Om förändringar, arbetsvillkor och kunskapsbaserandet av socialtjänsten. En kvalitativ studie av hur utredande socialsekreterare upplever Malmö stads satsning på missbruksvård.

Sammanfattning: ABSTRACT Author: Krista Runersten Title: On change, conditions of work and the evidence-basing of social services. A qualitative study of how investigating social workers experience Malmös concentration on improving the care for heavy substance abusers. [translated title] Supervisor: Anders Giertz Assessor: Hans-Edvard Roos The purpose of this study was to examine how social workers investigating adult substance abusers experience changes regarding their work methods, how the changes influence their conditions of work and how the changes and the social workers themselves relate to the concept of evidence-based practice, EBP. The changes are a result from Malmö’s concentration on improving the social services care for heavy substance abusers. This purpose was explored in qualitative interviews with six social workers and one official clerk. The results were analyzed mainly with the help of Yeheskel Hasenfelds theory of human service organizations and Michael Lipskys theory of the street-level bureaucrat. The concept of EBP was found to be a strong influence in Malmö’s concentration on improvement and as a concept, EBP was also highly held by the social workers although they were not familiar with the theoretical issues and practical implications of EBP in its original form. Changes affecting the investigating social workers included implementation of the new work methods ASI (Addiction Severity Index) and MI (Motivational Interview) as well as implementation of a “guarantee for care”. Comparing the high aims of these changes that are described in documents produced on higher level in the organization, to the social workers descriptions of how they experience the changes in practice; I conclude that the implementation is weakly linked to the official goals. This is often the case when implementing change in human service organizations, due to their characteristic problems with designing and achieving goals. The social workers were more concerned with their conditions of work, which are typical of street-level bureaucracies: large case loads, high demands on documentation and administration as well as restrained resources. In conclusion, the social workers in this study do not yet experience the conditions necessary for becoming evidence-based practitioners. Therefore, the popular concept of EBP is far from implementation, but seems to influence practice on a rhetorical and symbolical level. Key words: change, human service organizations, social services, evidence-based practice, substance abuse.