Territory and community in Brazilian occupational therapy: a conceptual review

Abstract

The words territory and community were incorporated into the occupational therapy derived from social and economic policies in the country, as a way of theoretically informing the critique of social reality and professional practices, as well as influencing the way of its achievement. In this debate, we aimed to identify the use and theoretical development of the terms territory and community in the productions of Brazilian occupational therapy to discuss whether words are concepts or notions for the field. We conducted a conceptual review of the terms in the main journals of the area and in the Lilacs and SciELO databases between 1990 and 2016, and the two most recurrent authors in the selected publications were interviewed, with the purpose of discussing and ratifying the results found. The total of selected productions was: 124 articles that only present a concept to the terms and 30 publications that were dedicated to it. The first conceptualizations were from the 1990s, elaborated by the authors of occupational therapy. The dialogue with other knowledge areas, such as deinstitutionalization, geography, sociology, and philosophy began in 2011, accompanied by the increase of research and production of knowledge in the field. The concept of territory suggests a combination of space, process, and relation, surpassing the definition of physical geographic space. In its turn, the community brings the notion of collectivity, networks, belonging and identity. The use of both presupposes the reflection on the ways of life and of the appropriation of the material, social and cultural resources that are established in a place. Therefore, they are presented in an intrinsic way to the actions in occupational therapy.

Keywords:
Occupational Therapy/Trends; Professional Practice; Community Action; Sociocultural Territory; Concept Formation

Resumo

As palavras território e comunidade foram incorporadas à terapia ocupacional advindas por caminhos relacionados às políticas sociais e econômicas do país, como uma maneira de informar teoricamente a crítica sobre a realidade social e as práticas profissionais, bem como influenciar a forma de sua realização. Neste debate, visou- se identificar o uso e o desenvolvimento teórico dos termos território e comunidade nas produções da terapia ocupacional brasileira para discutir se as palavras são conceitos ou noções para o campo. Para tanto, realizou-se uma revisão conceitual dos termos nos principais periódicos da área e nas bases Lilacs e SciELO, entre 1990 e 2016, e entrevistou-se as duas autoras mais recorrentes nas publicações selecionadas, com o intuito de discutir e ratificar os resultados encontrados. Foram selecionados 124 artigos que apenas citavam e 30 publicações que se dedicavam à apresentação de um dos conceitos. As primeiras conceituações datam dos anos 1990, elaboradas por autores da terapia ocupacional. O diálogo com outras áreas de saber, como geografia, sociologia e filosofia, iniciou-se em 2011, acompanhado pelo aumento de pesquisas e produção de conhecimento no campo. O conceito território sugere uma combinação de espaço, processo e relação, superando a definição de um espaço geográfico físico. Já comunidade traz a noção de coletividade, redes, pertencimento e identidade. A utilização de ambos pressupõe a reflexão sobre os modos de vida e de apropriação dos recursos materiais, sociais e culturais que se estabelecem em um lugar. Apresentam-se, assim, de forma intrínseca às ações em terapia ocupacional.

Palavras-chave:
Terapia Ocupacional/Tendências; Prática Profissional; Ação Comunitária; Território Sociocultural; Formação de Conceito

1 Introduction

The concepts of territory and community entered into the technical performance of the health professionals and the social field in the period of change in the Brazilian social policies, with the displacement of assistance from centralized institutional equipment to the spaces of daily life, changing the focus to contexts and interventions based on the real and complex needs of the individuals, groups, and collectives. In this way, the use of words in the professional routine has become frequent and also a determinant of the type of action appointed in the assistance services.

The words territory and community have multiple meanings. Polysemic terms, capable of accepting different meanings depending on who uses them, the reference on which they are based and the context in which they are used. They are the so-called multipurpose word, in which each person, when projecting their beliefs, their moods, their context, allows the word to gain new outlines and the possibility of defining a wide range of designations (Silva & Simon, 2005).

In the academic environment, the words can be used to designate a term, a notion and also a concept. The terms are simple nominations with meanings based on common sense. The word notion refers to a known idea or process, but little theoretically elaborated and the elements of a theory that lack the clarity and depth to acquire concept status, used for approximate explanations of the real (Minayo, 2014).

Concepts are words historically built and show the attitudes and choices influenced by the socio-historical reality to which they belong; they are used to assign units of meaning to the forms and content of a given theory. Basic functions such as communication, organization, questioning, and deepening are attributions given to concepts in the construction of knowledge. Due to its refined historical and theoretical elaboration, the concepts are an important pillar for the production of knowledge in a given scientific area (Minayo, 2014).

In occupational therapy, the production of practices and knowledge related to the experiences lived by the field and aligned with the demands of the country's socio-historical reality come from the 1970s and 1980s, which is the period of the military dictatorship, struggles for democratization and health and psychiatric reforms. Important critical reflections and the development of new workspaces and questions about the political role of occupational therapists are highlighted in the time, expanding the field's dialogue with other areas of knowledge, such as sociology, anthropology, philosophy, among others (Soares, 1991; Barros et al., 2007).

The words territory and community are incorporated into the theoretical reference of occupational therapy related to the country's political, social and economic experiences and changes, as a way of theoretically informing criticism about social reality and professional practices. The occupational therapist aimed at the spaces of everyday life and collective aspects as well as a form of resistance to individualization and to the problems of capitalist society, in a critique of the profession's biomedical tradition (Galheigo, 2011).

There is a close relationship between the conceptual debate on territory and community and the actions in occupational therapy since this professional is dedicated to interventions in everyday spaces of the groups he intervenes. Furthermore, the concepts show an action strategy for the area by advocating the development of actions close to its target audience, whether physically - in the geographical sense - or close to its context - when considering social, historical, economic, political and cultural aspects in the place (Lopes et al., 2013).

Thus, the designations of territory and community in occupational therapy go back to specific practical actions, appropriate to the realities of life of the population groups they intervene. However, although they are used for more than thirty years in the technical repertoire of the area, little has been produced about the place they occupy in their theoretical-conceptual development.

How were the development and use of the words community and territory in Brazilian occupational therapy? Based on this questioning, this study aimed to identify the use and theoretical development of the terms territory and community in the bibliographic productions in the occupational therapy area. We intended to discuss whether words are concepts or notions for the field and to understand how it was inserted in the area, its use and definition in the vocabulary of occupational therapy in Brazil.

2 Methodological Procedures

This is a conceptual review of the terms territory and community in the production of Brazilian occupational therapy. The conceptual review aims to analyze how the term is theorized, with the intention of revealing, at a conceptual level, the theoretical references, historical debates and interpretations that are common to the literature in the area. For this reason, the conceptual review is devoted less to the synthesis and evaluation of the productions found and more to the methodological and epistemological processes in which the concept is produced and/or used (Hicks, 2016).

We collected data from February to November 2017 in two moments. The first moment was a survey of the articles in the main Brazilian journals in the area: Cadernos Brasileiros de Terapia Ocupacional (CadTO) (formerly Cadernos de Terapia Ocupacional da UFSCar) and Revista de Terapia Ocupacional da Universidade de São Paulo (RTO), and on the following databases: Latin American and Caribbean Literature in Health Sciences (Lilacs) and Scientific Electronic Library Online (SciELO). The second moment was semi-structured interviews with the two main authors found in the previous moment to discuss and ratify the results from the selection of articles.

We carried out the survey of the productions in two subsequent stages: in the first stage, we grouped the works that mentioned the terms territory and community in the title, abstract and/or keywords. In the second stage, after reading the first selected reference, we separated the productions with a definition of the terms territory and/or community in the body of the text, either starting from the elaboration constructed by the authors of the manuscript, by the authors in the therapy occupational area, or the authors linked to other areas of knowledge.

We considered all the articles available from 1990 (the year of the beginning of both journals) to 2016 in the journals of the area. We consulted 635 articles published by CadTO and 557 by RTO. To survey the databases, the combination of the following descriptors was used: occupational therapy and territory, occupational therapy and community, occupational therapy and territorial action and occupational therapy and community action. We found 128 articles in Lilacs and four articles in SciELO. Therefore, we consulted 1,342 articles.

The following criteria were applied in the systematization of the first stage: inclusion of works that used the terms territory and/or community and their correlates (territorial action, community action, community work) in the title, abstract and/or keywords and exclusion of editorials, abstracts of theses and dissertations, presentations of books and manuscripts written by authors of other nationalities and/or areas of knowledge.

At the end of the review, the materials selected for the study were classified about the use of the terms territory and/or community in two groups: the first group included articles that only cited the words in the body of the text, having 124 productions. On the other hand, the second group had articles dedicated to presenting a concept to the terms in the text, having 30 productions. Figure 1 shows the flowchart of the search, selection, inclusion, and exclusion of the articles.

Figure 1
Flowchart of the conceptual review stages.

When we evaluated the first group (n = 124), we sought to identify by a dynamic reading of the text, the meaning attributed to the words territory and/or community during the manuscript, aiming at understanding the meaning for the term. For the second group, after reading the 30 selected articles in full, a summary table was elaborated with the following information: year of publication, journal, authors, title, conceptualized term, referenced authors, theoretical line, text perceptions and the relation with occupational therapy. The articles in the second group are shown in the references of this text, highlighted with an asterisk.

After a complete survey of the articles, we conducted semi-structured interviews with the two main authors found in the review to discuss, complement and also ratify the data collected in the productions. The interview script had questions about the concepts found, the historical period and the theoretical references that supported the beginning and development of reflections on territory and community in occupational therapy.

We performed the analysis based on the full reading of the transcribed interviews and the selected articles. In the articles in which territory and community had not a theoretical elaboration, the aim was to identify the period in which the words started to be used in the field of occupational therapy and the meaning for the term. In the concepts found, we sought to identify the years of publication and the historical perspective, the referenced authors and the theoretical lines used for the development of the rationale and use of the terms territory and community in the production of Brazilian occupational therapy.

3 Results and Discussion

In the first group, in the 124 selected productions that only cited the words in the text, five were from the period between 1991 and 2000, 35 were published between 2001 and 2009 and 70 were from the third period studied, between 2010 and 2016. The year 2016 stands out with 18 publications. These data showed the expansion of the use of the words territory and community in studies in the Brazilian occupational therapy area. Although the articles do not show a conceptual development to the terms, the numbers reflect the significant increase in reports of practices and research that use designations in the writing of work in occupational therapy.

Also in the analysis of the first group we highlight the frequency in the use of the terms. Most of the studies, 67, presented the two words in the body of the text: territory and community. The word community was used alone in the first selected publication dated in 1991 and in 32 other articles. The term territory was mentioned alone in only ten studies. Figure 2 shows the results found in the analysis of the first group.

Figure 2
Use of the words territory and community in the production of occupational therapy in the first group (n = 124).

The information in the first group in different from the data found in the analysis on the conceptualization of terms (second group). The word territory, less mentioned in the texts of the first group (10), is conceptually defined in 24 works, 80% of the productions selected in the second group of the study (n = 30). The conceptualization of both terms territory and community appeared in only one article. The concept of the community appeared in just five texts, all written in the last six years of our study (2011-2016).

According to this review, the first conceptual elaboration on the term territory was published in 1999 (Oliver et al., 1999), present frequently until 2016. We can also see the predominance of the concept of territory in the first years of our review (1999-2010).

The year 2002 was also important with four productions, and in 2014 and 2016, the concepts were present in five productions. In the last four years (2013-2016), the terms territory and community were used in 15 studies, demonstrating an expansion of the use and presentation of concepts in Brazilian production. Figure 3 shows a summary of the results found.

Figure 3
The concepts of territory and community and their years of publication in the second group (n = 30).

Such data shows the movement of incorporating the concept of territory in public policies in the country, with the advent of the Federal Constitution of 1988. In the process of reorienting the Brazilian public health care model, the word territory entered into the technical vocabulary of professionals with the creation of the Unified Health System (SUS), being a structuring concept in the proposition of the Family Health Program in 1994, and remaining central when renaming it to the Family Health Strategy with the indication of the territorialization of health activities as the theme of the program (Santos, 2009).

With the proposal of placing the territory as a care strategy and geographic and affective approach of the individuals, SUS called professionals, including occupational therapists, to new confrontations: to enter the places where life happens and to adapt work actions to real needs of the population (Oliver et al., 2001).

Therefore, as the occupational therapist designed new actions appropriate to the propositions of the system and territorial logic, the technical design of the territory became part of the theoretical concerns, becoming a recurring definition in articles.

The expansion of the use and conceptual development of the terms in the two groups also corroborates the increase in the entry of occupational therapists in post-graduate programs, such as students and advisors, and the creation of a specific post-graduate program in occupational therapy (Malfitano et al., 2013) as contributions for the construction of their own knowledge and expansion of academic production in the area (Lopes et al., 2016).

Also, the search for a greater theoretical basis is also related to the effective move of occupational therapists to the territorial and community scope and, consequently, with the gathering of more elements for the theoretical-practical dialogue. The speech of author 2 shows this movement.

I think that when you start to study, you don't need to have a specific post-graduation program, you start to study your own practices, the chance that you will show your studies that are not published about different practices is greater, for the territory, community, child, mental health, the use of instruments, functionality, and assistive technology. I mean, you are bringing into the debate what was in a certain way spread in the practices, constituting the practices, and you are giving places for reflection on that. So, I think that post-graduate studies, São Carlos post-graduate programs and also the connection of people to other programs make this more evident (Author 2).

According to Minayo (2014, p. 177), we need an analysis to visualize the scope and propose reformulations to the concepts within a field, guiding its origin, path, and use, being necessary “[…] to understand the historical and sociological meaning of its definition and the combinations they produce”. Thus, the study proposes to show an analysis of the historical development of use and the meanings attributed to the terms territory and community in the field of Brazilian occupational therapy in the following sub-items.

3.1 Uses and meanings of the words territory and community in occupational therapy

In the historical course of the use of the words, the use of the term community and the development of community actions in the midst of occupational therapy practices started from the late 1970s (Barros et al., 2007).

According to Vasconcelos (1987), the word community composed the scene of struggles for the democratization of the country, of social movements in search of citizenship and of debates about the reorientation of public health, immersed in the concept of community participation and religious-oriented propositions by the ecclesial communities.

We lived in the late 70s, we lived a perspective of the struggle for the expansion of freedoms, so there was an idea of democracy and the end of the dictatorship. [...] The community is about what the communities were ... the community idea, this comes together with the social movement and the basic ecclesial communities, which was an important Catholic movement and which I think has a democratic mark by the base, let's say so, a seam by the base of the propositions (Author 1).

The word territory gained visibility when used by public policies in the 1990s. However, its approximation with the linguistic body of occupational therapy occurs in the previous decade, in 1980, influenced by the movements of deinstitutionalization (Rotelli, 2001), especially those of Italian Democratic Psychiatry, and for the search for a transformation in the way of mental health care at the beginning of the construction of the Brazilian psychiatric reform.

And then I think that the question of the word territory appears because it was not a word used. For me, the territory comes along with the wording around deinstitutionalization. I don't even know if, around the reading of the texts, I don't know if the word was there in the texts. It was in the conversation that we had about Italian democratic psychiatry because people went [to Italy] and came back in the mid-80s, they stayed a long time like that, a year, nine months. And then, what we talked was: “no, but it's the territory” (Author 1).

However, according to Barros et al. (2007), the territorial and community actions of occupational therapists held in isolated and sporadic experiences, without standards, systematizations and/or written records regarding this period.

In the 1990s, there was the expansion of operating spaces and the creation of two specific journals in the area: Cadernos Brasileiros de Terapia Ocupacional and Revista de Terapia Ocupacional of USP (Lopes et al., 2016), in which the terms entered into the theoretical body of academic productions with an extensive diversity of uses and meanings.

Most of the selected productions of the first group, 93, mentioned the word community with a sense of social group. According to Freire (2003), a social group is made up of people interconnected by the constancy of time and space, moved by similar needs and who share the coexistence and common goals. Thus, when attributing the term community to the notion of a group, the texts refer to the relationships of belonging, location, and participation of individuals in collectives, including beyond the family group.

The reference to the social group brings the perspective of the collectivity to the field. Occupational therapy, which became institutionalized in Brazil with the tradition of individual, institutional action and removed from social dynamics, arising from the North American and European formation that implanted the profession in the country (Soares, 1991), with the incorporation of the word community, it enters the realm of plurality and the consideration of the possibility of proposing collective action in its range of action, in contrast to the unique idea of individual clinic.

The presentation of the word community as a mention of social vulnerability was also found in three articles to a lesser extent. With this meaning, the term receives the design of a social group that shares the same situation of poverty, and the sense of peripheral and marginal neighborhood, excluded from the rest of the city, as exposed by Silva & Lima (2015, p. 675):

We constantly perceive that the peripheral neighborhoods of the city previously called peripheries or slums are now designated by the term “community”: “the community of Jardim São Luís, the community of Brasilândia”. What makes them called communities? Is it the fact that people share the same geographical territory, the same sub-prefecture, the same misery? Would it be a new, tidier and more harmonious way of referring to the situation of social vulnerability?

In 22 articles in the first group, the meaning of physical space to the word community is observed as in the following statement: “[…] the contexts for using the equipment, according to the parents' report, were: the school, the home and the community” (Volpini et al., 2013, p. 474). As in the example, the term refers to the physical geographical context in which the individual circulates, that is, the streets of the neighborhood.

Community is also used as a synonym for territory in ten articles: “The articulation between the team, equipment/services, and the territory/community is also a constant in the field” (Lopes et al., 2013, p. 945). The notions of a social group and physical space are indicated for both terms, used interchangeably throughout the manuscripts.

Materiality and geographical physical space are meanings attributed to the term territory in 47 of the 124 articles selected in the first group. There is a mention of the territory as the area of a health unit or the space where equipment is located: “[…] this information enabled the construction of a map of the scope of these proposals, facilitating the organization and access to data and resources available in the territory” (Castro & Silva, 2007, p. 104). Also, it was mentioned as the delimited area of an administrative unit: “[…] east, southeast, and north, territories with high demographic density and low access to public and social resources” (Antunes & Rocha, 2011, p. 271).

In 33 productions, there was the union between materiality and the lives that are built in the space, with its contradictions and disputes. The understanding of territory as a living space and a setting for everyday actions is illustrated in the article by Paiva et al. (2013, p. 600): “[…] the territory was configured as an environment with many riches and contradictions, in which cultures and different histories intertwine, people who fight for a more dignified life condition”.

The words territory and community are used with multiple meanings, with an implicit meaning when reading the text. These words are part of a range of words known to the field, as part of a common sense of occupational therapy.

Also, there is the recurrent use of words as related terms, that is, a dialogical pair that complements in the presentation of the same conception of occupational therapeutic intervention, aimed at the collective scope and appropriate to the social dynamics of the assisted individual and groups.

3.2 Occupational therapy and the concept of territory: first theoretical designs

According to this review, the first article on occupational therapy about a conceptualization of the term territory was from 1999. Written by occupational therapists Fátima Corrêa Oliver, Marta Carvalho de Almeida, Maria Cristina Tissi, Luciana Castro and Simone Formagio, the study discussed an experience based on Community Based Rehabilitation (CBR) as a territorial intervention proposal (Oliver et al., 1999).

CBR is a rehabilitation strategy for people with disabilities based on community development, equal opportunities, facilitating their access to low-cost technologies and the inclusion of people in their daily lives (Organização Internacional do Trabalho, 2004). The strategy was promoted with the Declaration of Alma-Ata, in 1978, aiming at the attention from disability from high complexity to primary health care, indicating the territory as one of the protagonists and placing it as a resource for the technical action of professionals, such as occupational therapists in this new rehabilitation setting.

In the text, the relationship between territory and community is presented in a dialogical and complementary way. However, the term community is not defined, is a social group determined by its geographical location. The word territory receives broader outlines when it is conceptualized as a geographical space demarcated by historical bias and by social and cultural relationships.

The notion of territory is a geographically delimited space, historically constructed and with socio-economic and cultural relationships to be unveiled. It is possible to observe different ways of existing, dreaming, living, working and carrying out all possible social exchanges (Oliver et al., 1999, p.5).

In the same year, Fátima Corrêa Oliver and Denise Dias Barros also published the article “Reflexionando sobre Desinstitucionalización y Terapia Ocupacional” in the Matéria Prima magazine, an Argentinian journal in the area. The work is a reference in many studies analyzed and, although it does not present a conceptualization of the terms studied, it shows the influence of the deinstitutionalization movement in the profession, presenting the historic moment of breaking institutional walls and going to other areas of activity, beyond the reach of perception of the “beyond individual”, that is, the person allied to his context, historicity, relationships, and spaces of everyday life (Oliver & Barros, 1999).

The deinstitutionalization process in the field of psychiatry and the criticism of total institutions and the role of technicians in maintaining the status quo of these services was addressed in the article Occupational social therapy, prepared by occupational therapists Denise Dias Barros, Maria Isabel Ghirardi and Roseli Esquerdo Lopes. The article highlighted historical importance in the conceptual development of the term in occupational therapy by showing the movement to expand the scope of the occupational therapists' work towards the social field and the territory. According to the authors,

We can say that the processes of deinstitutionalization triggered and enabled the development of a new practice in occupational therapy, whose main characteristics, in addition to those mentioned above, are marked by the principle of territorial responsibility in assistance [...]. Thus, the territory is the fundamental idea and recognition of the other, meeting the otherness (Barros et al., 2002, p. 99-100).

Besides being the pioneers in the construction and presentation of a definition of the concept of territory, in tune with professional practice, the three articles gave theoretical bases and were bibliographical references of twelve other productions that started from a similar concept about the territory in Brazilian occupational therapy. The milestone of the articles is confirmed when we observe that, until 2010, 11 of the 12 selected productions had the concept for the term territory under these three references.

In the early years, the concern of occupational therapists was based on the foundation of professional practices since new equipment, policies and perspectives of assistance were being built in the country. Thus, they used elaboration of the concept based on their own experience and readings that supported the performances in the process of elaboration.

3.3 Interface dialogues: contributions to occupational therapy

The authors of occupational therapy elaborated on the first definitions of the term territory found in the productions, based on specific theoretical lines such as deinstitutionalization. Conversation with areas of knowledge in interface with occupational therapy, such as geography, sociology, and philosophy became part of the area's productions only in 2011, twelve years after the first conceptualization.

The search for other areas of knowledge for master's and doctoral studies (Emmel & Lancman, 1998) offered occupational therapists contact with authors and different theoretical lines, expanding the discussion beyond the references of the field. The author 1 interviewed showed this movement,

Maybe it was a demand. For example, I heard that [...] I remember [Paolo] Nosella saying something like this: “but if you use territory, why don't you use Milton Santos?” [...] We will produce another level in this discussion academically. You will seek to better explain what “I know what it is, but I need to explain how”, and then, you will seek references (Author 1).

The theoretical line about the themes of deinstitutionalization of the Brazilian psychiatric reform and psychosocial rehabilitation was the second most used group to support the concepts of both territory and community in occupational therapy, with six productions. The most remembered author in this theoretical group was the Italian Franco Basaglia, with two citations, followed by also Italians Franca Ongaro Basaglia, Benedetto Saraceno, Giuseppe Dell'acqua and Roberto Mezzina, and by Brazilians Paulo Gabriel Godinho Delgado and Roberto Tykanori Kinoshita.

Geography remains as the third most used area of knowledge in the conceptualization of the terms. The discussion of territory based on the theoretical reference of geographic bias had four studies. The first work was published in 2012 and the last two in 2016, showing a recent phenomenon about the approach of occupational therapy with geography theorists. The most cited contributions are by Brazilian geographers Milton Santos and Rogério Haesbaert.

The text prepared by Leão & Barros (2012, p. 576) shows the concept of territory based on the area of geography for occupational therapy:

The social space that we can call as the territory is a relational reality, composed, on the one hand, by natural, geographical objects, and, on the other hand, by society in motion. Dynamism corresponds to the interrelationships established between individuals, mediated by cultural, social, legislative, political, economic and social aspects, producing transformations, which occur through the natural scenario and the social history inscribed and reflected in the ways of living and in the environment that is perceived and understood about the place (Santos, 2007, 2008 apud Leão & Barros, 2012, p. 576).

Although such a dialogue is still recent, we can say that geography contributed by inserting macro-structural characteristics into the concept of territory used by occupational therapy. In the aforementioned section, there is an indication of aspects related to the macro-social structure related to the term territory, such as legislation, politics, and economics. The authors also add that territory is also a space for action and relationships of both power and resistance to the power experienced in the minutiae of everyday life (Leão & Barros, 2012). In other words, it brings the understanding of the territory as a concept of interconnection between micro and macro-social structures.

The conceptualizations of territory and community in three also recent studies were based on the area of philosophy published in 2015 and 2016. The studies of the French philosopher Félix Guattari, together with the Brazilian psychoanalyst Suely Rolnik, were the most cited, as seen in the following statements:

The territory can be relative both to a lived space and to a system perceived in which a subject feels “at home”. The territory is synonymous with appropriation, with subjectivity closed on it. It is the set of projects and representations in which, pragmatically, a whole series of behaviors, investments will result in social, cultural, aesthetic, cognitive times and spaces (Guatarri & Rolnik, 1996 apud Ferigato et al., 2016b p. 18).

In 2015, the study that used the precepts of philosophy for the concept of community is based on the Italian philosophers Giorgio Agamben, Antonio Negri, and Michael Hardt and on the Hungarian philosopher, resident in Brazil, Peter Pál Pelbart. Based on the report and analysis of experience, the study went beyond a definition of the concept, proposing a reflection on the nostalgia that the word reflects and the utopian form that is used today in the search for the uniqueness of a fragmented society.

For Nancy (1986 apud Pelbart, 2006), the lost, harmonious and unitary community, never existed and is nothing more than a ghost. But how can the presence of this nostalgia for a non-existent harmonious community be so strong, given the human history of conflicts? (Silva & Lima, 2015, p. 675).

Also, two studies work from the perspective of the community based on sociological references. The first work, published in 2012, discussed the concept of community, “[…] not as a spatial delimitation, but as a collective construction of identity” (Costa, 2012, p. 47), using the reference of the German sociologist Ferdinand Tonnies, considered founder of the community theory.

On the other hand, the second study was based on the reference developed by the Polish sociologist Zygmunt Bauman in “Community: the search for security in today's world”. The authors sought support in the idea of a collective identity to conceptualize the term community:

The community is a space that brings positive influences to the routine of services and care, being a comfortable and cozy place, where everyone recognizes each other (Bauman, 2003). Living in a community means being willing to experience identification with the territory, creating collective subjectivity, feeling safe and showing solidarity in the relationship with the actors of the social network (Silva et al., 2014, p. 147).

The sociology area brought new elements to discuss occupational therapy. In addition to the proposed reflection, the notions of identity and belonging and the concept of community as a social group that is interconnected by similar characteristics are presented in this line. In other words, sociological and philosophical knowledge brings the contribution of looking to the processes that occur in the territory and in the community, to what is raised in the production of daily life in these scenarios.

With only one article each, we also see references to social service and pedagogy. The social service reference is very close to the theoretical perspective of geography and shows the interconnection between micro social life and the macro social structures of the contemporary capitalist society. It adds the reflection about the rights and the possible dialectical relationship existing in these spaces: between the denial of citizenship and the forms of resistance and claim, visible in the concreteness of acting, participating, and living.

Koga (2003, p. 33) showed the territory as the concrete ground of everyday life, public policies and the exercise of citizenship, in which “[...] the right to have rights is expressed, denied or claimed from concrete places: to live, to study, to work, to have fun, to live healthily, to transit, to opine, to participate” (Costa & Brasil, 2014, p. 438).

The last concept has a clear distinction from the others when approaching the community in the composition of a strategy “[…] for learning, continuing education and fostering the exchange of experiences in service, ceasing to be purely spontaneous and starting to be stimulated” (Galheigo et al., 2015, p. 465); it is the Community of Practice. According to Galheigo et al. (2015), it consists of a group of people, in this case, occupational therapists, gathered to share experiences, provide discussions about a certain problem and deepen knowledge, a strategy of continuing education. In this sense, the community is a specific group interconnected by common characteristics that aim at communication and the production of knowledge, sharing, and solidarity among its members.

Therefore, we can see contributions incorporated by occupational therapy from other areas of knowledge and the construction of reinterpretations within the field. As pointed out by author 1, the designations attributed to the terms are circular: they seek additions in the dialogue with peers; however, they present the concepts in a convergent way, along the same line since the first definition developed by occupational therapists in 1999.

The impression I still have is that we work little, maybe less than we should on the designation of these concepts. On the other hand, seeing what you have gathered, I think we are going around, the impression I have, seeing what you have selected, we kind of go around the same things, to say I differently, with different authors, but in the end, it is very close to everything (Author 1).

Thus, the dialogues with the interface areas bring contributions to the occupational therapy area. However, they do not culminate or synthesize the elaboration of a proper concept and adequate to the theoretical and practical propositions of occupational therapy.

3.4 Territory and community: concepts or notions for occupational therapy?

In the analysis of the texts in the selected groups, although there is an effort in occupational therapy productions to trace a conceptual design to the words territory and community, the terms received outlines of notions in the productions of the area, that is, they have a passable meaning reading comprehension. However, they are not developed theoretically, with theoretical references and lines demarcated by the occupational therapy area. This analysis converges with the opinion of the interviewed authors:

It is a notion that comes from outside to inside [...]. It is a notion that we appropriated and produced a reinterpretation [...]. I don't think we have designed anything specific to the profession. From this, you can develop actions, practices, which are linked to this notion (Author 2).

The words territory and community as notions are intertwined with practical actions and used to describe and name the technical action of the professional in the field. In other words, these words fit the designation reference more aligned to the practical area than to the theoretical-conceptual scope of occupational therapy.

Thus, in the elaboration of synthesis and in the attempt to move forward in the discussion and conceptual proposition, the concept of territory suggests a combination of space, process and relationship, overcoming the delimitation of geographical space, a physical space, private or public. The concept of community brings the idea of collectivity and the production of networks, belonging and with an identity. Speaking about territory and community together is to highlight a reflection on the construction of ways of life and ways of appropriating material, social, cultural and relational resources that are established in one place, based on a collective perspective of life.

In historical terms, bringing the concepts of territory and community to occupational therapy determines a reference for changing the intervention paradigm. The extravasation of the closed and institutionalized therapeutic setting also enabled to go beyond the scope of professional practice, expanding the attention of individualized to collective subjects and of a punctual assistance to the dynamics and complexity of everyday life, that is, of the inseparability existing between the individuals' singularity and social groups and the social history that constitutes them, addressing the existing socio-economic, political and cultural processes.

For the occupational therapist, the proposition of a territorial and community action is to understand the individual' ways of life and the relationships they establish with the space in which they live; in other words, it presupposes the notion of otherness, as already exposed by Barros et al. (2002). Thus, develop a technical action appropriate to the forms of life built in that place, socially contextualized and involved in the real-life conditions of the subjects with whom we work.

4 Final Considerations

As indicated by Maximino & Tedesco (2016), the relationship between terminologies and practical actions is fundamental in the occupational therapy area, so that conceptualization instrumentalizes practical action at the same time that the description of the practice can provide data for the theoretical construction of new conceptual references. In this line, occupational therapy appropriates the concepts of territory and community, through practical experiences and real contact with the complex needs and demands arising from daily life.

Although the conceptual review provides information about the use and development of the words territory and community in occupational therapy publications in Brazil, it does not respond to gaps and the absence of theoretical elaborations specific to the area, and it only provides clues for the construction of aligned concepts interface references and its theoretical-practical reference.

Therefore, there is the task of developing research on the theoretical and conceptual based on occupational therapy to promote reflections and studies on the designations of the area.

However, this discussion is not restricted to the occupational therapy area. As the actions in the territory, adequate to the demands of the communities in their real contexts of life, are placed as action strategies of Brazilian social policies, it is necessary to debate the theoretical and conceptual terms within the professional categories that compose the interdisciplinary teams recommended by the policies, instrumentalizing and strengthening the technical actions developed in the daily services.

• How to cite: Bianchi, P. C., & Malfitano, A. P. S. (2020). Territory and community in Brazilian occupational therapy: a conceptual review. Cadernos Brasileiros de Terapia Ocupacional, Ahead of Print. https://doi.org/10.4322/2526-8910.ctoAR1772
• Funding Source This work was carried out with the support from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brazil (CAPES) – Funding Code 001.

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Publication Dates

• Publication in this collection
  22 May 2020
• Date of issue
  Apr-June 2020

History

• Received
  18 Aug 2018
• Reviewed
  21 Nov 2018
• Accepted
  27 Feb 2019