Notes
Doctoral dissertation explores the work of community care coordinators-social workers employed at social work centers in Slovenia, who provide support to people with mental health problems living in the community. In our dissertational research we tried to ascertain how community care coordinators form the subject of social work together with service users; how they come to conclusions; what kind of goals service users have; and what changes have to occur to change their living situations. Throughout the research and the writing of this doctoral dissertation we tried to comprehend how community care coordinators use assessment methods (personal planning) and how social work assessment is connected to concepts such as needs, problems, desires, goals etc. We tried to obtain a better understanding of the ways community care coordinators think in practice and use their knowledge when faced with the complexities of their work. The dissertation is divided into four parts. The first part presents the theoretical framework for understanding the subject of social work. In the theoretical part of the dissertation, we define concepts and describe issues such as a constructivist perspective of social work, social work knowledge, constructing the subject of social work, social work assessment, goals, desires and (social) problems. We take a closer look at the subject of social work in the field of mental health. At the end of the theoretical part of the dissertation, we present the theoretical and legislative framework of the community care coordinators. In the second part of the dissertation, we describe the methodology of a doctoral research and show how grounded theory was applied during our fieldwork, interviews, data analysis and writing. In the third part of the dissertation, we present results and in the fourth part the synthesis and the discussion of the results. Research showed that the working relationship between community care coordinators and service users is dynamic, both in the personal planning and in the service delivery phases. Throughout the process, personal planning (assessment) and service provision are intertwined. In practice community care coordinators carry out assessments (personal planning) in different ways which often depend on the desires of service users, specific situations and also on the preferences of the coordinators themselves. Coordinators mainly use two strategies of personal planning: structured personal planning and unstructured personal planning. Some community care coordinators use a personal planning method mostly as it is presented in the literature and is a part of their education. Other coordinators use the structure of a personal planning method very loosely or use only certain elements of personal planning. Despite the different use of the method, both strategies have elements of personal planning that are maintained, which is especially true for the concept of goals, which is an important part of the structure of personal planning or, above all, the focus of situation assessment. An important finding of the research tells us that it is easier to understand a life situation of service users if the assessment is a continuous process connected with the provision of services. It is an important experience of coordinators that the assessment is not too complex or demanding when personal planning is a long-lasting process in which the needs, goals and desires of service users are revealed through the assessment of the situation and the provision of services. Community care coordinators understand personal planning as a dynamic process in which it is not uncommon for goals to change or new goals to form. The experience of coordinators shows that many service users know what their desires and needs are - what is important to them in their lives - and this can be the basis for further exploration of their living situations. The experience of community care coordinators shows that with such an approach to the assessment, the problem is not how to extract important information from service users, but rather how to empower service users in cases where expressing the desires is not straightforward and unambiguous. Viability of personal planning is conditioned by the adjustments community care coordinators need to make in their practice. Personal planning is conditioned by the ability of coordinators to establish a good working relationship and trust. Service users have to have sufficient power to express their desires and views. Personal planning also needs to be a continuous process in which the assessment of the situation and the delivery of services are combined. The purpose of personal planning is to design the subject of community care: goals. The research showed that goal setting is dynamic and that goals - in addition to being a product of personal planning - serve other purposes. Goals are not only important from the point of view of defining the subject matter of social work, but also serve as a tool for the community care coordinators (and service users). Goals are important during the process of assessing the situation as a reference point for a further exploration of how to achieve goals and to address who, when and what needs to be done. Goals are a tool for community care coordinators to structure their thinking. Goals are important for the evaluation of community care and can also be used as tools and a means to advocate for service users when communicating with other services or organizations. In personal planning a reference framework of needs is crucial. Professional and science-based needs provide community care coordinators with a tool to test the potential of goals to improve users' quality of life. With the help of needs, community care coordinators can reflect their own frame of reference to help them in their work. Although community care is a voluntary service and coordinators respect the perspective of service users, they cannot avoid the issue of power, as they have the ability to influence service users in the support process and use professional mandate to intervene in situations they recognize as harmful. Coordinators are also faced with a dilemma of supporting service users to be as independent as possible while providing them with a better quality of life or avoiding more harm, which is not always the same. The question of power is important in instances when coordinators have to provide a more caring form of support. The research shows that the work of community care coordinators is important in the Slovenian mental health field as it provides comprehensive, individualized support, based on the perspective of service users.