The research that changed practices in social services

When SBU investigated what interventions were used for children and young people in need of support from social services,at least 102 interventions were identified. 

Only nine of them, however, had a strong scientific foundation.

But the future looks bright, according to Knut Sundell, senior advisor for social affairs at SBU:

“Currently, about one study a week is being published that measures the effect of an intervention, a dramatic increase since the 1990s when only a handful were published each year.

The research findings are later compiled in SBU reports and ultimately used by institutions such as the National Board of Health and Welfare to produce a knowledge base and formulate guidance in the field. This approach allows municipalities to choose effective interventions and methods, and avoid spending money on measures that may not work.

Every year, approximately 800,000, from a population of 10 million, people benefit from Swedish social services and disability interventions.

Parental support based on the right components

The City of Stockholm is one of the municipalities that aims to put scientifically based methods into practice. One concrete example is parental support programs.
Katarina Munier is the head of the unit at the Center for Children and Youth (Kompetenscenter för barn och unga) in the City of Stockholm:
“Assessments have shown that some parental support programs work well. Parents with children who act out are now offered this type of help, which is based on precisely those components deemed to have a beneficial effect.

Structured methods to predict repeat violence in young people

Structured methods such as SAVRY can provide guidance in assessing the risk of repeat violence and other criminal activities among young people, at least at lower levels of risk.

SAVRY stands for Structured Assessment of Violence Risk in Youth. Between 2020 and 2022, the City of Stockholm trained almost 260 social workers in the SAVRY decision support tool.

Foster care treatment helps young people with behavioral problems

An alternative to living in special residential homes (SiS-hem) under the auspices of the Swedish National Board of Institutional Care is available for young people who have engaged in criminal behavior or who have other serious behavioral problems. An SBU report has shown that young people with serious behavioral problems fare better when living in the foster care setting, in which both they and adult family members receive special support. Foster care is also cost-effective for society compared with institutional care.

There are several types of foster care, but the approach supported by research is the US model known as Treatment Foster Care Oregon (TFCO).

Independent living is easier with proper support

Few Swedish municipalities provide support programs for youth who transition from placement in a “home for care and living” (HVB) or family home to independent living. Research has shown that these young people successfully transition to independent adulthood better when receiving support, such as the program for Independent Living Services (ILS) in the US. Individuals about to exit from residential care are assigned a mentor who provides support as needed, for example regarding housing, education, employment, health care or in relation to social issues.

Support for vulnerable adults

Residential support can also be effective for adults who have been excluded from society, as shown by research on how to reduce homelessness among people with substance abuse, addiction and mental health problems. SBU has reviewed assessments of the Case Management (CM) and Housing First interventions, aimed at reducing homelessness in this group.

Peter Sonnsjö is head of operations in Kristianstad, one of the municipalities where these types of intervention are used in social services:

“We have several fully trained case managers in the municipality, and the “Housing First” caseworkers have also received basic skills in CM to enable them to adhere to the program.

IPS provides jobs to more individuals with mental disabilities

A growing number of Swedish municipalities have availed themselves of recent research concerning support for individuals with mental disabilities in order to help them find and keep a job. With this approach, municipalities provide Individualized Support for Employment (Individanpassat stöd till arbete, IPS), which is supported by scientific research and significantly increases the chances of finding work in the open labor market with greater success than through traditional work rehabilitation programs.

Despite the good results from IPS and a recommendation from the National Board of Health and Welfare, this approach has only been used to a limited extent. To date, the National Board of Health and Welfare’s national guidelines only recommend IPS for people with schizophrenia or schizophrenia-like conditions.

About the reports

• Support program for parents of children who act out: Effects and active components. SBU 2019. (Föräldrastödsprogram vid utagerande beteende hos barn: Effekter och verksamma komponenter.)
• Foster care for young people with serious behavioral problems – Treatment Foster Care Oregon. SBU 2018. (Behandlingsfamiljer för ungdomar med allvarliga beteendeproblem – Treatment Foster Care Oregon.)
• Risk and needs assessment of young people regarding recidivism in violence and other criminality. SBU 2019. (Risk- och behovsbedömning av ungdomar avseende återfall i våld och annan kriminalitet.)
• Support for young people moving out of residential care. A systematic review. SBU 2020. (Stöd till unga som ska flytta från placering i social dygnsvård. En systematisk översikt.)
• Interventions to reduce homelessness for people with substance abuse, addiction and mental health problems. SBU 2018. (Insatser för att minska hemlöshet för personer med missbruk, beroende och psykisk ohälsa.)
• Individualized Support for Employment (IPS) for people with mental disabilities. SBU 2020. (Individ- anpassat stöd till arbete (IPS) för personer med psykisk funktionsnedsättning.)

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