Comunidade terapêutica: relato e análise de uma experiência

Neste trabalho, procuramos analisar fatores que contribuem para o sucesso ou insucesso de determinadas práticas terapêuticas em instituições psiquiátricas. Como prática social, que se realiza através de instituições, a psiquiatria e as relações sociais e humanas dela decorrentes, são, um campo privilegiado de aplicação de descobertas das ciências sociais e do comportamento e seu estudo dificilmente se fará a partir de uma só perspectiva, que nos possibilita referendar este trabalho sob uma abordagem institucional, considerando o hospital estudado como fazendo parte de um contexto mais amplo da sociedade. A análise foi realizada através da comparação de dados referentes aos pacientes e à equipe de atendimento do hospital psiquiátrico que ilustra este trabalho. Estes se referem a dois períodos diferentes de atendimento psiquiátrico. Consideramos o primeiro período como de terapêutica clássica e o segundo como o da implantação e expansão da experiência de comunidade terapêutica. Colocamos este segundo momento como o mais relevante na história das práticas terapêuticas daquele hospital, posto que marca o início de um período bastante diferente do anterior , tanto no que concerne às ideias e à abordagem dos problemas psiquiátricos em geral, quanto à atenção dispensada aos pacientes especificamente, deixando cada vez menor a margem para um tratamento unilateral da doença mental, não somente em termos teóricos, mas também, em termos práticos em virtude da tentativa de fortalecimento da vinculação paciente/família/comunidade. Entretanto a comparação realizada nos permite concluir que de acordo com os dados apresentados pelo hospital os dois períodos não diferem significativamente no que se referem aos pacientes e a equipe de atendimento. Considerando ainda que a prática terapêutica em hospitais públicos está organizada em função de objetivos da política de saúde vigente.

Serviço Social e terceiro setor: considerações sobre as atuais relações e condições de trabalho para o Assistente Social em Natal

The present study analyses the actual relations and work conditions found in the third sector in Natal city, in the context of productive restoration and increasingly retraction from the State in providing Social Service before the new approach that has been destined to the social issue. The study talks about the work of the social worker when fighting the different expressions the social issue has, such as social service provision as a way of teamwork associated to work relations and conditions, to accessible resources and quality control management. These are elements that affect and interfere in the accomplishment and in the work of the social worker itself. The State s improvement, according to neoliberal-political precepts and increasingly retraction from the public investment in the areas of social concern (health, social welfare, assistance) and in the wage and employment policy, besides expanding the partnership with the public and private areas, in search for social services with quality, it has diversified the structures of the professional work with the growth of the so called third sector institutions. However, the absorption of the social workers by the third sector groups in general, has as major features the impoverishment of work relations, the maintenance of an unequal salary model, pointing out the deadline contracts and/or single tasks that generate work instability. The research debates, with a critical view and full perspective, over the conception of the third sector, interpreted as an action that expresses functions and values, treated as a real phenomenon generated from the restoration of the capital based on neoliberal principles. This study aims for responding what the established work relations are and under what work conditions the social worker has been fitting in the third sector and how such a reality echoes in the current work conditions for a social work in the city of Natal, before this new model of state intervention that transfers part of the social service provision to distinctive divisions of society, among them the so called third sector. The research results have shown that like the other workers the social worker passes through the same crises, dilemmas, advances and challenges that occur in the world of employment and which are expressed in the drop of salary average in the growth of contemporary contracts, unemployment, and in the ever more selective requirements to one be included in the social spaces, where the professional work is done, having as a result a greater impoverishment of work relations and conditions as well as more vulnerability as a salaried occupation

Serviço Social Audit Saúde no SUS/RN: projeto ético político profissional e de reforma sanitária

Health policies in Brazil, the decentralization of SUS management responsibilities for the three spheres of government has driven the creation and regulation of the audits of health services in the National Audit Office, this is a trend of neoliberal policies imposed by international bodies like the World Bank and IMF to peripheral countries characterized by productive restructuring and reforming the state focuses on the presence of two competing projects in the area of health: Health Sector Reform Project which is based on the democratic rule of law with the assumption of health as social right and duty of the State in defending the extension of the conquest of rights and democratization of access to health care guaranteed through the public financing strategies and the effective decentralization of decisions pervaded by social control and privatized Health Project which is based on the state minimum, with a reduction in social spending or in partnerships and privatization, stronger nonprofit sector, subject to capitalist interests, is made effective through strategies targeting health policy and refilantropização actions. In this context, the present study is an analysis on the work of social audits of public health in infants from a qualitative and quantitative approach, embodied by the critical method of dialectical Marxist social theory that enabled us to unveil the characterization, the demands, challenges and outline the profile of Social Work in teams inserted audits of SUS in RN, but also provided evidence to demonstrate the prospects and possibilities of this area of activity of social workers. It was also found that through the audit work that the state fulfill its role as bureaucratic and regulator of health services with efficiency, effectiveness and economy. Yet, paradoxically, the audits of SUS may provide a vehicle for enforcing rights and ensuring the fundamental principles contained in the project of health reform, because it can be configured in a space of political struggle as representing a new field of knowledge production that needs to be appropriate for a theoretical critic able to redirect the social interests in favor of the user. From this perspective, it is concluded that the work of social audits of public health in infants despite the social relevance that prints, as they constitute an activity study of reality and its transformation proposition requires a transformative political action guided the discussion Marxist theory holds that the ethical project professional politician of Social Work

Representação social em saúde mental na perspectiva de médicos generalistas da ESF na cidade de Diadema-SP

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A atuação do assistente social como educador ambiental nos Projetos de Trabalho Técnico Social (PTTS)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

(In)capacitados para o trabalho?: trabalho, estranhamento e saúde do trabalhador no Brasil (2000-2010)

Pós-graduação em Ciências Sociais - FFC

Risk factors that may signify a propensity to the use of drugs in students at a public university

Introduction: We sought to evaluate the risk factors that may increase the propensity to use licit and illicit drugs among students at a public university. Methods: The project involved students (n = 268) enrolled in the first and fourth years of courses in the areas of the social and biological sciences at a public university. Data collection was conducted by means of self-administered, semistructured questionnaires, based on such standardized assessment instruments as Audit, Assist, Cage and Duse. Collected data were analyzed quantitatively by calculating the percentages and evaluating the data in terms of categories of risk, classifying them by age, gender, religion, schooling, use (before or after entering university) and contexts of use. By means of this survey the researchers were able to correlate the use of drugs to the risk factors that might increase the students’ propensity to use these substances. Results: The results revealed a high proportion of current drug-using students, but showed no significant differences between the first and fourth year students as regards contexts of use. However, 67% of students regarded the university environment as encouraging the use of drugs. Students pointed to such major risk factors as friends’ and fellow-students’ influence, university parties, excessive curiosity and desire to experiment. Conclusion: Due to the high rate of drug use among university students, by the determination of the risk factors related to the university environment and also knowing that the process of addiction is one of growing chemical dependence, the importance of the development and implementation of public health policies at all levels, especially in terms of approaches and specific interventions addressing this population, should be noted.

A intersetorialidade das políticas de saúde e de assistência social no sistema de atenção domiciliar em Franca/SP

Pós-graduação em Serviço Social - FCHS

The Effect Of Social Support On Health As Moderated By Sex-Role Orientation

Previous research has established a significant association between social support and health; high levels of social support are consistently shown to both directly and indirectly improve health (Cohen, 1998, House et al. 1988, Rook, 2001, Schwarzer & Leppin 1989). Additional research has investigated the role of sex and gender differences in social support, health and the interaction between these variables (Barbee et al. 1993, Burda, Vaux & Schill 1984, Cleary, 1987, Rook, 2001, Shumaker & Hill, 1991). The present study aims to further examine the influence of sex-role orientation on social support and health. Forty-nine female participants completed a three-part survey assessing their sex-role orientation, perceived social support, current stress levels and physical health. Results revealed that both masculinity and femininity relate to social support network size and health outcomes. Masculinity and androgyny were significantly negatively associated with health problems, whereas undifferentiated individuals had higher rates of physical illness. These findings demonstrate the important role of gendered traits in social support and ultimately, physical health.

Citizenship and Mental Health Policy in Europe

The problems confronted by people who experience mental disorders are often conceptualised in terms of health and illness. However, these problems extend far beyond the healthcare system, into all areas of human life. Having a psychiatric diagnosis may have a negative impact on every aspect of the individual’s life, leading to the deprivation or limitation of rights in relation to housing, employment, and family life. In this article, some of these problems are discussed within the theoretical framework of debates on citizenship and on human rights. As the context is Europe, reference is made to the recent policy initiatives with the EU, to national and European level consumer organisations and to cases brought before the European Court of Human Rights.

Resisting Postmodernity: Swedish social policy in the 1990s

The purpose of this paper is to introduce ideas that have emerged during the course of writing a book on Swedish welfare in the 1990s. The book is the result of many years of writing about two subjects: Swedish drug policy and the Swedish welfare state. The one very specialised, the other, more general. I first became interested in Swedish drug policy on a research visit to Örebro Län in 1986. A social worker showed me a copy of the county's drug policy programme and explained the significance of the 'restrictive line'. I have spent the years since that visit, trying to understand and explain the Swedish goal of a drug-free society (Gould 1988, 1994, 1996b). I only began to write about the welfare state in Sweden in the early 1990s, just as things were beginning to go wrong for the economy (Gould 1993a, 1993b, 1996a, 1999). For the last few years I have intended to write a book on the events covered by the period 1991-1998 - the years of a Bourgeois and a Social Democratic Government -which would bring the two halves of my work together. Material for this study has been accumulated over many years. A number of research visits have been made; large numbers of academics, politicians, civil servants, journalists, unemployed people, social workers and their clients have been interviewed; and extensive use has been made of academic, administrative and public libraries. Since September 1991 I have systematically collected articles from Dagens Nyheter about social services, social insurance, health care, employment, social issues and problems, the economy and politics. The journal Riksdag och Departement (Parliament and Ministry), which summarises a wide range of public documents, has been invaluable. Friends and informal contacts have also given me insights into the Swedish way of life. The new book is based upon all of these experiences. This paper will begin with a brief account of major global social and economic changes that have occurred in the last twenty years. This is intended to provide a background to the more recent changes that have occurred in Swedish society in the last decade. It will be suggested that the changes in Sweden, particularly in the field of welfare, have been less severe than elsewhere and that this is due to political, institutional and cultural resistance. The paper will conclude by arguing that Sweden, as an exemplar of an Apollonian modern society, has had much to fear from the Dionysian characteristics of postmodernity.

Cultural models of healing and health: An ethnography of professional nurses and healers

Cultural models of the domains healing and health are important in how people understand health and their behavior regarding it. The biomedicine model has been predominant in Western society. Recent popularity of holistic health and alternative healing modalities contrasts with the biomedical model and the assumptions upon which that model has been practiced. The holistic health movement characterizes an effort by health care providers and others such as nurses to expand the biomedical model and has often incorporated alternative modalities. This research described and compared the cultural models of healing of professional nurses and alternative healers. A group of nursing faculty who promote a holistic model were compared to a group of healers using healing touch. Ethnographic methods of participant observation, free listing and pile sort were used. Theoretical sampling in the free listings reached saturation at 18 in the group of nurses and 21 in the group of healers. Categories consistent for both groups emerged from the data. These were: physical, mental, attitude, relationships, spiritual, self management, and health seeking including biomedical and alternative resources. The healers had little differentiation between the concepts health and healing. The nurses, however, had more elements in self management for health and in health seeking for healing. This reflects the nurse's role in facilitating the shift in locus of responsibility between health and healing. The healers provided more specific information regarding alternative resources. The healer's conceptualization of health was embedded in a spiritual belief system and contrasted dramatically with that of biomedicine. The healer's models also contrasted with holistic health in the areas of holism, locus of responsibility, and dealing with uncertainty. The similarity between the groups and their dissimilarity to biomedicine suggest a larger cultural shift in beliefs regarding health care. ^

The influence of staff and organizational characteristics on social environment in substance abuse treatment facilities

The staff of 20 substance abuse treatment facilities were administered the Ward Atmosphere Scale, an instrument which measures treatment environment. Ten facilities were freestanding and ten were hospital based, and were drawn from a large, not-for-profit national chain using a random selection process. Controlling for several staff and facility attributes, it was found that no substantial effects on treatment environment existed due to facility type, freestanding or hospital-based. Implications of the study exist in selection of facility type for purchasers of substance abuse treatment and for the hiring and training of clinical staff for treatment facilities. Study findings also suggest that inadequate or insufficient measures exist to examine the construct 'treatment environment'. ^