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Sanktionerat motstånd: Brukarinflytande som fenomen och praktik

Eriksson, Erik LU (2015) In Lund Dissertations in Social Work 47.
Abstract (Swedish)
Frågan om brukarinflytande inom välfärdssektorn har sin grund i de krav på humanisering, demokratisering och maktdelning som höjdes av den ideella brukarrörelsen på 1960- och 70-talet. I dag har tanken om brukarinflytande anammats av det offentliga och de krav på inflytande som tidigare höjdes av en social rörelse utifrån och underifrån, drivs nu politiskt inifrån och uppifrån inom den offentliga administrationen. Hur agerar välfärdsorganisationer för att tillmötesgå de ökade politiska kraven på ökat brukarinflytande? Och vad händer med frågan om brukares inflytande när den blir institutionaliserad?

Syftet med den här avhandlingen är att undersöka hur brukarinflytande konstrueras (det vill säga hur det formuleras, bedrivs och... (More)
Frågan om brukarinflytande inom välfärdssektorn har sin grund i de krav på humanisering, demokratisering och maktdelning som höjdes av den ideella brukarrörelsen på 1960- och 70-talet. I dag har tanken om brukarinflytande anammats av det offentliga och de krav på inflytande som tidigare höjdes av en social rörelse utifrån och underifrån, drivs nu politiskt inifrån och uppifrån inom den offentliga administrationen. Hur agerar välfärdsorganisationer för att tillmötesgå de ökade politiska kraven på ökat brukarinflytande? Och vad händer med frågan om brukares inflytande när den blir institutionaliserad?

Syftet med den här avhandlingen är att undersöka hur brukarinflytande konstrueras (det vill säga hur det formuleras, bedrivs och genomförs) inom samtida människobehandlande arbete, och hur denna konstruktion påverkar och påverkas av rådande maktstrukturer mellan brukare och offentliganställda (se Hasenfeld 2010). Genom deltagande observation har jag under tre år följt två välfärdsorganisationer – en psykiatriförvaltning och en kommunal individ- och familjeomsorg – och studerat hur de definierar och praktiserar brukarinflytande.

Genom att analysera materialet med hjälp av koopteringsteori (Selznick 1949) undersöks hur maktstrukturer och institutionella logiker upprätthålls och ifrågasätts genom de vardagliga interaktioner som äger rum när brukarinflytande genomförs. Det visar sig att ett offentligt drivet brukarinflytande innehåller avsevärda delar kontroll och reglering från välfärdsorganisationernas sida. Samtidigt ger aktiviteterna brukarna möjlighet att driva sina frågor inifrån. Det som sker kan därför beskrivas som ett ”sanktionerat motstånd”. Studien visar att det brukarinflytande som bedrivs skapar en marginell snarare än radikal maktöverföring från organisationsföreträdare till brukare, och att den påverkan som äger rum i regel handlar om inominstitutionella justeringar snarare än omvälvande förändringar av organisationerna. Vidare pekar resultaten också på att den omgivande politiska kontexten får stor betydelse för vad brukarinflytandet blir i praktiken. Vad chefer och anställda kan göra för att tillmötesgå brukares krav och behov är villkorat av socialpolitiska direktiv och prioritetringar. (Less)
Abstract
The roots of the idea of user involvement within social services can be found in the efforts of the rising service user movement in the 1960s and 70s. Today the concept of “service user involvement” has been adopted by the state and is widespread within political rhetoric’s as well as in human service practices. However, user involvement is known to be an imprecise phenomenon that can take on different meanings (cf. Cornwall 2008; Patterson et al. 2008), opening for potential conflicts between service users and organisation representatives concerning goals, intentions and activities.



The aim of the thesis is to investigate how service user involvement is constructed within contemporary human service organisations, and... (More)
The roots of the idea of user involvement within social services can be found in the efforts of the rising service user movement in the 1960s and 70s. Today the concept of “service user involvement” has been adopted by the state and is widespread within political rhetoric’s as well as in human service practices. However, user involvement is known to be an imprecise phenomenon that can take on different meanings (cf. Cornwall 2008; Patterson et al. 2008), opening for potential conflicts between service users and organisation representatives concerning goals, intentions and activities.



The aim of the thesis is to investigate how service user involvement is constructed within contemporary human service organisations, and how the construction is affected by, as well as affects, the prevailing power structures characterizing the relationship between service users and welfare workers (see Hasenfeld 2010). The study has an ethnographic and constructionist base. During three years I conducted fieldwork in two welfare organisations – a county based psychiatric hospital and a municipal social service administration – following such activities that the organisations defined as working with “service user involvement”.



The concept of co-optation (Selznick 1949) is used to analyse how power structures and institutional logic within the welfare organisations are maintained as well as questioned through the everyday interactions taking place when service user involvement is carried out. At the same time as the institutionalized service user involvement control and constrain the way service user representatives act and pursue their goals, it gives them a possibility to challenge the welfare organisations from within. Hence, service user involvement can be understood as a “sanctioned resistance”. The study suggests that no radical change in power positions is achieved through the service user involvement. The influence that users have can commonly be understood as adjustments within a prevailing institutional logic, rather than changes that transform the organisations in a more profound way. Moreover, the surrounding socio-political context plays a vital role in determining what service user involvement becomes. What employees can do when it comes to meeting service users’ demands is conditioned by the overarching welfare politics and resource allocation. (Less)
Please use this url to cite or link to this publication:
author
supervisor
opponent
  • Docent Topor, Alain, Institutionen för socialt arbete, Stockholms universitet
organization
alternative title
Sanctioned resistance: Service user involvement as phenomenon and practice
publishing date
type
Thesis
publication status
published
subject
keywords
consensus., resistance, control, institutional theory, co-optation, power, psychiatry, social services, human service organisations, welfare organisations, user involvement, service user involvement, konsensus, motstånd, kontroll, institutionell teori, kooptering, makt, new public management, psykiatri, socialtjänst, människobehandlande organisationer, välfärdsorganisationer, brukarperspektiv, Brukarinflytande
in
Lund Dissertations in Social Work
volume
47
pages
337 pages
publisher
Lunds universitet, Socialhögskolan
defense location
Palaestra övre, Paradisgatan 4, Lund
defense date
2015-11-13 10:15
ISSN
1650-3872
ISBN
978-91-89604-54-4
language
Swedish
LU publication?
yes
id
04316a8d-b3c4-4906-a916-03e4bf6980a8 (old id 8081637)
date added to LUP
2015-10-21 09:17:02
date last changed
2016-09-19 08:44:50
@phdthesis{04316a8d-b3c4-4906-a916-03e4bf6980a8,
  abstract     = {The roots of the idea of user involvement within social services can be found in the efforts of the rising service user movement in the 1960s and 70s. Today the concept of “service user involvement” has been adopted by the state and is widespread within political rhetoric’s as well as in human service practices. However, user involvement is known to be an imprecise phenomenon that can take on different meanings (cf. Cornwall 2008; Patterson et al. 2008), opening for potential conflicts between service users and organisation representatives concerning goals, intentions and activities. <br/><br>
<br/><br>
The aim of the thesis is to investigate how service user involvement is constructed within contemporary human service organisations, and how the construction is affected by, as well as affects, the prevailing power structures characterizing the relationship between service users and welfare workers (see Hasenfeld 2010). The study has an ethnographic and constructionist base. During three years I conducted fieldwork in two welfare organisations – a county based psychiatric hospital and a municipal social service administration – following such activities that the organisations defined as working with “service user involvement”. <br/><br>
<br/><br>
The concept of co-optation (Selznick 1949) is used to analyse how power structures and institutional logic within the welfare organisations are maintained as well as questioned through the everyday interactions taking place when service user involvement is carried out. At the same time as the institutionalized service user involvement control and constrain the way service user representatives act and pursue their goals, it gives them a possibility to challenge the welfare organisations from within. Hence, service user involvement can be understood as a “sanctioned resistance”. The study suggests that no radical change in power positions is achieved through the service user involvement. The influence that users have can commonly be understood as adjustments within a prevailing institutional logic, rather than changes that transform the organisations in a more profound way. Moreover, the surrounding socio-political context plays a vital role in determining what service user involvement becomes. What employees can do when it comes to meeting service users’ demands is conditioned by the overarching welfare politics and resource allocation.},
  author       = {Eriksson, Erik},
  isbn         = {978-91-89604-54-4},
  issn         = {1650-3872},
  keyword      = {consensus.,resistance,control,institutional theory,co-optation,power,psychiatry,social services,human service organisations,welfare organisations,user involvement,service user involvement,konsensus,motstånd,kontroll,institutionell teori,kooptering,makt,new public management,psykiatri,socialtjänst,människobehandlande organisationer,välfärdsorganisationer,brukarperspektiv,Brukarinflytande},
  language     = {swe},
  pages        = {337},
  publisher    = {Lunds universitet, Socialhögskolan},
  school       = {Lund University},
  series       = {Lund Dissertations in Social Work},
  title        = {Sanktionerat motstånd: Brukarinflytande som fenomen och praktik},
  volume       = {47},
  year         = {2015},
}