From Needs to Relationships to Organisations: Transactional Complexity in Social Work in the Swedish Social Services

Abstract

This article explores how Swedish social workers in different sectors of the social services understand complexity in relation to the needs found in ‘family’ and in social work practice. This study is based on interviews with sixty social workers in five service sectors: child welfare, elderly care, disability care, substance abuse and social assistance. The social workers’ reports of understanding and dealing with families with complex needs reveal distinctions between deeply rooted and broadly based needs. Complex family needs are transformed into complex cases based on family composition, relationships between clients and social workers and organisational context. Complexity theory, and in particular the term transactional complexity, is applied to describe the interactive relationship in and between complex needs, relational complexity and organisational complexity. The boundaries between these three domains are not distinct, and the interconnectivity and complexities occurring in and between them contribute to the production of much of the ‘wickedness’ that exists in social work practice. Social workers may gain from this knowledge in order to unravel the often intangible complexity that commonly appears in social work with families.

Introduction

Social work is a complex profession practiced in a wide range of settings in which social workers draw upon a number of theoretical orientations to identify and alleviate the social needs of individuals, families, groups and communities. These needs are often rooted in poverty and social exclusion and take numerous forms such as conflict, substance abuse (SUB), mental illness, violence, ageing, disability and other social needs. It is almost a truism to say that social work is complex given the wide-ranging social needs or problems to which the profession responds, the variety of organisational contexts in which social work is practiced, and the importance ascribed to the relationally bound nature of professional practice (Payne, 2008; Healy, 2014). Nevertheless, the significance of this complexity is less understood and, therefore, remains the subject of an expanding field of research.

Complexity and the uncertain and ambiguous nature of social work have been examined in services ranging from work with suicidal clients (Mishna et al., 2002) and child abuse (cf. Devaney and Spratt, 2009; Jenkins et al., 2017) to family-based social work more generally (Walsh et al., 2018). In recent years, complexity theory has been used to explicate the intricacies of social work practice (Payne, 2008; Adams et al., 2009; Ewijk, 2018), its management and organisation (Lawler and Bilson, 2010) as well as offering a new approach to the evaluation of social services (Israel and Wolf-Branigin, 2011) and understanding client perspectives of organisational complexity (cf. McArthur et al., 2010; Butler et al., 2012; Grell et al., 2016).

While we are learning more about the barriers that individuals and families with complex needs face when trying to access services, less is known about how social workers understand complexity in their work. Researchers have found that complexity in practice leads social workers to experience their work as demanding and stressful (Tham and Meagher, 2009; Blomberg et al., 2015). Reupert and Maybery (2014) point out that complexity arises from difficulties in determining the focus of practice as well as multiple and conflicting ideas of what is important to address where even the problem of worker turnover becomes an additional source of muddied waters. In child welfare (CW) alone, Hood (2015) found that professionals experienced complexity as an interplay between causal complexity and relational complexity.

Even in a field like CW, where social workers engage in ‘family’-based (though also child protective) practice, evidence of normative practices show that we may ‘manufacture bad mothers’ (Swift, 1995) and ‘ghost fathers’ (Brown et al., 2009). It is less clear where family fits into other fields of social work practice. But, what is it that makes this work so complex and, when it comes to family complexity and social work, are there any shared understandings of complexity that exist across different fields of practice? These questions serve as a starting point for our examination of family complexity and social work in the Swedish social services.

In this article, our purpose is to analyse how social workers in five different social service sectors (CW, elderly care (EC), disability care (DIS), SUB and social assistance (SA)—the administration of means-tested and cash benefits) describe complexity in their work and particularly when considering families with complex needs. Although our study is based in Sweden and we recognise the importance of context to practice, our analyses reveal aspects of complexity that resonate beyond national boundaries.

The Swedish social welfare system

The Swedish welfare system has developed with the equality and equity of all citizens in mind. The intentions of welfare policies are both to decrease or eliminate discrepancies in living standards between families with children and without children but also to eliminate power divisions in families by giving opportunities for women to combine family life with work life and men the opportunity to share in parenting (Ahlberg et al., 2008). Policies are individualised with few references to ‘family’ (Nygren et al., 2018) but are meant to ensure that individuals and families have good living conditions. At the same time, ‘Individual and family [emphasis added] care’ is a well-established organising concept for large parts of social welfare services.

The public sector provides social services in all of the country’s 290 municipalities. Although municipalities have high degree of organisational autonomy, CW, SUB treatment, care for elderly and disabled as well as social (financial) assistance make up the core of social work in the Swedish social services. Most municipalities have separate organisational units managing these services with units often subdivided functionally (e.g. intake or ongoing services) (Blom, 2004; Bergmark and Lundström, 2008; Lundgren et al., 2009). At a policy level, social services aim to promote economic and social security, equality of living conditions and active participation in social life. Services are supposed to be provided on the basis of democracy and solidarity but are at the same time the last safety net of a welfare state (Stranz et al., 2016) having both supportive and controlling elements. Social workers must assess requests or referrals regarding social needs but the provision of services may depend on investigations of need, risk, safety and the ability of individuals to meet these needs on their own contra the municpality’s limited obligation to respond to (financially or through personal social services) these needs.

Complexity as starting point to understanding practice contexts

The theoretical starting point for this article is in theories of complexity as applied to social work. Although we may intuitively understand that much of the social world is complex, there still is no one unifying and rigorous definition of what complexity is. Considering Pycroft and Bartollas’ (2014, p. 5) representation of theories of complexity ranging from positivist to quantum, our standpoint on complexity in social work is positioned in the borderland between critical realist and constructivist approaches. Needs may be ‘real’ but embedded in time and space at the same time as being essentially relational. Social needs are not ‘natural’ in a biological sense but exist in the intersection of the many relationships between the individual and a labyrinthine web of complexities (including but not limited to gender, age, education and social status) that cannot be reduced.

Several key concepts from complexity theory are particularly relevant in explorations of social work with families with complex needs. The kinds of problems or needs encountered may range from tame to wicked (cf. Rittel and Webber, 1973; Peters, 2017). More complex problems carry with them elements of ambiguity and uncertainty both with respect to their causes and potential solutions. Needs do not exist in isolation but rather occur in the context of complex adaptive systems, be they families, groups or organisations (Ewijk, 2018). These are not just nested as defined by ecosystemic approaches but are open and dynamic systems which may behave randomly and in a nonlinear manner (Byrne, 1998). In social work, different systems are in interaction with each other and these have both dissipative and emergent structures where complexity leads to the whole system being greater than the sum of its parts. Törnberg (2017) goes so far as to say that social systems are ‘wicked’ in their complexity because they: (i) are not decomposable—it is not possible to separate the components of social services from relations between components and the people in them; (ii) and they are open to external influences. And, since social complexity lacks a core, it cannot be easily steered or controlled (Ewijk, 2018). In our view nonlinearity, the non-decomposability of part-whole relationships, as well as the irreducibility of properties displayed by social systems (Cilliers, 2005) all are essential aspects of complexity in social work where complex adaptive systems come into contact with each other in a deeply relational way.

Complexity theory may help us to understand why, in social service organisations, one intervention may lead to different outcomes for families with similar problems. In the Swedish social services, families are deconstructed, sorted and categorised into individual problem-bearers or persons who can support or hinder service provision (Gümüscü et al., 2014). Working methods are, therefore, not only aimed at people changing and people sustaining but initially focused on defining and labelling clients and their needs (Hasenfeld, 2010). A major problem with the fragmentation that follows from this sorting and categorisation is that it implies a certain understanding of causality that does not conform to non-reductionist views of social phenomena (Andersson and Törnberg, 2018).

Complexity theory can offer a more nuanced and deeper understanding of human systems and change and may be especially useful in social work research when assessing and analysing risks (Stevens and Hassett, 2007; Stevens and Cox, 2008; Warren-Adamson and Stroud, 2015). Managing complexity in social work is caught between organisational attempts to control complexity through disassembling, sorting and measuring its various aspects (e.g. through new public management (NPM) and other reductionist approaches) and creativity and competencies used in professional judgement. Indeed, scholars in child protection research such as Hassett and Stevens (2014, p. 7) propose a move away from determinism towards ‘empowerment of professionals to balance procedural dictates with professional judgement’. In more general terms, Evertsson et al. (2017, p. 219) conclude that ‘complex problems demand organisations that enable flexible professional practice, general theoretical knowledge and situational adaptivity’.

Methods

This qualitative research study was carried out in 2012 in four Swedish municipalities with social workers in five service sectors: (i) CW, (ii) EC, (iii) DIS, (iv) SUB and (v) SA. We chose a purposive sample of social service organisations taken from a database containing all of Sweden’s 290 municipalities (Lundgren et al., 2009). Two larger municipalities (100,000 + inhabitants) and two smaller (10,000–20,000 inhabitants) were chosen to obtain a variation that reflected different organisational types, whereas the five service sectors were chosen to encompass in broad terms the complexity of needs that social workers encounter (Morris et al., 2008). In this article, we do not aim to make a comparative analysis between service sectors but to get an overall picture of social workers’ understandings of complexity and experiences in working with families with complex needs.

Recruitment began first by contacting the director of social services in each municipality to provide information and request their organisation’s participation in the study. The aim was to telephone interview fifteen social workers from each municipality and working in different service sectors. Sixty social workers participated in this study although the number interviewed in each sector is not equal since there were more social workers working in CW than in SUB in one of the smaller municipalities.

The interviews were carried out after first receiving ethical approval from the Regional Ethical Review Board (protocol number 2010-390-31 Ö) and then receiving informed consent from respondents. During the interviews, respondents referred to cases that they had been involved in. All potentially identifying information about respondents themselves or the individuals and families they worked with has been removed from excerpts in this article. In the interview excerpts, respondents are designated as IP followed by a number and by service area, e.g. IP2/CW.

Description of respondents

Of the sixty respondents, thirteen worked in CW, twelve in EC, twelve with DIS, eleven with SUB and twelve with SA. Almost all respondents were women (fifty-five of sixty interviewed). Their ages ranged from twenty-five to sixty-six with the average being forty-five years old. The majority were between thirty-five and fifty-five years old; coincidentally, eight of them were younger than thirty-five and eight of them were older than fifty-five. Work experience (at the current workplace) varied widely between respondents from one month to thirty-six years, with an average of nine years of experience. Respondents’ educational background also varied though less so: forty-seven respondents had social work degrees while the remainder had ten different educational backgrounds; some respondents practice social work without having a social work degree which reflects that there is no professional monopoly for social work degree holders within Swedish social services.

Data collection and analysis

Since the municipalities were widely geographically dispersed, we used audio-recorded telephone interviews to enable data to be collected at a lower cost and more quickly than by field interviewing (Thomas and Purdon, 1994). A semi-structured interview guide was used to systematically interview the respondents. The same questions were asked in order with all of the respondents though follow-up questions varied depending on the responses received by the interviewer. At the beginning of each interview, respondents were asked to define ‘family’ and describe their perceptions of family in private life and at work. They were then asked about how they target interventions to different family members and to give an example of a case that involved a family with complex needs. Each interview lasted between thirty-five and sixty minutes.

We began the analysis by transcribing all interview texts verbatim. The interviews were carried out in Swedish and translated into English. We then read the transcripts several times in order to obtain the whole sense derived from the text. Transcripts were later imported into the NVivo data analysis program which helped us to organise, code and categorise emerging themes from the interview data (Graneheim and Lundman, 2004). We carried out a directed qualitative content analysis (Hsieh and Shannon, 2005; Mayring, 2014) coding units of text that covered complex needs and social worker’s descriptions of working with families with complex needs. We then recontextualised the data based on manifest and latent analyses, essentially sorting data into material to include or exclude. We worked both together and individually in triangulating our analyses and later compiling our findings.

Findings

In our analysis, we found that social workers have to grapple with three domains of complexity: (i) complex needs, (ii) relational complexity and (iii) organisational complexity. We use the term domain to refer to specific areas wherein complexity can occur and where features of complexity are qualitatively distinct. Although these domains of complexity should not be understood as isolated from each other, we present each of these findings separately for analytical purposes and then discuss how transactional complexity occurring in and between these domains transforms attending to client needs to managing complex cases. Although the term transactional complexity has been used in the fields of business and psychology, we apply it in a unique way to describe an interactive relationship in and between complex needs, relational complexity and organisational complexity in social work. We wish to emphasise the interconnectivity between these three domains of potential complexity where fluid boundaries between these contribute to the production of much of the ‘wickedness’ that exists in social work practice.

Complex needs—deep-rooted and broad-based

Respondents claimed that their work is largely about working with complex needs. Although the concept of needs can be ambiguous and may refer to anything from basic human needs for food and shelter to more abstract needs such as the need for self-actualisation (Maslow, 1943), when we asked respondents to give examples of work involving families with complex needs these were explained as being deeply rooted or broadly based.

‘Deep-rooted needs’ were described as profound, individual needs which could affect family members in different ways but were of different kinds in the different service sectors. For example, an individual with extensive disabilities may need multiple and long-term interventions to meet not only their most basic needs but also other social and psychological needs, whereas family members may have needs connected to the person with the disability. Meanwhile, an adult with an addiction may have specific needs while family members may also need to support and education to help the person with SUB problems. Respondents described these needs as problematic because it is not always clear whose needs need to be addressed first. A social worker described one situation as follows:

…Like when you have a married couple living together where one gets sick and has a huge need for help, which means that you have staff for a large part of the day at home. This may be a concern for the healthy partner…. This can be very difficult … (IP39/EC)

As the quote above illustrates, needs become complex when there are multiple and potentially competing concerns arising not only out of the presenting problem itself but also as a part of social work interventions themselves that can end up impacting others in a household.

‘Broad-based needs’ were described as arising when several individuals in a family have separate but concurring needs for support from the social services. These needs may be within the same service sector or in different sectors. These needs often have some kind of interrelation and affect the family as a whole. In a field like disability, social workers referred to different people with a disability and individual needs. In the quote below, complexity is connected to meeting the various individual needs in the family and bring the family together in the casework process.

‘…we have had a case in which children in the family have had interventions due to a disability where the parents also have a functional impairment and where I mainly think of developmental disorder … the children still are the responsibility of the parents but have no [other] guardians, and where they themselves have a disability … disability there makes it very, very complicated.’ (IP3/DIS)

In CW, complexity is front and centre. There may be custodial parents with SUB problems, violence or mental illness in the family in combination with a family needing financial assistance or other forms of support. Social workers in this service sector described how easily they could access examples from practice.

I have a family that I have been working with for generations, where I have worked with a girl who is now 13 years old. I have seen her since she was 2 years old. She was placed at her grandmother’s when she was 3 or 4 and her mother lived with an addict and abused amphetamines and bennies [Benzedrine] and was generally psychotic sometimes; so that family I have followed and I'm still in the middle there. (IP19/CW)

While the social workers in our study described some needs as deeply rooted and others as broad-based, not all needs were considered complex. Deep-rooted needs were generally seen as complicated but not necessarily complex whereas broad-based needs could quickly become complex because of the number of people involved and the potential though sometimes unpredictable interactions between these needs. Needs that were both deeply rooted and broadly based were considered the most complex and difficult to work with. The combination of prolonged, recurring and changing needs rooted in the problems of individuals in the family or between family members may require multiple interventions across different sectors of the social services or even involve other parts of the broad welfare system (for example: education and health care). Thus, in this sense needs cannot be separated from other domains of complexity.

Relational complexity: in the family and between family and social worker

As Morén (1994) and Blom (2009) have posited, social work is a ‘beautiful’ if also ‘tricky’ relational science and practice. Relational complexity refers to both the complexity that exists in interpersonal relationships and the specific and unique aspects of these relationships as they are given meaning by social workers with clients/families and in particular organisational contexts. Our study has shown that complexity in family-based social work occurs in relationships within families and between family members and social workers. For example, respondents described it as more difficult to relate to and address the needs arising in families that did not fit into normative ideas regarding family composition or behaviours.

In the following quotes, social workers describe variations in the family composition that challenge the normative notion of family.

…a family that is a little special is one where there is a mother with four children from three different dads and two of the children live with one dad and one child lives with another dad and another child is placed in a foster home or with relatives. (IP27/CW)

… a case when in the beginning there are uncles who are very involved in the family … initially, the question was “why are the uncles so involved?” It was a little more than usual that they almost took over the responsibility of the parents and [the case] is about this young guy. But my thought was, “what's this all about?” (IP6/CW)

Some respondents expressed feelings of confusion and struggling to meet the needs of certain types of families where there were multiple needs of support and help because the social services are so strongly individualised and it becomes difficult to attend to the needs of the family as a whole.

The conflict between social workers and family members was identified as a common source of complexity and could arise because of different perspectives each person has about the problem, the approach or the solution. In some cases, the individual or family may refuse intervention or sabotage social workers efforts to help. During longer-term interventions, worker turnover may exacerbate relationship problems between social workers and families.

In the following two examples, social workers describe what may result from relational complexity.

… periodically they isolate themselves and do not want to have contact with us … (IP11/ SUB)

… it may be that relatives can see a different need than the individual himself can or does not see himself. Here you may end up in a small conflict with family members. (IP16/ EC)

Respondents pointed out that understanding clients’ views of their own needs as well as the professional assessment of these needs is important but that relationships can have a profound impact on what emerges out of a helping process. It is important to point out that relational complexity in social work involves power differentials (Sakamoto and Pitner, 2005) between people and systems. However, while the helping relationship is foundational in any change process, relationships in social work are also mediated by the organisational contexts in which they take place.

Organisational complexity

The public administration of social services in Sweden is built upon a bureaucratic rationale that emphasises devolved authority, functional specialisation, delegated authority and proceduralisation (Holosko et al., 2009). Several respondents described organisational difficulties as hampering their work with families with complex needs. In spite of working in one social service organisation, social workers in different sectors do not use the same assessment methods and lack a common approach to addressing needs in families. In addition, cooperation between sectors was personally bound and sensitive to the nature of the relationships existing between social workers in these sectors, making it difficult to keep track of needs in complex cases.

Where children are involved it is always particularly complicated, because there are more people to take into account and more to cooperate with in social services and more for the individual to cooperate with … There are several in charge: someone who is in charge of the children and someone who is responsible for her part, in terms of having to deal with external treatment, for example, and then there are two dads in the periphery that you do not really know … It becomes messy for the individual that we are divided in this way. In addition, I know from own experience that worker changeover happens more often in the child and youth groups than in treatment units so only that can be messy too … (IP57/SUB)

Inadequate coordination and communication are other organisational difficulties that cause problems in working with families with complex needs. In cases where several social workers from different sectors and authorities (health, education and social services) were involved, the different conceptual definitions could create confusion and complicate cooperation. For example, different interpretations of family life, the family concept or child perspective could lead social workers to address the problem from their own perspectives. Not having one person responsible for coordination could be another difficulty in working with families with complex needs.

I had a case with two children with developmental disabilities who had divorced parents each from a different culture. Coordinating services so that everything on the whole would be good was really difficult. Everything was divided up into little pieces of pie: special education was in there, disability services, child psychiatry and a mother who had a previous trauma and wasn’t doing well and an undiagnosed father. There was so much around this family and trying to set goals together for this family just didn’t work. Everybody was protecting their own little bit of turf. Partly there were also legislative and economic considerations that prevented us from providing whatever measures, privacy rules, fear of different alliances within the family. It wasn’t good. (IP23/SUB)

Organisational guidelines could also make work complex—and to address this complexity professional discretion could be used to oppose guidelines and try to support needs. Organisational complexity was also connected to uncertainty about needs that fell outside of their own area of expertise.

…It’s often the lone individual we have here, but a lot has to do with how their relationships look, how they behave with their children and how they interact with others. So, it’s complicated, depending on how you look at the family … I remember a case where we were involved where we could see that the children were neglected. We made a report [to the child welfare sector of the social services] …nothing ever came of it … we made several reports but did not get anything out of it. When I think back to those who work with the children, they see only the children. Those who work with parents, they just see the parents… (IP24/SA)

We observe in the above quotes that social workers’ descriptions do not neatly separate organisational complexity from complex needs or relational complexity. However, the organisational structure of social services in Sweden can lead to a silo mentality where information and knowledge-sharing are reduced and collaborative working is impeded.

Limitations

This article is based on a qualitative study of social workers in a small number of Swedish social services and, therefore, findings should be interpreted cautiously. Respondents also had primary responsibility for gatekeeping and various kinds of needs or risk assessment. Other stories of complexity in family-based social work may have arisen if we had chosen an even broader cross-section of respondents working in a large sample of municipalities and different areas of service delivery. At the same time, this study has shown some of the problems associated with viewing service user needs in isolation.

Discussion

The findings of this study reveal a more nuanced answer to the question of what it is that makes family-based social work so complex. In the following discussion we address this question, and that it leads us to propose the term transactional complexity as a useful theoretical concept for the interactive relationship in and between different domains of complexity wherein complexity takes the different forms of complex needs, relational complexity and organisational complexity. In family-based social work, complexity as a whole retains essential characteristics. However, social workers’ discussions also highlighted the importance of recognising the inherent distinctions between domains of complexity whilst understanding that these are inseparably complex and in an ongoing and changing relationship with each other.

When families approach or are referred to social services, they have needs which may be met in some way by the provision of services. The depth and breadth of needs identified in individuals in the family and the family as a whole alone do not, however, account for all of the complexity in family-based social work. In EC and disabilities, needs may be profound but service provision in Sweden, especially in the disability sector, is based on the right of clients to receive up to a certain number of interventions regardless of how deep-rooted their needs are. It may be that in these sectors, social workers attended mostly to the physiological and safety needs of service users, however, complicated they may be, while taking a limited view of social needs. Meanwhile, the problems of poverty, CW and substance misuse often intersect but to address social needs concurrently would immediately bring complexity into practice as these needs are best understood as being embedded within multiple and interpenetrating relational systems of power and influence (Törnberg, 2017).

Relational complexity in families, between families and social workers and between social workers in different service sectors of the social services added another dimension to complexity in family-based social work. From a complexity perspective, connectivity and interdependence are central in relational work. A connection needs to be made before an interdependent relationship can form between social workers and service users. When ideas about social problems, needs, or even who constitutes a family are contested, this may have an immediate effect on the practice of social work in the social services (Bäck-Wiklund, 2012; Gümüscü et al., 2014). And, in the case of social work with involuntary clients, which in Sweden is possible in CW and substance misuse sectors, relational complexity may have been even more obvious because of mistrust, risk and hostility. In our study, in all service sectors, complex needs transformed into complex cases as soon as there was a further dimension to the problem where more family members had complex needs or where family composition fell outside normative or legal parameters. Cases also became complex where there were relational difficulties or the need to involve services in other sectors. Furthermore, when organisational complexity interacts with relational complexity and complex needs, clients’ needs are recreated to fit particular organisational frames (Juhila et al., 2003).

Transactional complexity is the main theoretical contribution of this article. As a concept, it transcends previous constructions of complexity as situated in either organisations or relationships between professionals and clients, by adding a transactional component. In social work with families with complex needs transactional complexity occurs within and between different domains (the characteristics of needs present, interpersonal relationships and the organisational contexts in which social work is practiced) and in a process where complex adaptive systems come into contact with each other. Families with complex needs come into contact with social services either through self-referral or via concerns reported by others. This initial contact between these complex adaptive systems is transactional in the sense that ‘somebody wants (or needs) something’—but the ‘somebody’ is both the client seeking or declining services but also the social worker who needs or wants information to determine if and what services may be offered. Introducing and implementing services results in increasing complexity in systems on the verge of chaos (Stevens and Cox, 2008). But, being able to see the forest for the trees in transactional complexity requires attending to the different domains of complexity, their interactivity and variability over time.

To date, the approach used in many social service organisations in Sweden can be defined as bureaucratised but influenced by three neo-liberal elements: governance, marketisation and managerialism (Lawler and Bilson, 2010). While this system may work for some, families with complex needs continue to seek ways to deal with the frustration and confusion they face in encounters with the social services. Grell et al. (2016) describe strategies ranging from fight to flight, resignation to consensus-seeking. Such strategies serve as a warning flag to social workers who could benefit from complexity thinking when working in the trenches and trying to disentangle themselves and their clients from some of the transactional complexity that is inherent in the work they do together. As Ewijk (2018, pp. 98–9) argues, ‘in order to deal with complexity the capacity of social workers must include artistry, reflection, a research attitude and craftsmanship’.

Working with complexity begins with considering that complexity is inherent to all social systems and thereby social work as a profession. It is not simply something that can be organised out of the social services (Blom et al., 2011). The respondents in our study implicated organisational issues such as differences in interpretations of problems, concepts and different approaches from different perspectives in further complicating their work. Whereas, Fish and Hardy (2015) rightly state that functional and procedural specialisation have helpful though limited purposes, an integrated organisation that includes theory of change models (see, for example: Jenkins et al., 2017) and, where appropriate, risk assessment, may make complexity more manageable (Rogers, 2008). It may, therefore, be more important for social workers—and organisations—to be able to sort simple cases from more complicated or indeed complex ones. Mapping complexity and viewing it as transactional may be a useful way of understanding social needs but have limited use in prescribing solutions. Family complexity and social work contain elements of ambiguity and uncertainty that could be better addressed by a social worker with the expertise and specialised knowledge necessary to stand in the centre of a complex web of difficulties and be able to attend to parts of a problem that can be managed as tame but also grapple with the jagged, nonlinear and complex problems which evolve over time.

Conclusion

Families with complex needs often have combinations of vulnerability and difficulties that result in various needs of help and support. When social workers meet these families, they may feel a sense of ambiguity and uncertainty. Complex needs may be emergent, unpredictable and have unknown outcomes. We suggest that three aspects are of particular importance in social work and family complexity, given that complexity can be handled and not tamed:

• (1) Dealing with uncertainty: Both individuals and organisations need to devise ways not just to assess risks associated with social needs but to analyse uncertainty factors and determine what risks we can tolerate. This does not imply further bureaucratic governance but more space for ‘out of the box’ thinking given the dynamics of emergent problems and their complexity.

• (2) Integrating of interests: Integrating different types of models, tools, viewpoints and expertise across different sectors of the social services. Although areas of expertise and specialisation have their place, families with complex needs benefit from integrative approaches to service provision.

• (3) Aligning services to complexity: The social services would benefit from the development of a more nuanced understanding of whose needs they are expected to attend to and whether these needs are simple, complicated or complex.

A narrow, individualised focus makes it difficult to see situations of the family as a whole. Relationally, social workers can manage complexity by making it explicit in the encounters with clients (Morén, 2015) but also in other professional relationships; to face together that which is difficult to define, to discuss not knowing when change will happen, and to sort out what clients understand can be a means of transforming the web of complexity into recognisable needs. Organisationally, the social services need to be able to look up from the immediate presenting problems which, as a statutory authority, they are mandated to address and deal with the bigger picture. This is, of course, acknowledging that complex social problems are not just difficult to define but also highly politicised and that what works today may need to be revised as our knowledge and attitudes towards what works will change over time.

Acknowledgement

The authors gratefully acknowledge those social workers that participated in this study.

Funding

This work was supported by the Swedish Council for Working Life and Social Research, FAS dnr. 2010-0198.

Conflict of interest statement. None declared.

References