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Psicologia USP

Print version ISSN 0103-6564On-line version ISSN 1678-5177

Psicol. USP vol.30  São Paulo  2019  Epub July 10, 2019

http://dx.doi.org/10.1590/0103-6564e180192 

Articles

Psychology in the Centers Specialized in Assisting Women

Emmanuela Neves Gonsalvesa  * 
http://orcid.org/0000-0002-2170-2269

Hebe Signorini Gonçalvesb 
http://orcid.org/0000-0003-1688-9927

aUniversidade de São Paulo, Faculdade de Medicina. São Paulo, SP, Brazil

bUniversidade Federal do Rio de Janeiro, Instituto de Psicologia. Rio de Janeiro, RJ, Brazil


Abstract

The article shows the results of the research which motivated further knowledge and to discuss upon the psychology work in the Centers specialized in assisting women (CEAMS) in Rio de Janeiro. The field research had three stages: telephone calls to the Centers in the state; digital questionnaires to the CEAMS psychologists and interviews with the psychologists from the CEAMS in the city of Rio de Janeiro and with one psychologist who had initiated the psychology work with the women in situation of violence in RJ. Three categories were formed based on the analysis of the contents of the researched material: the working structure in the CEAMS; the institutional work of psychology in the CEAMS; the sense of the work according to the psychologists who act in the CEAMS. The approach of the psychologists who work in the Centers made it possible to relate the practices of psychology in these services and to develop a discussion about psi practice in the context of these public policies.

Keywords: psychology; gender violence; public policies

Resumo

O artigo apresenta os resultados de pesquisa que objetivou conhecer e discutir o trabalho da psicologia junto aos Centros Especializados de Atendimento à Mulher (CEAMs) no Rio de Janeiro. A pesquisa de campo foi realizada em três etapas: contatos telefônicos com os centros do estado; questionários digitais para os psicólogos dos CEAMs, entrevistas com psicólogas dos CEAMs do município do RJ e uma psicóloga que iniciou o trabalho da psicologia junto a mulheres em situação de violência no RJ. A partir da análise de conteúdo do material foi possível elaborar três categorias: as estruturas de trabalho dos CEAMs; o trabalho institucional da psicologia nos CEAMs; os sentidos do trabalho segundo os psicólogos que atuam nos CEAMs. A aproximação dos psicólogos que atuam nos centros possibilitou relacionar as práticas da psicologia nestes serviços e desenvolver uma discussão sobre a prática psi no âmbito dessas políticas públicas.

Palavras-chave: psicologia; violência de gênero; políticas públicas

Résumé

L’article présente les résultats de la recherche de Master dont le but a été celui de comprendre et d’examiner le rôle que la psychologie joue dans les Centres spécialisés de soutien aux Femmes (CEAMs), à Rio de Janeiro. L’enquête de terrain a été effectuée en trois moments: des contacts téléphoniques avec les Centres de l’État de Rio de Janeiro; des questionnaires numériques passés aux psychologues des CEAMs; des entretiens menés auprès des psychologues de la ville de Rio de Janeiro et avec une psychologue qui y a entamé l’assistance psychologique auprès des femmes en situation de violence. D’après l’analyse des données l’on a conçu trois catégories: les structures de travail des CEAMs; le travail institutionnel de la psychologie dans les CEAMs; les sens du travail selon les psychologues des CEAMs. La démarche des psychologues travaillant dans les centres a permis de relier les pratiques de la psychologie dans ces services et de développer une discussion sur la pratique du psi dans le contexte de ces politiques publiques.

Mots-clés: psychologie; violence de genre; politique publiques

Resumen

El artículo presenta los resultados de la investigación que tuvo como objetivo conocer y discutir sobre el trabajo de la psicología junto a los centros de atención a las mujeres (CEAMs) en Río de Janeiro. La investigación de campo fue realizada en tres momentos: contactos telefónicos con los Centros gubernamentales, encuestas digitales para los psicólogos de los CEAMs y entrevistas con las psicólogas de los CEAMs de la ciudad de Río de Janeiro, asimismo con una psicóloga que inició el trabajo de la psicología junto a las mujeres en situación de violencia en el Departamento de Río de Janeiro. Desde el análisis de los resultados fue posible elaborar tres categorías: las estructuras del trabajo de los CEAMs; el trabajo institucional de la psicología en los CEAMs y los sentidos del trabajo de acuerdo con los psicólogos que trabajan en los CEAMs. La aproximación de los psicólogos que actúan en los Centros posibilitó relacionar las prácticas de la psicología en estos servicios y desarrollar una discusión sobre la práctica psi en el ámbito de esas políticas públicas.

Palabras clave: psicologia; violencia de género; políticas públicas

Introduction

This article derives from a master’s research developed by the first author at the Federal University of Rio de Janeiro (UFRJ) and undertaken with the objective of knowing the work of psychology in the Centers Specialized in Assisting Women (CEAMs) located in the state of Rio de Janeiro, as well as examining the place of psychology in policies to address gender violence1. The reflection proposed by Soares (1995) on the same theme is the starting point of this analysis: considering that, traditionally, psychology refers to individual and intrapsychical issues and that the theme of gender violence is related to the sociocultural sphere, the author points out an apparent dichotomy between the fields and questions: “what does psychology have to do with violence against women?” (p. 4).

These concerns of Soares, formulated in the 1990s, still echo today. After all, what does psychology do in public policies, specifically in policies of confronting gender violence? Despite the relevance of the theme, few papers directly address the issue (Porto & Bucher-Maluschke, 2012; Magalhães, Morais, & Castro, 2011; Santos & Vieira, 2011). We understand that the discussion of the research is relevant - be it for the academic community or for the professionals who work with women’s services - as a way of establishing theoretical and practical frameworks that allow to further qualify the insertion of psychology in public policies to confront violence against women (Porto & Bucher-Maluschke, 2012).

This article is divided into three topics: a discussion on theoretical aspects regarding the insertion of psychology in the context of public policies to confront violence against women; the research methodology; and the discussion about the results, in the light of the theoretical reflections on the theme. The results of the research devolutions with the institutions are included in the text. In this way, we intend to contribute to the production of knowledge regarding the professional performance of psychology with the CEAMs.

The project was approved by the Research Ethics Committee and the Certificate of Ethics Presentation Certificate number (CAAE) is 28359314.2.0000.5582.

Psychology and public policies to confront violence against women

In Brazil, policies aimed at women have been developed within the federal, state and municipal go­vernments as specific policies. In the federal go­vernment, the National Secretariat of Policies for Women (SNPM) of the Ministry of Women, Family and Human Rights is established. In the states and municipalities, policies for women are developed through the institutionalization of superintendencies, subsecretariats or secretariats for women. The national policy to confront violence against women has been implemented mainly through the network to confront violence against women, which includes services of different institutional vocations (social assistance, health, education, justice, among others) in favor of eradication of gender violence in Brazil.

An integral part of this network, the CEAMs are structures that aim to break the situation of violence and the effective exercise of women’s citizenship. For this purpose, the CEAMs promote interdisciplinary care (information, orientation, social, legal and psychological care) and global actions2. In addition, they are responsible for the articulation between the services that constitute the service network for women (Gonçalves, 2006). In this way, it is up to the reference centers to integrate the services that constitute the various assistance fields to promote integral care for women in situations of violence.

According to the Technical Standard of Uniformization of the Centers, psychology professionals constitute the minimum staff of these services for women in situation of violence (Gonçalves, 2006). It is, therefore, necessary to know how psychology has integrated these technical staff, to reflect on the place it occupies and to examine the epistemological bases for its performance.

Gonçalves (2010), along the lines of Soares (1995), points out a dichotomous view in theories of social psychology: for the author, certain currents of psychology tend to emphasize “individual processes in a naturalizing perspective of social phenomena” (p. 73). Likewise, Oliveira (2012) considers that some discourses of psychology on the subject still operate today in the order of the dichotomy between the social and the individual, depoliticizing practices of psychology.

It is true that, in the history of its constitution, psychology sought to occupy a place among the natural sciences, letting itself be traversed by the presuppositions of universality and neutrality, without realizing that it thus distanced itself from political and social questions. Many psychological theories, according to Nascimento, Manzini and Bocco (2006), constructed a dichotomous and supposedly objective vision of a human being, based on “beliefs, immutable and universal truths, and therefore ahistorical and neutral” (p. 15). In more recent decades, a whole theoretical body has rescued the perception that social processes are essential for understanding the subject’s issues. According to Gonçalves (2010), when subjectivity is understood as “arising from multi-determinate, complex and historically charged processes” (p. 20), the fundamental character of the overcoming of the dichotomy between society and individual for the performance of psychology is highlighted in public policies.

The overcoming of the idea of neutrality and the attention to the political crossings in the psychological intervention propitiates the construction of a psychology engaged with cultural and social questions, which subjects should not be thought about without. Regarding to the intersection between psychology and the field of gender studies, this view has been the most widespread and practiced.

In spite of this, psychological theories often contribute to the naturalization and essentialization of violent processes in social relations. Pougy’s (2010) reflection on the challenges of the national policy to confront violence against women, after the promulgation of the Law Maria da Penha, examines, among other issues, the “psychologizing” aspects in this context. For Pougy (2010), there is still a certain tendency to “pathologize gender violence as if it were an anachronistic relationship of untempered people” (p. 82).

As can be seen, the discussion is still current: psychology, which proposes to face the issues of gender violence and to operate in the field of these policies, is divided between different assumptions, acting now from an individualizing conception, now taking the social processes - the hierarchical relations of gender - as central elements to be faced. How are these tensions among the psychologists who work in the CEAMs of the state of Rio de Janeiro?

Methods

The field research was divided into two stages: (1) the actions developed by the CEAMs located in the state of Rio de Janeiro were mapped. This stage was carried out from telephone contact with the institutions, followed by digital questionnaires3 sent to the psychologists who worked in the CEAMs; (2) interviews were carried out with psychologists who worked in the centers located in the city of Rio de Janeiro, to deepen the discussion about the data collected by the questionnaires. In two centers, the psychologists interviewed were the only ones who worked in the service and, in two other centers, the interviewees were indicated by the coordinators of the respective centers. Subsequently, an interview was conducted with a psychologist who participated in the construction of psychology work in the context of public policies to confront violence against women in the state of Rio de Janeiro. One of the interviews was not recorded in audio because of the interviewee’s lack of authorization and was recorded in a report certified by the interviewee. The other interviews were recorded in audio and transcribed in full.

In the first stage of the study, 33 CEAMs were contacted, which represents the totality of these services located in the state of Rio de Janeiro. Telephone contacts were made with 32 centers4 and 45 digital questionnaires were answered, referring to all CEAMs that had psychologists in their staff. In the second stage, five face-to-face interviews were carried out with psychologists who were part of the service teams for women in situations of violence at the specialized centers located in the city of Rio de Janeiro. In total, field research lasted one year and four months. All research material was submitted to content analysis (Bardin, 2011).

To ensure confidentiality, nomenclatures were created to refer to institutions without identifying them. Similarly, reference codes have been created for the various research tools. We sequentially number each of the centers that participated in the research, here designated by the letter C followed by a number between 1 and 33. The same was done for the telephone contacts, designated by T and numbered from 1 to 32. The digital questionnaires, indicated by the letter Q, are accompanied by a number between 1 and 45; and face-to-face interviews are indicated by the letter E followed by a number between 1 and 6.

After the work was completed, research devolutions were undertaken with the institutions that participated in the study. Initially, the “I Seminar Professional activities in public policies to confront violence against women: experiences, research and reflection” was carried out, in which the professionals who participated in the research and the respective institutions were invited, and the results of the study were presented and discussed. Subsequently, the first author went personally to the CEAMs located in the city of Rio de Janeiro and presented the results of the research to the teams of each institution. It was not possible to perform the devolution in this format in two centers, since they no longer had psychologists in their teams.

Results and discussion

We present below the results of the investigation, analyzed from three categories: (a) the working structures of the CEAMs; (b) the institutional work of psychology in the CEAMs; and (c) the meanings of work according to the psychologists who work in the CEAMs.

The working structures of the CEAMs

This category included a great diversity of discussions about the conditions of the services offered in the CEAMs: the constitution of professional staff, the physical and organizational structure of the centers, the political and economic situation in which the network of assistance to women in situations of violence is inserted, the question of training and professional qualification, among others. In this article, the training of the technical staff, the academic qualification and the professional training of the psychologists who work in the CEAMs are highlighted, as well as the discussion about the interdisciplinarity that the field requires.

Employment relationship / technical staff turnover / policies precariousness

According to the questionnaires, the employment relationship of 14 of the psychologists was through temporary contract; other 7 had a commissioned position; 9 were civil servants, assigned from other government agencies; 5 were scholarship holders; 2 were outsourced; and 5 were full-time employees.

In one of the centers, the employment relationship were quite different and this was a difficulty, given that each technician received a salary and had a different workload: three professionals had a five-year contract, renewed annually from the relationship with a public university; two were civil servants assigned from another body; one had the position of psychologist and the other not, but both worked as psychologists in the center; the others occupied commissioned positions (E4).

During one of the institutional telephone contacts, the psychologist pointed out, critically, that there were no full-time employed professionals in the institution, only commissioned (T14). In the questionnaires, a psychologist commented: “We have a job that requires a public tender for Secretariat of Policy to Confront Violence Against Women” (Q16). The latter referred to the need to consolidate stable technical staff to guarantee continued service.

According to another interviewee, the institutions that integrate the policies for women in the state of Rio de Janeiro have never had their own workforce: much of it is ceded from other agencies or hired in a precarious way, which is a reason to understand its significant turnover (E1). As Baptista points out (2012), precariousness is a mark of psychologists’ relationship with public policies in the country:

It is important to emphasize that the insertion of psychologists in the field of Public Policy occurs very often through contracting by the State. Thus, the performance of psychologists in the public service has an inexorable implication with relations of power, and therefore with ethical and deontological aspects of the category. It makes new works important. Works which allow a more comprehensive understanding of the relations between these fields of knowledge. (pp. 62-63)

In this sense, Pougy (2012) notes: “the turnover of professionals . . . who do not have an employment relationship with the service that seeks to empower women’s citizenship is contradictory and unacceptable, because it violates rights and affects its many members” (p. 47).

In fact, the financing and political clashes that it entails directly affect the implementation, development and continuity of public policies to confront gender violence, especially in relation to the construction of staff teams for the services. In the sixteen months that elapsed between the first telephone contact and the last questionnaire answered, many changes occurred regarding the composition of the teams.

As an example of the impact of policy (dis)financing on the continuity of care services, the technical staff of one of the CEAMs was limited to a single social worker; the lawyer had resigned; the psychologist, hired for a fixed time, had been disconnected, could only be rehired in six months and at that time the team would be without the professional of the area or contract another, always with loss to the continuity of work (T2).

On the changes related to the composition of the technical team occurred during the research, we bring as examples a center that in the first contact reported the presence of two psychologists (T25), and another that had a psychology professional (T30); in later contacts, both were no longer counted on any of the professionals. In the first, an employee reported that all staff, including the psychologist, had been exonerated by the city hall and only one social worker, a civil servant assigned to another body, was working in the institution. According to this informant, the closure of the center (T25) was considered. In the second, they were waiting for the end of the electoral period to hire a new psychologist (T3). Still on the changes, in Center C3, we were informed that the team counted on two psychologists, but in later contact, months later, there was only one psychologist in the institution. In the C20, which initially had three psychologists, months later there were only two, and, finally, only one. At the moment of devolution of the research to the service (C24), the psychologist who granted the interview at the time no longer worked in the institution and the devolution was performed for the rest of the technical team. These are some of the examples that reveal the problem of the discontinuity of the teams that tackle the public policy equipment for women in the state.

Still on this topic, unfortunately, the C24 service was deactivated due to the impossibility of costing the professional team, according to information received during research return in the C25 service. The issue pursues services associated to the policy of defending women’s rights, as Diniz (2006) pointed out:

In Brazil we have this problem of institutional instability: often teams that have set up excellent services are dismantled once the government changes. There are transfer or exit of trained people, or programs and networks formed dismantle with change of government. But we have services that have crossed several “adverse” governments, have grown and continue as a reference. (pp. 29-30)

According to our data, some centers rely on the same team for several years, but this is not the usual situation. One of the psychologists interviewed pointed out that the same team has already undergone three different actions in the city hall, which has always maintained the professionals and ensured the continuity of the work. The fact that there are civil servants in the team, although transferred from other agencies, may be one of the factors that contributes to this permanence (E3).

The devolution of the research in the C25 found some stability in terms of maintaining the composition of the technical team; however, as pointed out by the team, the service faces a fierce political clash to keep this workforce as it stands.

The data showed the inconstancy of policies for women in Rio de Janeiro. Frequent management changes dismantle teams and services for personal and non-collective interests. In fact, the lack of a permanent workforce for the development of the policy weakens the teams and allows changes in government management to interfere in the continuity of care service for women in situations of violence in the context of public policies for women (E2; T19, C26, T30). As Pougy (2012) points out, in spite of the advances in the implementation of the policy for women in Brazil, the country still lacks financial investment that allows the creation of state technical staff to guarantee the continuity of the programs, so that, the National Policy of Confronting Violence against Women becomes, effectively, a state policy.

Training / qualification

Thinking about the constitution of the technical teams to assist women in situations of violence inevitably passes for thinking about the training and the qualification of the professionals that integrate them. On this question, the first interviewee showed the absolute absence of the subject in its formation and, when attending a specialization, verified that there would be a single class on gender violence and, at that time, she was invited by the person responsible for the discipline to “talk” with the class about attending to women in situations of violence, allegedly because she, for her experience, would have more to contribute on the subject (E1) than the teacher in question. About this same postgraduate, another interviewee confirmed that the issue of gender violence was little discussed (E4).

According to Narvaz and Koller (2007), feminist and gender studies have gained space in the academic environment, but still marginally, more present in research than in actual teaching. The authors affirm that the disciplines related to this field of study are offered, in general, in the postgraduate, considering the greater curricular flexibility. In the undergraduate courses, in which the scientific discussions on gender relations are inserted, these are offered from elective subjects, not in the compulsory subjects.

Despite this, 43 professionals reaffirmed the relevance of academic qualification to professional practice in the field. A single psychologist claimed that her academic background did nothing to contribute to her work in the area.

Criticisms of qualification in psychology have been undertaken because there is a certain distance between academic psychological knowledge and the demands of the professional field. In this sense, Cruz (2016) notes that the problem of the “professional formation process of the psychologist, especially in the capacity to teach, learn and integrate scientific knowledge and professional activity” (p. 3) is important.

In fact, as one of the interviewees pointed out, undergraduates “will never talk about everything” (E6) and, as long as academic curricula do not fit the demands of the population and public policies, training ends up being borned by the services (E1). However, we believe that, in addition to the substitution of responsibilities, academic qualification, professional training and professional practice must complement each other in the overall process of education/professional qualification. Scisleski and Fernandes (2012) go beyond and propose the inseparability between professional practice and academic life. For them, user attention spaces are also legitimate spaces for the production of knowledge, and closer dialogue between them could contribute to professional autonomy.

Included in the set of general guidelines for the operation of specialized centers is the training of human resources; the norm, according to Gonçalves (2006), establishes that “all professionals of the Reference Center should participate in initial training, which should have at least 80 hours” (p. 27). However, it could be observed that professional training is not always undertaken and, when executed, does not comply with the norm. The most common is the training through observation of the care of professionals who have worked in the service for the longest time, followed by face-to-face follow-up of the first appointments of the newly hired professional (E5, E1, E4).

The data collected showed that only five centers (T11, T18, T19, T25, C23) have an initial training project for the newly hired professional. In most of them, this training was conducted by a state body, with annual frequency. The participation in congresses and courses related to the work theme was also mentioned by the professionals as part of the professional training in service. In fact, one of the interviewees (E5) stated that she did not have initial qualification, but when she joined the institution she participated in many lectures and events. These moments instigated her to “want to know more” (E5).

Considering the aspects enumerated above, qualification and professional training seem to be fundamental aspects for the implementation of quality public policies. Santos et Vieira (2011), after also identifying that a significant number of professionals point to the need for qualification and training for the work in the gender field. The authors recall that “the professional who works in this field faces, in his everyday life, a dense web of human problems” (p. 104). Considering the impact of these problems on professionals, the authors argue that professional training is essential to effective female citizenship and ensure women’s access to quality services. In conclusion, the annual training promoted by one of the policy bodies for women in the state of Rio de Janeiro, as well as the participation of professionals in congresses and courses can, in fact, contemplate the continued formation of the team, but does not replace the responsibility of each institution for the initial training of the team itself.

Interdisciplinarity

The Technical Norma orientates that the attendance to women in situations of violence in the specialized centers should be carried out in an interdisciplinary way and be conducted by a team composed, at least, of professionals in psychology, social service and law (Gonçalves, 2006). As Portugal and Jacó-Vilela (2012) point out, the gender theme is interdisciplinary in nature. But how is the interdisciplinary approach constructed in practice? Would it be an automatic consequence of the presence of two or more professionals from different areas at the time of the intervention? Would it happen when - and if - the service to the users was carried out by a pair of professionals from different fields of knowledge? Does interdisciplinarity require or organize from the exchange between professionals of different areas, or does it refer to the posture of each professional?

Our data indicate that it is not necessary the presence of more than one professional at the time of intervention to ensure interdisciplinarity. For the psychologists interviewed, interdisciplinarity is guaranteed when the service is discussed among the different areas, which ensures the interdisciplinary look even when the service is individual; the psychologists claim that in this circumstance, even if focused on the psychological issues brought, they are also attentive to social and legal demands (E2, E3, E4, E5). In the digital questionnaire, the psychologists are unanimous in affirming that their professional performance is done in an integrated way with the other areas.

For Santos and Vieira (2011), interdisciplinary work is essential in the field of violence against women. According to the authors, interdisciplinarity implies and requires respect for the diversity of perspectives, the non-fragmentation of knowledge and the search for transversality. Interdisciplinary professional practices are, therefore, the great challenge, so that, as Pougy (2010) affirms, “intervention is organic to the project of the desired society, a possible situation based on the elaboration and development of a consistent theoretical-political plan” (p. 82). In this respect, the interventions carried out by the CEAMs seem to be in line with the proposed guidelines, although each team finds ways to do so.

The institutional work of psychology in CEAMs

The Technical References for Psychologists’ Performance in Women’s Attention Programs in Violence (Federal Council of Psychology [CFP], 2012) emphasize that the professional practice of psychology in women’s services should:

provide information on the care network to build together with the woman a plan for confronting violence. In addition, enhance social criticism on the role of women in society and on the ways that this society creates to confront violence. Part of the work is also the function of strengthening the subjectivity to understand, criticize and face society, as well as presenting to this woman the devices (institutional, egoic and communicational) that allow change, transformation of life and society, portraying the political aspect of the doing of this psychologist. (pp. 64-65)

Throughout the investigation we conducted it was common to hear the phrase “the psychology participates in all activities” in the CEAM (T3, T5, T9, T12, T15, T17; T25). During the research, it was possible to know in detail the specificities of this work.

The list is long and involves: individual care; interdisciplinary care; group service; network articulation; global actions; psychotherapy; individual interdisciplinary care; psychological support; neuroaerobic; lectures in other institutions; home visits; course monitoring; reflection groups; campaigns; cinema activity; space for debate; community therapy; prevention of violence with young people; rounds of conversation; psychological group counseling; art therapy; internship supervision; case study; diligences; couple care; workshops; technical visits; participation in hearings; participation in training actions; courses for community agents; monitoring of social workshops; training of workshop coordinators; group coordination aimed at generating work and income; triage.

One psychologist interviewed summarized:

The work consists in offering reception and guidelines pertinent to public policies for women (Law Maria da Penha and other benefits the Municipal Secretariat offers to women), with spontaneous demand, aiming at the promotion of women’s autonomy and empowerment. We also offer lectures and social actions aimed at promoting the theme. (Q12)

The care service

Activity developed by all the psychologists who participated in the research, care service occupies a central place for the work of psychology in the CEAMs. In the interviews, the description offered to the psychologists referred to “individual care”, “interdisciplinary care” and “group care”, with a view to broaden the concept of care, since the literature, when referring to the term, usually relates to the space of individual listening, almost always under the bias of the clinic.

The Technical Standard subdivides the service into four stages: (a) reception, which involves the provision of information and should be executed by the administrative team; (b) orientation to women in situations of violence, initial diagnosis and referral, which refers to the initial care by a pair of professionals (preferably psychologist and social worker); (c) in-depth diagnosis and care, which includes art therapy, social, psychological and legal care; (d) monitoring and closure of care (Gonçalves, 2006).

The term reception, widely used in health care, is often used as a synonym for care service and can be related, according to the Federal Council of Psychology (2012), to “a set of actions or procedures that seeks to guarantee access to users to a certain service with the purpose of adequate listening to solve problems or referral when necessary” (p. 85). It is the initial listening and attention dedicated to the demands of women in situation of violence, considering the principle of confidentiality.

Carlson and Goulart (2012) argue that it does not refer exclusively to an action, but to an institutional stance. For them, the challenge of this initial listening is to make the individual issues raised become collective - that is what the service will need to address.

The discussion about the meanings of the care service was one of the central focuses of these reflections, at the same time that it represents the main limitation of the present research: in the scope of the interviewees’ speech, the service was treated in its more traditional sense - as an individual and therapeutic space of listening.

In the first stage of the research, we verified a certain diversity regarding the forms of composition of individual care for women in situations of violence in the CEAMs. The reception, term which many professionals designated the first service with, could be done whether by the administrative team; only by the social worker; by the professional (psychologist, social worker or lawyer) available; or by interdisciplinary team. After the reception, the user could receive external referral or a specific internal referral, for psychosocial, psychological, social or legal care.

In two situations, the psychologists stated that the first service (reception) was responsibility of the social worker (E3), who could sometimes be accompanied by the psychologist (E2). Only after this first service (reception), the social worker refers the user to other professionals. When the psychologist is present, she evaluates whether the woman should be referred for individual psychological care (E2).

Another dynamic is established in a center where the first service (reception) is carried out on a shift schedule. The woman is received, presents her demand and is referred to the individual care. In the space of the reception, trainees and technicians take turns, refer the user to external services and / or schedule their return. In general, the first service is performed by two professionals from different areas, but the professional can serve alone if there is no other technician available or if the woman so wishes (E6).

In another center, the first service is always executed by a professional; if this professional perceives demand for other areas, he refers the woman to a subsequent service. In this CEAM, only the psychologist and the social worker do the first service. The lawyer only serves women sent by legal action, for what the team calls “return.” The technician in charge of the first service becomes the reference professional of the user and will have the responsibility to follow the development of all the services provided to the woman (E4).

Referring specifically to the service in the digital questionnaires, 43 psychologists stated that they executed individual care, 38, interdisciplinary care and 5, psychotherapy.

Specifically in the interviews, the work of psychology was referred to as individual care (psy­chological or interdisciplinary), psychotherapy, triage (individual or interdisciplinary), triage for shelter, first care, follow-up and care in reflection groups.

In the scope of research findings, it was considered that care is a privileged place for the practice of psychology in the institutions, but this need not to be a restricted place, but expanded with regard to the diversification of the format and the possibilities of intervention.

It seems we need to problematize the privileged place that individual care occupies in the psychological practice of the CEAMs. He speaks of a professional practice designed in the light of the psychotherapeutic model, without questioning the convenience of this design in the field of gender policies.

The meanings of work according to the psychologists who work in the CEAMs

The main objective of the intervention of the centers is the interruption of the situation of violence. This intervention must understand women as subjects of rights and promote the improvement of self-esteem, interdict the cycle of violence and prevent its repetition (Gonçalves, 2006). In this regard,

the Psychology professional plays a very important role in the network of care services for women in situation of violence. Whether it is to identify the signs that a woman is in a situation of violence or to assess the possibilities that violence may occur, the psychologist must always intervene to help the woman to develop conditions to avoid or overcome the situation of violence, from the moment it favors their process of awareness. (CFP, 2012, p. 64)

In many instances, the research participants reinforced the importance of psychology in serving women in situations of violence and in the development of public policies for this public. Although the work of psychology in this field is still recent, and there is no consensus as to the format of this action - as we have seen above - a respondent affirms that this is a “new space that is being built, but of utmost importance” (Q38).

All the interviewees affirm that the insertion of psychology is organic in the institutions, and that the professional practice of psychology is well respected in the CEAMs. In the words of one interviewee, the work of psychology is not only “arrived, answered and done”, it is a relevant intervention that cannot be waived (E2). Psychology is inserted organically in the CEAMs because it can take the psychological eye to the team meetings and the planning of the actions, which makes its insertion wider and far-reaching (E3), being convened at all times (E4). The insertion of psychology is necessary because it enables to understand the individual from all its crossings, being able to understand the human being from the relations that construct it and that he himself constructs (E6).

As Narvaz (2010) points out, it is necessary to “overcome the old historical dichotomy of psychology versus politics, still present among us today” (p. 56). The antagonistic relationship between psychology and politics, which reflects the individual dichotomy and society, must be overcome by a political perspective in the performance of psychology, especially when it comes to the field of gender violence, itself constituted in social relations and in the history between men and women.

Final considerations

At the end of this study, we return to the initial question - after all, what does psychology do in public policies, specifically in policies to address gender violence? - hoping to have collected some clues that allow the psychologists working with the question to reflect on their own practices.

Considering the complexity of gender violence and the incompleteness of the disciplines before it, the need for interdisciplinary practice is widely recognized in women’s services. The present work pointed to the emphasis on interdisciplinary intervention, on the exchange and support relations among professionals. But this dynamic needs to be better problematized, failing to be satisfied in its first steps. Setting up an interdisciplinary team is not simple. The political clashes, which involve public administration and the precariousness of employment ties, represent impasses in the continuity of the teams. If interdisciplinarity requires a minimum of permanence of the professionals, it also requires a solid, competent and continuous formation that allows to face its numerous challenges.

In-service professional training is, therefore, broader than at first glance. The gap we see here seems to be fundamental as regards the formation of the teams and the quality service that women demand and deserve. Few are the services that invest in the professional training of the technical staff, being restricted to the training offered by a governmental body, considered important, but not sufficient.

Regarding the daily work of the psychology professional, it is interesting to observe the diversity of the activities developed by psychologists in the CEAMs: psychology participates in gender violence prevention work, home visits, rounds of conversation, lectures and courses. However, this study showed that individual care is still the preferred place for the performance of psychology. Considering the diversity of activities developed and the centrality the individual format of service for women occupies in the work of psychology in these institutions, it is necessary to think about the very notion of care service, with a view to extending it beyond the notion of individual care as traditionally conceived. The service says about the professional position of the psychologist, regardless of whether the activity is individual, in a group, in a closed room or outdoors. In line with what we deal with throughout the text, in particular in the item Care Service, the psychologist who maintains a posture focused on the care service, understood as an angle of analysis of subjectivity, which dialogues with the perspective of gender and gender relations, is serving in the best sense of the word.

From a notion of psychological intervention that aims at overcoming the dichotomy between social and individual, which comprises the psychological processes within a broad and fundamental context for such engenderments, it can then be said that psychology is not inconsistent with the social view and politics on gender violence, on the contrary, it is a science and an essential profession to make integral care of women in situations of violence.

Based on his professional experience, Soares (1995) suggests this place for psychology:

women in violent marital relationships seem to be embarrassed in a web where motives for leaving and motives for staying are entwined and confused. Trying, with the woman, to follow the path of each thread, to verify how it was woven, where it crosses with the other, is one of the possibilities of deconstruction of this web. It is not a question of individualizing the issue of gender violence, but of singling it out. (p. 44)

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1 The authors understand that the term gender violence is the most appropriate to refer to the violence suffered by women because they are women. However, the reference to this type of violence, within the scope of Brazilian public policies, has been made from the term ‘violence against women’. In this sense, both expressions will be used throughout the text, although we know that they hold important theoretical distinctions.

2 Designation not specified in original document.

3 The questionnaires included open and closed questions about the work of the psychologists themselves in the CEAMs.

4 A specialized center was not contacted by the researcher by telephone because it was the author’s workplace. At this center only digital questionnaires and interviews with psychologists were considered.

Received: March 01, 2019; Accepted: April 05, 2019

Correspondence address: emmanuelaneves@yahoo.com.br

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