Qualitative Studies https://tidsskrift.dk/qual Journal of qualitative research and qualitative studies in psychology, education, health and the social sciences, management, organization, sociology, anthropology, methodology Aalborg Universitet en-US Qualitative Studies 1903-7031 Researching Organisational Imbrications and Interstices https://tidsskrift.dk/qual/article/view/111314 Bagga Bjerge Tobias Georg Eule Kasper Trolle Elmholdt ##submission.copyrightStatement## 2018-12-04 2018-12-04 5 2 49 56 10.7146/qs.v5i2.111314 A Case Study of Casework Tinkering https://tidsskrift.dk/qual/article/view/104419 <p>Citizens with complex problems are often in touch with different welfare services and administrative systems in order to receive the help, they need. Sometimes these services overlap and sometimes they conflict. The lack of ready-made services to match the complex, multiple, and often shifting needs of citizens with complex problems presents a challenge to caseworkers in the welfare system. In this article, we zoom in on the management of a single user´s case, in order to examine in detail how caseworkers nevertheless make casework ‘work’. We employ the concept of ‘tinkering’ to highlight the ad hoc and experimental way in which caseworkers work towards adjusting services to the unique case of such citizens. Tinkering has previously been used in studies of human-technology relations, among others in studies of care-work in the welfare system. In this paper, we employ the concept to capture and describe a style of working that, although not a formally recognized method, might be recognizable to many caseworkers in the welfare system. We show how tinkering involves the negotiation of three topics of concern, namely the availability of services, the potentials of services to be adjusted to the particular problems of the citizen, and finally, the potential for interpreting these problems and the citizen’s needs in a way that they match the service. We further demonstrate that casework tinkering involves both short-term and long-term negotiation of services. Firstly, tinkering is involved in the continual adjustment and tailoring of services to the immediate needs of the citizen, but secondly, it also speaks to a more proactive process of working towards a more long-term goal.</p> Maj Nygaard-Christensen Bagga Bjerge Jeppe Oute ##submission.copyrightStatement## 2018-12-04 2018-12-04 5 2 57 71 10.7146/qs.v5i2.104419 Health Care Professionalism Without Doctors https://tidsskrift.dk/qual/article/view/104462 <p>The article uses the organization of health houses in Denmark as a case to study the relationship between spatial surroundings and professionalization. The question is whether these new local health houses comprise an alternative to the medical view on health or ––even in the absence of the hospital–– script the professionals to identify themselves as agents from the medical field? In this article, macro-structural theory is combined with micro-relational theory in order to identify how macro structures such as professionalization nest the way social interaction takes place in concrete spatial situations and surroundings. The argument put forward is that we need to identity this process at the level of the individual in order to qualify and anchor our understanding of professionalization as a macro phenomenon. The empirical basis is two dissimilar locations (health houses), selected from a larger qualitative data set of interviews with health professionals and citizens and observations of health houses, originally selected from a nationwide survey. The presented analysis zooms in on selected places and situations and relates analyses to the overall picture of differences and similarities identified in the larger sample. The analysis shows how entrances, receptions, information screens and coffee tables not only design houses, but also script styles of interaction between health professionals and citizens as well as they work as signs creating expectations about professional roles and how to reflect and act as a professional in a given physical and social setting. The main finding is that spatial surroundings facilitate processes of identification and counter-identification crucial to a new kind of health professionals such as the ones under study here.</p> Marie Østergaard Møller ##submission.copyrightStatement## 2018-12-04 2018-12-04 5 2 72 94 10.7146/qs.v5i2.104462 Using Ignorance as (Un)Conscious Bureaucratic Strategy https://tidsskrift.dk/qual/article/view/104421 <p>Street-level bureaucrats working in the field of migration enforcement have the uneasy task of finding irregularised migrants and processing their cases – often until deportation. As the encounters are unforeseeable and characterised by tension and emotions, bureaucrats develop practices and strategies, which help them to manage the often very personal encounters. Besides the frequently debated strategies summarised under the term ‘copying mechanisms’ and the problem of ‘dirty’ or many hands, ignorance as a tactic in the daily work of bureaucrats has not been studied to a sufficient extent. This work looks at how ignorance, including deliberate not-knowing or blinding out, as well as undeliberate partial-knowing or being kept ignorant, is used in public administration, through multi-sited, ethnographic fieldwork in migration offices and border police/guard offices of three Schengen Member States: Sweden, Switzerland and Latvia. It distinguishes between structural and individual ignorance, which both have the ability to limit migrant’s agency. Further, by analysing their intertwined relation, this article furthers our understanding of how uncertainty and a lack of accountability become results of everyday bureaucratic encounters. Ignorance thus obscures state practices, subjecting migrants with precarious legal status to structural violence.</p> Lisa Marie Borrelli ##submission.copyrightStatement## 2018-12-04 2018-12-04 5 2 95 109 10.7146/qs.v5i2.104421 Assembling Advice https://tidsskrift.dk/qual/article/view/104898 <p>Voluntary sector advice agencies play, for many in the UK, a key role in accessing and understanding public services. As such, whilst fiercely ‘independent’, their relationship to the welfare state is a complex and conflicted one. Presenting data from participant observation, interviews and focus groups with advisers and managers within the Citizens Advice Service, this paper explores this relationship by focusing on two particular areas of the service; the voluntary provision of advice, and the different funding streams that enable this provision. The paper draws upon assemblage theory, focusing as it does upon elements of an organisation in their ongoing practices and relationships; a processual approach that allows us to reflect upon the broader implications of our ethnographic data. Whilst this approach was motivated by our interest in how the Citizens Advice service <em>endures</em>, we conclude by reflecting upon the ‘fragile futures’ of advice in the context of aggressive budget cuts and the welfare reform agenda.</p> Morag McDermont Samuel Kirwan ##submission.copyrightStatement## 2018-12-04 2018-12-04 5 2 110 124 10.7146/qs.v5i2.104898 Treatment of Dual Diagnosis in Denmark https://tidsskrift.dk/qual/article/view/104500 <p>Treatment for dual diagnosis in Denmark is divided between a medically based psychiatric treatment system and a socially oriented substance use treatment system; consequently, in order to deliver the most effective treatment to people with dual diagnosis, the two need to cooperate. A number of projects have been initiated to try out different models for cooperation, yet, on a larger, societal scale, we have not solved the puzzle of how it can be made to work in practice. My focus in this article is to suggest some reasons why it is so difficult to introduce cooperation between psychiatry and addiction treatment despite the many projects directed explicitly towards this. I suggest that at least part of the answer lies in the unequal power relations between psychiatry and substance use treatment.</p> Katrine Schepelern Johansen ##submission.copyrightStatement## 2018-12-04 2018-12-04 5 2 125 139 10.7146/qs.v5i2.104500