The Balancing Act: Clients with Complex Needs Describe Their Handling of Specialised Personal Social Services in Sweden

Dealing with specialised social service organisations can be a challenge for clients with complex needs. These organisations may appear confusing and hard to navigate, and there is also a risk of service fragmentation, as such clients often participate simultaneously in an array of interventions. An additional complication to be handled is that these parallel interventions can range from voluntary to more or less involuntary. The aim of the present article is to describe and analyse how clients with complex needs account for their handling of service conditions within specialised personal social services (PSS), using data from a qualitative interview study with PSS clients in Sweden. A conceptual model is presented, covering four ideal typical client approaches to these specialised services: consensus, resignation, fight and escape. One key finding is that the clients combined these approaches in a balancing act intended to promote their own best interests in their parallel contacts with different parts of the specialised PSS organisation. The article concludes that future improvements in social services could be made by paying more attention to the structural arrangements that surround encounters between clients and the social services, as well as clients' valuable first-hand knowledge of social service organisations.