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Nordgren, J. & Richert, T. (2024). ‘A free position in midfield' – a qualitative study of faith-based social work with people who use drugs in Sweden. European Journal of Social Work, 27(2), 401-412
Open this publication in new window or tab >>‘A free position in midfield' – a qualitative study of faith-based social work with people who use drugs in Sweden
2024 (English)In: European Journal of Social Work, ISSN 1369-1457, E-ISSN 1468-2664, Vol. 27, no 2, p. 401-412Article in journal (Refereed) Published
Abstract [en]

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.

Abstract [sv]

‘En fri position på mittfältet' – En kvalitativ studie om diakonalt socialt arbete med personer som använder narkotika i Sverige

Många diakonala organisationer (FBOs) utövar socialt arbete riktat mot marginaliserade grupper såsom personer som använder narkotika, men vi vet lite om hur diakonalt eller trosbaserat social arbete med denna grupp genomförs och hur personal ser på sitt arbete. Syftet med den här studien var att utforska hur socialt arbete med missbruk och beroende inom diakonala organisationer bedrivs. Studien är baserad på semistrukturerade kvalitativa intervjuer med 14 anställda vid olika kyrkor i Sverige. Det empiriska materialet analyserades med hjälp av kvalitativ textanalys. Personalen kanaliserar ett personligt kall genom att erbjuda sociala insatser via organisationerna och de ansåg att personer med missbruk framför allt behöver akuthjälp. Personalen ägnade sig åt gränsdragningsarbete som att skilja mellan aktiviteter genomförda i kyrkan eller på gatunivå. Personal följde med klienter till möten med socialtjänst för att bistå klienterna och de såg fördelar med den mer fria rollen jämfört med socialtjänstpersonalen. Organisationerna agerar framför allt som stabiliserande i relation till offentliga sociala välfärdsinsatser. Profetiskt diakonalt arbete med fokus på social rättvisa var begränsat och klienternas nödhjälpsbehov var i fokus, vilket indikerar att organisationerna mestadels kompletterar det sociala välfärdssystemet i Sverige.

Place, publisher, year, edition, pages
Routledge, 2024
Keywords
Faith-based social work, diaconal work, social work practice, people who use drugs, trosbaserat socialt arbete, diakonalt arbete, socialt arbete med missbruk, personer som använder narkotika
National Category
Social Work
Identifiers
urn:nbn:se:mau:diva-61803 (URN)10.1080/13691457.2023.2227774 (DOI)001019815700001 ()2-s2.0-85164463167 (Scopus ID)
Funder
Riksbankens Jubileumsfond, P18-0892:1Riksbankens Jubileumsfond
Available from: 2023-08-09 Created: 2023-08-09 Last updated: 2024-04-11Bibliographically approved
Richert, T., Stallwitz, A. & Nordgren, J. (2023). Harm reduction social work with people who use drugs: a qualitative interview study with social workers in harm reduction services in Sweden. Harm Reduction Journal, 20(1), Article ID 146.
Open this publication in new window or tab >>Harm reduction social work with people who use drugs: a qualitative interview study with social workers in harm reduction services in Sweden
2023 (English)In: Harm Reduction Journal, E-ISSN 1477-7517, Vol. 20, no 1, article id 146Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
Drug addiction, Harm reduction, Harm reduction social work, People who use drugs, Recovery, Rehabilitation, Social work
National Category
Social Work
Identifiers
urn:nbn:se:mau:diva-63174 (URN)10.1186/s12954-023-00884-w (DOI)001086757900001 ()37833801 (PubMedID)2-s2.0-85174318108 (Scopus ID)
Funder
Malmö University, P18-0892:1Riksbankens Jubileumsfond
Available from: 2023-10-17 Created: 2023-10-17 Last updated: 2024-02-15Bibliographically approved
Stallwitz, A., Nordgren, J. & Richert, T. (2023). ‘Not having a real life’: psychosocial functions of using and selling drugs among young Afghan men who came to Sweden as unaccompanied minors. Journal of ethnic and migration studies, 1-21
Open this publication in new window or tab >>‘Not having a real life’: psychosocial functions of using and selling drugs among young Afghan men who came to Sweden as unaccompanied minors
2023 (English)In: Journal of ethnic and migration studies, ISSN 1369-183X, E-ISSN 1469-9451, p. 1-21Article in journal (Refereed) Epub ahead of print
Abstract [en]

Unaccompanied minors (UM) entering Europe face significant psychosocial challenges. Uncertain residence situations, marginalization during the asylum process, and low levels of support increase their risk of developing mental health and drug use issues. However, little is known about drug involvement (using and dealing) in this group. This is the first study to investigate drug involvement among young adults who entered Europe as UM from their subjective perspectives. We conducted qualitative interviews with 11 Afghan men who came to Sweden as UM in 2015/2016 and had experience of using and/or selling drugs, and analyzed the transcripts based on grounded theory. Drug initiation usually occurred after arrival in Sweden and was related to peer influence. Using and selling fulfilled specific psychosocial functions including self-medication and money-making. ‘Not having a real life’ (being excluded from school, employment, and many social activities) emerged as a central motive for drug involvement. By using or selling drugs, feelings of social belonging and control over one's own life could be experienced. Long, uncertain asylum processes and social exclusion exacerbate the risk of UM and former UM using or selling drugs. Policy and intervention measures must focus on providing this group with support, social inclusion, and meaningful activities.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2023
Keywords
Unaccompanied minors, Sweden, drug use, drugselling, social exclusion
National Category
Social Work
Identifiers
urn:nbn:se:mau:diva-64820 (URN)10.1080/1369183x.2023.2290984 (DOI)001128558000001 ()2-s2.0-85180208679 (Scopus ID)
Funder
Riksbankens JubileumsfondRiksbankens Jubileumsfond
Available from: 2024-01-03 Created: 2024-01-03 Last updated: 2024-01-04Bibliographically approved
Liahaugen Flensburg, O., Richert, T. & Väfors Fritz, M. (2023). Parents of adult children with drug addiction dealing with shame and courtesy stigma. Drugs: education prevention and policy, 30(6), 563-572
Open this publication in new window or tab >>Parents of adult children with drug addiction dealing with shame and courtesy stigma
2023 (English)In: Drugs: education prevention and policy, ISSN 0968-7637, E-ISSN 1465-3370, Vol. 30, no 6, p. 563-572Article in journal (Refereed) Published
Abstract [en]

The study aims to provide insight into the lives of parents to adult children with drug addiction. We focus on how the parents' social life and interactions were affected by feelings of guilt and shame, and how they dealt with the stigma that often accompanies drug addiction. 32 semi-structured interviews were conducted with parents (age 46-70) of adult children (age 18-47) with drug addiction in Sweden. Three themes emerged (1) Experiences of guilt, shame, and courtesy stigma, (2) Impact on social life and relationships and, (3) Strategies to reduce guilt and shame. Guilt, shame, and courtesy stigma complicated and restricted the parents' social interactions. Many parents applied a selective openness, carried experiences of alienation and in some cases isolated themselves. At the same time, several parents described that they were open about their child's addiction in certain contexts. For some parents, this meant a relief from guilt and shame and an opportunity for increased social interaction. Both informal and professional support for family members of individuals with drug addiction is vital to reduce experiences of guilt, shame, and courtesy stigma.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
Alienation, courtesy stigma, drug addiction, parents, selective openness, shame
National Category
Social Work
Identifiers
urn:nbn:se:mau:diva-54097 (URN)10.1080/09687637.2022.2099249 (DOI)000827486300001 ()2-s2.0-85134374643 (Scopus ID)
Available from: 2022-08-02 Created: 2022-08-02 Last updated: 2023-12-11Bibliographically approved
Houborg, E., Richert, T., Nordgren, J., Bancroft, M. & Hesse, M. (2022). Et sund eller et ocean?: Ligheder og forskelle på stofbrugeres hverdagsliv på de to sider af Øresund. In: Houborg, Esben; Kammersgaard, Tobias; Bach, Jonas; Bancroft, Morgan (Ed.), Byen og Rusmidlerne: Oplevelser, konflikter og regulering. Aarhus: Aarhus Universitetsforlag
Open this publication in new window or tab >>Et sund eller et ocean?: Ligheder og forskelle på stofbrugeres hverdagsliv på de to sider af Øresund
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2022 (Danish)In: Byen og Rusmidlerne: Oplevelser, konflikter og regulering / [ed] Houborg, Esben; Kammersgaard, Tobias; Bach, Jonas; Bancroft, Morgan, Aarhus: Aarhus Universitetsforlag, 2022Chapter in book (Refereed)
Place, publisher, year, edition, pages
Aarhus: Aarhus Universitetsforlag, 2022
Series
Samfund og Rusmidler, ISSN 1904-6987
National Category
Social Work
Identifiers
urn:nbn:se:mau:diva-47038 (URN)9788772193151 (ISBN)
Available from: 2021-11-24 Created: 2021-11-24 Last updated: 2022-08-16Bibliographically approved
Johnson, B., Richert, T. & Svensson, B. (2022). Physical Violence and Property Damage towards Parents, Committed by Adult Children with Drug Problems. Journal of family Violence, 37, 165-180
Open this publication in new window or tab >>Physical Violence and Property Damage towards Parents, Committed by Adult Children with Drug Problems
2022 (English)In: Journal of family Violence, ISSN 0885-7482, E-ISSN 1573-2851, Vol. 37, p. 165-180Article in journal (Refereed) Published
Abstract [en]

Drug use has previously been identified as a risk factor for child-to-parent abuse. We examine how common it is for parents to be exposed to physical violence and property damage by adult children with drug problems, and whether such victimization varies based on factors related to the parents and the adult children, respectively. A self-report questionnaire on victimization was completed by 687 parents of adult children with drug problems. The data were collected via a postal questionnaire to members of the Parents Against Drugs association and a web-based questionnaire to persons recruited via social media, treatment centers and other associations for families of drug users. The proportion of parents who reported having been exposed to physical violence was 19% ever, 6% during the past year. The proportion who had been exposed to property damage was 40% ever, 10% during the past year. Exposure during the past year was higher among parents whose children were currently experiencing drug problems. Mental health problems in the children were associated with higher levels of parental victimization, particularly in the form of physical violence. Parental victimization was also associated with the children being younger and still living at home. Exposure to property damage was higher among parents of male children. Adult children's drug problems are of significance for parental victimization; they do not however appear to constitute a major risk factor but rather one risk factor among several others. Exposure to physical violence is clearly related to the presence of mental health problems in the children.

Place, publisher, year, edition, pages
Springer, 2022
Keywords
Parent abuse, Physical violence, Property damage, Adult children, Drug problems
National Category
Social Work
Identifiers
urn:nbn:se:mau:diva-17909 (URN)10.1007/s10896-020-00181-1 (DOI)000546218800001 ()2-s2.0-85087641307 (Scopus ID)
Available from: 2020-08-13 Created: 2020-08-13 Last updated: 2024-02-05Bibliographically approved
Nordgren, J., Richert, T. & Stallwitz, A. (2022). Police officers’ attitudes and practices toward harm reduction services in Sweden: a qualitative study. International journal of drug policy, 104, 1-8, Article ID 103672.
Open this publication in new window or tab >>Police officers’ attitudes and practices toward harm reduction services in Sweden: a qualitative study
2022 (English)In: International journal of drug policy, ISSN 0955-3959, E-ISSN 1873-4758, Vol. 104, p. 1-8, article id 103672Article in journal (Refereed) Published
Abstract [en]

Background

Since the 1980s, Swedish drug policy has combined a restrictive zero tolerance approach with the vision of a “drug-free society”. However, in recent years, access to harm reduction services has increased through local initiatives and new national guidelines. The possible success of these services may be affected in part by police drug law enforcement. The aim of this study was to explore how Swedish police officers act toward and view harm reduction services in a national drug policy setting of zero tolerance toward drug use.

Methods

Applying a qualitative research design, we conducted 19 in-depth interviews with police officers who worked with drug law enforcement in Malmö. We conducted a qualitative textual analysis of the data.

Results

Officers largely supported harm reduction services and refrained from overtly enforcing drug laws in their vicinity. Officers engaged in boundary work that assigned the responsibility of care of marginalized people who use drugs (PWUD) to the health care system, while including policing of drug market problems, young PWUD and dealers in their own jurisdiction. Opioid substitution treatment was seen as positive, although diversion of medicines was pointed out as a problem. Needle exchange programs were seen as offering important public health services and a no-go zone for the police. Several officers wanted to carry naloxone on duty but requested more information about its use.

Conclusion

The general support among police officers for harm reduction services is an indication of a changing drug policy landscape in Sweden. Drug policy should take police officers’ views into consideration and there is a need for collaboration between police and harm reduction services. Further research should focus on how the police conduct boundary work since police actions may impact on the success of harm reduction services.

Place, publisher, year, edition, pages
Elsevier, 2022
National Category
Law and Society
Identifiers
urn:nbn:se:mau:diva-51037 (URN)10.1016/j.drugpo.2022.103672 (DOI)000802964800006 ()35405454 (PubMedID)2-s2.0-85127805570 (Scopus ID)
Funder
Riksbankens Jubileumsfond
Available from: 2022-04-11 Created: 2022-04-11 Last updated: 2024-02-05Bibliographically approved
Nordgren, J. & Richert, T. (2022). Risk environments of people who use drugs during the Covid-19 pandemic: the view of social workers and health care professionals in Sweden. Drugs: education prevention and policy, 29(3), 297-307
Open this publication in new window or tab >>Risk environments of people who use drugs during the Covid-19 pandemic: the view of social workers and health care professionals in Sweden
2022 (English)In: Drugs: education prevention and policy, ISSN 0968-7637, E-ISSN 1465-3370, Vol. 29, no 3, p. 297-307Article in journal (Refereed) Published
Abstract [en]

Although research is emerging on how the Covid-19 pandemic has affected people who use drugs (PWUD), there is a lack of studies focusing on professionals' views on Covid-19 related risks and consequences for this group. The aim of this study was to analyze how social workers and health care professionals in the city of Malmö, Sweden viewed the effects of the Covid-19 pandemic on PWUD risk environments. We used a mixed methods approach including an online survey with social workers and three qualitative focus group sessions with social workers and health care professionals working with PWUD. The professionals defined PWUD as an especially vulnerable group that had difficulty protecting themselves from contracting Covid-19, and who risked severe consequences if infected. They described risks relating to lifestyle and marginalization, limited health literacy, and health-related problems. Reported consequences of the pandemic included reduced access to treatment and support, social isolation, anxiety, and increased drug use. Factors at both micro and meso levels of risk environments seemed to contribute to a particular vulnerability for PWUD during the Covid-19 pandemic. It is important to learn from this development in order to provide better support to at-risk groups in future crises.

Place, publisher, year, edition, pages
Taylor & Francis, 2022
National Category
Social Work
Identifiers
urn:nbn:se:mau:diva-50777 (URN)10.1080/09687637.2022.2051435 (DOI)000772327600001 ()2-s2.0-85127187719 (Scopus ID)
Funder
Riksbankens Jubileumsfond, P18-0892:1
Available from: 2022-03-25 Created: 2022-03-25 Last updated: 2024-02-05Bibliographically approved
Richert, T. & Nordgren, J. (2022). Social work with people who use drugs during the Covid-19 pandemic: A mixed methods study. Nordic Social Work Research, 1-14
Open this publication in new window or tab >>Social work with people who use drugs during the Covid-19 pandemic: A mixed methods study
2022 (English)In: Nordic Social Work Research, ISSN 2156-857X, E-ISSN 2156-8588, p. 1-14Article in journal (Refereed) Epub ahead of print
Abstract [en]

Measures to control the spread of Covid-19 are challenging social work practice in terms of difficulties to deliver services to vulnerable groups. The aim of this study was to investigate how the Covid-19 pandemic affected social work with people who use drugs regarding ways of working, quality of work, accessibility, and staff motivation. A mixed methods approach was used which included an online survey (n = 81), and three qualitative focus group sessions with social workers in the field of addiction. We analysed the quantitative data through frequency calculations, cross tabulations and Pearson’s χ2 test, and the qualitative data with qualitative textual analysis. The demand for physical distancing challenged important principles of social work such as social closeness, trust and accessibility, and led to a difficult work environment and fewer opportunities to conduct high quality social work, as well as a reduced likelihood of vulnerable clients receiving adequate assistance. Altered practices concerning client meetings negatively affected assessments, working alliances as well as motivation and energy in social work practice. Social workers on the frontline became the ‘last outpost’ when other services shut down, and ‘digital bridges’ between clients and other social workers. Social workers faced a difficult trade-off between protecting themselves and clients from the risk of infection and providing support to a vulnerable group. There were also examples of new practices and lessons learned, for example, the introduction of ‘walks and talks’ with clients and an increased knowledge of how and when to use digital tools for communication.

Place, publisher, year, edition, pages
Taylor & Francis, 2022
National Category
Social Work
Identifiers
urn:nbn:se:mau:diva-55994 (URN)10.1080/2156857x.2022.2141839 (DOI)2-s2.0-85141616872 (Scopus ID)
Funder
Riksbankens Jubileumsfond, P18-0892:1
Available from: 2022-11-14 Created: 2022-11-14 Last updated: 2024-04-04Bibliographically approved
Liahaugen Flensburg, O., Johnson, B., Nordgren, J., Richert, T. & Svensson, B. (2022). "Something wasn't right"-parents of children with drug problems looking back at how the troubles first began. Drugs: education prevention and policy, 29(3), 255-264
Open this publication in new window or tab >>"Something wasn't right"-parents of children with drug problems looking back at how the troubles first began
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2022 (English)In: Drugs: education prevention and policy, ISSN 0968-7637, E-ISSN 1465-3370, Vol. 29, no 3, p. 255-264Article in journal (Refereed) Published
Abstract [en]

In this study we analyze how parents of adult children with drug use problems view the initial stages of identifying their children's troubles as a severe drug problem. We focus on the parents' accounts of the discovery process by identifying significant events in the parents' narratives through 'the micro-politics of trouble'. The study is based on an analysis of 32 semi-structured interviews with parents of adult children (aged 18+) with drug problems. Four themes emerged from the parents' narratives: (1) the first signs of a problem, (2) drug problem or teenage defiance? (3) the awakening, (4) a passing phase. The different themes show how the parents' interpretations of the situation influence their definitions and thus their actions. Early signs and indicators of something being wrong do not initially result in parents framing the situation as problematic as they are perceived as everyday concerns and dealt with as such. Our focus on the initial phase of the problem definition process and how this affects the parents may provide a better understanding of the parents' situation and needs for support. This may be of use to professionals in the fields of social work and drug treatment who meet these parents and may have a role to play in the development of support measures that can improve their situation.

Place, publisher, year, edition, pages
Taylor & Francis, 2022
Keywords
Discovery process, drug problems, parents, symbolic interactionism, trouble, qualitative interviews
National Category
Social Work
Identifiers
urn:nbn:se:mau:diva-41537 (URN)10.1080/09687637.2021.1897525 (DOI)000629044700001 ()2-s2.0-85102719486 (Scopus ID)
Available from: 2021-04-01 Created: 2021-04-01 Last updated: 2024-02-05Bibliographically approved
Projects
Urban drug scenes as risk environments - how do the police and social welfare institutions intervene and how are problem drug users affected?; ; Publications
Nordgren, J. & Richert, T. (2024). ‘A free position in midfield' – a qualitative study of faith-based social work with people who use drugs in Sweden. European Journal of Social Work, 27(2), 401-412Richert, T., Stallwitz, A. & Nordgren, J. (2023). Harm reduction social work with people who use drugs: a qualitative interview study with social workers in harm reduction services in Sweden. Harm Reduction Journal, 20(1), Article ID 146. Stallwitz, A., Nordgren, J. & Richert, T. (2023). ‘Not having a real life’: psychosocial functions of using and selling drugs among young Afghan men who came to Sweden as unaccompanied minors. Journal of ethnic and migration studies, 1-21Richert, T. & Nordgren, J. (2022). Social work with people who use drugs during the Covid-19 pandemic: A mixed methods study. Nordic Social Work Research, 1-14
Föräldrar till vuxna barn med narkotikaproblem; Malmö University
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-0653-0849

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