Community Service and Bond Strength and occupational therapy: an experience report building citizenship and social participation¹

Abstract

Introduction

The legislation seeks to certify that children and adolescents are individuals of rights, and, when these are violated, public authorities offer social assistance actions to guarantee their protection. An example is the Living and bond strengthening Service that can reckon on occupational therapists in its team.

Objective

To report the experience of the practice in occupational therapy with children and adolescents of a Living and Bond Strengthening Service in the state of Sergipe.

Method

Experience report of intervention in Occupational Therapy bound to the education activity of the Occupational Therapy Department of the Federal University of Sergipe. The systematization of the process of practice and construction of the reasoning in Occupational Therapy was recorded through a field diary, drawings, photos, and filming. The data were analyzed descriptively and discussed according to the social Occupational Therapy literature.

Results

The practicing process consisted of the evaluation of the collective, territory, and the service, followed by the identification of social needs and collective demands that guided the objectives to be aimed through an intervention, concluding with the evaluation of the whole process.

Conclusion

This experience report reveals the potential of Occupational Therapy along with children and adolescents in social assistance services. The theoretical-methodological input from social Occupational Therapy showed significant importance in the settings of this intervention as a possibility of social technology with these individuals. Especially regarding the reported practice, its importance in the awareness and action is evident, fomenting the protagonism of children and adolescents, their families and community.

Keywords:
Occupational Therapy; Community Participation; Social Work

Resumo

Introdução

A legislação busca garantir que crianças e adolescentes sejam sujeitos de direitos e, quando estes são violados, ações socioassistenciais são ofertadas pelo Poder Público para garantir sua proteção. Um exemplo é o Serviço de Convivência e Fortalecimento de Vínculos, o qual pode contar com terapeutas ocupacionais em sua equipe.

Objetivo

Relatar a experiência da prática em terapia ocupacional junto às crianças e aos adolescentes de um Serviço de Convivência e Fortalecimento de Vínculos no interior do estado de Sergipe.

Método

Relato de experiência de intervenção em terapia ocupacional vinculada à atividade de ensino do Departamento de Terapia Ocupacional da Universidade Federal de Sergipe. A sistematização do processo de prática e construção do raciocínio em terapia ocupacional foram registrados por meio do diário de campo, desenhos, fotos e filmagens. Os dados foram analisados descritivamente e discutidos à luz da literatura da terapia ocupacional social.

Resultados

O processo de prática consistiu na avaliação do coletivo, território e do serviço, seguido da identificação das necessidades sociais e demandas coletivas que pautaram os objetivos a serem alcançados por meio de uma intervenção, finalizando com a avaliação do processo.

Conclusão

Este relato de experiência revela potencialidades da atuação da terapia ocupacional junto às crianças e adolescentes em serviços socioassistenciais. O aporte teórico metodológico proveniente da terapia ocupacional social tornou-se significativo na configuração desta intervenção enquanto uma possibilidade de tecnologia social junto a esses sujeitos. Especificamente quanto à prática relatada, ressalta-se sua importância na conscientização e ação, fomentando o protagonismo das crianças e adolescentes, suas famílias e comunidade.

Palavras-chave:
Terapia Ocupacional; Participação da Comunidade; Serviços Sociais

1 Introduction

The set of civil, political and social rights and obligations are part of the group of attributes inherent to the citizen. Thus, speaking about citizenship means to speak of rights and duties. According to Botelho & Schwarcz (2012), citizenship is a collective construction in social and individual experiences, configuring a social identity. Besides the social identity, according to Morais (2013), citizenship brings a political sphere originated through the contrasts, conflicts of society, mobilizations, approximations, and resources of the real, daily, experiential, and symbolic life.

The concept of citizenship has gained dimension since the 1970s, full of struggles involving minorities and the search for equality. Thus, in the Rule of Rights, it becomes an exercise that emphasizes the coexistence between differences and between differences and equality (Morais, 2013).

Botelho & Schwarcz (2012) also highlighted the incorporation of the concept and social practice of citizenship in everyday political experience. This scenario brings together citizenship and civil rights, legitimizing it as coexistence exercise between similarities and, also, differences, diverging from the idea of equality, which shows the defense and legitimation of diversity.

Together with the social construction of the citizenship construct, actions and mobilizations occurred in Brazil in defense of the rights of the population, legitimated and guaranteed, especially with the promulgation of the Federal Constitution of 1988. Specifically to children and adolescents, until then neglected as individuals of rights, became social actors with the promulgation of the Statute of Children and Adolescents (ECA) (Brasil, 1990).

ECA provides the full protection of children and adolescents, considering them with special rights due to their peculiar condition as a developing person (Lopes et al., 2008).

Article 3 - The child and adolescent enjoy all the fundamental rights inherent to the human being, without prejudicing the full protection in this Law, assuring them, by law or by other means, all opportunities and facilities to give them physical, mental, moral, spiritual and social development, under conditions of freedom and dignity (Brasil, 1990).

Issues related to social inequality and the violation of fundamental rights are factors that increase the fragility of social bonds. Thus, social injustices correspond to violations of basic human rights as a form of disrespect to the citizen and increasing social inequalities (Sabino et al., 2017).

Some of the actions of the Brazilian State involving the violation of rights are the services from the Unified Social Service System (SUAS), such as the Living and Bond Strengthening Service (SCFV), which integrates the Basic Social Protection services and is regulated by the National Typification of Social Assistance Services, CNAS Resolution 109/2009. The SCFV was reordered in 2013 through CNAS Resolution 01/2013 (Brasil, 2017).

The SCFV is offered by the Integral Family Protection and Assistance Service (PAIF) and the Specialized Families and Individual Protection and Assistance Service (PAEFI) as another social work with families and protection against the occurrence of vulnerabilities and social risk. It is a preventive care service to strengthen family and community relationships, and to promote the integration and exchange of experiences among the participants, valuing the meaning of collective life. It is based on the defense of the rights and development of the capacities and potentialities of each individual, preventing situations of social vulnerability and violation of rights (Brasil, 2017).

Resolution 17 of the National Council of Social Service (CNAS) recognizes higher-level professional categories that must meet the specificities of social assistance services and the essential management functions of the Unified Social Service System (Brasil, 2011). Occupational therapy is one of the specialties of these reference teams because it considers the composition of services and their structural needs, considering the territorial characteristics and the main demands of users (Almeida et al., 2012).

In this sense, autarchies governing the profession, such as the Resolution of the Federal Council of Physical Therapy and Occupational Therapy 445, of April 26, 2014 show guidelines for this practice. This resolution sets and establishes the occupational therapeutic care parameters in different modalities provided by the occupational therapist in services, programs and social assistance service projects of Basic Social Protection, Special Social Protection of Medium Complexity and Special Protection of High Complexity, supporting the performance of occupational therapy within the demands directed to the violation of the rights of people, families and communities in vulnerability, threat or violation of rights (Conselho Federal de Fisioterapia e Terapia Ocupacional, 2014).

Thus, the literature supports the relevance of social, occupational therapy in intervention processes with children and adolescents in socially vulnerable situations (Almeida et al., 2012; Bardi et al., 2016; Pereira, 2016; Sabino et al., 2017), and these processes can be performed via services from SUAS, such as SCFV.

Based on the understanding of the daily challenges faced by children and adolescents that literature and reality reveal, such as violence, social and gender inequality, fragility in the support and protection network, and other factors, this experience report has social, scientific relevance and politics. Also, it has relevance in the occupational therapist's academic training deepening the debate in the area of occupational therapy and SUAS and enhancing actions and implementation of local public policies aimed at this collective.

In this sense, this study aims to report the experience of occupational therapy practice, linked to the Graduate Course in Occupational Therapy of the Federal University of Sergipe, together with a Living and Bond Strengthening Service (SCFV) in a municipality in the interior of the state of Sergipe.

2 Method

This is an experience report carried out in one of the headquarters of the Living and Bond Strengthening Service (SCFV), located in a poor neighborhood of a city in the interior of Sergipe.

The guiding teacher of this paper performed the practice. She is an intern student of the IV period of occupational therapy training and students of the II period (divided into two classes into opposite shifts, one of 8 students and one of 12 students), all them linked to the Occupational Therapy Department, Federal University of Sergipe.

It is worth mentioning the absence of professional occupational therapists hired to work in the social assistance services of SUAS in this city. Therefore, every action in occupational therapy performed in this area is mediated by professors of the Undergraduate Course in Occupational Therapy at UFS.

A total of nine weekly meetings were held, divided into three months of immersion and action in the service, in the morning and afternoon shifts.

Twenty-two children and adolescents in the morning shift and 14 in the afternoon shift, aged between 5 and 16 years old, of both genders, included in the SCFV, and their families, community, and technical staff of the service participated in the practice.

The agreement for the development of the practice was held with the Municipal Secretariat of Social Action and Labor Development, the coordinators of the SCFV, and the social educators based at the headquarters.

Considering the guidelines for working with human beings, this paper was guided by ethical care. Respect, confidentiality, commitment to the reliability of the information, care with the risks and return of work to participants were issues considered throughout the work process. Also, professional ethics was considered at all times, from planning to intervention with this collective.

A field diary was elaborated to record the practice, consisting of a set of descriptive annotations of the place, people, actions and conversations, physical and symbolic phenomena, and reflective annotations that capture the observer's perceptions and subjectivity (Bogdan & Biklen, 1994).

Besides these diaries, the graphic records (drawings) and digital resources (photographs and filming) used in the interventions were also a source of analysis for this experience report.

Data were analyzed descriptively and presented based on the guidance of the construction of occupational therapeutic reasoning and its practice process. Finally, the process was discussed based on occupational social therapy literature.

2.1 Theoretical reference

The development of this practice is linked to the pedagogical activity of teaching inherent to the curricular subunit called Integration Practice in Teaching and Service in Occupational Therapy I, offered in the second period of the Graduate Course in Occupational Therapy of the Federal University of Sergipe. This subunit is based on the problematization methodology, more specifically the Maguerez Arch (Berbel, 1998; Colombo & Berbel, 2007; Santos et al., 2011), which supported the development of analytical activity (theoretical-conceptual) in the construction of this article. The application of the Problematization Methodology is based on the Maguerez Arch. It was first presented in the 1970s by Bordenave and Pereira, inspired by Paulo Freire (Colombo & Berbel, 2007).

The purpose of the arch is for the development of five stages. The first stage is the observation of the reality and definition of the problem, starting a reflection about the possible factors related to it and its complexity, leading to the identification of key points that can be expressed by basic questions, statements about the problem or questions to be investigated, featuring the second stage. The third stage is the theorization, consisting of the construction of answers to the problem with the literature support. The fourth stage involves the construction of solution hypotheses, highlighting the creativity and criticality of the student, culminating in the fifth stage of application to reality, envisioning its transformation (Berbel, 1998).

The construction of critical knowledge of reality is a path for dialogic and disalienation as liberating practice, as presented by Paulo Freire (Colombo & Berbel, 2007).

Figure 1, the following is a flowchart that illustrates the stages of the Maguerez Arch and its equivalence in the process of occupational therapy practice.

Figure 1
Flowchart showing the relationship between the Maguerez Arch and the occupational therapeutic process. Source: Taken from the Teaching Module of the Curricular Unit Practice of Integration Teaching and Service in Occupational Therapy (Minatel, 2018).

According to the figure above, the occupational therapy process is consistent with the construction of the arch. The first stage regarding the observation of reality is the evaluation process (of the collective, the individuals and their territory). Based on the understanding of reality, the next stage in the arch is the identification of key points, corresponding to the identification of social demands and needs with the collective. The third stage is about the theorization that for the therapeutic process leads to the study of the literature on the identified demands and needs and definition of the theoretical-methodological reference that will guide the actions. The fourth stage builds the hypothesis of solution, equivalent to the construction of objectives and definition of occupational therapeutic action strategies. Finally, the application to reality corresponds to the intervention process.

The flowchart also shows that after the application to reality, the stages begin again, demonstrating a continuum of the process of teaching and research with reality. Thus, there is the occupational therapy process in which the assessment is continuous and resumed at the end of the intervention to understand if the objectives were met and the need for continuity of therapeutic intervention.

2.2 Theoretical-methodological reference for the practice developed in occupational therapy

The theoretical-methodological foundation used in the occupational therapeutic intervention was based on the perspective presented by Malfitano (2016). For the author, work within the social perspective has two principles: the collective perspective of apprehending the reality of population groups and the articulation between the micro and the macro-social. On the other hand, professional practice has two directions: daily life and the promotion of living spaces.

In the work principles, the collective perspective of apprehending the reality of population groups includes a reading of reality that is not restricted to individual elements but considers that the problems arising from this sphere are collective ones. Therefore, the action must consider the macro-social and collective understanding articulated to the policies and services available in the care network, always considering this articulation between the micro and the macro-social (Malfitano, 2016). All the construction of the reported practice considered such principles, focusing mainly on contextualizing the individuals, service, and territory. Life stories and individual reports were considered, but all the demand raised was contextualized with larger issues involving collective and social policy issues.

Regarding the directions of professional practice, Malfitano (2016) brings daily life as a central element for the creation of intervention strategies, such as the work under personal, social, and territorial resources. Such strategies defined by the author as a social technology of “articulation of resources in the social field” lead to the approximation of different ways of life and joint actions with the individuals involved. All strategies and technologies developed in the construction of the reported practice were created and carried out with the collective that proposed the intervention. This fact revealed the power of contextualization, the apprehension of reality, and territory, enabling the construction of bonds and affections that provided important moments of reflection, awareness, and actions of transformation.

Besides the references of social occupational therapy, the dialogical perspective of Paulo Freire (1979) and assumptions of Sarmento and collaborators (Sarmento et al., 2007; Sarmento & Marchi, 2008) guided the critical understanding of childhood, alterity and defense of the protagonism of children and adolescents in active participation in society and construction of citizenship.

3 Results and Discussion

This section shows the results and discussion and is systematized based on the construction of occupational therapeutic reasoning and practice processes.

The process of occupational therapeutic practice began with the understanding and evaluation of the collective and its territory, and the service for the practice development. Then, the survey of social needs and objectives to be achieved through an action plan were held, ending with a final intervention and evaluation of the process.

Four practice analysis axes were elaborated to show the experience: 3.1) Collective, Territory and Service; 3.2) Social needs and objectives: action strategies; 3.3) Final intervention; 3.4) Process evaluation: new projects and new demands.

3.1 Collective, territory, and service

According to Malfitano (2016), the actions of social, occupational therapy aim at the emancipation and autonomy through the expansion of opportunities for the individuals who have socioeconomic impediments and/or difficulties in accessing their social rights. They can be one individual and a collective.

In this sense, the collective with this developed practice was made up of children and adolescents who used the Living and Bond Strengthening Service of a poor neighborhood in the interior of the state of Sergipe. The ages of these children and adolescents ranged from 5 to 16 years old, boys and girls, who shared the social vulnerability situation that integrated them with the SCFV. In addition to children and adolescents, the collective included their families and the neighborhood community and the SCFV technical team (composed of two social educators and a general services assistant).

In this paper, we understood that children and adolescents inserted in the SCFV and their families belong to a vulnerable zone (Castel, 1997), corresponding to the fragility of relational support associated with a precarious economic condition.

The territory corresponds to the geographical space, which is the historical stage of human actions and relationships. This is where the different forms of expression of existing, living, working, and performing social exchanges occur (Barros et al., 2002). Developing a good contextualization of the territory guarantees the occupational therapist a greater possibility of acting, expanding the visualization of individual and collective demands (Malfitano, 2005).

The territory shared by this collective and in which the SCFV is inserted is formed by a poor neighborhood, marginalized in the municipality, stigmatized by crime and violence. Other neighborhoods around it share, to a lesser extent, the social stigma. According to information from residents, the neighborhood was built in the 1970s, with the arrival of rural workers who came to look for work on nearby farms. The first houses were raised by the occupation or donation of small areas by farmers of the region. Gradually, the neighborhood became populous but neglected by the government.

Currently, the territory has a Basic Health Unit; two schools, one in kindergarten and one in kindergarten and elementary school to fifth grade; grocery stores and building supply and feed stores, all were small stores. In the religious sphere, there are three yards, a catholic chapel, and three evangelical churches. There are other buildings in the neighborhood, such as an outdoor sports field and without one of the goalposts, unfinished and in poor condition; a small square (with plants put by the residents); and the building where the SCFV activities take place.

Neglected by the government, the basic sanitation is poor, with few houses having a septic tank, and most of them share open sewage. This situation is worse on rainy days when sewage overflows into the utility holes overflowing with sewers and mud. There is no asphalt in the streets; only the main roads have cobblestones. Going further into the neighborhood, there is a part called by the community and the Government of “the small hell,” representing a place without any infrastructure regarding sidewalks, streets, sewage and garbage, and also drug trafficking and violence.

Another important point identified with the collective was the distrust and discredit of the residents of the neighborhood regarding the promises of changes in the territory by the Government and politicians, especially in the electoral period. This fact affected the organization of the population who, subject to constant promises, are not organized in the search for improvements, nor do they believe in the strength they have to fight for their rights and more dignified living conditions, highlighting a feeling of naturalization of the situation that they share.

As Galheigo (2016) reported, the condition of exclusion of these individuals is worse by the condition of poverty or vulnerability, configuring a “no citizenship, no belonging”.

SCFV had two social educators who had just come about six months ago in service (they claim that in the division of services at the beginning of the year, when going to this neighborhood was a “punishment” for being politically opposed to those in charge) and a general services assistant (community resident and commissioned position). Approximately 80 children were registered in the service; however, attending on practice days, there was an irregular frequency of 22 children in the mornings (two were 15years old, 19 children between 8 and 12 years old and one boy were five years old) and 14 children in the afternoon (nine adolescents between 13 and 16 years old and five children between 8 and 11 years old). The children and adolescents shared the same space, the same educators, and same activities in both shifts.

The service building was a large, poor airy, dark hall with broken tilting windows. The bathrooms had no doors, a there was a small kitchen. It had an outside area that could not be used because of a leak from the neighbor's sump seeping through the wall and also from a large amount of rubble (broken chairs and old materials) that could not be disposed on the street because they were City Hall property. Finally, the front door was the only view of the street and a ventilation source closed by a grid as the favorite place for the adolescents as the service users and other young people and some drug leaders were inside watching and questioning what was going on there.

The first impression was not the best, the place is dark due to the poor lighting and the dark paint on the walls, the burnt and red-painted cement floor and the ceiling could see the holes in the tiles; it was a poorly ventilated place, had no fan and the chairs were broken, rusty, chipped and dirty (Record - Trainee Field Diary, June 2018).

The institution had the following service routine: morning - arrival at 8 am, and departure at 11 am; afternoon - arrival at 12:30 hours and departure at 15 hours. The exits were linked to the snack, because, once it was offered, users already asked to leave. According to the educators, the institutional activities were together with themes stipulated by the social action secretary, such as culture and citizenship, for example. However, in the days when we were present, the children and adolescents had little or no directed activity, being a daily life marked by the tensions of coexistence, of sharing the small space, of conflicts between users and educators.

For the immersion in the field and meet the users of the service, we used activities such as popular games directed by children and adolescents in both shifts, such as dodgeball, cops, and robbers, colorful elephant, mime, among others, as conversation circles, building a board game, interviews (similar to a newspaper where users interviewed students and vice versa) and drawings.

For us as students, who were organizing the activities, it was important to observe the reactions of the participants and how they got involved in the activities; we realized in practice the importance of entering the territory and approaching the individuals because only then, it was possible to know their reality and demands. Developing this perception was the starting point of the practice of occupational therapy because it would not be possible to know reality without deepening it (Record – Trainee Field Diary, August/2018).

This first axis of analysis corresponds to the beginning of the construction of the Maguerez Arch (reality observation) and the occupational therapy practice process (the evaluation).

3.2 Social needs and objectives: action strategies

Not only the field approach and the users' knowledge strategies and the creation of a bond with them were mediated by the activities, but also the identification of the social needs and demands of the collective, as well as the entire technical intervention process.

Considering the human activities as an action instrument of the occupational therapist and the central element that guides the occupational therapeutic process (Barros & Galvani, 2016), it is essential to reflect on the meanings of the concept of activity.

According to Barros et al. (2002), the activities in social occupational therapy generate a range of interpretations that make them situated and meaningful - perceived, lived and interpreted by each of its actors (person, the therapist, mediate group, culture, and values) and are modified for transforming the enrollment program objectives. Thus, the activity is understood as a construct capable of mediating the relationships that are established in time and space of culture. It is characterized by incompleteness, by movement, as a process of communication and language, taking place in the experience and lived situation, according to history, social practices, and cultural values that each person or social group performs in a particular way (Barros et al., 2002).

For Almeida & Soares (2016), following the World Federation of Occupational Therapists (WFOT) indicative, it is up to the occupational therapists to integrate processes that aim to elaborate, invent, evaluate and improve new ways of intervening on the problems in dialogic processes with the population that experiences them. In this sense, the dialogic and praxis process defended by Paulo Freire becomes an important theoretical reference in the area, establishing the dimensions of action/reflection, supporting the methodology of social work.

[…] the consciousness means the passage from immersion in reality to a distance from this reality, surpassing the level of awareness by unveiling the reasons for being in a given situation followed by a transforming action of this projecting reality (Lopes, 2016, p. 44).

The vulnerability and violation of rights in the context of practice, result, as pointed out by Almeida & Soares (2016), in difficulty (systematic or temporary) of people or social groups to perform autonomously the activities that are meaningful for themselves and their social environment. However, the needs are silenced by standardized Programs and Services and their professionals. In this work, the practice and speech of the SCFV technicians revealed the silencing required by managers, unveiling important political control and standardization of actions for the real needs.

Thus, it is part of the technical and political dimension of the occupational therapist to understand the real needs of the artificial ones (Barros & Galvani, 2016).

First, the process involves the protagonism of the participants in activities worked as instruments of mediation of the transformative action of the individual in the real world (Almeida & Soares, 2016). We highlight here the ethical and political position before the individuals during this report, in which first there was the recognition of children and adolescents as protagonists of their history, the collective and the territory, culture producers, social actors, rights subjects and, also with this, they were also responsible and builders of action strategies, as presented by Sarmento et al. (2007).

Almeida & Soares (2016) call it the validation of the others and recognition of their place as an individual of rights, through the activities and their dialogical process, characterizing the expression of the ethical and political commitment of occupational therapy to cope with situations of inequality. For these authors, the professional attitude can be of domination (perpetuation of the status quo) or creation of opportunities, gains of autonomy and protagonism (Almeida & Soares, 2016).

Also, Pereira (2016) agreed on this methodology of social action, characterizing the action of social, occupational therapy by a confluence between the understanding of the reality of the individuals and direct action, with the subjects, on this reality, causing changes.

The activities performed during the process of identifying collective demands and social needs mediated the process of awareness/reflection and action about the collective, service, and territory they share, having the reality of vulnerability and violation of rights as their central point. To this end, technical strategies were developed involving a range of activities and actions. These technologies were presented following the chronology of events in practice and are systematized in Table 1 regarding the proposed activity, the materials used, the participants and the intended objective.

Table 1
Technologies developed in the identification of social needs and collective demands.

ACTIVITY	MATERIALS	PARTICIPANTS	OBJECTIVE
Game: What neighborhood is this?	Pencils and colored pencils, marker pens, cardboard, tape and dice making, and pins with cardboard.	Service Users	To identify the weaknesses and potentialities of the neighborhood and territory they share.
Drawings and textual production (according to preference) and recording of narratives through interviews	A4 paper, pencil, marker pens, brushes, and gouache ink. Mobile phone for recording.	Service Users	To reflect on the weaknesses and potentialities of the SCFV and the neighborhood.
Rights Soccer: Guarantee X Violation	TNT, inks, sulfite, marker pens, and tape. Mobile phone for recording.	Boys	To reflect and represent by a football match, the challenges faced in guaranteeing rights.
Newspaper	Cardboard television, paper fingerprints, and camera phone.	Girls	To provide a discussion on ECA rights.
Conversation circle with SCFV technicians	Registration paper sheets	Two social educative techniques and the SCFV cook	To reflect on the issues and potentialities of the service and the territory that is inserted.
Conversation circle with family members of SCFV children and adolescents	Data projector, video built with users of the service.	Service users, family members, and educators.	To reflect on the reality of the collective and empower families about social protagonism in guaranteeing the rights of children and adolescents.
Interviews with community representatives	Diary record and interviews recording	Community leaders listed by SCFV users: president of the neighborhood association, principals and coordinators of the two schools in the territory, manager of the primary health care unit, parish priest and the business owner of the neighborhood (market, feed house, and building material)	To collect data and information on key community demands and potentials.
Meeting with municipal managers (Secretariats of Social Action, Education and Health)	Data projector, video built with service users based on the activities mentioned above.	Municipal managers of the departments of Health, Education, Culture, Social Action.	To provide a moment of reflection about the collective and the guarantee of rights, as well as the role of managers.

• Source: Field Diary – Records of the Trainee (September/2018).

The first activity developed in the identification of social needs and collective demands was the construction of a game with SCFV children and adolescents entitled “What is this neighborhood?” Through the identification of its potentialities and weaknesses, the territory was represented on cardboard, configuring the game board. The neighborhood, the support networks in it, the social facilities as well as actions or reference people were represented, highlighting the strengths and weaknesses observed by children and adolescents within it. This activity was an important strategy for the reflection on the space and relationships built and shared by users in their daily lives. More than one board was built, as the children and adolescents were organized in small groups (which had a higher affinity). Therefore, there were different representations, however, with converging points, such as the potential represented by the growing commerce, by the court and the local square, by the church, for example, the weaknesses represented by fear and violence, drugs, dirt, and open sewage. Some points in some representations appeared with negative and others positive vision, as the SCFV itself, the court, and the square (for being places of leisure, but also, for the use of drugs and trafficking), for example.

Following a similar objective to the game, the produced drawings about the potentialities and weaknesses of the SCFV and the territory and, later, the narratives of the boys and girls were recorded explaining them. The narratives focused on the desire for safe play areas in the neighborhood with adequate safety and structure (such as the adequacy of the court), improvements in the SCFV, both structural (building), and the organization and activities offered. In the weaknesses, they reported about the neglect of the SCFV building, the sanitation, and garbage of the neighborhood, the prejudice experienced by them being residents of the neighborhood, drug trafficking, and violence.

Together with the reflections related to citizenship and the problems of the territory, a soccer match was simulated through a soccer field made of TNT and where the players represented the rights and duties of one side and the violation of the rights of the other. The boys and adolescents guided the activity, and with each goal, they hit or missed in the game, a “player” was glued to the TNT; if it was right, it was the right, if it was wrong, it was the violation.

Considering that the activities were based on the interest of children and adolescents, the game was organized by the boys, and the girls preferred another strategy to materialize their reflections about the service and territory, building a newspaper. The newspaper was built using cardboard television and finger puppets to ensure that users of the service were not identified and at the same time could show their views on violence and insecurity, poor sanitation, and precariousness of public services provided to the community. The newspaper was recorded and edited with a soundtrack chosen by the children and adolescents.

These four activities were fundamental for the construction of a documentary with all these productions/reflections and enabled the manifestation of children and youth with the Government and the community. When asked about the possibility of exposing themselves in an action that could speak to the other individuals of this collective, such as technicians, family members, and the community and municipal managers, the children and adolescents preferred to use the digital resource, the documentary, enabling not to nullify and have a voice instead of debate with other actors.

Also, in the identification of social demands and needs to identify the potentialities and weaknesses present in the service and territory, the following meetings comprised the performance of two conversation circles, held on different days and with different people.

The first conversation circle was held with the two educative techniques and the general services assistant of the SCFV. The objective was to reflect on the problems and potentialities identified by them in the territory and within the SCFV. From this action, the neglect of the Government with the neighborhood, with the service offered about the resources intended for it were highlighted in their speeches, as they usually needed to buy supplies and even food by their own to diversify what they offer to the children and adolescents, for example. They recorded the constant retaliation of managers regarding complaints about the lack of structure, the lack of support from other social assistance, and health services in inter-sectorial care for children and adolescents, as well as the absence of an effective safety net for this population. There was also little participation of families, difficulty in dialogue, and construction of collective activities that involved, besides boys and girls, the community as a whole, justifying the actions focused mainly inside the SCFV building and only with children and adolescents.

In the second conversation circle held with service users, family members and educators, the objective was to reflect on the reality of the collective and to stimulate the social role in in the families to guarantee the rights and duties of children and adolescents, presenting and reflecting the ECA guidelines with families and users of the service, as the regulatory standard that reaffirms the full protection of children and adolescents, considering that such individuals are in the process of development and that the family, society and the state are also responsible for the formation and structuring of individuals (Brasil, 1990).

Eight of the 22 families invited to this action were present through a note sent by the educators. After the meeting, minutes were produced, signed by the representatives of the families present. In summary, families were consonant with the speech of their children and adolescents in the activities performed with them, highlighting points such as the negligence of the Government, the lack of infrastructure in the neighborhood (basic sanitation and garbage) and the service, the fluctuation of time in children stay on duty, leaving at different times, without following a routine; violence, lack of security, lack of leisure, directed activities and vocational workshops for young people, construction of another daycare center in the neighborhood, overcrowding and precariousness in providing transportation to take children to schools and, a hotly debated issue among them about the absence of community mobilization in the pursuit of the common good.

After the actions, interviews were conducted with representatives of the neighborhood such as the community leaders listed by the users of the SCFV: president of the neighborhood association, principals and coordinators of the two schools in the territory, manager of the Basic Health Unit, the Preast and the owner of the neighborhood businesses (grocery store, feed house and building material). Although the owner of the neighborhood businesses was contacted, he did not want to participate in the interview. The interviews followed the same semi-open script with four central questions: what were the fragilities of the territory, what the potentialities were, what they suggested to improve and how did they perceive the actions aimed at guaranteeing the rights and protection of children and adolescents in the region.

The interviews were transcribed and organized for later presentation, without revealing the interviewees, but highlighting the opinion of different people of the territory about the daily reality. Respecting their place of speech and community experience, each representative was consensual about the structural problems of the territory and the need for improvements and changes by the public management (in the guarantee of social policies) and also by the community (highlighting the lack of initiative and union of this collective).

The last action taken preceding the final intervention was carried out with the municipal managers of the departments of Health, Education, Culture, and Social Action. The purpose of the meeting was to provide a moment of reflection about the collective and the guarantee of their rights, considering the role of these managers in this process. In this action, the issues and potentialities raised by the community and users of the SCFV were previously presented to those involved, as well as the invitation to hold a meeting, which intended to offer the possibility of dialogue and collective construction of strategies and commitment shown. At this time, the representatives of each secretariat actions (the Municipal Secretariat of Education, also representing culture, the municipal coordinator of Early Childhood Education, the coordinator of the basic protection services of the municipality and the person responsible for permanent education in the Municipal Health Secretariat) performed at the municipal level, with speeches permeated by justifications and successful actions in the municipality, almost without mentioning the neighborhood that the intervention was being carried out. Alongside the proposal, they agreed to participate in the final event, providing dialogue with the community.

With these eight technologies developed, the social needs and collective demands were listed, highlighting: the violence and social vulnerability; the lack of basic sanitation; the lack of cobblestones in the streets; the lack of quality transportation to the community; the need to open more daycare centers; the need to improve the physical structure of the SCFV, to guarantee users an appropriate living space that will correspond to the service proposal and the organization of activities; and the creation of social and cultural projects for residents.

Aware of the demands, the objectives to be achieved with the occupational therapy intervention were collectively constructed through the contributions of the service technicians, children, and adolescents, and their families, the community, and the occupational therapy. These objectives were: promoting citizenship and social protagonism of children and youth people; ensuring the social and political participation of neighborhood residents; articulating people and services in the construction and strengthening of a social protection network for children and adolescents, raising awareness and foster proposals for action with the Government for the social needs identified in the territory.

A meeting with the collective plus the Government and the judiciary was planned to initiate the actions that can contemplate such objectives, with the purpose of dialogue and debate on the issues raised and construction of referrals.

As a tool for social participation and ensuring the voice of the individuals, the documentary from the activities of children and adolescents, the family minutes and the summary of the notes of the neighborhood leaders were organized in a presentation using the data projector to open the meeting and trigger the debate, ensuring the voice and participation of all, especially children and adolescents, considering their social invisibility (Sarmento et al., 2007; Sarmento & Marchi, 2008).

Considering the arch construction, this second axis was the identification of key points; the theorization; and the construction of solution hypotheses. In this direction, for the process of occupational therapeutic practice, the identification of social demands and collective needs with the individuals; the theorization was highlighted, in which the aspects of reality were theorized (such as the problems identified) and the theoretical-methodological reference that would guide occupational therapeutic intervention, in this case, social occupational therapy, as defined; and also the definition of occupational therapeutic goals.

3.3 The final intervention²

The final intervention was organized by the professor responsible for the practice and 24 students of the occupational therapy undergraduate course, the SCFV technicians, and the coordinator of the Basic Social Protection of the Municipal Secretariat of Social Action. The support of the social action secretariat gave the SCFV building offered for the meeting, offering a snack for the participants and offering resources such as a speaker and microphone. Invitations, both to people in the community as well as families and representatives of the secretariats and services and justice were made by handing out invitations personally to the undergraduates.

On the day of the meeting, the Social Action Department interfered with the improvement of the building to receive everyone, removing the rubble from the place and taking plastic chairs to hide the broken ones. However, for the reality to be experienced by all, through the students and responsible professors, it was possible to keep the furniture in place, as well as the organization of desks in circles, without reserving a table (with privileges such as water and more comfort) to managers. This ambience is considered to be an important action, as it was a strategy that sought participation and opportunity for dialogue among all participants. Also, everyone would experience the thermal and uncomfortable sensation that children, adolescents, and technicians experience in the SCFV building.

Seventy-three people attended the meeting. In addition to the organizing team already presented, another professor from the University of the same department, representatives, and professionals of the municipal departments and services, justice, and community participated (users of the service and residents of the neighborhood). The invitation delivery strategy explaining the objectives of the meeting and the technologies used to reach this intervention ensured the presence of a large number of representatives, such as the municipal secretary of education, the municipal coordinator of Children Education, the municipal secretary of planning and works, the coordinator and professionals of a Reference Center for Social Service (CRAS), a representative of the Prosecutor and another of the Childhood and Youth Court, the coordinator of the Social Services municipality, the priest of the local church and the president of the neighborhood association.

The meeting aimed to the dialogue and debate among the participants, as well as the forwarding of collective actions and commitments. It began with the presentation of the documentary made with the productions of children and adolescents, followed by the synthesis of the minutes of the conversation with the families and the notes of the community representatives; the speech was then opened for each person present representing the executive and the judiciary so they could expose their actions and propositions. The speeches were mediated by the professor in charge and the whole meeting recorded by students who, in the end, elaborated a protocol.

Several times in this mediation, the participants had to be reminded of the validity and legitimacy of the speech of children and adolescents, as many representatives of the government, justifying their (non) actions affirmed a contrary reality, especially in SCFV and invalidated the notes of children and adolescents. Another important issue was the silence of the service technicians throughout the debate, revealing much of the work relationships and political organization of the municipal services and social programs. To finish the event, the protocols containing the speeches and referrals constructed were read.

The referrals were some commitments by those present: from the secretary of planning and works there was the agreement with the community to seek strategies for garbage collection in every neighborhood, to give priority to a project of “disintegration” intended by the acting mayor, seeking to remedy the problems of infrastructure and basic sanitation, and to improve the block and build another square. From the Secretary of Education, along with the Secretary of Planning and Construction was the agreement of expanding the nursery in the neighborhood and resuming the construction of another one that collapsed before being inaugurated. From the representative of the social action, the coordinator of the SCFV, the commitment of networking was established, to articulate local actions and to foster participation and attention to the needs of families with the support of the service's CRAS reference, and to seek improvements in the structure of the service offered at the SCFV given the available budget. From the judiciary, the commitment to the residents was established, in search of more security and clarification of where to seek the guarantee of rights. From the university, the commitment of occupational therapy to this community was established and the availability of partnership with the present secretariats for future actions that would guarantee protection and attention to the children and adolescents of this territory. In summary, it was possible to meet the representatives of the community, the neighborhood association with representatives of the executive and the judiciary, with the acquisition of contacts and possibilities for future dialogues and support; the agreement for strategies to strengthen the protection network for children and adolescents and guaranteed the participation of everyone present there.

According to Galheigo (2016), based on a political, ethical commitment, the action of occupational therapy with this collective took advantage of those who had less power to promote social transformation. The attentive and sensitive listening to this group and the critical perception of their daily lives, considering the macro processes involved, were determinant in the construction of occupational therapeutic reasoning and the practice process.

Considering the construction of the arch, this axis corresponded to the application to reality and the intervention for the occupational therapy practice process.

3.4 Process assessment: new projects and new demands

The evaluation of the process took place with the techniques and users of the SCFV. We returned to the service the week after the final intervention and we delivered the protocol of the registration of the intervention meeting to SCFV (with copies to families and who like it) and to the president of the resident association the minutes, containing the participants' signature, as well as the highlighted demands during the discussion.

The return of children and adolescents was very important as they were able to share the opportunity of this debate and to be a protagonist in the articulation and implementation of public policies. Tensions were brought by the technicians of the service regarding the social action secretariat before the notes made at the meeting; however, they emphasized how satisfied they were to be heard in front of so many silences required.

The occupational therapy was compromised by the continuity of work with this collective and territory, and the possibilities of insertion in culture and social action were a strategy for approaching and carrying out other projects aimed at citizenship and guaranteeing the rights of the population, especially the children and adolescents.

4 Final Considerations

Considering the whole process of construction of the practice performed with SCFV children and adolescents, the relevance of the occupational therapist's role as an articulator and mediator of the process of reflection, awareness, and transformation of reality is highlighted.

The theoretical-methodological reference chosen for the practice was the social, occupational therapy, offered an instrument that enables us to configure this experience as an important social technology that can be experienced in other localities and collectives.

The attentive view at children and adolescents and for the whole territory and collective involved implied issues that go beyond professional technique, responding to the profession's ethical and political commitment to vulnerable groups.

The study revealed the absence of occupational therapists in the social assistance services and programs guided by the Unified Social Assistance System in the municipality, highlighting the political role of the university, both in fostering the incorporation of the professional by the services of building the field and resisting the lack of knowledge of potential of the profession and its possibilities for action with the population in situations of social vulnerability at different levels of complexity. Social and political responsibility characterized the actions developed by the university beyond the strictly pedagogical and formative character of new professionals.

In the emergence of research objects from this practical experience, we highlight the investigation of the theoretical-methodological foundation of the practice in occupational therapy for the teaching and learning of the occupational therapy practice process linked to active methodologies, especially to problematization methodology.

Specifically, in the reported process of practice, its importance in awareness and action is emphasized, promoting the protagonism of children and adolescents, their families and community. Thus, it is understood as an initial project with much to be traced and built collectively, but already offering positive indications of the use of this social technology for the construction and guarantee of citizenship.

Acknowledgements

We thank SCFV users and the community for authorizing us to publish this practice report and for sharing their realities with us and welcoming our intervention proposal. We also thank all students of the undergraduate program in Occupational Therapy at the Federal University of Sergipe, who were in any way linked to the development of this practice.

• How to cite: Minatel, M. M., & Andrade, L. C. (2020). Community Service and Bond Strength and occupational therapy: an experience report building citizenship and social participation. Cadernos Brasileiros de Terapia Ocupacional. Ahead of Print. https://doi.org/10.4322/2526-8910.ctoRE1917
• 1
  This paper is an occupational therapy intervention report. Considering the ethical care that involves working with human beings, the ethical precepts and the systematization of the report were followed throughout the process of practice.

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2

It was called the “final intervention” because it was an action finishing with this cycle of intervention by occupational therapy students with this group. However, as highlighted later in the text, the actions of occupational therapy did not end with the practice presented here.

Publication Dates

• Publication in this collection
  14 Feb 2020
• Date of issue
  Jan-Mar 2020

History

• Received
  27 Mar 2019
• Reviewed
  03 June 2019
• Reviewed
  06 July 2019
• Accepted
  07 July 2019