Family Support Services in Sweden

By De Bernardi, Vivien | Journal of Comparative Family Studies, Autumn 1995 | Go to article overview

Family Support Services in Sweden


De Bernardi, Vivien, Journal of Comparative Family Studies


VIVIEN DE BERNARDI* THE CHILD HEALTH CARE PROGRAM The current Swedish family care program is one of the most admired European models of social democracy and despite financial restrictions due to worldwide recession, the programs described here seem securely mandated. On the principle that the economy flourishes in direct relation to the mental health of the population, Sweden maintains a family support system that acknowledges mental and social, as well as medical, needs of its citizens, especially children. Our observations in southern Sweden began in Helsingborg with the Child Health Care Program.

Besides the normal medical check-ups and vaccination appointments, the Swedish pre-schooler has four developmental check-ups, at eighteen months, two and a half years, four years, and six years. The original program, established in the 1930's, was expanded in the late sixties to include practical problems encountered in the day to day care of children, such as feeding or sleeping difficulties, developmental delay, aggression towards a younger sibling or other children, disobedience, or the trauma related to divorce. Sometimes it is sufficient for parents to speak with a specialist about development and upbringing, or to meet with other families concerned with the same issues. Other problems require more comprehensive treatment. This may take place at the Child Health Care Center, in the home, in the day-care setting or nursery school. Because these visits are considered preventive health care, there is no charge and all Swedish families participate to some extent. Perhaps the single most impressive aspect of the services provided is their firm economic base in federal funding (There are presently only two tax categories in Sweden: one pays either 30% or 50% of income in taxes). Either parent can have from twelve to eighteen months off work with 80% pay after the birth of a child. Parents also have the right to ninety days off work with pay per year for child care or illness. This may well be the key to successful intervention: parents. are available to participate.

The Child Health Care Program also provides support for mothers at risk. Midwives generally refer these women to the treatment program. Common signs of risk are going very late in pregnancy to the midwife for pre-natal care (denial of pregnancy), poor relationship with partner, poor relationship with mother, no sense of pride. in growing tummy, not sharing the news of pregnancy with friends, not choosing names or clothes for the baby.

One of the purposes of the Child Health Care Program is to teach parents alternative ways of interacting and appropriate techniques for discipline. Most interventions are once or twice a week and there is a national consensus as to what healthy childcare practice entails. In 1958 teachers were forbidden by law to hit students and since 1979 it is also against the law for parents to hit their children. Serious Problems We found the approach to more serious cases of child abuse and/or neglect strikingly exemplified three notable aspects of the Swedish model: I) prevention, 2) preparation for any psychological counseling, and 3) integration of services. Helsingborg, with a population of 110, 000, is one of Sweden's larger communities and Villa Maria is a lovely home situated on the grounds of a former state mental hospital (all such hospitals are being phased out in favor of smaller, more family-like treatment centers). The Villa Maria staff are multidisciplinary including a developmental psychologist, a psychiatric nurse; an educational therapist, a kindergarden teacher, a pediatric nurse, a child and adolescent psychologist, and a social worker who, as always in Sweden, is considered the key figure.

Initially the family comes to Villa Maria with the professional who has referred them. The first step is agreement as to what is the problem. The first week of intervention includes the whole family four mornings 8:30 to 1:00 AM. …

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