It has been globally recognised that COVID-19 has impacted the prevalence of domestic violence (DV). Various international research has reported obstacles for DV workers in reaching out to victims during the pandemic. To investigate how DV victims experienced seeking help and experienced support received from specialised units within social services or women’s shelters during the pandemic, an interview study was conducted. Fifty-one women subjected to DV who turned to domestic violence support units in Sweden during the pandemic were interviewed on how the pandemic affected the support received. Through a thematic analysis, two themes were identified: the path to treatment; and support during the pandemic. Contact with a DV worker could most often continue through personal meetings with the necessary safety precautions maintained. When switched to digital meetings, it could still be effective if contact had initially been established through physical meetings. For women who participated in group sessions, the consequences were significant as the group sessions were completely cancelled. The findings indicate the need for a wide range of work methods that are sensitive to the needs of DV victims where continuity is crucial for treatment progress.

At this presentation, we present results from research with the aim to investigate how conversations about violence are enacted in interactions between children exposed to physical abuse and professional practitioners. Although it is clear from Swedish law that the social services should offer protection, support, and assistance to children subjected to parental physical abuse, and that interventions aimed at ending violence should be provided to abusive parents, current guidelines and policies do not specify how these objectives should be achieved. The Combined Parent – Child Cognitive Behavioral Therapy (KIBB) has, however, been highlighted as a potential approach to meet both requirements.

The target group of KIBB consists of families in which physical child abuse has occurred. The treatment follows a structured manual, is based on specific themes, and takes approximately 16 weeks to complete. Previous research has shown that children perceive KIBB as a child-centered treatment in which their needs are prioritized. However, there is no existing research that examines how the treatment is carried out and how children’s participation is expressed.

Drawing on a unique dataset consisting of authentic video-recorded treatment sessions with children and follow-up interviews with practitioners, we will demonstrate how KIBB treatment is implemented, the considerations behind the strategies practitioners employ, and how the topic of violence is manifested and made comprehensible. We will also discuss and problematize how children’s opportunities for participation are framed within a structured treatment model and how practitioners work to achieve a balance between children's involvement and manual-based working procedures.

Bakgrund 

Socialtjänsten ska erbjuda barn utsatta för fysisk misshandel skydd, stöd och hjälp, och våldsutövande föräldrar insatser som syftar till att våldet upphör. Metoden Kognitiv integrerad behandling vid barnmisshandel (KIBB) har lyfts fram som en metod med potential att leva upp till dessa krav. Målgruppen är familjer där fysisk barnmisshandel har förekommit.Tidigare forskning har visat att barn uppfattar KIBB som en barncentrerad behandling där deras behov står i centrum. Det finns dock ingen forskning som visar hur behandlingen genomförs och hur barns delaktighet ges uttryck. 

Syfte 

Syftet med forskningsprojektet är att visa hur KIBB-behandling genomförs, vilka överväganden som ligger till grund för de sätt behandlare arbetar på och hur samtalsämnet våld manifesteras och begripliggörs. 

Metod 

Presentationen baseras på två typer av data; videoinspelade behandling-sessioner mellan barn och behandlare, samt efterföljande intervjuer med behandlare. 

Resultat 

Vid presentationen presenteras forskning med fokus på hur samtal om våld gestaltar sig i interaktioner mellan barn utsatta för fysisk barnmisshandel och professionella behandlare. I presentationen kommer vi även att redogöra för hur barns möjlighet till participation ser ut inom ramen för en strukturerad behandlingsmodell och hur behandlare arbetar för att eftersträva en balans mellan barns delaktighet å ena sidan och manualbaserat arbete å den andra. 

Diskussion 

Genom analys av videoinspelade samtalssessioner kommer den aktuella presentationen visa hur barns våldsutsatthet kan adresseras i en behandlingskontext. Resultatet från den aktuella studien visar även på exempel på tillvägagångssätt som stärker barnets delaktighet.

Introduction: Wellbeing, encompassing hedonic and/or eudaimonic components, provides a two-dimensional framework for evaluating the effects of psychosocial interventions for individuals with severe mental illness (SMI). This study investigates how this conceptualization of wellbeing is reflected in existing research on psychosocial interventions for people with SMI. This is the first systematic review to assess the effects of psychosocial interventions on wellbeing as a purely positive phenomenon in this population. The study was registered in PROSPERO (CRD42024598954).

Method: A systematic review was conducted on intervention studies involving adults with SMI receiving psychosocial interventions in an out-patient setting, with a control condition and a wellbeing outcome aligned with a wellbeing framework. Five databases were searched, supplemented by manual searches, yielding 2,842 potential studies. Due to considerable heterogeneity (I2 = 94%), interventions were analyzed independently, with results summarized based on the proportion of studies reporting significant effects. The study followed PRISMA guidelines.

Results: Seventeen studies met the inclusion criteria. Only one study (6%) provided a full rationale for using a wellbeing measure as the primary outcome. Over 70% reported a significant positive effect on wellbeing. In 13 studies effect size could be calculated, 29% in reference to all 17 studies demonstrated a positive effect (ranging from small to large). Clinical implications of the wellbeing construct were discussed in 47% of the studies, including an increased emphasis on positive functioning. Fewer than 50% received a high-quality rating, and only three studies reporting significant effects used Intention-To-Treat (ITT) data.

Conclusion: Research on two-dimensional wellbeing is a promising yet underprioritized field, providing a renewed focus on abilities and generating significant clinical implications. Wellbeing ought to be a prioritized outcome in out-patient treatment policies, but today no recommendation as to which interventions are most effective are possible due to insufficient data. The implications of detecting changes in wellbeing in individuals with SMI, along with recommendations for future research, are discussed.

This article examines multi-agency interaction aimed at protecting women from intimate partner violence, both preventively and through support for those who have experienced abuse. The article interprets these issues as stemming from the need for organisations to protect their autonomy while simultaneously building trust and collaboration. Drawing on Anselm Strauss’s concept of articulation work, the article uses vignettes, interviews and focus groups with social workers and other professionals to explore how this tension manifests in practice. The findings reveal an ongoing conflict between maintaining organisational boundaries and fostering cooperation. Professionals express frustration through such practices as blaming work and boundary-marking work yet also engage in trust-building initiatives and collaborative efforts. The interviews provide examples of strategies to enhance cooperation, highlighting that successful multi-agency work requires continuous input to build trust. Overall, the article underscores the value of multi-agency safeguarding work and suggests that increased awareness of the mechanisms at play is essential when agencies are required to collaborate.

The acknowledgement of domestic violence as a serious social problem in the Swedish public sector, and knowledge about its devastating consequences for victims, has led to the development and implementation of various support measures in the social services. Still, little is known about how social workers deliver support to victims of domestic violence, the types of work they actually perform when they interact with victims, and the premises they connect to their work. To gain a deeper understanding of the underlying principles and functioning of these measures, we conducted a program theory analysis of two social services units specializing in domestic violence. Utilizing a combination of documents from the units, focus groups with staff, interviews and an analysis of authentic interactions between women seeking support and social workers, we elucidate the core components and mechanisms believed to contribute to successful outcomes. The findings highlight the critical role of risk work, safety work and external stabilization in enabling individuals to reconstruct and process experiences of violence. The importance of professional discretion, when the content and scope of support in relation to individual women are to be tailored, is also significant for successful work. 

Increased concern was raised globally at the outbreak of COVID-19 that victims of domestic violence would be even more at risk when isolated with a violent partner and out of reach of support due to restrictions. Swedish staff in violence against women services prepared for increased calls for help. Instead, a worrying silence arose in a time and place of high uncertainty. This article analyzes the narratology of risk, when staff members in violence against women services, reflect upon their accounts, responses, and experiences, during the pandemic. The analysis is based on three themes, accounting for expected increased influx, making sense of silence and accounting for mobilization. The findings are discussed by applying the relational theory of risk.

Older persons with dementia have several risk factors for being exposed to domestic abuse, for example dependency on others to manage daily life. The purpose of the study was to explore how staff act and reason when suspecting domestic abuse perpetrated by informal caregivers of persons with dementia. Eight semi-structured group interviews were conducted with staff (n = 39) working with persons with dementia living in their ordinary homes. A thematic analysis generated two themes; Missing a map for guidance and Being left to one’s own inner compass for direction indicating that staff experienced a lack of guidelines and protocols to work from when suspecting abuse. This resulted in staff taking actions based on their own norms, values, and experiences when suspecting domestic abuse. Not knowing how to act risks leading to staff ending up doing nothing or being unable to identify effective interventions, accompanied by feelings of guilt and ethical stress. The results highlight the necessity of providing staff with tools for how to act when they suspect domestic abuse, such as collaboration with others, colleagues, and other organisations where different options for interventions can emerge.

Svensk titel: En svensk studie om hur personal resonerar och agerar när demisstänker våld i nära relationer som begås av anhöriga tillpersoner med demenssjukdom.

Äldre personer med demenssjukdom har flera riskfaktorer för att utsättas för våld i nära relationer, till exempel att vara beroende av andra för att klara det dagliga livet. Syftet med studien var att undersöka hur personal agerar och resonerar vid misstanke om våld i nära relationer som begås av anhöriga till personer med demenssjukdom. Åtta semistrukturerade gruppintervjuer genomfördes med personal (n = 39) som arbetar med personer med demenssjukdom som bor i ordinärt boenden. En tematisk analys genererade två teman; karta saknas för att ge guidning och vara utlämnad till en inre kompass för att finna riktning, vilket tyder på att personalen upplevde en brist på rutiner och riktlinjer att utgå ifrån vid misstanke om våld i nära relation. Detta resulterade i att personalen vidtog åtgärder utifrån sina egna normer, värderingar och erfarenheter vid misstanke om våld i nära relationer. Att inte veta hur man ska agera riskerar att leda till att personalen inte gör något eller har svårighter att hitta effektiva insatser, vilket kan leda till skuldkänslor och etisk stress. Resultatet belyser behovet av att ge personalen verktyg för hur de ska agera vid misstanke om våld i nära relationer, såsom samarbete med andra, kollegor och andra verksamheter där olika alternativ för insatser kan växa fram.

Purpose: To evaluate the long-term effects of an Arts on Prescription (AoP) programme on sense of coherence (SOC) in Sweden.

Design: A controlled intervention study with a quasi-experimental prospective design, including questionnaires at baseline, with follow-ups at 6 and 12 months. Participants were on sick leave due to common mental disorders (CMD) and/or non-specific musculoskeletal pain, recruited from primary care in six regions. The intervention group also included participants from open psychiatric care. The study sample comprised 586 participants (335 in the intervention group and 251 in the control group).

Results: Both groups showed a significantly stronger SOC at follow-up, with a medium effect size for the intervention group and a small effect size for the control group. No statistically significant difference in SOC change over time was observed between the groups. Participants from open psychiatric care in the intervention group showed a significant improvement in SOC compared to those from primary care. Concerns about finances had a significant main effect on SOC for the entire study population.

Originality: Unlike most AoP studies, this controlled study with a relatively large sample provides insights into the long-term effects of AoP on SOC, with results reported using p-values and effect sizes.

This article focuses on the complexities of using a new intervention when parents are suspected of child physical abuse. Children leaving a child forensic interview due to suspected child physical abuse are often handed over to their parents, who sometimes are the suspected perpetrators. The Efter barnförhöret (EB) [After the child forensic interview] intervention was developed to aid children in this stressful situation by providing professional support from child welfare services to the child and parents. The article is based on interviews with 11 respondents working with EB. Narratives reveal how respondents use their discretionary space to navigate different institutional logics. In the themes Focusing on the child, Getting parents motivated, The challenges with organizational boundaries and Demand trumps resources, respondents argue that EB, despite organizational challenges, is considered an important intervention that meets the needs of children and families after the disclosure of child physical abuse.