照顧與控制之間—以「個案管理」在社工場域的論述實踐為例

Abstract

本文針對目前社工專業居於主流論述地位的「個案管理」，以傅柯的知識與權力觀點進行微觀考察與批判。從社會工作專業所處的社會矛盾，「個案管理」作為一個知識論述，本身即隱含照顧與控制的內在矛盾。「個案管理」在台灣興起的歷史脈絡，與社工專業的殖民學術性格有關，廣泛支持的力量則來自於「個案管理」作為體制改革方案的保守性格、台灣社會福利民營化過程中國家對於管理機制的需求、以及社工專業自我追求建制化的動力。本文透過田野資料說明「個案管理」如何進入不同的場域中，形塑社會工作專業的專業自我、重組社工專業內部各個位置的行動者（政府官員、專家學者、社工員）之間的權力互動關係。結論指出以目前「個案管理」論述進入社工專業的運用方式，不但並未解決資源分配不均的困境，反而將社工在資本主義社會的矛盾加以個人化，並使社工專業日益遠離其專業所承諾服務的弱勢案主。

This paper critically examines the discursive practices of case management from the Foucaultian perspective. As a model for social work practices, case management contains the paradox of care and social control. The import and rise of case management is supported by the conservative nature of case management as an option for reform, colonial character of social work profession, the needs for management by the privatization of social welfare services and the pursuit for professional status. The ethnographic data will demonstrate how case management discourse constitutes social workers` professional self, the tool for social control, and the object for regulatory power. The paper concludes that the usage of case management fails to make structural problems faced by social workers visible but rather individualized. Its effect is that social work profession moves further away from its commitment to disadvantaged people.