Output 1

The country reports used the findings from existing literature on user participation in social work as well as descriptions of the social work context in each country, to generated questions about similarities and differences between the countries. Project members were particularly interesting in exploring issues of power relations between various actors and institutions involved in the process of facilitating and/or promoting user participation, and how these affected issues of policy, practice and education in the countries. These discussions considered pivotal issues to be addressed when summarizing the results of the contribution of the project’s first part.    

In conclusion, based on the separate country reports and discussions among project members at the monthly transnational meetings of project the central questions to be considered were as follows: 

1. What is the role of social workers in user involvement/participation in the partner countries and what is the relation between social work practice and research in these countries?
2. Who is involved in facilitating/promoting user participation? 

Below, these questions will be briefly discussed.

(1) As already mentioned, the individual country reports indicate that there is considerable variation in the level of published research on this topic in the respective partner countries to help us understand issues of user participation in the partner countries. With this in mind, partner countries agreed to widen the knowledge search to include more narrative and personal views of project participants on how service user participation in social work occurs. The point here is that, although there may not be studies carried out in some countries, there is practice evidence and wisdom which highlights a variety of traditions of, user participation in policy and practice development. The rather weak position, or short history, of social work within academia is emphasized in some of the country reports (Portugal, Czech Republic), perhaps because of the history of the profession, education and research traditions. For example, the Portuguese country report points out that, the reconceptualization of social work education in Portugal after the collapse of the dictatorial State in 1974, followed by a period of great dynamism, marked by many social movements, and social and political conflicts gained great visibility. The Revolution set the ideal conditions for social workers to perform alternative forms of intervention, moving away from the assistance-focused practices characteristic of the former authoritarian rule. Incited by the new progressive political agenda, social workers stood at the forefront of the Revolution, working alongside grass-roots mobilizations and experimental participative projects, overtly assuming political stands. (Silva, 2018). 

In Belgium, where social work has not received full recognition on a university academic level in the French speaking part of the country, there are variations in policy and practice paradigms. In the Dutch speaking area research activity has been more developed, and at the practice level, user participation seems to be an important issue. This can be partly explained by the ways in which this issue has been actively promoted and supported in social policy and by social movements, creating a tradition of ’experts by experience’ in social work research, policy and practice developments that bring forth a critical-normative and reflexive professionalization of social work. 

In the Czech Republic, social work has long traditions; however, it was interrupted not only by the two wars, but also by 40 years of a communistic system, which suppressed human rights and civil society. The full recognition of university academic level social work was received after 1990, and has later gained further strength through doctoral programs at four Czech universities. Since 2006, law regulates the position of social workers. The idea of participation was supported particularly in the sector of NGO services. However, in the governmental sector, as in the sector of the traditional residential services, the organizational cultures were blind to real user participation. Reflexivity has been practiced particularly when it comes to developing external supervision in social work since 1995.

In Finland, all social work programmes, and in Ireland most social work professional are educated to the Master’s level and there is growing attention to the importance of evidence based and/or evidence informed practice, in Ireland also supported by doctoral studies programmes. In both countries, it is necessary to register to a national body for acquiring the right to use the title of social worker and to practice as a social worker. Yet, as in other countries, change in the area of user participation in services seems to be hampered either by a lack of perceived possibilities, or of concrete actions aiming at, altering existing modes of provision. 

It was evident from the country reports that there was variety, complexity and fluidity of the concepts that were being used to understand service user participation. Examples of these include, for example, participation, user participation, involvement user/customer involvement, user engagement, empowerment, engagement, social inclusion, (partner) collaboration, partnership, customer driven orientation and agency. Thus, ‘user participation’ does not have one all-embracing definition or meaning within or between the participating countries. Noteworthy is also that the goals of user involvement are often not in focus in the literature. User involvement may not be an end in itself, but rather it can be viewed as a means to enhance service user’s agency or strengthen democratic citizenship.  

(2) Who is involved in facilitating/promoting user participation?

The country reports highlight the way that types of user participation has grown during the last decades. It can be argued that it is increasingly viewed as a way of improving social and healthcare services, but with rather different stakeholders as main driving forces. Contemporary approaches emphasis the notion of the concept of a vehicle for (re)defining power relationships between researchers, practitioners and clients/consumers, utilized by politicians, the academia, the public and private sectors and civil society. However, real shifts in power relations seem often to have remained rather modest in the participating countries. In this sense, there are substantial similarities between the countries, despite prevailing variations in historical-institutional legacies, the (relative) position of social work and research opportunities. The concern is that service user participation remains, to an important degree, tokenistic in many examples.  

In some cases, however, there appear to be partly diverging explanations for rather modest shifts in ‘real’ power relations. For example, in the case of Finland, user participation at the institutional level is rather weak, yet individual social workers and agencies sometimes have adopted a rather critical stance. In general, however, is a limited tradition of increasing user participation through enhancing their collective action or collective participation. Social work remains to a great extent a public, ‘authority-driven’ activity and user participation is not embedded in the daily work of street-level workers, at least not as more concrete action (although perhaps as a “mind-set”). 

Another aspect to be considered is the role of ‘funders’ as a driving force affecting the position of user participation in research and practice. For example, in Portugal, where social work is not a registered academic discipline, there is little or no funding opportunities to fund participatory (or other) research. Belgium and Finland have a much longer established tradition of participation in social work research, but, at least in Finland, there have not been that many (‘outside’) funders for academic research in social work. Ireland’s shift to PPI also seems to have also been influenced and driven by the requirement of funding bodies. It generally the case that little social work and health care funding in Ireland will be agreed unless there is core involvement of service users in the design and delivery of research projects. Again, it would seem to be relevant to reflect on further as regards these issues. It remains a question as to why research funding bodies in some countries require the involvement of users in the research process and others not. Where there are funding opportunities which encourage participatory approaches may lead to more meaningful studies on service user participation in social work research. 

Another important issue arising from the country reports concerns the several similar challenges in many of the participating countries, when it comes to factors enabling or hindering (increasing) user participation in social work. As is mentioned in the Irish country report, the international literature on forms of participation suggests a number of challenges and opportunities. Of particular concern is the tendency towards ‘tokenism’ despite the intention of policy makers and some professionals. Notions of resistance to change might be explained by exclusionary professional attitudes; professions spend years learning about knowledge and skills which some believe cannot be subject to sharing through a transfer of power to service users. Some of the country reports also raised the question of forced participation, in which the outcomes of different participatory approaches and interventions may reinforce the problems that they intended to solve. 

Some service users may be comfortable with this inequality, they want the expert to diagnose or direct. Even where individuals wish to engage with service users and become more inclusionary, organizational cultures are difficult to shift. Sometimes service user empowerment is used by governments and politicians to break down professional solidarity and replace state provision with market-based interventions. 

Thus, although user involvement (or participation) in social work research (and as well as in education and practice) is considered desirable among almost all partners participating in the INORP-project, the question remains how realistic it is to expect real and authentic redistribution of power. This appears to be contingent on the involvement of different stakeholders representing governments, large NGOs or academia which determines which resources to initiate and what issues to define and who should and could be involved.  Participation is also often embedded in projects and activities which do not live up to the genuine aims of participation, or the projects are too short-termed.