This chapter explores the meaning(s) of "treatment effect" within the psychodynamic tradition. The conventional wisdom is that a successful treatment presupposes a transformation of unconscious "material" to a conscious level. The "treatment effect" is reinterpreted as being better understood as changing an old (and detrimental) story into a new tale-an alternative narrative about the self. New possibilities following this conceptual change are introduced with the aid of some concrete examples.

This overview of four evidence maps is based on systematic reviews of assessment and interventions in social work practice. The aim was to investigate the evidence and evidence gaps within four important areas for social work research and practice. Descriptive data on search strategies and domains were collected from four evidence maps, on Social Assistance, Substance Dependence, Care for older adults respectively for persons with disabilities. The scientific quality and scientific evidence were assessed. Key findings were summarised by analyzing and discussing common and specific elements in the evidence maps. The overview was undertaken in close collaboration between researchers with expertise in the field and a government agency. The overview identified both evidence and evidence gaps with respect to effects and experiences of interventions and assessment methods in four evidence maps. Evidence maps provide a comprehensive picture of the state of social services research and can thereby be of use to both researchers and practitioners, and in the production of evidence based social work.

This thesis is a comprehensive examination of cross dressing among men and providesdescriptive information, a review of the literature and some new research data. The theoreticalpart presents a multidimensional model for the analysis of transvestism. Various theoreticalapproaches are analyzed and a self theory based on a cognitive and transpersonal psychologyperspective is successfully elaborated. Transvestism is viewed as a multidetermined phenomena. One important argument in the model is that transvestism can be seen as an expression of a second self or a feminine self. The feminine self is conceptualized as a subsystem of the self.

The empirical section of the thesis contains three different studies. The main part focuseson a qualitative in-depth analysis of a group of twelve transvestites from a cross dressing clubin Sweden, This group of transvestites is also compared with a small group of marginaltransvestites and male-to-female transsexuals. The empirical results give a detailed picture ofthe experiential world of the transvestite and the cognitive and affective changes associatedwith cross dressing. The results confirm previous findings that male transvestism can be seenas an expression of a second self or a feminine self and that cross dressing follows a dynamicpattern from an early "fetishistic stage" to a later "gender identity stage".

The second part of the empirical study contains a comparison between treated and untreated male cross-dressers. This comparison was based on an interview study with 92 male members of a cross dressing club in Sweden. Multiple comparisons showed many similarities between the two groups. However, those in the treated group were more often unmarried or divorced, had experienced more difficulties functioning in the male gender role and also seemed to have a more intense identification with the feminine self.

The third part of the empirical section reviews the findings from a study of 50 wives andlong-term partners of transvestites in Sweden. The results show both positive, neutral andnegative attitudes in various degrees towards cross dressing and both positive and negativefactors in marriage attributed to transvestism.

Syfte

Syftet med denna rapport är att kartlägga det vetenskapliga kunskapsläget utifrån systematiska översikter om utredningar respektive insatser som genom­förs eller kan genomföras i eller på uppdrag av kommunal socialtjänstverksamhet för vuxna individer som är beroende av eller missbrukar alkohol eller narkotika, eller för deras anhöriga.

Bakgrund

Missbruk och beroende av alkohol eller narkotika är sammansatta fenomen där många olika faktorer påverkar. Från ett kliniskt perspektiv har det uppmärksammats att personer som missbrukar eller är beroende av alkohol eller narkotika ofta samtidigt har psykiska och psykosociala problem. Utredningar och insatser involverar därför ofta olika professioner för att ge medicinsk såväl som psykologisk och psyko­social bedömning och behandling. Olika utrednings- eller behandlingsinsatser som kan erbjudas är till exempel ASI (Addiction Severity Index), individuella stödsamtal, kognitiv beteendeterapi, gruppterapi, familjebehandling och moti­verande samtal. Rekommendationer om vård och stöd vid missbruk och beroende finns i Socialstyrelsens nationella riktlinjer, som riktar sig till både socialtjänsten och hälso- och sjukvården.

Metod

Denna kartläggning utgår från elva domäner (listade i tabellen) och systematiska över­sikter publicerade inom dessa domäner. Litteratursökningen efter systematiska översikter utfördes under vintern år 2017 i databaserna Academic Search Elite, ASSIA, Campbell library, IBSS, Proquest Sociology (Sociological Abstracts och Social Services Abstracts), PsycInfo, Medline, SocIndex, Social Care Online och Scopus. Efter litteratursökningen relevans- och kvalitetsbe­dömdes de systematiska översikterna. Utifrån författarnas slutsatser i dem har kunskap och kunskapsluckor doku­menterats områdesvis. Om ingen översikt av medelhög eller hög kvalitet identifierats för en domän redovisas hela domänen som en kunskapslucka. Det kan visserligen finnas primärstudier, men om dessa inte är sammanvägda i en tillförlitlig översikt är det en kunskapslucka enligt SBU:s definition. Kartläggningen inkluderar ingen kvalitetsbedömning av de primärstudier som ingår i de systematiska översikterna.

Huvudresultat

Totalt identifierade SBU 20 systematiska översikter som bedömdes ha hög eller medelhög kvalitet (se Tabell 1). Av dessa berör 17 domänen Psykologiska och psykosociala behandlingsinsatser, varav de flesta rörde allmänna psyko­sociala insatser följt av motiverande samtal och 12-stegsbehandling. Domänen Stöd, råd och information berörs i 5 översikter. Sammantaget visar översikterna att det finns både vetenskaplig kunskap och vetenskapliga kunskapsluckor inom dessa två domäner. Övriga domäner utgör alla vetenskapliga kunskapsluckor.

Forskningsmetoder i socialt arbete diskuterar olika typer av metodrepertoarer som kan vara användbara vid forskning inom samhällsvetenskap i allmänhet och socialt arbete i synnerhet.Antologin syftar till att ge en första introduktion till olika metodstrategier, kvalitativa och kvantitativa metoder, olika specialmetoder, rättsvetenskaplig metod, metaanalyser,fokusgrupper, fallstudiemetodik, videoanalyser,organisationsanalys samt multidimensionell forskning och analys.Antologin diskuterar även helt kort några olika former av utvärderingsinsatser. Sammantaget utgör boken en ”metodverktygslåda” för studenter och forskare.

This chapter provides a short introduction to, and an overview for, using narrative analysis in the understanding of the use and misuse of alcohol and drugs. Important theoretical and methodological dimensions are discussed. Some tentative conclusions, limitations, and unresolved critical issues concerning the use of narrative research methods in the analysis of substance use-related dependency problems are also presented.

The narrative turn has entered many different academic disciplines and is now also emerging in social work. This article focuses on a discussion of the possibilities and limitations of doing narrative research in social work, including a scrutiny of definitions and of a number of theoretical and methodological arguments often used by some of the leading narrative researchers.

This chapter examines the possibilities and limitations of using a narrative method as a framework within a multidimensional model for exploring and analyzing the use and misuse of alcohol and drugs. It is posited that a multidimensional model, based on narrative reasoning, can give a more detailed and specific understanding of substance users, who represent a heterogeneous population of people, and of substance use-related dependency problems. Such a model describes and analyses the drug-use related problems in a manner that provides holistic and important information and knowledge about the person by contextual and situation interaction processes which are involved in the use/misuse of alcohol and drugs. Tentative conclusions and unresolved critical issues are considered.

The chapter presents a multidimensional model where alcohol and drug use-misuse is considered as a multifactorial bio-psychosocial process. The multidimensional model describes the complexity of factors that contribute to alcohol and drug usemisuse and how this makes its study very challenging. The theoretical model considers many dimensions related to different intrapersonal and extra-personal factors affecting alcohol- and drug use-misuse.

The intrapersonal influences include processes contributing to personal differences in alcohol and drug use. The focus is especially on neurobiological processes, personality, affective states, including, cognitive motivation or expectancies as behavioral motivators. Extra-personal influences consider demographics, environmental, social and sociocultural factors.

This article discusses different self-theoretical perspectives of the self that are of importance in the analysis of the use and misuse of alcohol and psychoactive drugs. The self-theories considered here include cognitive, psychodynamic, transpersonal, and social constructivist perspectives. A multidimensional perspective focusing on the connection between identity structures and analyzing the use/misuse of alcohol and psychoactive drugs is presented. The article argues for a self-theoretical analysis based on narrative data in order to reach an in-depth understanding of the use and misuse of alcohol and psychoactive drugs.

Many substance use prevention programs directed at adolescents exist that have been developed by researchers in the United States and are intended to be used in school settings. Some of the problems associated with such programs are reviewed, including their accessibility, ease of use, copyright status, evaluation options, program scales, and ratings, together with an overall consideration of the factors and processes posited to be associated with substance use and non-use (posited "at-risk" and "protective" mechanisms). The authors contend that there is a great need to: (a) develop substance use prevention programs which are commercially available but are not protected by copyright, (b) assess empirically each component in a program separately, and (c) encourage funding bodies to be more active in supporting the production of manuals and evaluation instruments for substance use prevention programs directed at adolescents. We need more and better process evaluations that are also sensitive to both endogenous and exogenous forces in order to know the processes by which a successful prevention program achieves its effects, is prevented from doing so and which processes are irrelevant. A social competence framework might be used as both a goal and as a theoretical base to achieve a better understanding of the processes by which substance use prevention programs reach their effects.

Preliminary and tentative conclusions concerning theoretical and methodological issues about narrative methods and their use as a research strategy for investigating and understanding the use and misuse of alcohol and drugs are presented. The treatment methods that are influenced by narrative strategies as well as this tool's limitations are noted. The article focuses particularly on approaches based on, and influenced by, psychology, sociology and social work when conducting narrative research.

There is a great debate considering social work related to health issues, wellbeing and sustainable development. This chapter examines possibilities and limitations of using a multidimensional perspective to explore and analyse use and misuse of alcohol, based on self-theoretical reasoning, gives a more detailed and specific understanding of substance users who represent a heterogeneous population, and of substance use-related dependency problems and their treatment to restore health and wellbeing and more sustainable life situations. Such an approach describes and analyses drug-use related problems in a manner that provides holistic information and relevant knowledge about persons and situational interaction processes that are involved in the use and misuse of alchol and drugs and its treatment. Tentative conclusions are presented.

The article focuses on narratives of clients' experiences of using/misusing alcohol and drugs and includes comments on their therapeutic process during treatment for dependency on psychoactive drugs. It discusses the role of narratives that focus on clients' experiences of understanding the use/ misuse of psychoactive drugs, emphasizing the importance of the narratives. Narrative therapy for substance-use-related dependency is discussed. Insight into the treatment processes of dependency, based on narrative case illustrations, is also provided.

This article considers different perspectives on the treatment of substance use-related dependency, focusing on the importance of a therapeutic relationship, working alliance, counseling, and the use of narrative methods. The article also discusses some unresolved critical issues concerning the possibilities and limitations of acquiring necessary knowledge about substance use-related dependency when using narrative research methods. The main conclusion is that the therapeutic relationship between the therapist and the client is of crucial importance for a positive outcome of treatment and that narrative methods provide a detailed empirical database for analyses of substance use-related dependency.