Action and formation of social occupational therapy with young people in public schools¹

Abstract

The METUIA/UFSCar stands out in the Brazilian scene as the pioneer in therapeutic and occupational propositions to public school and the demands arising from the social issue. This research aimed to understand what was produced by this group in terms of action and training in social occupational therapy in public schools, focusing on urban popular youth, in a period between 1998 and 2017. Interviews were conducted with 10 occupational therapists who worked at METUIA/UFSCar, a collective meeting with these professionals to discuss the topic, application of questionnaires with former undergraduate students who did a professional internship at METUIA/UFSCar, and an individual interview with seven of them. The analysis of the results indicates a training proposal that sensitizes occupational therapists to work with the poor youth, apprehending the centrality of the public school for them and, at the same time, produces actions that seek to resignify the school and its space, with production meaning and belonging, which can contribute to the desire for permanence and/or return to the studies of these young people. It is indicated also the incorporation of its theoretical and methodological frameworks in the working experiences of those who went through the group, occupational therapists, and former students, as well as inspiration for similar productions in other universities in the country. It concludes by the relevance of what is being done by METUIA/UFSCar, especially in what is the training of occupational therapists and practices that address demands related to social inequality, which is still a hallmark of Basic Education in Brazil.

Keywords:
Occupational Therapy, Youth, Education; Education, Elementary and Grade School, Educational Mainstreaming

Resumo

Tomando o pioneirismo do METUIA/UFSCar no cenário brasileiro quanto a proposições terapêutico-ocupacionais para a escola pública e às demandas advindas da questão social, esta pesquisa buscou compreender o que foi produzido pelo grupo em termos de ação e formação em terapia ocupacional social em escolas públicas, com foco na juventude popular urbana, num período compreendido entre 1998 e 2017. Para tanto, foram realizadas entrevistas com 10 terapeutas ocupacionais que atuaram pelo METUIA/UFSCar, um encontro coletivo com essas profissionais para discutir a temática, a aplicação de questionários com ex-estudantes de graduação que passaram por estágio profissionalizante junto ao METUIA/UFSCar e entrevista individual com setes deles. As análises dos resultados indicam uma proposta de formação que, de um lado, vem sensibilizando terapeutas ocupacionais para o trabalho com a juventude pobre, apreendendo a centralidade da escola pública para ela e, de outro, produzindo ações que buscam a ressignificação da escola e do seu espaço, com produção de sentido e pertencimento, que possam contribuir para o desejo de permanência e/ou retorno aos estudos desses jovens. Pontua-se a incorporação de seus referenciais teóricos e metodológicos nas experiências de trabalho daqueles que passaram pelo grupo, terapeutas ocupacionais e alunos egressos, assim como a inspiração para produções semelhantes em outras universidades do país. Conclui-se pela relevância do que vem sendo feito pelo METUIA/UFSCar, especialmente naquilo que é a formação de terapeutas ocupacionais e práticas que se voltem para demandas relacionadas à desigualdade social, que ainda é uma marca da Educação Básica no Brasil.

Palavras-chave:
Terapia Ocupacional, Juventude, Educação; Educação Básica, Inclusão Educacional

Introduction

At the intersection between the occupational therapy and education areas, the METUIA/UFSCar group has been a pioneer in the Brazilian scenario, in the proposition of therapeutic-occupational practices in public schools with young people, aimed at the demands arising from the social issue, from the perspective of social occupational therapy (Calheiros et al., 2016; Pereira, 2018) and the history and sociology of education (Lopes, 2013).

Created in 1998, the Metuia Project was conceived with the proposal of training occupational therapists to promote an action focused on social demands and guaranteeing the rights of the populations they work with, in a perspective of the inseparability between technical, ethical, and political action, constituted as an inter-institutional² group of studies, training, and actions for the citizenship of populations in processes of rupture of social support networks (Barros et al., 2002), focused on the development of projects in the scope of teaching, research and extension in social occupational therapy and its interconnection with different sectors (Lopes & Malfitano, 2016).

In 2004, the nucleus, until then composed of the University of São Paulo (USP) and the Federal University of São Carlos (UFSCar) was dismembered, with the structure of METUIA/UFSCar, with the METUIA Extension Program – Social Occupational Therapy, existing since 2001 remaining together with the Dean of Extension at UFSCar and giving body to the METUIA Laboratory of the Department of Occupational Therapy at UFSCar. With that, through the composition of a work team formed by professors, occupational therapists, and undergraduate and graduate students, the prioritization of this group in the development of research and extension projects, articulated with practical teaching in social occupational therapy, begins with a focus on youth³ (Lopes & Malfitano, 2016).

Taking mainly the urban popular youth and mostly poor, public school and educational policies are fundamental. On the one hand, they are one of the main and few public policies guaranteed and aimed at this group and, on the other, because of their centrality formal education in our social organization, mainly because its rooted in the social imagination is one of the only legal means for popular classes to reach less unfavorable social positions (Lopes & Malfitano, 2016).

Since then, within the scope of the research, several projects have been – and continue to be – carried out that dealt/deal with important problems experienced by this layer of the Brazilian population, some of which focused on issues related to public schools.

Concerning training, particularly in practice, METUIA/UFSCar has proposed a series of university extension actions, which have also been constituted as a field for professional education, considering the scarcity of experiences aimed at the construction of spaces of democratic participation and expansion of sociability networks and possibilities for poor youth. The interventions centered on a neighborhood in the outskirts of the city of São Carlos – SP, gain notoriety over time, specifically in two of its social facilities, a youth center, and a public school (Lopes & Malfitano, 2016).

Assuming that the accumulation of experiences over these years provides subsidies for theoretical and methodological elaborations in the correlation “social occupational therapy, school, and youth”, this study sought to apprehend what was and has been produced by METUIA/UFSCar in its proposals of teaching, research, and extension in and about the public school, what have been their results and, equally, what their contributions have been both for occupational therapy and for education.

Methodology

We sought for a historical understanding of the proposals for action and training of social occupational therapy developed by METUIA/UFSCar in public schools, focusing on their experiences and analyzing what was produced and what can be pointed out as a result of this work, since its beginning in 1998, until 2017. For this purpose, we used different procedural strategies to substantiate sources and composition of the research field: documents, individual interviews, application of questionnaires, and holding a collective meeting with part of the participants and collaborators, as detailed below.

Initially, a survey was carried out on the ProexWeb/UFSCar Platform ⁴ of university extension projects that involved therapeutic-occupational action (Table 1) in the public school, their respective reports, and the professionals who acted as therapists in these projects (Table 2) together with the secretariat of the Coordination of the Undergraduate Course in Occupational Therapy at UFSCar of students who went through professional internships at METUIA/UFSCar.

Table 1
Extension projects developed by METUIA/UFSCar in the education and public schools between 1998 and 2017.

Project	Period
Casarão Project – Celso Garcia Culture and Coexistence Center	2000 – 2002
AFAGAI5 Project - Shelter and homeless children/teenagers	2003 – 2004
Workshop on Activities and Projects for UFSCar Working Boys and Girls	2005 – 2006
Community In-form-Action Project: Schools and PROGEN6	2006 – 2007
Recreating paths and building perspectives: confronting urban violence among adolescents and young people from popular groups	2006
Youth, Violence, and Citizenship in Urban Popular Groups: collective intervention and social development	2007
Building Citizenship: audiovisual resources among young people from popular urban groups	2007
Workshops at the Full-Time School: propositions and possibilities	2007 – 2008
Articulation with Youth in the Territory of Jardim Gonzaga	2007 – current
Social Networks, Public Spaces, and Citizenship: policies and actions with youth	2009 - 2010
Social Occupational Therapy: Resignifying Formal Contents of High School in Public Schools	2010
Student Area: Strengthening Relationships between Public Schools and Youth in the Territory from the Perspective of Social Occupational Therapy	2011
Social Occupational Therapy and Public School: a space of (re) meaning and (re) creation for youth	2012 – current
ECA Caravan: Promoting Rights and Articulating Actions	2013
ECA Caravan: Promoting Rights and Articulating Actions with Public School Teachers	2014
Dialogue: proposals for a democratic school space	2015 – 2017

• Source: ProexWeb/UFSCar, our elaboration

Table 2
Occupational therapists who worked at METUIA/UFSCar, between 2001 and 2017, in the project(s) in public school.

Occupational Therapist	Bond Type	Period7
Ana Paula Serrata Malfitano	Occupational therapist at institutions that developed projects together with METUIA/UFSCar, substitute professor, and professor at DTO/UFSCar	2001 - current
Carla Regina Silva	Substitute teacher, temporary contract with the city hall of São Carlos, student/master, and doctoral scholarship holder and professor at DTO/UFSCar	2005 - 2015
Beatriz Akemi Takeiti	Substitute teacher	2006 - 2007
Tatiana Amador Doval	Substitute teacher	2007 - 2008.1
Patrícia Leme de Oliveira Borba	Occupational therapist hired with PROEXT8 resources, substitute teacher and student/masters and doctoral scholarship holder	2005 - 20109
Mariane Bosqueiro Papini	Substitute teacher	2010 - 2011
Marina Jorge da Silva	Temporary contract with the city hall of São Carlos and professor at DTO/UFSCar	2011 2014 - current
Carolina Donato da Silva	Substitute teacher	2012 - 2014
Aline Cristina de Morais	Substitute teacher	2013 - 2014
Letícia Brandão de Souza	Temporary contract with the city of São Carlos; occupational therapist hired with PROEXT resources and substitute teacher	2012 - 2014
Lívia Celegati Pan	DTO/UFSCar Professor	2014 - current

• Source: Research data, our elaboration.

During the first half of 2017, in-depth interviews were conducted with each of these professionals¹⁰. They were guided by a semi-structured thematic script and the rhythm of the conversation. We scored their professional experiences with METUIA/UFSCar related to public school, as well as their analysis of the group's proposals and their reflections on the possibilities of professional insertion of the occupational therapist in public schools. All interviews were recorded, transcribed, and sent to colleagues for knowledge and possible corrections and/or additions.

Subsequently, a collective meeting was held within the scope of the seminar “Proposals, Stories, Construction and (Mis)Meetings of METUIA/UFSCar in Public Schools” to discuss the design of social occupational therapy in the education sector, from narratives and memories of these collaborators. It took place on an afternoon in November 2017, at the Department of Occupational Therapy at UFSCar, in a closed discussion group format, in which seven of the eleven occupational therapists participated. This discussion was followed by the presentation of synthesis and initial analysis of the data arising from the interviews, in addition to those referring to the survey of bibliographic production by METUIA/UFSCar on the themes of occupational therapy and public school. This material was discussed by the occupational therapists, building consensus, based on the previous analysis of the results, referring to the following axes: METUIA/UFSCar proposals for/with/in public schools and with youth; its goals and specifics; and results and possibilities of professional insertion of occupational therapists in public schools.

At the same time, online questionnaires¹¹ were sent to undergraduate occupational therapy graduates who were taking a professional internship at METUIA/UFSCar, between 2006¹² and 2017, resulting in 42 returns from the total of 89 graduates.

After analyzing the completed questionnaires, seven of these former students were selected. Those who explained their involvement in the questionnaire were invited, according to their professional activities at the time of the research, with public schools and/or with the social occupational therapy sub-area, once again, collaborating with the research by granting an interview, carried out between the end of 2017 and beginning of 2019.

These interviews, like the previous ones, were recorded, transcribed, and sent to collaborators, and the Seminar was recorded in audiovisual and also transcribed; all agreed to participate, signing an Informed Consent Form, including their identification. Considering the authors' involvement with the research object, it is worth emphasizing our foundation in ethnographic references (Magnani, 2002) for the ethical exercise of the transition between the “inside” and the “outside” of the research for the collection of data and the production of analyses.

Finally, the data produced were compiled, described, and organized into themes that emerged from this set, taking the analysis based on theoretical references from the socio-historical foundations of education, in general, and in Brazil, from the sociology of education and of youth and, also, of social occupational therapy. This process led to the composition of thematic categories, presented and discussed below: the centrality of the public school; objectives and specificities of METUIA/UFSCar proposals in public schools; on the results of actions; constructions and perspectives for the work of occupational therapists in public schools.

Results and Discussions

The centrality of the public school

The understandings about the public school and its place in the METUIA/UFSCar proposals comprised the interviews with the occupational therapists, emerging understandings about the complexity of this institution in Brazil, and its double difficulty in responding to society's concerns, as well as, and mainly, of students. At the same time, the centrality of this equipment in our social structure was also evidenced for what makes it possible and the contributions of social occupational therapy so that everyone has access to it:

[...] what I think that we have as a common thread, from any of these experiences [of METUIA/UFSCar] is: what is the meaning of the school institution in the daily lives of these children and adolescents that will allow greater inclusion and social participation of these people? If school is something significant, something that adds, something that enables greater cultural capital for them, the possibility of participating in social life is another, even if this is just literacy, even if this is just the experience of a few years in a school institution and what is learned from it, even if this does not mean academic success in terms of completing high school. So, I think it's this question that moves us, the meaning of the school for the social inclusion of these people, the insertion in the school for this social participation and this inclusion goes [...] through those who are not at school (Malfitano¹³, 2018, personal communication, p. 20-21).

The debate around the place of the public school in METUIA/UFSCar's proposals became more explicit during the seminar “Metuia/UFSCar's Proposals, Stories, Construction and (Mis) Meetings in Public Schools” when the beginning of the development of actions was discussed by METUIA/UFSCar in this type of institution.

During this meeting, one of the debates was about the beginning of actions by METUIA/UFSCar with public schools. The initial understanding among those present marked the year 2005 when the activities began in the city of São Carlos - SP. However, as it was verified in the survey of the extension projects developed and with part of the interviews, the school was, since its early days, a concern in the Metuia Project. It was like that in the “Casarão Project – Celso Garcia Culture and Coexistence Center”, in São Paulo - SP, carried out by the USP/UFSCar nucleus and which formatted, to a large extent, social therapeutic-occupational practices. Also, in the AFAGAI Project – shelter and homeless children/adolescents” and in the “In-Form-Community Action Project: schools and PROGEN”, both carried out in the city of Campinas – SP, in partnership with occupational therapists of these services, trained by METUIA/UFSCar, in which the public school was also the object of interventions, understood as one of the social facilities that make up the network of care for children and youth, although it was not a specific locus of action, as it later became.

Roseli Esquerdo Lopes, the coordinator of METUIA/UFSCar, points out that the group's focus on poor youth in 2005, brought public schools to the center of the actions; however, it was also emphasized how much the services of the education sector formed the perspective of community work and the strengthening of social support networks since the beginning of the intervention proposals of the Metuia Project (Lopes, 2017, personal communication).

Social support networks, according to the formulations of Castel (1997, 2012), play an important role in social cohesion, being one of the axes that, in the author's analysis, in convergence with the work axis, configure the zones of insertion in the social area: of integration, encompassing the situation of having a permanent job with guaranteed rights and the existence of a solid relational network, which can be mobilized when necessary; of disaffiliation, at the other extreme, which combines the absence of work and a network of relationships; and, in the middle, social vulnerability, resulting from the precariousness of work and relational fragility.

Strengthening (or creating) these networks can help to face situations of social vulnerability and disaffiliation. In addition to family, community, and collective bonds, it can be seen that social equipment and its professionals, including public schools, constitute references and supports for the people.

Another objective of social occupational therapy is the guarantee of citizenship rights (Lopes, 2016), with education being one of the central rights for citizenship, as stated by Cury (2008). Ensuring it must be one of the priorities of professionals who work with this objective, at all levels.

Also, during the referred seminar, the beginning of activities in public schools in São Carlos was recalled, with the projects “Workshop of Activities and Projects of UFSCar Working Boys and Girls” and “Recreating Paths and Building Perspectives: Fighting Urban Violence among teenagers and young people from popular groups”, carried out between 2005 and 2006, and the resulting option of the group to focus its actions on the State School “Dona Aracy Leite Pereira Lopes”.

Among other possibilities, this school, which had been a partner in the aforementioned projects, was identified, as mentioned in the collective meeting, as presenting greater demands to be worked on, given its location in a peripheral region of the city and stigmatized by prejudice, violence urban and illegal trade. Faced with the possibilities of the team being able to be more closely in a single space, this school and its territory aggregated most of the actions that followed. Occupational therapists recalled their experiences in this school and the demands placed by the professors and the management team of a work that was aimed at the more “difficult”, “messy” and/or “with learning difficulties” students.

The expansion of access to public schools, in the precarious way in which it was and has been carried out in our country, without the necessary investment in their qualification and other sectors of social policy, has brought demands related to social inequality, which the institution has shown not to have been prepared to deal. Arroyo (2018) states that, in general, pedagogical theories were designed for individuals that have been directed until then; to the extent that, in the words of the author, “Other Individuals”, who did not access the school, start to do so, they raise the question of the pedagogies used.

These Other Individuals are those who historically had their rights violated and the exercise of their full citizenship denied, that is, they are the poor. Such individuals, when accessing the school, carry with them their identities, values, social and cultural experiences that, hegemonically, are not only not considered by traditional pedagogy, but are inferior, seen as individuals to be civilized and moralized (Arroyo, 2018).

An action that is done in the opposite direction requires the recognition of these Other Individuals as people of rights, with their particular values, political, economic, and cultural relations, which bring other ways of thinking about education, demanding Other Pedagogies¹⁴, which turn to the emancipation of students (Arroyo, 2018).

Thus, the requests of the school team become understandable, for which METUIA/UFSCar, by accepting these demands, on the one hand, presented a technical response to a real problem and, on the other, made it possible to create a bond with this school and the development of several projects and actions, including those that are still ongoing, which can be understood as legitimizing this work.

On the design that was built, with the proposal of an action that would be carried out within the school institution, but also outside it, together with other equipment and services of the care network for adolescents and young people in that territory, Patrícia assesses that:

[...] we were there for the young people [...] being in different spaces to compose this network of these young people, so I think this design is also very assertive in the design of social occupational therapy [...] circulating in the school, at the community center, and in the neighborhood [...]: articulating actions at school and the youth, center to expand and build a support network for young people and especially for young people we accompanied and who were out of school or they had difficulty staying in that space (Borba, 2017, personal communication, p. 12/13. Seminar).

Such statements and reflections explain the methodological proposal developed by METUIA/UFSCar for the public school, in what has been called here as “from the outside in, from the inside to the outside”, interweaving points of the care network of adolescents and poor youth.

During the seminar, through the dialogue of the collective debate, we could formulate a consensus that the focus and priority of the work were (and continue to be) young people, which generated the following reflection: then, it would only be school a context for the work of the occupational social therapist?

Takeiti pointed out that, in a sense, yes, being in school is a strategy to reach young people (Takeiti, 2017, personal communication). On the other hand, Lopes draws attention to the specificity of the school institution and its ways of functioning that shape the experience of young people in this space (Lopes, 2017, personal communication).

Both points can and should be considered. The public school, within what has been and has been undertaken by METUIA/UFSCar, can be considered a context in that, as this is the place where most Brazilian young people from the popular and/or poor classes are concentrated, carry out actions that institution facilitates access to them. However, due to the particularities of the school institution, especially due to its contradiction between disciplining and the production of autonomy, it also becomes a locus of action, that is, it brings specific demands.

As stated by Dubet (2003), the school is not only influenced by the excluding structures of society, but it is also an agent of exclusion processes for those who do not adapt to its rhythms and norms. At the same time, the centrality of the school in the social imagination as the main means of change and social ascension, its fundamental relationship with the socio-economic development of countries, as well as a place of learning and preparation for adult life, can lead young people to seek to shape their behavior and desires according to the institution's rules.

Even more complex in Brazil, it is necessary to consider the mark of social inequality that persists in our history of not prioritizing, as necessary to overcome it, Basic Education, in terms of investment, management, and distribution of public resources, to include everyone in a quality public school, as has occurred in many other countries, including South America, since the end of the 19^th century (Buffa, 2012).

Another point to be considered about the conformation of school experience is its place for the sociability of youth and in the formation of their identities (Dayrell, 2007). Although the school is, in essence, a collective space, of group relationships, the format in which its activities are traditionally structured, with short periods, do not favor the enjoyment of relationships, as there is no incentive to meet; on the contrary, its performance is difficult (Dayrell, 1996). In contrast and even in resistance, young people seek to create other ways of being in this space that favor sociability, imprinting their rhythms, with emphasis on the “chaos”, often already cultivated in virtual environments and outside of school, but in their disciplinary standards are not considered in everyday school life (Pereira, 2014).

Thus, we evaluated that the dynamics of this institutional organization conform to specific demands that can be worked on by occupational therapists in partnership with managers and teachers, enhancing the creation of more inclusive, democratic, and participatory processes, of meaningful experiences that help poor young people in its future projections and the expansion of spaces for exchange, sociability, and construction of supports, including for the school team.

Objectives and specifics of METUIA/UFSCar proposals in public schools

The occupational therapists' testimonies point to different types of objectives of the therapeutic-occupational interventions, from more specific ones, which have been shaped and diversified over the years, according to the proposals and demands read by the work team and/or brought by the school teams, which also outlined the drawings of the extension projects, as well as more general objectives that guided such proposals:

[...] the themes of the class were worked on, the sociology teacher brought themes and the METUIA team [...] managed to develop dynamics, as an attempt at differentiated learning for the students. So, we used the content, but in a different way [...] this approximation of the young person's language with the content (Papini, 2017, personal communication, p. 3).

The school thought that the theater workshop would be interesting, and it was a student from the school who would coordinate the workshop with us [...] had the objective [...] of participating in these workshops and helping [...] for them to happen (Silva, 2017b, personal communication, p.4.).

[...] the project had the objective of publicizing the ECA, and discussing, problematizing it with children from public schools [...] we used to do activities with the children through games, the most playful resources so that they could understand the ECA, the issue of rights, guarantees (Morais, 2017, personal communication, p. 4).

One of the general objectives was to stimulate reflection, as well as to promote experiences that also brought the issues to the level of the body, favoring the expansion of the creation of life projects (Souza, 2017, personal communication, p.3).

[...] this reconstruction of the sense of seeing studying again as a perspective for the future, a project for the future, I think this is another dimension. This issue of the network, as we help via the place we are, which is not necessarily the school, but the school institution in the reception of certain demands, in the permanence [...] the creation of a more favorable space for learning [...] the discussion of rights and citizenship [...] this possibility of facilitating this process and creating a more favorable or meaningful environment, with meaning for learning (Malfitano, 2018, personal communication, p. 20).

Regarding the general and specific objectives of METUIA/UFSCar's proposals for public schools, during the seminar, when a synthesis of the testimonies given by the occupational therapists was presented, there was a consensus that all those who were listed compose the list of objectives of the actions, which would be, about young people: the guarantee of their rights, the strengthening of those young people towards the construction of more autonomous lives with more possibilities of choice and participation, as well as the construction and articulation of support social networks around them. Specifically, in the public school, the professionals showed the understanding that the actions are aimed at building a more inclusive, dialogic, and democratic space in the daily experience of young people, in an action that takes place in the simultaneous transit between collective and individual care¹⁵.

In this sense, the occupational therapists also indicated that the experiences of METUIA/UFSCar support work for the transformation and redefinition of the school space, developing more democratic ways to build relationships, with spaces for exchange and socialization, creating strategies for the promotion of dynamic learning, so that the contents are closer to the youth universe, contributing to supporting together with students and different subjects of the school for the construction of collective proposals. Such actions, in the view of those professionals, contribute to the creation of a feeling by young people of belonging to the institution and to encourage the participation of young people both in the school context and outside it, positively impacting school permanence.

The testimonies and collective discussions reveal a consonance of the speeches with the bibliographic productions made by the METUIA/UFSCar team and widely publicized (Pan & Lopes, 2020).

Regarding the specificity of the work of social occupational therapy in public schools developed by METUIA/UFSCar, there was agreement in the understanding in the practical application of this theoretical-methodological reference, referring to what underpinned how occupational-therapeutic interventions were thought and created:

[...] this creation of what to do, in terms of resources, this creation and that is not even such a different thing, from dynamics or projects, interdisciplinary projects, theater, more collective projects within the school and bringing people together, joining partners to do these actions, that's fine, I don't know if it's ours, it's not our specific one, but I think this is very strong in our education, in social occupational therapy as a concern (Borba, 2017, personal communication, p.14-15).

This and other testimonies bring us back to Lopes & Malfitano (2016) about the objectives of METUIA/UFSCar in the production of intervention methodologies for working with youth, which can be incorporated and learned by professionals, particularly occupational therapists, in working with this population, in different spaces, including schools, considering their specificities.

The concern with activities designed in such a way as to enable the approximation and connection with the individuals, identification of demands, creation of spaces for coexistence and participation, and, based on Paulo Freire's (Freire, 2011), production of awareness processes is highlighted (Barros et al., 2002).

The analysis of the interviews also revealed a consensus in the understanding regarding the specificity of a work proposal aimed at social demands, as exemplified in the following statements:

[...] I start by comparison. I'm not there for inclusion. If we think strictu sensu, inclusion of the boy who has a specific problem within the school context, then I look at the youth dimension, I look at social issues (Takeiti, 2017, personal communication, p.9).

[...] specifically with social occupational therapy, I believe that there is this relationship of being able to think of all these people beyond those who have specific issues of disabilities, problems, problems that are often invisible also within the school [...] with their issues of poverty, of inequalities and with all this daily life that comes with it, inside the school, inside, outside, that is, in short (Silva, 2017a, personal communication, p.11).

Therefore, we identified a convergence in work that is developed in a different perspective from Special Education, in the direction that the demand worked occurs, specifically, due to the condition of social vulnerability to which people are submitted and the implications for the performance of their citizenship rights and their social participation. This does not mean that young people with disabilities are not targeted individuals of occupational social therapy actions; on the contrary, in public schools, they make up the group in a situation of social vulnerability and, possibly, with limited social participation.

The occupational therapists' testimonies and statements also indicate a disagreement with the fact that an inclusion action is produced or not. These notes are pertinent, considering that the bibliographic productions of the group do not make a direct reference to Inclusive Education, nor Special Education (Pan & Lopes, 2020). However, if we are guided by an understanding that Inclusive Education is a proposal that focuses on building an inclusive school for, in fact, everyone (Bueno, 2014), we must think about how to include everyone who is excluded from it or, as discussed by Buffa (2012), those who even attend the school institution are somehow excluded from school processes, which involves students with disabilities, but not only that.

If METUIA/UFSCar's actions focus on the access and permanence in public schools of children and young people who have difficulties for reasons related to the situation of social vulnerability they experience, that is, aimed at the exclusion of this public from and in school, we can consider that such actions are consistent with the perspective of Inclusive Education, understood in its scope as a whole, which is not common in occupational therapy.

This is a necessary discussion about the differentiation between Special Education and Inclusive Education, which, in Brazil, have sometimes been put as synonyms (Mendes, 2010), also in the productions arising from occupational therapy (Pereira, 2018). Nevertheless, if there is an alignment with Inclusive Education, by analyzing the textual productions of experience reports and the designs of extension projects, we can also consider that the METUIA/UFSCar proposals go beyond it since they are not limited to the institution school, as brought up by some occupational therapists in their interviews, as exemplified: “Thinking about actions that reach young people and that they are interested in so that their experiences leave school too and can go to their families, can go into the territory” (Morais, 2017, personal communication, p. 13).

Therefore, it is a work proposal that seeks to link the “inside” and the “outside” of the school, interweaving support points between the school institution and the community and its territory and other social facilities. This inside-outside relationship allows knowing the reality experienced by young people in their different spaces of life, providing subsidies for the promotion and strengthening of their social support networks, their projects for the future, as well as the creation of strategies that help them to access and remain at school.

Another objective of METUIA/UFSCar's actions, punctuated by occupational therapists, is the training of professionals trained to work with poor youth and/or popular groups, guided by the social issue¹⁶, and who understand the public school as a central institution for this population, in general, and not just for those with disabilities.

The recognition of young people as people of rights, for whom the formulation of specific social policies is necessary, is a recent fact in Brazil. Although some progress has already been achieved, the negative stigma persists, particularly with poor young people, due to violence rates related to them (Abramovay & Castro, 2015).

We can point out the importance of the actions developed by METUIA/UFSCar with urban popular youth and the training of professionals sensitized to work with this audience, being recognized by the egress students, in their testimonies, from the experiences in the professional internship, such as illustrated below:

Before the internship at METUIA, I had not experienced working with young people. I knew about the possibilities of occupational therapy work with the elderly, children, women, etc... but not with young people. METUIA allowed me to become much more sensitive and prepared to work with this population, even if it was in a context beyond work in public schools (Research Documents, collaborator 30¹⁷. Questionnaire).

[...] the internship was able to provide techniques to approach young people and their realities of life, as well as the understanding of issues that permeate the social issue, their vulnerability processes, among other aspects (Research Documents, collaborator 4. Questionnaire).

In response to the online questionnaire, in general, former students point to the expansion of the reading of the occupational therapist's possibilities of action in public schools based on a foundation that is neither based on health references nor focused on school inclusion of children and adolescents with disabilities, but that evokes social participation inside and outside the school. The following comments are illustrative:

The work of occupational therapy in schools historically, as we know, was built by looking at disability: the difficulties of access and mobility, adaptations for better student development. The internships at Metuia allowed us to understand another position (just as important) of the occupational therapist as a facilitator of discussions and youth empowerment, as a mediator between different sectors, to propose workshops and activities that cause transformation and approach to relevant issues seen at school or of current events, both with young people and school professionals (Research Documents, collaborator 11. Questionnaire).

I believe that the work of occupational therapy in the field of education should be a social articulator, in defense of citizenship rights, guaranteeing access, permanence, and quality of education for all (Research Documents, collaborator 10. Questionnaire).

One of the main objectives of METUIA/UFSCar has been to train professionals who are ethically and politically committed to the demands they deal with, questioning the responsibility of the technician or, based on the ideas of Basaglia (1986), the social mandate of the technician in society.

If occupational therapy is a profession that focuses on the social participation of people who, for various reasons, have restrictions for it to take effect, the ethical and political commitment of these professionals must be given in this regard. However, full social participation can only be done, in fact, with the guarantee of social rights within the scope of citizenship, according to the formulations of Marshal (1967). That is, one can only speak of social participation together with the guarantee of the duties and rights of full citizenship.

Therefore, we defend that training in occupational therapy as a whole must encompass this complexity of knowledge since the struggle to guarantee rights and social participation must be placed in the entire area.

In addition, a proposal for training occupational therapists “inside the school”, in which the professional in training has experience of the specificity of this institution, its dynamics, and rhythms, with the deepening of theoretical contributions appropriate to the field, can contribute to this technician both to think of this institution as a place of work and/or intervention achievements, as well as for the development of a more contextualized practice.

About the results of actions

In the previous notes on the objectives of METUIA/UFSCar actions in/for/on public school, the results are brought in different senses, as elucidated in the interviews with the occupational therapists:

[...] what I saw, as a result, was a redefinition of meaning, and even the meaning of life, it seems like a very philosophical thing, but it isn't, many people there talked about it, how much that space had a meaning for them, and how much even that this allows you to review other things in life. Look for other things, belief in their potential (Amador, 2017, personal communication, p. 6).

I think that from a more individual point of view, we can point out that we can work with an idea of expanding access, of law, for those students who are there [...] another way for you to work with awareness and [...] how do you look at education in a way that brings awareness, of your social place, of the social place of that school, of those people, of your group [...]. It is logical that we would like a social transformation that was for everyone, [...] but it is also an individual touch, even though I believe that strength is for the collective, but that's it, I need empowered individuals for this collective to happen, to actually produce other things, so for me this is our greatest contribution: a look, an action, a reflection that I do not know if many people do (Silva, 2017a, personal communication, p.13-14).

During the collective meeting and the debate about what is produced from the interventions and what can be inferred from the results, after the presentation of the data synthesis and the initial analyses, the occupational therapists agreed on the impacts achieved being in a subjective dimension and more associated with the lives of young people than with the institution but that influence their relationship with the school. In this sense, they pointed out that interventions create spaces of belonging, for young people to appropriate their rights, think, expand and change their projects for the future, enable processes of discussions, reflections, and awareness, which contribute to the production of meaning at school and the education.

Such analyses, although they cannot be measured so far, are indicative of the work of occupational therapists in public schools.

According to the last National Household Sample Survey, carried out in 2016, 24.8 million young people between 14 and 29 years old did not attend school and/or had not gone through the entire educational cycle, with the most recurrent justifications being working or looking for a job, lack of interest and need for household chores or care for others (Instituto Brasileiro de Geografia e Estatística, 2016), which highlights the importance of interventions aimed at redefining the school and its space, as well as to foster the feeling of belonging to it, which can result in the desire to stay and/or return to study.

In an extremely unequal country, achieving completion of Basic Education cycles means, although not in a direct but fundamental relationship, the guarantee of citizenship rights, as well as the concrete possibility of better living conditions, given that completion of high school is a minimum requirement for many jobs.

The results presented here indicate the possibility of the contribution of social occupational therapy around the permanence of poor young people in Basic Education, which continues to require investments, in the scope of education, beyond access (Ferreira Junior & Bittar, 2006). Nevertheless, it is also necessary to emphasize the need for investment in the quality of education, which involves better working conditions for teachers and better infrastructure (Ferreira Junior & Bittar, 2006).

Other testimonies showed the processes of reflection and awareness that contribute to the redefinition of the place of the school in the daily lives of young people, but, in addition, they can provide experiences of social participation, inside and outside the school, and of emancipation.

Therefore, it is necessary to invest in other studies that look more closely at the point of view of partner professionals and young participants on therapeutic-occupational practices in public schools from the perspective of social occupational therapy.

Concerning the results for professional training, based on the answers obtained from the questionnaires, the absolute majority of students who went through an internship at METUIA/UFSCar recognize the importance of this experience for their professional training in a more general way. In their comments, they point out the contributions of the internship regarding the expansion of the understanding of the profession beyond the health sector and the understanding of the social field and the demands arising from the social issue, as well as the reflection on the role of the technician, of accountability with the demand they deal with and the understanding of the occupational therapist also as a political agent, as exemplified below:

It allowed me to tread a path with more meaning in my professional life, taking into account the technical, ethical, and political dimensions of the occupational therapist (Research Documents, collaborator 10. Questionnaire).

It taught me to make a critical and contextualized reading of occupational therapy in any other area of knowledge and activity (Research Documents, collaborated 20. Questionnaire).

METUIA allowed me to better discover what citizenship and rights mean and to find strategies to fight social inequality. My experience at METUIA was fundamental for my training (Research Documents, collaborator 30. Questionnaire).

In addition to the training of students, occupational therapists highlighted the importance of their experiences with METUIA/UFSCar, as well as providing learning for themselves:

Before the contact I had was in a meeting with the teacher, case discussion, now living the school, smelling the school, the sound of the school, it's different, so for me it was a very big challenge, and at the same time very cool, because I think METUIA has a collective work thing, so for me it was a unique experience, to be able to think with the students [...], in a more horizontal relationship, because I was also starting in this field [...]. I think I brought much more with me than I could take, today I see that how much I learned there (Amador, 2017, personal communication, p.5).

As some productions indicate (Calheiros et al., 2016; Pereira, 2018), METUIA/UFSCar has been a pioneer in the undertaking of actions in public schools from the perspective of social occupational therapy. Thus, we expect that occupational therapists who were involved at the beginning of these elaborations, and who did not have this specific prior training, feel this professional experience also as a training process.

From this process, the result is the incorporation of theoretical and practical references taken by occupational therapists and by graduate ex-students, in their subsequent professional practices.

We highlight those who, as part of teaching, created other centers of the Metuia–Occupational Social Therapy Network in different public universities in the country¹⁸, with emphasis on those who propose to implement proposals that correlate social occupational therapy, youth, and public schools.

For these professionals, this reverberation is presented in the three dimensions of work that make up the public university: teaching, research, and extension. Specifically, in poor youth or from popular groups and public schools, the proposition of actions that, in a way, replicate the experiences lived with METUIA/UFSCar stands out.

Such data are indicative that undergraduate students in occupational therapy at these universities are having the opportunity of training in social occupational therapy and with experiences in public schools and/or with opportunities to raise awareness of this theme, in addition to what has been developed by METUIA/UFSCar.

For professionals who are involved in assistance services, this repercussion on their practices is manifested at different levels: thinking of public school as a space to promote interventions with young people, in youth as a specific population group in which it is necessary to think public policies, the resources, and methodologies that work with young people requires and how METUIA/UFSCar structures the relationships between team members and those with the individuals to whom the actions are directed.

The set of data showed the contributions of METUIA/UFSCar both at the theoretical level, when professionals incorporate the references produced and used by the group in their practices, interventions, and teaching, as well as at the technical-operational level, in the creation, elaboration, and development of university extension projects, training practices, and care services, especially in the use of resources and methodologies learned from their experiences at METUIA/UFSCar, proving the possibility of replicating their work methodologies, developed and named so far (Lopes et al., 2014).

Constructions and perspectives for the work of occupational therapists in public schools

One of the points of debate about the action and formation of social occupational therapy in public schools is around the possibilities of professional insertion. Therefore, occupational therapists bring multiple and different views, moving from acting in schools and with different audiences, not just young people, to practice in other social facilities, with the school, as exemplified in these statements:

I believe that occupational therapy has to be part of the public school, it has to be part of the school team, both in early childhood education and in elementary and high school education, I think we have a lot to contribute. Occupational therapy actions at school are still very focused on health, learning, and inclusion difficulties, but there are other possible types of intervention, such as in the social sphere [...]. It is necessary to integrate the school with the community, the school has to be without walls, and this is a concern of occupational therapy for public schools (Papini, 2017, personal communication, p. 6).

I think there are a thousand possibilities [...] if you are an occupational therapist, you are at the NGO and you will form a partnership with the school [...] if you are from a UBS and then you will form a partnership with the school [...] will also depend on the occupational therapist's repertoire, then on the institutional place and the occupational therapist's repertoire (Borba, 2017, personal communication, p. 14).

There are different glimpses into this professional performance, from the composition of the school team to the articulation with this social equipment from another service or sector. Therefore, it is a broad discussion on the possibilities of occupational therapist contribution in public schools and, particularly, from the perspective of social occupational therapy, incorporating this professional into the education sector and/or developing projects in partnership with these institutions. Several of us have proposed this debate to our collective organizations, such as what happened in the Occupational Therapy and Education Working Group at the V National Seminar on Research in Occupational Therapy, held at UNIFESP, in 2018, to build common places for the area in its correlation with the education sector, given the complexity arising from different coexisting perspectives.

Conclusions

This research sought to understand the proposals for actions in occupational therapy developed by METUIA/UFSCar in the public schools and the training of occupational therapists to work in these institutions and/or who consider them, in the practice aimed at young people, problematizing the contributions of the area and its professionals to what are the demands related to social vulnerability. These propositions aim to produce, fundamentally, therapeutic-occupational interventions that deal with the individuals, individually and collectively, in the search for the transformation and redefinition of the school space, with more democratic ways of building relationships, with the creation of spaces for exchange, socialization, and strategies to promote dynamic learning with human substance, seeking to bring school contents closer to the youth universe and support with students and different school individuals for the construction of common projects. At the same time, individual care and/or embracement is produced, strengthening the individuals to participate in a more effective and committed way in the spaces and groups in which they are inserted. We should note that this concept of action is only possible with the articulation of services and social equipment and with the social support networks.

Paripassu promotes the training of professionals who are sensitive to poor youth as a group that, during the social issue, should be considered in its various markers in the struggle that is, at the same time, for redistribution and recognition (Fraser, 2006), with the offer of a theoretical and methodological repertoire for an action that addresses its demands. This is a very significant result reflected in the testimonies of graduates of professional internships at METUIA/UFSCar and for the occupational therapists who worked professionally there, above all, in both cases, for those who entered public universities as professors and have as focus, in its teaching, research and extension proposals, mainly, adolescents and young people.

The experiences built by these professionals in their workplaces, based on their previous experiences at METUIA/UFSCar, show that the engendering of therapeutic-occupational practices in public schools, from the perspective of social occupational therapy, has expanded beyond this group, possibly meaning the expansion of this training proposal in other institutions.

Therefore, we conclude that the contributions of METUIA/UFSCar are not only of guiding the debate on social demands for occupational therapy but substantially in the training of occupational therapists, with the production of contributions to professional practice, especially in the work with young people, with public schools and in the articulation between different services with the education sector.

Finally, we emphasize the coexistence of different theoretical and methodological perspectives that support the design of proposals for the work of occupational therapists in the education sector. Adding contributions to this debate both in the academic and professional spheres is part of the objectives of the set of works that we have been developing and this study is one of its results.

Acknowledgements

We would like to thank the occupational therapists who worked at METUIA/UFSCar and the former undergraduate students who went through a professional internship with the group and who greatly contributed to this research.

• 1
  This paper is part of the doctoral work “Interlacing dots – from the outside to the inside, from the inside to the outside: action and formation of social occupational therapy in public schools”, developed with the Postgraduate Program in Occupational Therapy at the Federal University of São Carlos, who was part of the thematic research proposal “Education, School Inclusion and Occupational Therapy: Perspectives and Production of Occupational Therapists in Relation to School”.
• 2
  Currently, under the name of Rede Metuia – Occupational Social Therapy, six centers are in operation at the following higher education institutions: University of São Paulo (USP), Federal University of São Carlos (UFSCar), Federal University of São Paulo (UNIFESP) , Federal University of Espírito Santo (UFES), University of Brasília (UnB) and which integrates the Federal University of Paraíba (UFPB) and the State University of Health Sciences of Alagoas (UNCISAL).
• 3
  The term youths is used, in the plural, due to the understanding that there is not only one youth, but a series of groups that are diversified according to their social class, race, gender, culture, etc. Far from trying to break up the group that makes up the youth age group, we seek to make visible the differences that mark the experience of these subjects (Abramovay & Castro, 2015).
• 4
  An online platform that registers and manages university extension activities at UFSCar.
• 5
  Associação Fraterna de Apoio Global ao Adolescente e à Infância.
• 6
  Projeto Gente Nova.
• 7
  We considered the period of attachment referred to the coordination of actions developed by METUIA/UFSCar in the field. Most of these occupational therapists already had other previous bonds with METUIA/UFSCar, such as scholarship holders in extension projects, scientific initiation, participation in study groups and graduate studies.
• 8
  The University Extension Program (PROEXT) was created in 2003 by the Ministry of Education, with the aim of supporting, through funding, public higher education institutions for the development of university extension projects and programs that would contribute to the implementation of public policies, with a focus on social inclusion (BRASIL, s/d). One of the possibilities for applying PROEXT resources was the hiring of technicians. The last notice issued by the MEC took place in 2015 for the development of proposals in 2016.
• 9
  Patrícia Borba was linked to the practices of METUIA/UFSCar as an occupational therapist until 2010, but refers to a transition period, in which she continued to provide support and linked to the field of intervention until the end of 2011.
• 10
  With the exception of Lívia Celegati Pan, for her involvement with the research. Nevertheless, the experiences lived both professionally and through the trajectory consisting of a professional internship, university extension and research with METUIA/UFSCar were considered to enrich the data set and the discussions that were intended to be carried out.
• 11
  Questions were addressed regarding the professional internship experience with METUIA/UFSCar, the evaluation in METUIA/UFSCar's action and training proposals, possible contributions to training, to working with youth, to thinking about public school as a space for the occupational therapist and the professional performance developed at the time of collaboration with the research.
• 12
  First year of offering this type of internship.
• 13
  We decided to use the last name of the collaborators when referring to the documents produced in/by the research with the transcript of the interviews. Although they are not articles in the public domain, they are available by contacting the researchers.
• 14
  An important note of the author is the fact that these Other Individuals, in their struggle for the expansion of their rights and recognition, engendered and engender the construction of Other Pedagogies that should be valued in teaching.
• 15
  Here, care is understood to be the offer of intense support for the maintenance of collective life (Fine, 2005), with the purpose of making society more democratic (Tronto, 2007).
• 16
  Castel (2012)'s understanding of the social issue is used as a reference, for whom it can be defined as the result of the contradiction between capital and labor.
• 17
  Testimonies identified as collaborator come from the online questionnaire and could be answered anonymously.
• 18
  Among the occupational therapists and graduate students who attended METUIA/UFSCar, Patrícia Borba created, the UNIFESP nucleus in 2012, currently composed also by professors Débora Galvani, Gabriela Pereira Vasters and Pamela Cristina Bianchi. In 2014, Gustavo Artur Monzeli and Giovanna Bardi, professors at UFES, together with professor Maria Daniela Côrrea de Macedo, created a center at this university. Beatriz Prado Pereira and Iara Falleiros Braga, professors at UFPB, created in 2018, in partnership with professor Waldez Cavalcante Bezerra, from UNCISAL, a nucleus that brings together these two institutions. Finally, although there is no Metuia Network nucleus at UFRJ, two professors from that university, Monica Villaça Gonçalves, a METUIA/UFSCar graduate, and Beatriz Takeiti, who worked as an occupational therapist at METUIA/UFSCar, bring the reference in their statements METUIA/UFSCar's proposals for the preparation of their projects.

• Funding Source

  Financing: Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPQ) – Processo Nº 434490/2018-0. Apoio: CNPq – Processo Nº 311017/2016-9 (Bolsa PQ - Produtividade em Pesquisa) and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) – Código de Financiamento 001.

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Edited by

Section editor

Prof. Dr. Daniela Tavares Gontijo

Publication Dates

• Publication in this collection
  02 Feb 2022
• Date of issue
  2022

History

• Received
  13 July 2020
• Reviewed
  15 July 2021
• Reviewed
  01 Dec 2021
• Accepted
  21 Jan 2021