Social workers' and General practitioners' perceptions of non-problematic situations

Aim: To describe and analyze written accounts of non-problematic situations (NPS) by social workers (SW) and general practitioners (GP). Accounts were collected from 28 SWs and 24 GPs in Swedish. Results: SW and GP had... [ view full abstract ]

Aim: To describe and analyze written accounts of non-problematic situations (NPS) by social workers (SW) and general practitioners (GP). Accounts were collected from 28 SWs and 24 GPs in Swedish.

Results: SW and GP had different perceptions of NPS. GPs’ accounts of NPS referred to situations where they solved the patient’s problem and lived up to the expected institutionalized role as competent diagnostician. These situations involved well-known and easily diagnosed conditions where they could rely on their professional experience, evidence-based practices and guidelines. SWs’ descriptions of NPS were more complex and their accounts were tied to their relationship with the client and their coercive role and function. NPS referred to situations where clients were perceived as co-operative, compliant and open to change, or where the client left the SW with no other choice than to use coercive means.

Conclusions: We argue that the different perceptions of NPS indicate that conditions for establishing and maintaining control over professional practice differ between SWs and GPs. For GPs, control was a matter of choosing and applying knowledge on voluntary help seeking clients’ medical problems. In comparison to GPs, the clients SWs met were often “involuntary clients”. Hence, control over SWs professional practice came down to establishing and maintaining control over the relationship with the client.

Findings support the idea that evidence-based knowledge, guidelines and manuals might be useful to support GPs’ professional routine practice. However, similar strategies might be of limited use in SWs’ practice since evidence-based knowledge, guidelines and manuals to a large extent rest on a tacit assumption of “relationship truce” between professionals and clients.