Contribuições da psicologia histórico-cultural para o processo grupal com usuários com esquizofrenia nos Centros de Atenção Psicossocial

Abstract

The intent of this research was to investigate and systematize theoretical-practical contributions capable of adding up to a greater range of group activities at Psychosocial Care Centers – known in Brazil as CAPS - particularly to assist, along people with schizophrenia, the reorganization of personality through new mediations for reconstitution of the psychological system. This is a theoretical-conceptual study that evokes categories from historical-cultural psychology, collective health, historical-dialectical materialism and the group process theory according to the Latin American social psychology. By considering that the set of care actions in a mental health service needs to be aimed at socialization, without giving up therapeutic purposes, of psychosocial rehabilitation, it is understood that it is necessary to think about the group process in the light of the cultural-historical theory, evoking Leontiev's Activity Theory and the relation between the structure of activity and the development of the psyche. The starting point was the need to reflect on the possible mediations that a group activity could intentionally dynamize, focusing on the reorganization of consciousness and the entire psychological system. For this, it is necessary to take into account the particularities of each person with schizophrenia’s system disintegration and how this person has reacted, according to the singular and general conditions of the development of consciousness that takes place in historically configured social relationships. As a result of the theoretical-conceptual research, illustrations and practical recommendations were synthesized for the development of the main types of workshops recommended for the CAPS (therapeutic with manual and expressive, income generation and literacy/pedagogical activities). Two sections were organized: one which has more general contributions that these references add up to group practices in mental health; and another that has contributions of greater specificity for carrying out with people with schizophrenia. The most relevant principle is that groupality (sociogenetic plan of development) is the source and expression of microgenetic processes of development, which can reveal themselves as processes of reconstitution of higher psychological functions disintegrated in schizophrenia, and of the personality as a whole. Group management will be more powerful the more professionals direct their attention and efforts both to grouping (identifications, bonds, collective dimension of tasks, activities, roles and meanings), and to the dimension of singularity (needs, reasons, meanings to perform the activity), in addition to the system dynamics of the psychological functions of each participant. It is expected that the study can derive technical materials and training activities for CAPS professionals, promoting the advance in the conscious use of group techniques with users in general, particularly those affected by schizophrenia, contributing to the consolidation of the mental health policy in Brazil.