Shared decision making in Israeli social services: Social workers' perspectives on policy making and implementation

Over the past decades, social policies in Israel have been characterised by a growing trend towards involving social service clients in decision-making processes. Drawing on interviews with seventy-seven social workers from various backgrounds employed in a range of organisations and positions, the current study sought to illuminate the contested nature of shared decision making (SDM), the practice and policy dilemmas it generates, and the readiness of the Israeli policy context to support its implementation. Findings from interviews are described as they relate to questions regarding participants' definition of SDM, major dilemmas and challenges they identify in the process of using SDM, ways of coping with such issues and their perspectives on policies promoting SDM. Their discussion delineates some of the key lessons of the study, raises critical questions about potential contradictions between the call for SDM in social worker-client relationships and the ethos of policy maker-social worker relationships, and uses Critical Systems Heuristics (CSH) to ask, in light of participants' accounts, how suitable the policy platform of Israeli social work is for supporting an effective and reflexive approach to SDM.