Projeto terapêutico singular em saúde mental: contribuições da terapia ocupacional

Abstract

The Singular Therapeutic Project (in Portuguese "Projeto Terapêutico Singular", PTS) presents itself as an instrument that organizes care, considering the uniqueness of the person in their life context. Psychosocial Rehabilitation encompasses the person with psychological distress, a social support network and family members, in a proposal of shared, negotiated care, seeking autonomy, protagonism and social inclusion. Occupational Therapy as one of the professions that are part of the interdisciplinary team of mental health services is shown as a powerful category for strengthening the users' Singular Therapeutic Project. Thus, it is essential to investigate the contributions of Occupational Therapy in the construction and conduction of the Singular Therapeutic Project. The objective of this research was to analyze how Occupational Therapy contributed to the construction of PTS in CAPS (Psychosocial Care Center, in Portuguese "Centro de Atenção Psicossocial"). This is an exploratory study with a qualitative approach, in which 21 occupational therapists from CAPS from 5 cities belonging to the Regional Department of Health VII, in the region of Campinas - SP participated. The data acquisition was conducted through a protocol of professional and service information and an interview script, remotely, through the Google Meet application. The analysis of data from the protocol was performed in a descriptive way and those from the interview were analyzed through thematic analysis. From the findings, it was possible to characterize the participants and the services. Most of them are female, white skin, aged between 26 and 46 years old, graduated from private universities, with complementary training in mental health and have been working in the current service between 1 year and 2 months and 14 years; As for the services, different CAPS modalities were part os the study. Through thematic analysis, it was possible to identify the following categories: Professionals understanding of PTS; Composition of the Family and users in the PTS; Team of professionals that make up the PTS; The professional`s perception of what a successful PTS would be; Challenges in the construction and conduction of the PTS and the Occupational Therapy core. The results explained the perception and characterization of PTS consistent with the proposals for the use of this instrument in the Psychosocial Rehabilitation. However, prioritizing its construction for the person and not groups or collectives of people. The families and users are considered important actors in the composition of the PTS although family members are characterized as not very participative and users, despite the appreciation of their protagonism, may not be present in some practical actions in the service. The ideal professional was appointed as the closest person to the user and the greatest articulator of the PTS. The biggest challenge for the construction and management of the PTS at that time was the COVID -19 pandemic, although other challenges, related to social vulnerability and stigmatization of people in psychological distress or even difficulties that already exist in the work dynamics have also been evidenced. The interdisciplinary aspect was highlighted by the participants. The Occupational Therapy was presented in two dimensions, clinical and methodological pointed out as a powerful and creative profession that, through its understanding of the activities and daily life of people in psychological distress, can contribute in a very significant way to the construction and conduct of PTS. We believe that this research presents important contributions to the debate that became heated around the field of Psychosocial Care, as well as Occupational Therapy practices in mental health.