Every year, Riksbankens jubileumsfond (RJ) publishes an essay collection on a current topic. Its aim is to provide a snapshot of the breadth and quality of contemporary research in the humanities and social sciences. In 2023 seven researchers have contributed texts on the theme of THE DEADLY SINS IN OUR TIME, presented as individually bound essays in a box set. This chapter - Lust, from fornication to dating apps - gives a broad picture of sexuality within a historical and cultural conctext and discusses wheter sexuality and desire is a deadly sin todat or not.

Children’s in-session involvement in child and family therapies correlates with both positive and negative treatment outcomes. Thus, it is important to gain a better understanding of the clinical practices that facilitate children’s involvement in therapy sessions so that practitioners can employ them with greater precision. To address this need, we conducted a study to answer the following question: What clinical practices facilitate children’s in-session involvement in child and family therapies? The data consisted of 16 extant audiovisual recordings of child and family therapy sessions and 24 stimulated-recall interviews with the participants in the recordings. Following constructivist grounded theory and incorporating storyline as an additional analytical technique, we have constructed a framework consisting of four involvement-enhancing practices: managing time, staying relevant, adjusting intensity, and facilitating inclusion. Furthermore, by detailing some of the complex processes that practitioners navigate when they facilitate children’s involvement, our study adds a multilayered and dynamic dimension to the list of already established involvement facilitators. It may be used to moderate an overstandardized work culture that continues to characterize services that address children’s needs. The results may be applied to other institutional encounters, providing resonance beyond the analyzed therapy sessions.

Objectives 

Health inequalities exist among children in Sweden, and one effort that the Swedish government has focused on to promote health among small children and their parents is an extended home-visiting program during the child’s first 15 months. This study aimed to illuminate healthcare professionals’ experiences of meeting parents in different social situations during the home visits within Grow safely. 

Methods

The chosen method was qualitative, and 13 interviews were carried out with healthcare, social, and dental professionals working with the extended home-visiting program within the child healthcare in the south of Sweden. 

Results

The results revealed that the parents raised differing needs in the meetings with the healthcare professionals in the program. The needs included advice on children with special needs, support with problematic breastfeeding, and more psychosocial support. The professionals met different groups of parents, such as young parents or newly arrived migrant parents, that in different ways needed the team to reach out to them. The professionals also met families who came from better-off areas and who were not initially considered to really need the program. As the program progressed, these parents could see that diverse, unpredictable needs could be met by the intervention. For example, the program provided access to and advice from social workers, which in turn created contacts that lasted longer than the program itself.

Conclusions

The professionals encountered various family situations and needs within the extended home-visiting program. This highlights the need for a close collaboration between child healthcare nurses and social workers, in order to be able to support the families and work towards the aim of reaching equal health among all children in Sweden. 

Background: Parents of teenagers who use illicit drugs experience a high degree of family burden and mental health issues but have received little attention in research. the aim of this study was to gain new knowledge of the situation of parents of teenage children with drug use.

Method: Fifteen semi-structured qualitative interviews were conducted with parents who received support or treatment with their teenagers at outpatient treatment clinics in sweden. the data was analyzed with thematic textual analysis.

Results: Based on scheff ’s theory of emotions, four central themes were identified in the parents’ experiences: parental strategies, shame, coping with stress, and communication as a protective factor. Parents had a heavy family burden and reported problem-focused and emotion-focused behaviors which created shame, impaired communication between parent and child, and a lack of trust. shame may shape the parents’ discomfort in seeking help from relatives and professional support.

Conclusions: clinical practice should pay attention to the impact of shame, behavior patterns as vulnerabilities and protective factors, and how communication and understanding can be developed. We argue that scheff ’s theory of emotions is useful to understand parents in crisis and that its concepts may be of use if applied in family support.

Background: Social work with people who use drugs (PWUD) has traditionally focused on abstinence and rehabilitation. In recent years, harm reduction has gained an increasingly more important role in social work with PWUD, and social workers are key professionals in many harm reduction services. This study investigates how social workers in harm reduction services for PWUD in Sweden understand the concept of harm reduction and how it relates to goals of rehabilitation, and how they assess and deal with dilemmas and challenges in everyday work.

Methods: The study is based on interviews with 22 social workers in harm reduction services for PWUD in the Scania region of Sweden. A thematic analysis in three steps was used in coding and processing the data.

Results: The social workers pointed to similar values between social work and harm reduction and argued for combining the two fields to improve services for PWUD. Three overarching principles for Harm Reduction Social Work (HRSW) were developed based on the social workers accounts: (1) Harm reduction is a prerequisite for rather than a counterpoint to rehabilitation and recovery, (2) motivational work must be non-mandatory and based on the client's goals, (3) a holistic perspective is crucial for Harm Reduction Social Work. Challenges in doing HRSW concerned restrictive laws, policies, and guidelines, resistance from managers, difficulties in setting boundaries between client autonomy and life-saving interventions, and the risk of normalizing high-risk behaviors.

Conclusions: We use the concept of Harm Reduction Social Work to show how social work with PWUD can have a primary focus on reducing harm and risks, while at the same time it involves a holistic perspective that facilitates motivation and change. The suggested principles of HRSW can provide guidance in practical social work with vulnerable PWUD. Social workers can have important roles in most harm reduction settings and may act to enable recovery.

Single mothers with a foreign background and their children are a growing group within the homelessness population in Sweden. However, they are also more likely to live in “hidden homelessness” than other groups and are therefore less visible in official counts, a factor that contributes to misrepresentation and misrecognition of their living circumstances. In recent years, this invisibility has been exacerbated through new guidelines that delimit target groups, including families with children, and put stronger emphasis on the individual’s responsibility to solve their own housing situation regardless of structural constraints. This article outlines the experience and impact of those changes as articulated by single mothers affected by homelessness and housing exclusion in the greater region of Stockholm. The findings presented show aspects of experiences of homelessness and encounters with social services that tend to be invisible in official accounts in Sweden. They further illustrate the difficulties and harmful impact on vulnerable women and children of a system that primarily focuses on exit and individual deficiencies.

In Sweden, during the parliamentary election campaign in 2022, birth control and family planning were identified as practices that could solve all variety of social problems, from poverty to crime. They were also presented as a solution to migrant women’s supposed lack of integration into Swedish society.

Criticism towards discourses and policies of family planning is extensive, from scholars challenging the notion of ‘voluntariness’ to those arguing that, in family planning, women’s lives are subordinated to economic and developmental goals. While contraceptive technologies hold an impressive emancipatory power in the lives of women globally, vulnerable groups of women have, in the name of family planning, experienced forced sterilisation and reproductive coercion.

This chapter aims to analyse political discourses and governmental policies on reproduction through the conceptual lens of reproductive racism. We hope to challenge what we identify as historical amnesia concerning Swedish ‘family planning’ and show how, in different ways, reproductive rights in Sweden are inscribed and embedded into racial inequalities.

The empirical material presented here has been collected with the aim of illustrating governmental policies that historically and today shape and frame diverse forms of reproductive racism with a special focus on welfare professionals.

Introduction

Experiences of sexual harassment are common among university students. At the same time, research shows that victims and bystanders find it difficult to determine when an incident meets the criteria for sexual harassment. The aim of this study therefore was to obtain a richer and deeper understanding of the obstacles that university students encounter in identifying sexual harassment in the academic environment.

Methods

Individual interviews and focus groups were conducted with a total of 85 students at the bachelor’s, master’s and doctoral level in five European countries (Belgium, Croatia, Germany, the Netherlands and Sweden) between 2020 and 2022. Thematic analysis was used to identify obstacles in identifying sexual harassment.

Results

The obstacles described by participants were found to fall into three main categories: (1) preconceived notions about what constitutes sexual harassment that did not necessarily concur with lived experiences, (2) navigating an often blurred or ambiguous line between acceptable and unacceptable behaviour and (3) the existence of competing interpretations of what had happened.

Conclusions

The results point to a gap between the participants’ lived experiences and their interpretations of them, which include difficulties positioning their experiences within their theoretical understanding of sexual harassment.

Policy Implications

Measures to counteract the obstacles faced by victims and bystanders in identifying sexual harassment in academia should target this cognitive gap, for instance by addressing the stereotypes that characterize preconceived notions about sexual harassment.

Within the confines of the receding Swedish welfare state, family homelessness and poverty are on the rise among one-parent families, in particular those headed by a single migrant mother. This development follows a trend that is noticeable across advanced welfare states, where female-headed households are facing an increased risk of being locked into vicious circles of low-paid work, inadequate income protection schemes, and porr housing options. Drawing on the findings from a PHD research project that traced the experiences of precariously housed single migrant mothers in greater Stockholm over time, this paper offers a critical perspective on current restrictive policies and practices that seek to impose "discipline" on mothers in poverty. It suggests that the intersection of weak safety net programmes for homeless families and discipining measures imposed through the social assistance scheme, risk exacerbating precarity and vulnerability rather than offer support or solutions. As a result, it is argued that there is an urgent need to reassess and re-imagine social work practice with vulnerable and precariously housed families in Sweden from both an ethical and political perspective. 

The basis of this article is a follow-up study of a cohort of pupils in the third largest city of Sweden, Malmo. The pupils finished fourth grade at compulsory school in 2008. We have data about every individual in the cohort as well as corresponding information about their parents. The information concern educational choices, educational accomplishments, employment relations, incomes from work and different kinds of social benefits and allowances. We got annual data on these variables from 2008 until the last follow-up year 2019 when most of the individuals were 21 years old. Most of them left upper secondary school in 2017 when they were 19 years old. They were therefore in the beginning of their transition 2019, either aiming for education or work. The results show that vocational education generated favourable conditions for work and incomes provided that the diploma goals ware reached. Individuals with foreign background and with unfavourable socioeconomic origins were overrepresented among those that didn't reach the diploma goals; this was true for students on VET-programmes as well as higher education preparatory programmes. It should also be mentioned that experiences from a national programme in upper secondary school generally improved conditions for establishment. Those that didn't reach the goals of compulsory school and weren't eligible for studying at a national programme met the greatest difficulties in finding jobs and decent income levels.

Young LGBTQ+ people are over-represented in various forms of state care. They experience hardships during their placements and staff competence in addressing specific needs among LGBTQ+ youth is lacking. In this article, we investigate whether and how LGTBQ+ issues are considered and described in digital marketing for state care providers. The material consists of the homepages of residential care homes and secure state care institutions, which we analyse using critical discourse analysis. The results show that LGBTQ+ issues are largely invisible. Of the approximately 1,000 existing state care providers, only twenty stated that they worked with or had competence in LGBTQ+ issues. Among these, no secure state care institution offered LGBTQ+ competence at the time of the study. The descriptions of how care providers work with LGBTQ+ issues are characterised by heteronormativity where there is a mix of two types of language on the homepages regarding LGBTQ+ youth; on the one hand, a heteronormative, traditional description based on a binary understanding of gender; and, on the other, an LGBTQ+ inclusive language is used. However, the LGBTQ+ affirmative language has been imposed upon the traditional rather than being integrated into it, which comes across as superficial and unclear. International studies show that LGBTQ+ youth are over-represented in various forms of state care. Using critical discourse analysis, we investigated how LGBTQ+ youth, as a target group, are described and how LGBTQ+ competence is presented on the home pages of residential care homes and secure state care institutions for young people in Sweden. The results show that LGBTQ is largely invisible. Of the approximately 1,000 existing residential care homes, only 20 stated that they worked with or had competence in LGBTQ+ issues. No secure state care institution offered LGBTQ+ competence at the time of the study.

Introduction: A dominant narrative, referred to as “the standard tale,” prevails in popular representations about female genital cutting (FGC) that often contrast with how cut women traditionally narrate their FGC experience as meaningful in contexts where FGC is customary. However, scholarship has increasingly highlighted how global eradication campaigns and migration to countries where FGC is stigmatized provide women with new frames of understanding which may lead to a reformulation of previous experiences. This article subjects the storytelling itself to analysis and explores how participants narrate and make sense of their FGC experience in a post-migration setting where FGC is stigmatized.

Methods: Semi-structured focus groups (9) and individual interviews (12) with Swedish-Somali girls and women (53) were conducted.

Results: The article highlights how the participants navigate their storying in relation to "the standard tale" of FGC in their efforts to make sense of their experiences. Navigation was conducted both at an intrapersonal level through continuous identity work, and in relation to the social context in interpersonal encounters, i.e., with service providers and others, among whom the standard tale has become a truth.

Discussion: The article places the analysis within broader discussions about anti-FGC work and considers the implications in relation to efforts to end FGC.

Growing evidence suggests that young migrants are particularly vulnerable to sexual violence. As young migrants often lack family and social networks, professionals are often the recipients of disclosures of sexual violence. This study aimed to explore how professionals experience young migrants' disclosures of sexual violence. A qualitative design was used, based on 14 semi-structured interviews with a range of professionals from the public sector and civil society in southern Sweden. The data were analysed using qualitative content analysis. The overarching theme developed was 'coming across the hidden problem of sexual violence in an excluded population' supported by three sub-themes: 'linking structural marginalisation and vulnerability to sexual violence'; 'realising that sexual violence is one among many other concerns'; and 'taking pride in backing up young people betrayed by society'. Professionals expressed a strong sense of responsibility due to the complex vulnerabilities of young migrants and their lack of access to services. This, coupled with the lack of clarity about how to respond to disclosures of sexual violence, can lead to moral distress. There is a need to strengthen support for professionals, including recognition of ethical dilemmas and the establishment of formal connections between organisations making access more straightforward and predictable.

Many faith-based organisations (FBOs) provide social work services to marginalised groups in need of care such as people who use drugs (PWUD), but little is known about how diaconal or faith-based social work with PWUD is carried out and how staff view their work. The aim of this study was to explore how social work with PWUD within FBOs in Sweden is conducted. This study is based on semi-structured qualitative interviews with 14 employees at a range of churches in Sweden. The empirical material was analysed with qualitative textual analysis. FBO staff channeled a personal calling to offer services through their organisations and found PWUD be in need mainly of emergency support. Staff engaged in boundary work such as differentiating between activities conducted at the church premises or on the streets. Staff accompanied clients to meetings with publicly funded welfare services to the benefit of the clients, and they appreciated their free role compared to social services staff. FBOs mainly act as stabilisers in relation to official public welfare services. The role of prophetic diaconal work aiming at social justice was limited and clients’ emergency needs were in focus, which indicates that FBOs in Sweden mainly complement welfare state services.

In the last decade, digitalized automated decision-making (ADM) has been implemented in many Swedish municipal social services to achieve values such as legal security, client empowerment and time efficiency. The paper aims to understand how ADM policy is legitimized and performed through time efficiency, by a comparison of ADM policy in two Swedish municipalities’ social assistance agencies. It builds on 17 interviews with managers and professionals in two Swedish municipalities’ social assistance units. Findings show ADM is legitimized through arguments of activation and relationships, and performed by handling more applications or increasing time spent with clients, rather than being perceived as increasing the quality of social assistance services. This highlights the significance of organizational goals regarding how street-level bureaucrats perform tasks within their discretionary powers.

The relationship between stability and change is a central paradox of administration that pervades all forms of organizing. Evaluation is not unfamiliar with paradoxical objectives and roles, which can result in tensions for evaluators and stakeholders. In this article, paradoxes between stability and change in the implementation of evaluation, and responses to them, are investigated through the case of social investment funds in Swedish local government. From interviews with staff, managers, and evaluators, findings show how responses to four main paradoxes give priority to top-down summative evaluation that produces instrumental knowledge on outcomes and costs for decision makers. The responses show that the concept of social investment fund evaluation is elastic to contain paradoxes and address different audiences. Also, paradoxes within the structure of the organization develop into paradoxes concerning the roles and goals of evaluation, raising the question of whether individual actors can deal with paradoxes.

Summary: The COVID-19 pandemic has dramatically changed the possibilities for people to interact and communicate. This article examines Swedish social workers’ experiences of the extent to which the COVID-19 pandemic has affected the use of digital tools in their work, and whether this use has affected the social worker–client relationship and their stress levels. The article draws on a web survey (N  =  541) via a quantitative analysis of responses and a qualitative analysis of answers to an open-ended question.

Findings: Most respondents agreed on experiencing increased use of digital tools in the relationship with the clients, increased skills in using digital tools, and a more positive view of digital tools in the social worker–client relationship. However, experiences on whether stress levels had increased and the relationship with the clients worsened, were divided. Age correlates positively with increased stress levels, and social workers working with social assistance, as well as women, are more likely to agree on that the relationship with the clients has worsened. Responses from open-ended questions highlight a rapid shift where social workers have gained a more positive view of digital tools, that video meetings can increase efficiency and flexibility, but also work environment problems.

Applications: This article contributes with useful insights into how the use of digital tools during the COVID-19 pandemic has changed and affected stress and the social worker–client relationship. It can support discussions on the future implementation of digital tools in social work after the pandemic.

The overall aim of the chapter is to contribute to the discussion on how teachers’ facilitation of classroom interaction can be understood in view of mono- and bi-/multilingual norms, and more specifically how teachers relate to, make use of, and strengthen children’s epistemic authority through language competences in the multilingual classroom. The analysis is primarily based on two sets of data. First, teacher interviews which answer to what problems and solutions teachers experience concerning teaching and learning in the multilingual classroom, and how they view their role as facilitator of dialogue and a promoter of agency and hybrid integration in relation to this. Secondly, video-recordings of classroom interaction in selected European localities teachers’ facilitation of dialogue were explored with regard to considering monolingual and bi-/multilingual ideologies and the promotion of hybrid integration. The analysis shows how the monolingual ideology permeates the data material. Students’ multilingual resources are not recognised and valued; consequently, multilingual students’ agency and epistemic authority is hindered. However, there are glimpses of “cracks” where spaces for alternative practices can be developed, in which students can use their full linguistic repertoire, including varying named languages to express their views or ideas beyond the language of instruction, which create potentials for strengthening students’ participation in classroom interactions. The chapter argues that children’s language competences should be integral to understandings of their epistemic authority and calls for further research into how strategies that accomplish this can be developed and transferred across classrooms and localities, with the purpose of strengthening all children’s epistemic authority in education.

Background

The goal of the Swedish child healthcare system is to reach all children with health-promotive actions and to create equal health opportunities for all children. In that context, an extended home-visit program – called Grow Safely – for first-time parents, with an interprofessional collaboration between child healthcare nurses, midwives, social workers, and dental assistants, was initiated. The current study aims at illuminating and evaluating the health, social, and dental professionals’ experiences of working within this program and how such collaboration could benefit the professions.

Methods

A qualitative method was chosen, and 13 interviews were carried out with professionals working within child healthcare centers that participated in an extended home-visit program in the southernmost part of Sweden. The interviews were analyzed via Burnard’s approach to content analysis.

Results

The results showed that it was satisfying for the health, social, and dental professionals to work with the home-visit program and that they encountered positive feelings among the parents receiving it. The creation of deep conversations and parents opening up about feelings that could otherwise be shameful to express, was a positive aspect of the home visits. A negative aspect was the difficulty of handling the (sometimes necessary) interpretation over the phone during the visits, and another one was the fact that the visits were time-consuming and required logistical planning. Overall, the professionals were positive about the home-visit program in that they felt that they were able to give the families what they needed and to have discussions on sensitive issues. They also appreciated the fact that different professions collaborated in order to reach the same goal. 

Conclusions

This study showed that the health, social, and dental professionals enjoyed working with the home-visit program and that they encountered positive feelings among the parents regarding the collaborative visits being conducted within the home, where the families felt safe and relaxed. Despite the extended time required and the logistical challenges involved, the professionals expressed that the home visits created a deeper collaboration amongst them. 

Imagine a brain in a petri dish in a biomedical laboratory. Not a whole brain, but a part grown with the help of cells. Through this collection of cells, the researchers perform various experiments. It may involve testing different disease models or experimenting with specific drugs to see how the brain cells react. The researchers can also remove, add or turn off specific genes to see how this brain reacts. Through these tests, medical knowledge is produced about the brain, but also about different brain diseases and treatments. Some of this neuroscientific knowledge can give medical understanding for developmental disability. It is knowledge that can be used to create diagnoses and classification systems which strengthen what we as critical disability researchers would call the medical model. These diagnoses and classification systems are not defined entities, but heterogeneous parts in the medical model. They are, one could say, in various ways linked back to the brain cells in the petri dish. The different parts are an assemblage where the medical knowledge about a specific developmental disability are linked to the materiality in the laboratory, as well to the doctor at the hospital or the person seeing the doctor. In this way, we as disability researchers might be able to transform our cultural framework, we use to criticize the medical model and turn this critique to the laboratory. Is the medical researcher´s work with the brain cells in a petri dish a practice that (re)produces not only the assemblage of what developmental disability is, but also the stigmatized and negative identity that many times exists in society around this disability? In this paper I want to elaborate critical disability theory to see if it can be used to understand the knowledge production practices in and outside the biomedical laboratory.

This paper explores how people with disabilities encounter and manage limits and uncertainty within the Swedish healthcare sector. Previous research has pointed out that individuals with different forms of disability often meet health-care professionals that lack knowledge about their specific conditions. These limitations have also been defined as a form of medical paternalism, where the professional's knowledge is emphasized over the patient’s knowledge. Within disability research, this displacement has been categorized as a medical model in contrast to a social model where the patient's body is not the focus, but rather the context in which the individual lives. This is a theoretical model that can be viewed through cultural analytical lenses to explore liminal healthcare practices. This paper addresses these questions based on interviews done with people who have lived with disabilities and their experiences of seeking care in the healthcare sector. What kind of embodied experiences of liminality do they have in relation to healthcare? How do they navigate health inequalities in relation to liminal spaces of healthcare? In what ways does this create uncertainties in everyday life for people living with disabilities? One of the findings in the interviews is that it is not only the professionals’ lack of knowledge that generates inequalities, but also the material infrastructure in, for example, the hospitals. Therefore, in this paper it will be suggested that the medical model from disability research should also be elaborated with cultural analytical perspective on material culture.

This poster will present our ongoing work with implementing an international, research based training resource on Frontline Practice Leadership (FPL) within group homes for people with intellectual disabilities and autism. The aim is to examine the context in which the work is performed, and whether FPL can be adapted and used by Swedish disability services and thus contribute to strengthening employees in occupational roles responsible for Practice Leadership. This special form of group home is controlled by the Swedish LSS law and that shall provide users with support and care based on their individual needs. LSS stipulate how users should be able to live like everyone else, promote equality and full participation in everyday life. At the same time, this form of accommodation sometimes creates ethical dilemmas when supporting the users' right to self-determination. This poster focusses on those ethical dilemmas, and what it means to work and manage operations within LSS housing and clarify the problems that exist around leadership when ethical dilemmas arise. Together with (+) 60 service pedagogue’s various empirical collections have been made: individual interviews, focus group interviews, observations and surveys. The poster will raise questions related to implementation of new working methods and emphasizes the significance of a comprehensive working model for person centered support. Furthermore, the concept of quality of life, which is central in FPL, entails in relation to a Swedish context. Finally, the occupational roles that is presented in this poster calls for new support structures regarding education and competence development.

This qualitative study explores student learning progression through reflective writing on a tertiary-level course in social work. The study is based on the content analysis of three sets of data: student reflective writing, instructor formative feedback on this writing, and student end-of-course reflections. Our findings demonstrate that structured, scaffolded reflection and continuous formative feedback stimulated learning progression, increased awareness of one’s own learning strategies, and supported the adoption of an explorative, reflective stance in students. Therefore, the experimental course design with several reflective tasks created the sought-after intersection of the academic and professional literacies. This design stimulated student engagement and resulted in high attendance. This design is particularly suitable in heterogeneous classrooms and promotes student inclusion and active learning.

Background/Aim: Opioid overdose deaths have increased in Sweden and other developed countries in recentdecades, despite increased treatment efforts and harm-reduction interventions. Furtherknowledge in this field is needed if this trend is to be reversed. Previous research suggeststhat mental health and patterns of prescription of opioids and other prescription drugs areassociated with increased opioid-related mortality. The present study therefore aimed toinvestigate what drugs were prescribed during the last six months of life to individuals with ahistory of illicit substance use who died with opioids present in their blood, the relationshipbetween drugs prescribed and drugs found in blood at time of death, and if prescription ofspecific drugs was temporally associated with death.

Methods: This was a retrospective, register-based observational study that utilized data from theNational Board of Forensic Medicine, the Prescribed Drug Registry, regional health careservices, and municipal social services. We used conditional logistic regression to findtemporal associations between the prescription and dispensing of drugs and time ofdeath.

Results: Prescription and dispensing of alprazolam and diazepam were temporally associated withdeath. The most frequently dispensed drugs were zopiclone, pregabalin, methylphenidate,diazepam and oxycodone. Methadone, alprazolam, and buprenorphine were the drugsmost often found in the blood. Opioids and tranquilizers in combination were found in a vastmajority of deaths, and prescription data suggested that the use of these drugs was illicit in amajority of cases.

Conclusion: Prescription of certain drugs, especially alprazolam and diazepam, should be made withgreat caution to patients with a history of illicit substance use or concurrent use of opioids.

Purpose

Drug sales facilitated through digital communication on the surface web and on darknet cryptomarkets have increased during the past two decades. This has resulted in an increase in drug law enforcement efforts to combat these markets and a subsequent increase in judicial sentencing of people selling drugs online. The aim of this study was to analyze how Swedish courts describe sentenced sellers and how the courts apply case law.

Design/methodology/approach

The empirical material consists of 71 sentencing documents produced by Swedish courts in cases of online drug selling between January 1, 2010 and January 1, 2020. In total, 99 sentenced persons occur in the documents. Using a qualitative research design, the authors analyzed the material through thematic text analysis.

Findings

Overall, in their descriptions of online drug sale operations, the courts’ characterizations of the concepts of street capital and digital capital show a dichotomy. These forms of capital are situationally described as both aggravating and mitigating aspects in the application of case law, indicating that it may be fruitful to view both street and digital capital as resources used on contemporary drug markets in general.

Originality/value

Very little research exists into how judicial systems describe and perceive the developing phenomenon of online drug sales. Using a relatively large sample from a decade of sentencing, the authors provide an analysis of how Swedish courts view and valuate capital forms in the online drugs trade.

Purpose: Studies on sexual health following male child sexual abuse (CSA) have identified the negative effects of such experienceson body functioning, but little is known about male CSA survivors’ ability to create emotional and physical closenessin romantic relationships. The purpose of this article is to explore how male CSA survivors perceive, experience and developintimacy in romantic relationships, including both the challenges they face and the positive changes that enable them to growand achieve healthy relationships.

Method: The study has employed a qualitative research approach and is based on in-depth interviews conducted among adultmale CSA survivors residing in Sweden. Participants were recruited through civil society organizations and an ad in a dailynewspaper. Using reflexive thematic analysis, the results are presented in relation to two themes: (a) challenges of intimacy;and (b) building trust and close relationships.

Results: The results show that participants desired couple relationships that included both sexual and emotional intimacy.The challenges of intimacy were related to compromised sexual identity, sexual dysfunctions and compulsions, emotionaldysregulation, and body shame. Efforts to achieve intimacy were facilitated by disclosing abuse experiences, developingemotional bonds or awareness, embracing sensitivity, and having an empathetic and supportive partner.

Conclusions: Reconstructions of abuse histories were both challenged and facilitated by the accessibility of various and shiftingideas about masculinities that co-exist in Sweden, which were important sources for meaning making and assisted themen in developing positive valuations of themselves as men.

The phenomenology of bioethics is approached here in relation to the lived experience as it relates to the everyday lifeworld of persons suffering from mental illness. Taking a road less traveled, the purpose here is to elucidate ethical issues relating to sociality, using findings from qualitative phenomenological psychological research. Qualitative studies of schizophrenia and postpartum depression serve as examples. Layered throughout is the applied phenomenological argument pointing to the importance of returning to mundane intersubjectivity and the reversibility between mental illness, the existential context of suffering, and sociality.

In relation to brain injury rehabilitation, research has stressed the importance of including sexuality issues due to increased risk for sexual dysfunctions after Acquired Brain Injury (ABI). This study aims to explore experiences after non-stroke ABI concerning individual and relational aspects of sexuality, received information about sexuality at rehabilitation, and gender differences. A postal nationwide survey was conducted in Sweden, 2018-2019. The sample included individuals who had participated in brain injury rehabilitation 2014-2016, response rate 40% (250/624). Among all participants 78% had resumed sexual activity, and there was a significant difference between males (84%, 118/140) and females (69%, 76/110, p = 0.004). Among all participants, 95% reported physical intimacy as important, 80% considered sex as important on an individual level, and 91% stated sexuality as important for the relationship (no gender differences). Significantly more females (52%) than males (22%) reported that they had tried sexual aids (p = 0.000), and more males (29%) than females (16%) reported that professionals addressed sexuality issues during brain injury rehabilitation (p = 0.024). However, only a few participants were offered specific sexual counseling during brain injury rehabilitation, such as individual counseling (3%), couples counseling (2%), and group counseling (3%). To conclude, the vast majority valued both individual and relational aspects of sex and sexuality highly, and more males than females had resumed sexual activity. Few had received information about sexuality after ABI, and even fewer females compared to males reported that the issue was raised during rehabilitation. Clinical implications are discussed in relation to sexual rehabilitation.

Welfare state policies, social workers, and institutions are not only key for organizing services and distributing social benefits for those in need, but also play an important role in the administration of migration and in the practices of differential inclusion in the welfare state based on the non-citizens’ legal status. Analyzing 12 key policy documents on the provision of basic social protection to non-citizens in Malmö and in Helsinki, the paper inquiries into what kind of groups of non-citizens are produced through policy categorizations, how the access to social protection for these groups are governed, and what kind of role social workers are ascribed to in this entanglement. Using the WPR-approach and critical frame analysis, the paper suggests that the policies produce precarity, but tendencies of municipal activism in social work are also identified. The findings are addressed through four overlapping policy frames: the production of the underserving subjects-frame; the precarious inclusion-frame; the armed love-frame drawing on the work by Miriam Ticktin; and the municipal activism in social work-frame. The paper contributes to the social work literature on non-citizens’ position in the welfare state by shedding light on how the differentiation of the access to welfare is produced, and how social work is ascribed both to reproduce and challenge this differentiation. 

In this chapter, we discuss how cultural expertise can be used to neutralize stereotyped images of minority cultures in court in female genital mutilation/cutting–related cases because, wisely employed, it may counteract possible negative effects of typification and judicial stereotyping.

Personal ombudsman (PO) in Sweden is a highly person-centered and recovery-oriented practice that strive to support persons living with serious mental health problems. With the foundation in Case Management (strength model in particular) the practice has since been developed and renamed; people living with mental health problems did not see themselves as “cases in need of being managed” (Berggren & Gunnarsson 2010). Personal ombudsman has, together with a few other practices from around the world, recently been highlighted by WHO as an example of good practice as a community- and rights-based approach to mental health (WHO 2021). This motivates the PO-practice to be discussed and shared with other professionals and interested parties as an example of a social pedagogical practice.What type of professional role is needed to be able to work as a PO? To answer this question, I will turn to the phenomenological interpretation of Empathy as a basic type of interpersonal understanding aimed at the experience of others. The main point is that regardless of our capacity to understand how it is to live with serious mental health problems such as schizophrenia we can understand something of how the person is experiencing this condition (Davidson 2003). As I have argued elsewhere (Stigmar 2022), the discussion is aimed to show how a phenomenologically grounded theory of empathy can be used as a means to achieve a close interpersonal relationship that supports shared decision making and recovery from mental health problems. This framework can also serve as a way to uphold and preserve a professional and emotional distance in that relationship. The aim of PO is to support the person with whatever the persons feel is needed and to strengthen the person’s own capacity to make decisions regarding his or her life. That is; a mobilizing empowerment perspective that takes a holistic point of view with a foundation in the recovery movement. The lived experience of others is of crucial value which makes the connection between recovery-oriented practice and phenomenology both necessary and valuable. By actively training to assume the empathic attitude, within a pedagogical context (Boregren 2022), we can increase the possibilities for a professional “we-relation” and minimize the risk for emotional contagion and too much emotional compassion. 

Reports indicate a decrease in youth mental health in Sweden but at the same time research suggests that what is interpreted as mental ill-health could be considered everyday challenges by young people themselves. The distribution of mental health and illness among young people is uneven based on inequities related to factors such as race, gender and socioeconomic status. Sweden in particular is a country with large socioeconomic inequities in youth mental health and in school results, compared to other European countries. The aim of this study was to explore young people's experiences of the role of race, gender and socioeconomic status in relation to everyday challenges. Sixty-five young people aged 13–15 years old were recruited by student health services and participated in focus group discussions at schools in the southernmost part of Sweden. Data were analysed by secondary analysis with deductive qualitative content analysis using Ecosocial theory of disease distribution as theoretical framework. The analysis resulted in one main theme; Navigating inequities to gain and keep social status, with three underlying themes; Guided by social norms, Negative impact in everyday life and Importance of family influence. Participants were aware and critical of norms and expectations related to race, gender and socioeconomic status. Experiences of prejudice and unfairness was both own lived experiences by the participants as well as observed through friends and classmates. Young people spontaneously identify everyday challenges related to race, gender and socioeconomic status, even when not asked directly about these issues. Conforming to sexist, racist and classist, expectations is a way to lose and gain status in a school setting. Many of the inequities discussed related to socioeconomic status and the direct consequences of having or not having money. Young people's everyday experience of inequities is important to consider in youth mental health promotion aiming to tackle health inequities. Further research is needed on those experiences and how this affects mental health.

Through a historization of the Swedish public sector together with vignettes grounded in interviews, this paper questions managerialism in the public sector. The chapter argues for leaderless management as a shift of attention from managerialism toward worker control. The chapter explores what nurses identify as central areas of conflict shaping their work, and what forms of change they view as necessary to create a more sustainable work situation, for themselves and the patients. Workers—not managers—within the public sector are key knowledge bearers in confronting the crisis of care. Inspired by Nancy Fraser’s idea of a care crisis, as well as Erik Olin Wright’s discussion on real utopia, the chapter analyzes how public sector workers frame their work-life. We use this to frame a vision of leaderless management. Specifically, we draw out three arguments for leaderless management of (1) time, (2) caring, and (3) resources. 

Early in the COVID-19 pandemic, social workers at battered women's shelters and night shelters and church deacons in Sweden warned that they were at risk of losing contact with their clients. Thus, even though Sweden was never subject to a lockdown in 2020 or 2021, many of the signals from the social workers indicated that their lost clients were at risk of increased ill health, mental illness, and violence due to the situation produced by the pandemic. The aim of this chapter is to develop a theoretical and empirical understanding of this vulnerable position that was imposed on these client groups by the COVID-19 pandemic. These developments also created fear and worry among the social workers themselves, when it became clear to them that they were at risk of losing contact with their clients. Therefore, the concept of shared trauma is used to focus on the way in which care workers are exposed to similar impacts of collective traumatic events as their clients. From the start of the project in March 2020, a total of 25 different civil society organisations have been followed through short telephone interviews. The method is inspired by rapid ethnographies.

In October 2022, a new employment protection regulation, often seen as a core aspect of the Swedish model of industrial relations, was implemented in Sweden. While the debate around the new regulation was heated, one interesting omission was that, in the unions' advocacy for maintaining various forms of labour market security, the racialised labour market was never discussed, despite a strong racially segmented labour market with varying working conditions. In this article we explore how three white, male-dominated trade unions representing employees in different class locations positioned themselves around the change in the new Employment Act. Inspired by contributions on racial capitalism, we unravel how trade unions take part in the contestation over industrial relations in a context in which neoliberal and ethnoracial policies are growing. Using the 'Swedish model' as an 'empty signifier' - highly variable in meaning, hence contestable - we find that the unions advance three different positions on employment protection regulation: flexible, skilled and protective, and in doing so contribute to the self-racialisation of white male workers in working life.

This study explores how consent has been conceptualized and studied in research on young people’s sexual communication online and through digital devices. By adopting an iterative review method the study maps recent developments within adolescent sexting literature in order to critically discuss how sexual consent is conceptualized within the literature. The review reveals the gendered and technological conditions youth face in their everyday digital sexual practices yet the limited ways in which consent has been considered within the literature. To enrich the recent turn toward consent within sexting literature this paper contributes to the field by drawing on concepts and findings from consent literature and suggests consolidation between the fields. The study further highlights the need to include a concept of consent in sexting literature which considers young people’s embeddedness in heteronormative technologies that reach far beyond their immediate social settings. Lastly, implications for sexuality education and policy are considered. 

PURPOSE: Vaginal changes, a frequently reported late effect among women treated with pelvic radiotherapy, can result in sexual dysfunction and distress. Women are recommended vaginal dilator therapy after completed radiotherapy; however, low adoption has been recognized. This study aims to provide insight into women's difficulties with carrying out vaginal dilator therapy and their experiences of information.

METHODS: Face-to-face, semi-structured interviews were undertaken with 12 pelvic cancer survivors in a selected sample of women with difficulties adopting the therapy. Interviews were audio-recorded, transcribed and analyzed using qualitative content analysis.

RESULTS: One overarching theme, Being unprepared, emerged from three identified categories relating to Experience of received information, Experience of performing the therapy, and Motivation to perform the therapy. The women experienced the information as unrealistic and insufficient, and requested clearer and earlier information. Bleeding, pain, fear of cancer recurrence, and recalling memories from treatments were experienced. Women described intestinal symptoms, fatigue, and feeling that the therapy was self-harm as barriers to performing the therapy. They described creating routines, breathing exercises, relaxation, pre-warming the dilator and performing therapy together with their partner as helpful strategies.

CONCLUSIONS: Careful discussion, early and clear communication, psychoeducation and supportive follow-up of vaginal changes should be integrated into cancer treatment and follow up. Healthcare professionals should be aware of potential difficulties with vaginal dilator therapy and identify women in need of extended support. Research is required to investigate interventions that suit the needs of female pelvic cancer survivors.

The aim of this scoping review was to identify, synthesize, and report research on reflective collaborative learning through virtual communities of practice (vCoP), which, to our knowledge, is scarce. A second aim was to identify, synthesize, and report research on the facilitators and barriers associated with resilience capacity and knowledge acquisition through vCoP. The literature was searched in PsycINFO, CINAHL, Medline, EMBASE, Scopus, and Web of Science. The Preferred Reporting Items for Systematic Reviews (PRISMA) and Meta-Analyses for Scoping Reviews (ScR) framework guided the review. Ten studies were included in the review, seven quantitative and three qualitative studies, written in English and published from January 2017 to February 2022. The data were synthesized using a numerical descriptive summary and qualitative thematic analysis. Two themes: ‘knowledge acquisition’ and ‘strengthening resilience capacity’ emerged. The literature synthesis provides evidence of a vCoP as a digital space that supports knowledge acquisition and strengthens resilience for persons with dementia, and their informal and formal caregivers. Hence, the use of vCoP seems to be useful for dementia care support. Further studies including less developed countries are, however, needed to enable generalizability of the concept of vCoP across countries.

Age-related macular degeneration (AMD) is the most common cause of incurable visual impairment and impacts daily life. These impacts include loss of social activities, decreased functional independence, and reduced physical activity. This protocol aims to describe a prospective, mixed-methodology for studying a population with AMD before, during, and after an empowerment-based physical activity intervention (EPI). A study framework was also developed for EPI. The intervention will include 20 older individuals (age 65+ years) with AMD recruited in Sweden. The intervention period is six months and comprises adapted physical activity and social activities in a group twice a week and individual health coaching on three occasions. The quantitative pre-test and three follow-ups include physical functional tests, an accelerometer that monitors physical activity continuously for one week, and questionnaires. Individual and focus-group interviews and ethnographic observations will explore the experience of living with AMD and what it means to participate in the EPI for individuals with AMD. The chosen methodology offers a structured way for researchers to explore the experiences and factors that may provide insights into the potential of creative supervised, adapted physical activity in groups, health coaching, and socialising that are significant to enable well-being among older individuals with AMD.

PURPOSE: This study investigates whether Acquired Brain Injury (ABI) is associated with changes in sexual function and satisfaction and how such changes are experienced, focusing on invisible impairments after ABI.

MATERIALS AND METHODS: A study-specific questionnaire was distributed in 2018-2019. The sample included individuals aged 20-90 years diagnosed with ABI due to subarachnoid hemorrhage (SAH), trauma, infection, or anoxia (ischemic stroke and intracerebral hemorrhage excluded), who participated in brain injury rehabilitation in Sweden, 2014-2016. Chi-square and Logistic regression analyses were used.

RESULTS: The study consists of 250 participants (response rate was 40%). Among participants 78% (194/250) had resumed sexual life. Participants reporting sexual changes also experienced more consequences related to ABI. Those with decreased sexual desire (63%, 148/234) reported more ABI consequences, including decreased memory (86% vs 65%, p = 0.000), decreased concentration ability (82% vs 65%, p = 0.003), and increased tiredness (91% vs 70%, p = 0.000) compared to those with intact desire. Such consequences can be invisible to others.

CONCLUSION: Visible impairments are known to impact sexual functions and satisfaction after ABI. Our results show how invisible impairments also have a great impact. From a biopsychosocial perspective, these results imply that individuals should receive sexual rehabilitation, irrespective of ABI impairment.

Comparative international studies show that about half of the deceased in the COVID-19 pandemic were persons living in institutional and residentialeldercare. As seniors are the most affected age group, we aim to study if and to what extent the eldercare services were included in theNational Pandemic Plans, and how they were included in the response during the first phase of the pandemic in Finland, Iceland, and Sweden. Weuse the CRISMART approach to crisis documentation and analysis in comparing national response to the pandemic for the eldercare sector. Themethod enables comparison of extraordinary crisis situations from the decision-making and policy-making perspective. We found that there wereboth similarities and differences in the preparedness of the three Nordic countries, as well as in how they responded to the pandemic. In all threecountries the focus of the national responses framed the problem as a health and healthcare services’ problem. We also found value conflicts in theresponse between the value of protection versus social contact and self-determination and hence relating to the quality of eldercare. Keeping in mindthe proportional increase of elderly people, care challenges, and future crises, we must strengthen the position of local social services within theemergency management systems to enhance disaster resilience and sustainability of our societies.