Tvångsvård enligt LVM : En studie om socialsekreterares och klienters erfarenheter och upplevelser av LVM-situationen

I denna rapport studeras socialtjänstens tvångsåtgärder mot missbrukare, LVM (lagen om vård av missbrukare i särskilda fall). Syftet är att med utgångspunkt från socialsekreterare och klienter få fördjupad kunskap om hur den utredande processen vid ansökan om LVM-vård uppfattas, tiden på LVM-institutionen och efter avslutad vistelse. Ett annat syfte är att fokusera på meningsskapande processer mellan socialsekreterare och klienter i LVM - situationen. I LVM-processen uppstår olika positioner mellan socialsekreterare och klient vilket speglar aktörernas interaktion i den givna situationen.A large part of the social work with drug abusers is carried out within the social services in Sweden. This is mostly based on voluntary treatment. An important aspect of the work is to motivate the substance abuser to stop the addiction and to change their life situation. In the Swedish welfare system, compulsory treat-ment is used in specific situations in the treatment of substance abusers and is regulated by the Care of Alcoholics and Drug Abuser Act (LVM, 1988:870). De-cisions concerning compulsory treatment are to be taken when the substance abuser has a need for care, which cannot be provided by the Social Welfare Act or in any other way. The social services apply to the county administrative court for a care order, and the court decides in accordance with the statutory provi-sions. When the social worker decides to apply for a care order, an investigation is conducted that includes both social and medical aspects. The aim of this study is to understand and interpret how social workers and substance abusers experience the investigation process for a care order, the time spent at the LVM-institution and after discharge. Another aim is to focus how processes of meaning are shaped within the interaction between social workers and clients. The investigation group consisted of 13 social workers and 10 sub-stance abusers who had been subjected to the process and investigation for applying for a care order. The interview was semi- structured and focused on the different stages in the LVM-process and the relationship between the social worker and the client during the investigation period. All interviews were tape recorded and transcribed to text. The material is analysed by Collins' concept of situation, which also is the main theoretical standpoint. The study shows how the situation is experienced by social workers and substance abusers through the in-vestigation process, being taken in to custody, the stay at the LVM-institution and the different positions taken by the actors during this process. The LVM-situation contains a combination of factors; the addiction, the sub-stance abusers’ life situation, the knowledge that the social services have about the client, the social workers’ values and knowledge and the administrative conditions. How these conditions work together and are assessed will vary depending on the interaction and relationship between social worker and client. The proc-esses of meaning that are created in the relationship between the social worker and client is analysed and theoretically interpreted. These processes create different kinds of meaning for the coercive intervention