Socialtjänstens stödgrupper för barn : En lätt tillgänglig insats?

In Sweden, preventive support groups for children exposed to domestic violence, substance abuse or mental illness in the home are provided by child welfare services (CWS). Support groups for children are often accessible without assessment, available for families to access at their own request, without formal referral or opening a case file which is assumed to lower the threshold. A current approach in a number of countries to bridge the gap between statutory social welfare agencies and families is the orientation towards prevention with a growing range of early interventions. Yet, the basis upon which services engage with families at a point prior to substantial problems become evident is far from straightforward. Parents’ gatekeeping role is a particular source of tension when recruiting children to support groups. Stigma related to parental problems and parents’ fear of being judged are barriers. Problems at home are often concealed leading to difficulties in identifying vulnerable children. Barriers are even greater when support is offered by CWS, inherently associated with negative attributes and stigma. Increasing the knowledge about how and on what basis children access early interventions is essential. The aim of this study is to gain an in-depth knowledge of the conditions and considerations that influence children's routes to CWS’s support groups. This licentiate thesis consists of two scientific articles. Article I comprises individual interviews with 18 children (aged 9–18) who recently attended support groups and 18 parents. Drawing on concepts from the Health Belief Model and Help-Seeking Model, analysis shows that children’s routes into CWS’s support groups depend on their parent’s motives and help-seeking actions. Support groups are an unknown intervention but linked to the broader support system where professionals such as school counselors and health care staff are facilitators in guiding families toward support groups. Perceived barriers to participation include shame associated with the parental problem and the unwanted involvement from CWS. There are also perceived benefits to be gained from talking to others and sharing experiences. However, seeing their lives as ordinary some children initially dismiss the need for support and only see the benefit of peer support after participating in a few trial sessions. Article II is based on five group interviews with 16 support group leaders and examines how barriers to participation are experienced and handled by professionals. It is found that professionals experience stigma as a barrier to recruiting children, mainly the parents’ shame but also their fear of CWS involvement. Professionals describe parents’ problems on a ‘scale of shamefulness’, ranging from divorce to domestic violence, and the barriers vary in strength relative to the shamefulness of the problem. Parents are gatekeepers for their children’s participation, so destigmatizing and shame-reducing strategies, whether on the interpersonal, organizational or structural level, are called for to increase children’s access. However, strategies targeting parental shame are not without their challenges and risks.Overall, the study demonstrates that children’s participation in support groups is shaped by a complex interplay of parental influence, professional guidance, and structural conditions. Support groups cannot be considered a stand-alone service but are linked to broader support systems, such as school health teams and health services. Context specific conditions of CWS, where voluntary interventions coexist with coercive interventions, need to be balanced by professionals. A shame-aware approach is crucial for reducing barriers and improving recruitment strategies in social work practice. The study highlights the need to reframe our understanding of people’s engagement in preventive interventions in the context of child and family social work.