groups, and building trust with clients. The second subtheme consisted of two categories: authorities´ conflicting views and expectations of clients, and the labour market opportunities and policy context. Categories were sometimes interwoven in the interviews. The following sections present the findings in terms of the themes and categories depicted in Table .
Main theme: Constraints in the provision of social services to long-term social assistance clients
The way that the interviewees perceived their work and their possibilities to offer support influenced the interaction with their clients. Specific challenges were highlighted which related to interviewees’ possibilities to work actively with each client, often in multicultural contexts. The status of their work and overall societal structures were other prominent aspects discussed in the interviews.
Unemployment was mentioned as a major problem and reason for clients applying for social assistance. The social workers distinguished clients who were ”fit to work” from those, who had additional needs, like addiction problems and/or health problems and who were “far away from the labour market” and needed other solutions, taking more time. One way to handle the number of clients was to concentrate on the clients closest to the labour market, to “manage them off” social assistance in various ways.
Two of the study areas had an overall reputation in social services of being innovative and oriented towards development, which interviewees from these areas mentioned as something positive. Active leadership with visions and goals, stability in working groups, emphasis on working methods and support in working groups were aspects mentioned as essential requirements to “reach results” in the work with social assistance (combined with a good labour market situation). Most of the interviewees talked about the importance of “working actively with clients”.
"“You need resources if you work actively, resources to employ social workers…but in the end it gives returns, that is, you save money. But this work is not only about financial resources and how many social workers there are… You also need a conscious strategy of how to work methodically. The content is of major importance.” (Lisa)"
Especially in multicultural areas with heterogeneous ethnic backgrounds among clients, it was said to be “exciting” and ”interesting” to work in these areas, where “the needs were huge”. Differing views concerning labour market participation among men and women and perceptions of illness and health were reflected. The interviewees in these areas expressed extra pressure to give information about the social welfare system and rules regulating social assistance. Many clients were also newly arrived in Sweden and had limited knowledge of the Swedish language and welfare system. Providing clear information was therefore mentioned as a significant part of the social workers´ task.
Social assistance work was described as a less attractive field in the social work arena. Interviewees who were relatively new in their profession pointed out that they were not going to work with social assistance for long. Generally, the work was perceived as quite stressful, especially at the end of the month, but at the same time “never boring”. New things happened all the time and they constantly had to deal with clients´ different kinds of “acute crisis”.
Social workers explained that in their work they faced structural problems such as lack of jobs for clients with reduced working capacity because of ill-health, and for clients with a short educational or an immigrant background, especially with limited knowledge of the Swedish language. It was a complicated task to try to find solutions for groups and individuals, when the opportunities and possibilities were limited by the societal context, and when the goals and expectations among different actors differed. Their possibilities as social workers to solve these kinds of problems were limited.
"“…in Sweden we have politics aiming at providing equal opportunities for all people but at the same time there is a directive to be restrictive and careful when granting for example sickness benefits…There is a double message in this…How can we have an ideology emphasising equal worth of all people and equal participation in society, but at the same time restricting…people´s return to the labour market?” (Olivia)"
Sub-theme one: Dilemmas in the interaction between social workers and clients
Social workers both supported and made demands on their clients to do specific tasks. How they managed to handle this dual role, and to treat clients as individuals, influenced the trust between social workers and clients, which was described as essential in work with long-term clients in particular.
Balancing the dual role
In interview accounts we found the dual roles of social workers as a recurrent concern: on the one hand social workers demanded and expected clients to do certain things and on the other hand had to act as support, help and guide for them. The demands made by social services included the requirement that clients actively seek jobs and participate in training and other activities to which they were referred. The helping part of the work consisted of trying to find solutions to clients´ problems as well as building trust in the client-professional relationship. It was sometimes problematic to combine these two roles, as Helen expressed:
"“We work with exercising authority and it includes both support and help but also some suspicion and control. Suspicion and control are the tough parts, but we have to find a balance there.”"
How social workers shared their time between exercising authority and supporting clients varied. Social workers stated that they work under the legal framework and follow the rules of their organization, but they still had some discretion to decide how to work at “micro level”.
"“I feel I can control pretty much myself … If I choose a client who I want to work with in a special methodical way … then maybe I choose this client now this month … and then I take someone else in another month…I have never been able to work with them all at once.” (Sonja)"
A focus on assessment and administration related to monthly payments was an essential part of the work and in many situations, especially when the caseload was heavy, this dominated the helping and supporting part of the work. Some social workers talked about their desire to do “real social work”, by which they meant supporting people to change their lives.
Interviewees with long experience talked about the importance of accepting the dual role and even using the role of an authority as an instrument to “push their clients to change”. Some, who were new in their profession, on the contrary, reported that they had to follow and act according to the rules and regulations, sometimes against their own convictions. The need for negotiation between clients and social workers was obvious, especially when the goals differed between the two. This was illustrated, for example, by clients´ participation in activities that social workers referred them to. Many cases were described where the clients did not see the activities as meaningful.
As a public official, the social worker had to make decisions about “acceptable” solutions in line with the organisational rules, regulations and practice, and inform the client about the rules and other possible solutions to support themselves. They had power in relation to the clients, which several social workers suggested should be more reflected in their working organisations:
"“You have extensive power as an authority towards clients. You make decisions…you have access to allocating money. We have to be aware of this role…and understand what power we have over people…to be humble in interaction with the clients.” (Lisa)"
Obligations vs. rights of the clients
Obligations and rights of the clients were discussed in the interviews with emphasis on clients´ obligations as social assistance recipients. Some clients were perceived to demand their rights, but did not recognise their own obligations. During recent years, with economic constraints, the control and demand on clients had become more central in social assistance. One interviewee explained:
"“There are those clients who think social assistance is a right without obligations. One cannot just receive money because they do not have any…it is not that simple. It has always been so, but it was much easier before. Now there is more control. We have to do a lot of paperwork…and we have to find out how clients live, with whom they live…tax papers, bank statements, and transactions…”(Irma)"
Expectations from social services towards clients were discussed as something positive in the long run for the clients. The provision of money alone was not seen as a long-lasting solution. According to most interviewees, when social workers expected and demanded that clients do things, and encouraged their clients’ belief in their own capacity to solve problems, this could in a long run help clients out of benefit recipiency into independent life.
"“…you have to place the responsibility on the individual and you have to make demands. You have to bring out the strength of the individual…I believe that if you make demands on people, they usually also find solutions to their situation.” (Ulla)"
Clients recognised as individuals vs. seen as categories
Clients were described as a heterogeneous group of people with differing needs and obstacles. The attitudes of social workers towards different clients and client groups influenced the way they described their interaction with their clients and also partly formed the expectations they had of them. Involvement of clients in the planning of their own cases was discussed as something that should be developed.
"“…it is the social worker who writes the action plan or planning … when we as an authority suggest something, the client agrees…This is a really big area to develop, to include small steps, not these huge jumps forward but small steps, which the client agrees to. And this should be discussed and revised during every visit.” (Helen)"
The social workers perceived that it was important for clients to be treated as an individual. With a high caseload, however, there was little time to meet clients and get to know them as individuals, and they were referred routinely to certain activities. During the economic recession of the 1990s, the average social worker caseload was described as high, especially in some of the study areas. One interviewee compared her work during and after recession:
"“Last fall, I had 139 cases. But now when I have 50 … now I see that I could not have done a good job … it became of course emergency-driven. … Right now…I know who the clients are, I know where they are, in which phases … If they are going to move forward I must also be able to meet them frequently.” (Rebecca)"
Interviewees had different attitudes to certain client groups, with more sympathy for some than others. In most areas, social workers had the opportunity in their working teams to reflect on their reactions to different clients and how to handle these feelings. In general, it was perceived as easier for a single person than for families with children to live on social assistance. Overall, interviewees felt strongly for children, and many discussed the negative effects for children of living long term on social assistance, like poor self-esteem and feeling as a burden to their parents. Interviewees reflected on how it was for children to live in families with low income for a long time.
"“…children see that the other children have bicycles or skates. You perhaps never get new skates, but used ones. Children I think are quite aware of these kinds of things…My children can also get used ones, but they know that we can afford to buy new ones if we want to. We have made a choice how to use our money. …These families cannot afford this little extra, they live on the margin all the time. They have no possibility to choose.” (Ylva)"
Young adults, with difficulties to enter the labour market, were identified as the most important group to prioritise and work with. The common statement among the interviewees was: “young adults should not start their adult life on social assistance”. They were also prioritised; the aim was to handle them quickly in order to prevent passivity. In several interviews, young adults were compared favourably to older persons with addiction problems, who were seen as less deserving.
In the interviews, social workers mentioned that it was “easier” to work with clients who were motivated, willing to develop, to find solutions in their life situation and to accept the prevailing normative values, like the notion that both men and women should work to support themselves. Clients perceived as “unmotivated” or as not willing to share the goals of social workers and social services were seen as difficult. Interviewees also described frustration, when they talked about people who tried to cheat or applied for social assistance when not entitled to it. In these cases, social workers felt that they had spent their time and energy “for nothing” while clients “who really are in need” got less attention.
Many clients received social assistance for a long period of time. Social workers therefore found it important to create a relationship, but building trust with clients took time. The disadvantaged position, and in many cases different cultural backgrounds of the clients, added to the clients´ suspicion and was not conducive to trust.
"“A person, who comes here is suspicious… what is this about… you meet an authority. As an authority you influence people’s lives with money. But if you start to inform in a good way and explain our role and make it clear that we are here to help…then suspicion can change into trust that your social worker doesn’t work against you, but with you.” (Karin)"
In the interviews, expectations of clients towards social services and social workers were reflected. Many clients were immigrants and refugees from other parts of the world, and some of them had limited knowledge about the Swedish social welfare system. Social workers reported that clients’ expectations of Swedish social services were often high:
"“… they cannot see the difference between social services, social insurance office, child allowance or whatever… and they have hopes and expectations that we can solve everything…: we can fix apartments, we can fix day care for children tomorrow…But we don´t have these possibilities. And we feel a huge frustration and disappointment directed towards us…” (Ingrid)"
Interviewees also discussed difficulties in building trust and making progress with clients who were ‘hard to reach’ and had difficult life experiences behind them, often combined with years of contact with social services. The importance of not losing hope was emphasised.
Sub-theme two: Societal influences on the interaction between social workers and clients
The societal context forms a framework in which social workers operate. For most clients the receipt of social assistance required collaboration between different agencies like health care services, the social insurance office and unemployment office. Exit from social assistance might require medical rehabilitation, work practice or medical certification for disability pension. The differing views and expectations on clients among the various agencies, as well as the overall construction of the welfare system, were considered of great importance.
Authorities conflicting views and expectations of clients
Different demands by different agencies, or conflicts between them in their views on the clients, were common. Social workers described how clients often had to balance between the differing demands. A joint plan between the various public agencies was lacking concerning the clients seeking support from different authorities.
Several interviewees stressed that those working with social assistance were seen as “the bad guys” by other public agencies, who had difficulty in understanding the rules and demands they as administrators of social assistance had towards their clients, as well as social workers´ emphasis on putting responsibility on clients, instead of helping them “too much”.
"“It upsets me, when the other actors involved are calling and nagging… they question our decisions and judgments. It is very, very frustrating… that you put so much energy into explaining, not only to the client … but also to other professionals, who do not behave professionally… They call and say we have to grant social assistance.” (Ulla)"
Cooperation between different units within social services, as well as with other actors like health care providers, was part of the daily social assistance work. Situations where cooperation was lacking were described, and where the goals between different agencies towards their clients differed. More contact with the various services involved and understanding of their different ways of working with the same clients was needed.
"“…we need a better contact with social insurance office and unemployment office for example. Meet each other. To sit and discuss…how we think about different things. That we could agree on a joint way to think, and increase the understanding for each other’s work… (Emilia)"
Labour market opportunities and overall policy context
Social assistance is the ultimate safety net in the Swedish society. Hence, people in need of financial (and other support), who are not entitled to social insurance or unemployment benefits resort to seeking social assistance. How the society and welfare state institutions function in general has a great impact on which clients seek social assistance and the needs the clients have. Birgitta who worked mainly with immigrants and refugees described the heterogeneity among her clients:
"“All clients are different. We have unemployed with mental or physical disabilities who are not covered by social insurance. We have those who are fit to work but who don´t know Swedish language. Then we have those, who are seeking jobs, but have not been successful."
Interviewees concluded that to a great extent, especially in disadvantaged areas with high unemployment and many refugees, they work with structural problems realised at individual and group level. One example was the lack of opportunities on the labour market for people with reduced working capacity. Much more effort was called for, not least in areas with many clients with differing backgrounds, health problems and multiple needs:
"“… You need more options. Some older men, for example. Their feeling is that they are retired although they may be in their 50s…we need alternative employment without significant demands on either Swedish language or strict attendance, but participation instead … They would never consider to work because they are so sick, but there is no medical certificate showing that. (Irma)"
Interviewees also considered that there was still much to develop in terms of Swedish language training for immigrants and ways to enter and remain on the labour market, especially for the majority of clients, who have few years of schooling. For many clients it took years to find a job and to learn the language. Prompt efforts from social and welfare services to the clients were seen as crucial.
Interviewees found it difficult to solve the income problems of clients with low education, often combined with other obstacles. A feeling of “constant failure” in life was described among many clients; clients tried to solve their situation without success. The goal in social assistance work according to all interviewees was to assist clients to support themselves in other ways than social assistance. Their task was to use their knowledge and effort to strengthen the individuals to find alternative solutions. In those cases, where it was not possible, they aimed to work for better quality of life among clients with the final aim of minimising social exclusion.
"“They [clients] should become a part of the society. Often they are a bit outside, they are falling out somehow, they are isolated…” (Ellen)"