The present study investigates patients' opinion on what constitutes good psychiatric care. It was a qualitative study using an open-ended in-depth interview centering on the patient's experiences of receiving psychiatric care. The subjects were selected to ensure maximum variation and heterogeneity. A model of deliberate sampling for heterogeneity and a modified, stratified sampling method were used. One outpatient and one inpatient sample were selected. The description and analysis of data were based on a variable-oriented, cross-case technique. The analysis was made separately for the two sub-samples. The main result for both samples was the emergence of one main category: the quality of the helping encounter. The quality of the relationship between patient and therapist/staff, and being understood by the therapist/staff, formed the most central aspects of good care. For the inpatient group the analyses also pointed to stability and structure and relief of pressure as main categories. Though the focus of the study was on satisfaction with general psychiatric care, the results revealed a construct initially identified within the field of psychotherapy, namely the 'helping alliance', as the most crucial factor. The results also gave some further indications of what bring about a good therapeutic relationship; and prominent in this study, and not very often reported in the context of helping alliance, was that ambivalence, time and meaning were important constituents of the relationship. The findings emphasize the importance and quality of the therapeutic relationship and point to the incorporation of psychotherapeutic principles in all provider-patient relationships in general psychiatric care.

This is an author produced version of a paper published in Social Psychiatry Psychiatric Epidemiology. This paper has been peer-reviewed but does not include the final publisher proof-corrections or journal pagination. Abstract:Background: The study examined client factors of relevance for the establishment of the helping alliance and for dropout in a routine psychiatric setting, admitting a variety of diagnoses and staffed with a multi-professional team. Method: Newly-admitted patients (n= 122) and staff completed questionnaires regarding the helping alliance, and the patients also regarding motivation, symptoms and interpersonal problems. The patients were also diagnosed according to the ICD-10 and followed up concerning early dropout. Results: Several variables correlated with the helping alliance and multivariate analyses showed that the cold/distant factor, motivation and the interpersonal sensitivity factor were the most important factors in establishing the helping alliance. Moreover, it was the alliance as perceived by the patients and not the staff that proved to be the most essential variable. A logistic regression analysis showed that early dropout was predicted by low helping alliance, low age and cold/distant. Conclusion:The most important client factors for establishing the helping alliance and for predicting early dropout seem to be those relevant to interpersonal processes. Further, the therapists'/staff's responsiveness to these client factors seems to be of decisive importance.

As welfare states are increasingly challenged and replaced by welfare mix models, new ideas about the functions of non-profit and voluntary organisations (NPVOs) provoke political conflicts that should be reflected in research. This paper explores the significance of political and ideological dimensions to present changes in the Swedish welfare state regarding NPVOs as welfare services providers. Investigating both national and local level, the study addresses political as well as practical implications of the reframing of NPVOs as service providers rather than being associated with a voice function. The article shows extensive differences between national and local levels as contentious ideological cleavages at national level are dormant in local level politics. Variations in the way relations to NPVOs are structured in practice at local level appear related to factors other than political dimensions. The findings support the development of an analytical framework that reflects political dimensions and allow for empirical focus that includes national and local level politics and practices. Resumen Dado que los estados de bienestar están siendo cada vez más cuestionados y sustituidos por modelos mixtos de bienestar, las nuevas ideas sobre las funciones de las organizaciones voluntarias y sin ánimo de lucro (NPVO, del inglés Non-profit and voluntary organisation) provocan conflictos políticos que deben ser reflejados en la investigación. El presente documento explora la importancia de las dimensiones políticas e ideológicas para presentar los cambios en el estado de bienestar sueco en relación con las NPVO como proveedoras de servicios de bienestar. Al investigar tanto el nivel nacional como el local, el estudio aborda las implicaciones políticas, así como también las prácticas, de la reformulación de las 1602Voluntas (2015 ) 26:1601 -1619 123 NPVO como proveedoras de servicios en lugar de asociarlas a una función de voz. El artículo muestra las grandes diferencias entre los niveles local y nacional, ya que las divisiones ideológicas polémicas a nivel nacional están latentes en la política a nivel local. Las variaciones en la forma en la que están estructuradas las relaciones con las NPVO en la práctica a nivel local aparecen relacionadas con los factores aparte de las dimensiones políticas. Los hallazgos apoyan el desarrollo de un marco analítico que refleje las dimensiones políticas y permita un foco de atención empírico que incluya la política y las prácticas a nivel nacional y local.

The findings emphasize that a holding environment is important in establishing a good helping alliance, which is consistent with results from the psychotherapy area. Since helping alliance is known to have a most important influence on therapy outcome, one conclusion must be that the staff, in their endeavour to strengthen the supportive element of the ward atmosphere, may improve the therapeutic outcome as well.

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Purpose -To clarify the core characteristics of Nordic activation policies in the context of typologies of European activation governance. Design/methodology/approach -The paper analyses activation governance in the light of the basic values and beliefs behind the formation of the Nordic social protection systems in the mid-20th century. Recent model-building efforts see the Nordic countries as being close to a ''universalistic'' and egalitarian type of activation policy that does not systematically submit citizens to work requirements. The authors ask whether this model captures the actual scope and contents of Nordic activation governance. Findings -The Nordic countries-based relatively generous income security systems on a strong work ethic and ambitions to maximise labour market participation of the working-age population. Citizens's rights to income security were generally linked to the fulfilment of work requirements. Although this active governance of unemployed citizens eroded in the 1970s and 1980s all the Nordic countries revived it after 1990. Largely reflecting the dual structure of the income protection system, Nordic active approaches to activation are not egalitarian. Research limitations/implications -Nordic countries are currently implementing major administrative reforms in social protection, possibly creating more unified and egalitarian governance of activation. Future research needs to assess the impact of these reforms. Originality/value -The article presents an analysis of activation policies that so far has been missing from comparative research and that will be of particular value for non-Nordic readers who may have received a biased view of Nordic activation policies.

A growing body of research highlights how the Internet and social media offer new platforms for advocacy. This article contributes to the debates on digital advocacy by combining interest group and social media studies and present the notions of digital access politics, digital information politics, and digital protest politics for a comprehensive analysis of digital advocacy. Based on a netnographic study of two highly different advocacy groups working with workers’ rights in a Swedish context, we find that online and offline activities are highly interconnected. While previous studies have largely focused on how groups gain political influence, present digital advocacy is much more oriented towards gaining political presence through social media. The article proposes that future studies into advocacy in the digital era needs to study acts for political influence and acts for political presence as intertwined or even as two sides of the same coin.

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