Contributions from the perspective of Psychosocial Rehabilitation for occupational therapy in the field of mental health¹

Abstract

The objective of the present study was to discuss the subject of mental health in a exercise to reflect on the possible dialogues and contributions of Psychosocial Rehabilitation assumptions for the theoretical and practical fields of occupational therapy. Since it is a reference that guides policies and practices in the field of mental health, it is considered relevant to explore Psychosocial Rehabilitation as a theoretical perspective that can greatly contribute to assistance actions in occupational therapy, since, according to literature, this profession has built its practice in this field from the main references that support transformations in mental health. In this sense, the exercise proposed here is precisely one that explores this perspective and its potential (or possibility) as a reference that can support practices and production of knowledge in occupational therapy, as well as to shed light on this perspective for the understanding of the different problems with which this profession deals, whether in the field of assistance or research. There are points of intersection between the perspective of Psychosocial Rehabilitation and Occupational Therapy, which suggests the importance and necessity of investigations focusing on this type of study.

Keywords:
Rehabilitation; Mental Health; Occupational Therapy

Resumo

O objetivo do presente ensaio foi discorrer sobre temática alusiva ao campo da saúde mental, em um exercício reflexivo sobre os possíveis diálogos e contribuições dos pressupostos da Reabilitação Psicossocial (RP) para os campos teórico e prático da terapia ocupacional. Tendo em vista que a RP se apresenta como um referencial que vem orientando as políticas e práticas no campo da saúde mental, considera-se relevante explorá-la como uma perspectiva teórica que pode contribuir para as ações assistenciais em terapia ocupacional. De acordo com a literatura, esta profissão tem construído sua prática neste campo, a partir dos principais referenciais que sustentam as transformações na saúde mental. Nesse sentido, o exercício aqui proposto foi justamente explorar a perspectiva da RP, assim como o seu potencial (ou possibilidade) como referencial que pode sustentar as práticas e a produção de conhecimento em terapia ocupacional, bem como colocar luz sobre esta enquanto possível lente para a compreensão das diferentes problemáticas com as quais esta profissão trabalha, seja no campo da assistência ou da pesquisa. Verificam-se pontos de intersecção entre a perspectiva da RP e a terapia ocupacional, sugerindo a importância e a necessidade de investigações que se dediquem sobre esse tipo de estudo.

Palavras-chave:
Reabilitação; Saúde Mental; Terapia Ocupacional

1 Introduction

This essay explored themes related to the mental health field in a reflexive exercise on the possible dialogues and contributions of the Psychosocial Rehabilitation (PR) assumptions for the theoretical and practical fields of occupational therapy.

Considering that PR is a reference guiding policies and practices in the mental health field, it is relevant to explore it as a theoretical perspective that can contribute to the care actions in occupational therapy. According to the literature, this profession has built its practice in this field, based on the main references that support the transformations in mental health. In this sense, the exercise proposed here was precisely to explore the perspective of PR, as well as its potential (or possibility) as a reference that can support the practices and production of knowledge in occupational therapy and highlight it for the understanding of the different problems this profession works, whether in the assistance or research area. There are points of intersection between the perspective of PR and occupational therapy, suggesting the importance and the need for investigations that focus on this type of study.

Thus, the starting point was a general presentation of this referential, highlighting some basic concepts and then, the step was to explore the possibility of dialogue/approximation of the concepts of this referential with occupational therapy in the mental health field.

This theoretical reference works on themes such as social inclusion, participation, autonomy, and social emancipation. In this way, there is an expansion of the scope of analysis about the processes involved and lived by people in psychic suffering, offering approaches and strategies of practices that transcend the dimension of suffering, and finally the diagnosis. Thus, the objective of this study was to initiate a theoretical discussion that shows a reference that has long supported studies and practices in the mental health area in the Brazilian context, including in the occupational therapy area, as a way of finding subsidies for future discussions and deepening.

The entire process of building and structuring the mental health area and its guiding policies begun in the 1980s, observing a profound transformation in what is understood as care, defined as an group of strategies to provide assistance and care to people in psychological distress (YASUI; COSTA-ROSA, 2008). In this sense, throughout this process, the current model that guides the care in mental health called Psychosocial Attention (PA) has been consolidated. According to Costa-Rosa (2013), this model translates into a set of practices, knowledge, and policies that guide mental health care.

Although PA is the current assistance model, there is still a strong relationship between services and even in the literature, an investment in approach and work with the perspective of PR, which justifies the proposal of this study. In spite of this, it is important to emphasize that from the perspective of Costa-Rosa, Luzio and Yasui (2003), this referential makes a composition with that of Psychosocial Attention, which allowed affirming in this study that such referential is in harmony with the guidelines proposals for the mental health field today.

2 Psychosocial Rehabilitation in the Mental Health Field

In this section, we have chosen to show more explicitly the main concepts that support the reference model of PR. These measures were carried out to reach, in the next section, possibilities of approximations and contributions of this perspective for occupational therapy in the mental health field. Thus, to introduce the discussion about RP, we started with the following definition:

The rehabilitation is not the substitution of disabling for habilitation, but a set of strategies aimed at increasing opportunities for exchange of resources and affections: only within the dynamics of exchanges, an “enabling” effect is created. Hence we can say that rehabilitation is a process that implies the opening of negotiation spaces for the patient, his/her family, the surrounding community and the services that care for the patient [...] (SARACENO, 2001, p. 111).

The aforementioned definition reveals a first fundamental aspect for the approach and understanding of the elements of this perspective, that is, that opportunities for the exchange of resources and affections among people in psychological distress, professionals, services, and society need to be expanded (SARACENO, 2001). This condition is justified of an understanding that opportunities for exchanges in different dimensions are precedent conditions in the process of building the capacity of subjects to establish relationships (SARACENO, 2016a). For example,

[...] it could be said otherwise that the market (that is, the physical and social place of the exchange of goods) precedes and the possibility of relationships between its members determines in a community [...] (SARACENO, 2001, p. 113).

In this sense, the market suggest to the context in which there is the opportunity to establish material exchanges, exchanges of identities, that is, it is the potential space for meetings where it is possible to recognize oneself and the other. Therefore, to participate in exchanges under its various possibilities in contexts such as this is enables the construction of the social network (SARACENO, 2001), and the consequent establishment of relationships.

This condition is directly implicated with a second fundamental concept of the PR perspective, called contractuality of the subjects.

Kinoshita (2016) problematizes the social reinsertion analyzed from the difficulty of the production of value by the subjects in psychic suffering. In this context, the author assumes that, in the social sphere, exchanges usually occur from a previous value attributed to each subject, indicated as a condition for the establishment of the various social exchanges, that is, this value confers their contractual power on the subject. The same author reflects that in the case of people in psychological distress, this presupposed value is conceived in a negative way, invalidating or making unfeasible the contractual power of these subjects. Then, he highlights that one of the commitments of rehabilitation would be precisely to enable the reconstruction of such values, broadening the contractual power of the subjects.

Reflecting on the process of (re) construction of contractual power by the subjects directly implies proposing actions that enable exchange spaces and also the negotiation exercise.

This creation and expansion of exchange spaces is defined by Saraceno (2001) as the link of a trading network. The author believes that negotiating networks, because they are flexible and interconnected, enabling to increase the participation and contractuality of people with less “power” in society. In this direction, it also points out that

The rehabilitation is not a process to adapt to the game of the strong, the weak ones. Rehabilitation is a process for the rules to change, and the strong ones can coexist in the same scenario as the weak ones (SARACENO, 2016a, p. 194).

Anchored in the conception of contractuality, Saraceno (2001, 2016b) presents a schematic analysis, in which he illustrates the three axes/scenarios of living/acting of all individuals: living/habitat, market/exchanging identities and work². From these three axes, Saraceno (2016b) argues that rehabilitation is a process of reconstruction of contractuality and also the exercise of the citizenship in these three spheres of life.

Given these aspects, there is a third concept of support from the perspective of Psychosocial Rehabilitation - full citizenship.

The construction of full citizenship, as the foundation of the PR, is conditioned to the circumstances that operate in favor or against the contractuality of the subject, based on the three axes previously mentioned (SARACENO, 2016b).

For Saraceno (2011, p. 99),

Citizenship is the precondition of any treatment of the disease. Citizenship is a right in oneself: the sum of negative rights (from being excluded, from being abandoned, from not being violated) and from positive rights (from being cared by the health service, to being treated well, to being recognized by the personal needs).

From these first introductory notes on PR, the following section will present a proposal for a dialogical reflection between the concepts of this perspective and the concepts of occupational therapy.

3 Psychosocial Rehabilitation and Occupational Therapy in the Mental Health Field: Possible Approaches and Necessary Dialogues

In its process of constitution and action in the mental health field, the occupational therapy has elaborated its conceptions and practices under the influence of the theoretical-practical transformations in this field, with reference to the Brazilian context (MÂNGIA; NICÁCIO, 2001; LEÃO; SALLES, 2016). Thus, currently its practice - when it aims at social inclusion, autonomy and the singularity of the subject - corresponds to the goals advocated by the psychosocial field (LEÃO; SALLES, 2016). As a result of this process and investment, Almeida and Trevisan (2011) point out that occupational therapy has developed its practice in the field of mental health directly based on the assumptions of Psychosocial Rehabilitation as a way of sustaining its actions and insertion in the current care devices.

These introductory considerations aimed at elicit reflections that indicate the extent to which the PR presuppositions can subsidize theoretical and practical constructions for occupational therapy in the field of mental health, contributing to the construction of the knowledge of this profession in this field. In this sense, it was sought to elucidate points of convergence and/or dialogue between some assumptions of this perspective and those of occupational therapy, reflecting on its possible unfolding and elaborations.

3.1 Promoting opportunities for exchanges spaces...

A first basic concept from the perspective of the PR to be explored is related to the need to promote opportunities for spaces of exchange by the subjects, for the production of the right to relationships (SARACENO, 2001) and to social exchanges. In this context, it is necessary that the practices have the opening of spaces of socialization, meetings and, therefore, that occur in spaces of circulation of the subject as a horizon. This perspective finds is strengthen in the field of occupational therapy since, according to Mângia and Nicácio (2001), one of the points of discussion about the guidance of the occupational therapist practice in the current configuration of mental health care is precisely in the reflection about the production of care in the real spaces of people’s lives and the involvement of the subject in activities that reflect their daily needs. That is, the authors’ statement shows a concern with a practice that responds to this premise, which is also revealed in Ribeiro e Machado (2008, p. 75), where

[...] Occupational therapy for effectively be constituted as a promoter of psychosocial rehabilitation, it must also be on the streets, in the markets, in the squares, in life [...].

In this case, there is an understanding that the professional actions must be in the exercise of the rights, inscribed in the social reality of the subject.

To enable the opening of spaces for access and exchange by people in psychological distress, the occupational therapist’s demand is not only an ethical and political commitment, but as Costa, Almeida and Assis (2015) suggest, the incorporation of the conception of social subject and rights to its theoretical-practical scope is required, especially from the subject/activity/therapist triad.

Incorporating this conception into the triad may mean producing practices that translate into concrete possibilities for social roles to be assumed by the subjects in society. Among these practices, they translate into the transposition of what is experienced in the subject/activity/therapist relationship to daily community life. These practices in community imply actions strongly articulated to the context of the subject, as well as a real commitment to the universe outside the therapeutic setting. However, by focusing on the triad, the risk of losing the dimension of social exchanges in people’s concrete lives is also highlighted.

Proceeding from this premise implies an analysis of the practice that goes back to the questioning about the means by which such action is achieved, which refers to the activity as an instrument of occupational therapy. For Ribeiro and Machado (2008), the occupational therapy has the potential to transform its action, together with people in psychological distress, in ways to promote their social protagonism because the activity is their main tool, which ultimately reflects the daily lives of subjects.

From the perspective of the activity, Castro, Lima and Brunello (2001) affirm that in the context of transformation in the field of mental health, there was a reconfiguration in the conception of activities, which play an important role in the process of overcoming exclusion and alienation. Thus, these activities are valued as an element of articulation between the subject and the community, enabling meetings and exchanges that produce meaningful experiences and insertion.

Therefore, a pertinent reflection concerns the conception of activity in the occupational therapy and its adoption to reach real possibilities of access of the subject to the exchanges and consequent relationships. According to this, Costa, Almeida and Assis (2015) consider that the activity, in the PR perspective, should be understood as a result of the interaction between subject and context, that is,

[...] Occupational Therapy interventions should consider the patients´ relationship with their territory, in their material and societal dimensions, seeking to create possibilities and resources that will make their entry into the social exchange circuit (COSTA; ALMEIDA; ASSIS, 2015, p. 193).

When reflecting on the profile of professionals working in the field of mental health, Amarante (2015) believes that their training should contemplate broader and deeper reflections on the complex composition of human life; which, in an allusion to Castoriadis, it would mean understanding about the senses produced by activities considered essentially human.

In this direction, occupational therapists have produced important reflections on human activity, such as the production of meaning, and the production of life projects (LIMA; OKUMA; PASTORE, 2013; SALLES; MATSUKURA, 2016).

It is argued that the occupational therapist contributes unequivocally to the process of caring in mental health because “... their training and their knowledge about human activity can contribute to achieving the goals of Psychosocial Rehabilitation” (ALMEIDA; TREVISAN, 2011, p. 304), especially when supported by this first pillar of analysis that deals with the production of opportunities for exchange spaces.

It is clear that the occupational therapist has the commitment not only to understand this concept but also to reflect on how human activity can be potent in the re-meaning of everyday social exchanges. Given that these exchanges are primordial, it is observed to reach real possibilities of promoting spaces of exchanges and relationships to the subjects, fulfilling one of the precepts of the process of rehabilitation.

3.2 (Re) Construction of contractual power...

A second concept of support from the PR perspective, Social contractuality is directly involved with an understanding of value production; that is, people, in general, have varying degrees of bargaining power that refer precisely to contractual power, that is, a “material of production of social value” (SARACENO, 2016b, p. 21).

Approaching this concept of the practice of occupational therapy imposes an analysis around the intervention processes of it, to assist the subject in his process of production of value socially legitimized. It is not a question of thinking about normative strategies that focus on the subject, but it presupposes actions that assist it in the process of discovering its potentials and possibilities. In the same way, these actions also encourage the subject to access the social game, which can be supported by professional actions that fall mainly on the context and its cultural transformation.

Castro, Lima and Brunello (2001) affirm that the new directions in the practice of the occupational therapist, proposing actions in the field of resources, possibilities and access to the social circuit - through play, art, care with daily life, the tours, the productive forms - promote the possibility of agency of experiences, impelling life, transformations and the production of value.

It is verified that the commitment to a practice that makes feasible the various forms of production of value finds correspondence in the concept of contractuality addressed here. In this direction, it is imperative to have the production of value as a horizon of the occupational therapist’s practice in a clear and substantial way, since this will enable the subject’s trajectory towards the (re) construction of his contractual power. As support for this reflection, there is the statement of Saraceno (1998), where care strategies should be premised on the production of value by the subject, which implies the possibility of producing meaning through it.

Therefore, the production of value is in a direct relationship with the production of meaning of life, existence and being. For the author, the function of rehabilitation is precisely to make this production worthy, which presupposes accompanying the subject in the (re) conquest of spaces that are not protected but socially open, therefore, with potential for the production of meaning (SARACENO, 1998). This discussion is found to correspond to the practice of occupational therapy and also to the use of activities, since Castro, Lima and Brunello (2001) point out that the performance of activities allows access to incomplete and meaningless experiences, or, life experiences.

For occupational therapy, it is possible to point to the importance of performing activities that have meaning for the subject or to construct with it new senses that support their existence in the world. In that direction,

The performance of activities comes from lived experience, providing experiences, broadening these fields, and allowing the subjects to act on their own environment. Through activities, we can dive into the significance of gestures and actions and establish relationships with material aspects. This doing is also linked to the spiritual values of subjects and groups and can represent the cultural process of a social group, presented as an active factor of social organization (CASTRO; LIMA; BRUNELLO, 2001, p. 50).

The previous citation shows that doing activities comes from the experiences of the subject and, by enabling settlements between subjective, material, identity and social aspects, the construction of meanings in the process of doing is possible that can be transposed into social reality. Therefore, in possession of this understanding, the occupational therapist can and should act in a way that facilitates the process of constructing meanings, and facilitates the transit between the construction of personal/existential/life sense and the consequent production of social value to the subjects. Ultimately, taking the production of value as a reference and also as a driver of entry into the circuit of social exchanges, it is possible to affirm that occupational therapy has the potential to boost this process, considering that in the scope of this profession “[…] the activities enable to “be recognized by others”; they allow knowing the life history of the subjects” (CASTRO; LIMA; BRUNELLO, 2001, p. 50).

A final important aspect to be addressed is the contractual power loan, which Kinoshita (2016) defines it as the use of the “prestige”, the mandate and the knowledge attributed and socially recognized to the professionals as a strategy to enable new experiences and relationships. In this direction, Ribeiro and Machado (2008) defend that the occupational therapist - by lending his contractual power as a form of effectiveness and improvement of the experience of social exchanges by the subjects - must transpose the institutional walls and know the territory and living spaces of this population.

It is argued that the occupational therapist must understand and master the conception of contractuality, proceeding in a way to become involved in the movements and actions of people in psychic suffering towards traffic and social exchanges. However, it is not a question of self-naming as a figure of authority or superiority; instead, to establish a partnership with the subject that facilitates the mediation and facilitation of the meetings.

3.3 Citizenship ...

Finally, the search for citizenship of the subject, a fundamental point of the PR, should be the guiding principle of the actions and strategies used by professionals and services who are dedicated to the care of people in psychological distress.

Saraceno (1998), when reflecting on activities such as painting and making handicrafts used in workshops in mental health services, he points out that these productions do not convert themselves into the process of rehabilitation, but are people’s own activities. It is opposed to the conversion of these as properly therapeutic, arguing that these activities can be powerful fields of expression, but their use must be the promoter of opportunities for the conquest of citizenship by the subject “who does not mean that a stage for reconstruction of the contractuality goes through theater, plastic arts, making ashtrays, passing through, not ending in” (SARACENO, 2016b, p. 23). Still on this theme, to problematize the rehabilitation is not only to discuss about theater or, as an example of the Santista experience, to discuss the TAM TAM radio; these strategies are understood as the beginning of the rehabilitation process. It is emphasized that through them, it becomes possible to access one of the fragments of the exercise of citizenship (SARACENO, 2016b), whose composition must pass through other elements and culminate in social exchanges, in the establishment of relationships, in the production of meanings, of value and contractuality.

The discussion shown by the author about the use of activities calls for occupational therapy - as a profession that works with activities in its different dimensions - to reflect on how these activities have been conceived, but especially, if they enable the subjects to experience real citizenship. ForConstantinidis and Cunha (2016) occupational therapists - supported by the ideals of psychiatric reform and aware of the criticisms about the use of activities throughout history - sought and still seek in their current practice, among others, to combat the null condition of citizenship lived by the subjects.

From a reflection on the importance of the relationship established between the human being and his production/objects used for this production, Benetton and Marcolino (2013) consider that the performance of activities by human beings does not only produce products in an understanding of “single direction” that is, of the human being toward what he produces, but may end up forcing a relationship with him, as well as a relationship in the sense of having to produce. For the authors, a similar relationship is established in the dynamics established between subject, therapist, and activity in the occupational therapy process, so these activities have the potential to take an active role in promoting change, and consequent emergence of the new. Thus, the way in which occupational therapy handles processes and events in care by doing activities are what enables the subject to experiment with enriching their daily lives.

It is worth questioning whether the occupational therapists, committed to care in the field of mental health, have in fact had the achievement of citizenship of the subjects as a goal; and consequently what strategies have been adopted to achieve this condition, which is ultimately based on the implementation of the PR process.

For Castro, Lima and Brunello (2001), the activities contribute to the daily organization of the subject, even enabling their structuring, besides having the potential to instrumentalize it, empowering it for life and becoming a structure of support for the development of independence and autonomy, which allows the subject a contextualized coexistence with their culture and community.

Under this perspective of the activity, it is possible to explore its potential for conducting citizenship processes; especially when evaluating his proposition to enable the subject to experience ways of doing, living, as well as knowing his rights and duties, his culture, his community. Finally, to provide the subject with a choice about their actions, integrating themselves into the networks and processes of community life, since

[...] only the full citizen can exercise his/her exchanges (and with these exchange also madness), while the citizen in the middle will not know what to do with the acquisitions (if actually acquired), with relational skills, since there will be no right or access to the exercise of relations or these will be given as relations devoid of the materiality that makes them real (SARACENO, 2001, p. 94).

The notes made here are certainly embryos for future discussions that deal with the concept of citizenship in the perspective of PR and occupational therapy. This is a fundamental investment since the occupational needs to understand and shape their practice in order to make citizenship processes viable therapist in order to operate in accordance with the current directives of care in the field of mental health.

As a note that precedes the end of this section, it is important to clarify that, by choosing only a few constituent concepts from the PR perspective, presenting them separately to explore them in depth in the dialogue with occupational therapy, there was a risk of obfuscating fundamental synergy that exists between them and that leads to a more macro reading of this perspective, that is, of productions that are inscribed in the context of the collective. This elucidation became necessary, since “[...] the dichotomy between subject and context founded the history of psychiatry and psychosocial rehabilitation is a useful conceptual formulation to overcome this dichotomy” (SARACENO, 1998, p. 27); and, in this sense, working with an exclusive focus on the subject would exactly reaffirm this dichotomy, contradicting the proposal of this referential. Therefore, it is essential that it is clear to operate in the logic of PR presupposes thinking and acting together with the subject to be contextualized in their environment and society, so that care projects ultimately reach “[...] the utopia of a just society with equal chances for all” (PITTA, 2016, p. 33).

4 Conclusion

In this essay, the investment focused on some concepts that underpin the PR perspective in the search for possible convergences and transits with occupational therapy, but clearly without exploiting them in all their magnitude and potential. Even within this reduced scope, there were some points of intersection - such as those worked on throughout this essay - from the three basic concepts of Psychosocial Rehabilitation: Promotion of opportunities for exchange spaces; (Re) Construction of contractual power and Citizenship, which suggests the importance and necessity of investigations that are committed to this type of study, considering that PR was inserted as a reference for the process of psychiatric reform. Additionally, as suggested in the literature, it is in response to this process that occupational therapy has reoriented its theoretical and practical conceptions in the field of mental health.

What can be seen more clearly in the exercise proposed here is that the elements that the perspective of PR presents as founding values ​​of a logic of care opposed to asylum converge with the values ​​of occupational therapy, which reflects on the potential of this profession to operate in the current logic of Psychosocial Attention. Obviously, this current configuration of the profession in the field of mental health was a construction whose historical process has already been portrayed by several authors of occupational therapy. In this sense, it was decided in this essay to invest in dialogue with PR only, due to the extension of the work that an incursion into the history of the constitution of the profession and its relation to the Classical Rehabilitation would require - which would extrapolate what is allowed for this manuscript. However, it is assumed that in making such a choice, important discussions and reflections were not made, remaining only as pressing suggestions for future studies.

It should be emphasized that, because this was an update of the dialogue exercise between the PR and occupational therapy assumptions, the limitations that emerged here were justified in parts; while at the same time they were able to elucidate the need for investment in this type of research, in order to explore this reference as a theoretical contribution to the profession.

References

• ALMEIDA, D. T.; TREVISAN, E. R. Estratégias de intervenção da terapia ocupacional em consonância com as transformações da assistência em saúde mental no Brasil. Interface - Comunicação, Saúde, Educação, Botucatu, v. 15, n. 36, p. 299-307, 2011.
• AMARANTE, P. Cultura da formação: Reflexões para a inovação no campo da saúde mental. In: AMARANTE, P. Teoria e crítica em saúde mental: textos selecionados. São Paulo: Zagodoni, 2015. p. 99-108.
• BENETTON, J.; MARCOLINO, T. Q. As atividades no método terapia ocupacional dinâmica. Cadernos de Terapia Ocupacional da UFSCar, São Carlos, v. 21, n. 3, p. 645-652, 2013.
• CASTRO, E. D.; LIMA, E. M. F. A.; BRUNELLO, M. I. B. Atividades humanas e terapia ocupacional. In: DE CARLO, M. M. R. P.; BARTALOTTI, C. C. (Org.). Terapia Ocupacional no Brasil: fundamentos e perspectivas. São Paulo: Plexus, 2001. p. 41-59.
• CONSTANTINIDIS, T. C.; CUNHA, A. C. Desinstitucionalizando conceitos: a terapia ocupacional em busca de um (novo) lugar no cenário da saúde mental. In: MATSUKURA, T. S.; SALLES, M. M. Cotidiano, atividade humana e ocupação: perspectivas da terapia ocupacional no campo da saúde mental. São Carlos: EdUFSCar, 2016. p. 37-59.
• COSTA, L. A.; ALMEIDA, S. C.; ASSIS, M. G. Reflexões epistêmicas sobre a terapia ocupacional no campo da saúde mental. Cadernos de Terapia Ocupacional da UFSCar, São Carlos, v. 23, n. 1, p. 189-195, 2015.
• COSTA-ROSA, A. Atenção psicossocial além da Reforma Psiquiátrica: contribuições a uma clínica crítica dos processos de subjetivação na saúde coletiva. São Paulo: Unesp, 2013.
• COSTA-ROSA, A.; LUZIO, C. A.; YASUI, S. Atenção psicossocial: rumo a um novo paradigma na saúde mental coletiva. In: AMARANTE, P. (Coord.). Archivos de saúde mental e atenção psicossocial. Rio de Janeiro: Nau, 2003. p. 13-44.
• KINOSHITA, R. T. Contratualidade e reabilitação Psicossocial. In: PITTA, A. M. F. Reabilitação Psicossocial no Brasil. São Paulo: Hucitec, 2016. p. 69-74.
• LEÃO, A.; SALLES, M. M. Cotidiano, reabilitação psicossocial e território. In: MATSUKURA, T. S.; SALLES, M. M. Cotidiano, atividade humana e ocupação: perspectivas da terapia ocupacional no campo da saúde mental. São Carlos: EdUFSCar, 2016. p. 61-76.
• LIMA, E. M. F. A.; OKUMA, D. G.; PASTORE, M. N. Atividade, ação, fazer e ocupação: a discussão dos termos na Terapia Ocupacional brasileira. Cadernos de Terapia Ocupacional da UFSCar, São Carlos, v. 21, n. 2, p. 243-254, 2013.
• MÂNGIA, E. F.; NICÁCIO, F. Terapia Ocupacional em Saúde Mental: tendências principais e desafios contemporâneos. In: DE CARLO, M. M. R. P.; BARTALOTTI, C. C. (Org.). Terapia Ocupacional no Brasil: Fundamentos e perspectivas. São Paulo: Plexus, 2001. p. 63-79.
• PITTA, A. M. F. O que é reabilitação psicossocial no Brasil, hoje? In: PITTA, A. M. F. Reabilitação Psicossocial no Brasil. São Paulo: Hucitec, 2016. p. 27-36.
• RIBEIRO, M. C.; MACHADO, A. L. A Terapia Ocupacional e as novas formas do cuidar em saúde mental. Revista de Terapia Ocupacional da Universidade de São Paulo, São Paulo, v. 19, n. 2, p. 72-75, 2008.
• SALLES, M. M.; MATSUKURA, T. S. O uso dos conceitos de ocupação e atividade na Terapia Ocupacional: uma revisão sistemática da literatura. Cadernos de Terapia Ocupacional da UFSCar, São Carlos, v. 24, n. 4, p. 801-810, 2016.
• SARACENO, B. A concepção de reabilitação psicossocial como referencial para as intervenções terapêuticas em saúde mental. Revista de Terapia Ocupacional da Universidade de São Paulo, São Paulo, v. 9, n. 1, p. 26-31, 1998.
• SARACENO, B. Libertando identidades: da reabilitação psicossocial à cidadania possível. Rio de Janeiro: Te Corá/Instituto Franco Basaglia, 2001.
• SARACENO, B. A cidadania como forma de tolerância. Revista de Terapia Ocupacional da Universidade de São Paulo, São Paulo, v. 22, n. 2, p. 93-101, 2011.
• SARACENO, B. Reabilitação Psicossocial: uma prática à espera de teoria. In: PITTA, A. M. F. Reabilitação Psicossocial no Brasil. São Paulo: Hucitec, 2016a. p. 193-198.
• SARACENO, B. Reabilitação Psicossocial: uma estratégia para a passagem do milênio. In: PITTA, A. M. F. Reabilitação Psicossocial no Brasil. São Paulo: Hucitec, 2016b. p. 19-26.
• YASUI, S.; COSTA-ROSA, A. A estratégia atenção psicossocial: desafio na prática dos novos dispositivos de saúde mental. Saúde em Debate, Rio de Janeiro, v. 32, n. 78-80, p. 27-37, 2008.

Notes

• 1
  This text is the result of studies, reflections and questions emerged from doctoral research, currently being developed by the first author, in the Post-Graduate Program in Occupational Therapy at UFSCar.
• 2
  Although the dwelling/habitat, market/changing identities* and work* axes are structuring in the reference model of Psychosocial Rehabilitation worked here, it was decided to approach and deepen “previous” concepts that subsidize the understanding and development of the notion of Rehabilitation Psychosocial from these three axes. This was necessary due to the extensive investment that this incursion would require, extrapolating the indicated for this work.

Publication Dates

• Publication in this collection
  Dec 2018

History

• Received
  22 Dec 2017
• Reviewed
  02 Sept 2018
• Accepted
  03 Sept 2018