Entre Caps AD e Comunidades Terapêuticas: o cuidado pela perspectiva dos usuários de um Caps AD / Between Caps AD and Therapeutic Communities: care from the perspective of users of Caps AD

RESUMO O debate em torno dos dispositivos e modelos de cuidado destinados aos usuários problemáticos de álcool e outras drogas tem ganhado cada vez mais espaço nas políticas públicas. A partir da discussão sobre os paradigmas da abstinência e da redução de danos, buscou-se investigar as relações e os sentidos que os usuários atribuem a esses paradigmas por meio da utilização das Comunidades Terapêuticas e dos Centros de Atenção Psicossocial Álcool e Drogas. Para isso, utilizou-se a metodologia da entrevista semiestruturada com usuários da rede de saúde mental que já haviam utilizado ou utilizavam os serviços supracitados. Além disso, investigaram-se os sentidos atribuídos ao conceito de redução de danos. Constatou-se que a utilização desses serviços possui pontos de convergência e divergência e que os momentos da busca por cada serviço não estão relacionados somente com uma demanda por tratamento. Observaram-se, também, a fragilidade na apreensão do conceito de redução de danos e a presença do ideal da abstinência na busca pelo tratamento. A partir da perspectiva dos usuários, espera-se contribuir para a ampliação das práticas de saúde mental no Sistema Único de Saúde.

ABSTRACT The debate regarding care models for problematic users of alcohol and other drugs has increased in Brazilian public policies. Based on the discussion on the abstinence and harm reduction paradigms, we sought to investigate the relationships and meanings that users attribute to such paradigms through the use of Therapeutic Communities and Psychosocial Care Centers for Alcohol and Drugs. For that, we used the semi-structured interview methodology with users of the mental health network who had already used the services mentioned above. In addition, the meanings attributed to the concept of harm reduction were investigated. It was found that the use of these services has points of convergence and divergence and that the moments of searching for each service are not related only to a demand for treatment. It was also observed a weak understanding of the concept of harm reduction and the presence of an abstinence ideal in the search for treatment. This research hopes to contribute to the expansion of mental health practices mainly, in the Brazilian Unified Health System.

The phenomenology of hairpulling in a community sample.

Assessment and treatment of trichotillomania (TTM) has evolved substantially over the past decade. However, standardized assessment and empirically supported treatment for TTM is still in early stages of development. We proposed that information important to the ongoing evolution of assessment and treatment could be obtained through the study of hairpulling across its range of severity. Hairpulling phenomenology was assessed in a large community sample across its range of presentation. Although the estimated prevalence rate of .6% for TTM is congruent with past studies, the 1.2% prevalence estimated for clinically significant hairpulling suggests that the current diagnostic criteria are overly restrictive. Overall, hairpulling occurred at a rate of 6.5%, while age of onset was 15.92 years. Symptoms of depression, anxiety, and history of teasing were positively associated with hairpulling, while self-esteem was negatively related to hairpulling. Cognitions most commonly associated with hairpulling were "feels coarse" (53.3%), "doesn't feel right" (30.0%), "is curly" (26.7%), and "doesn't look right" (23.3%). Environments most commonly associated with hairpulling included "while reading" (38.9%), "while watching television" (37.0%), and "in class" (35.25). Applications of findings to assessment and intervention formulation are suggested, and limitations and future directions are discussed.

A participação da enfermagem e do alunato nos grupos com pacientes / psicóticos: um encontro fundamental

Pequenos recortes ilustram a participação conjunta, da enfermagem e dos estagiários de graduação em psicologia e enfermagem, nos grupos com pacientes psicóticos numa enfermaria de agudos. Essa experiência aponta para a sua importância fundamental no construir da formação e da reciclagem, incentivando o respeito aos diferentes saberes e às singularidades, o que leva conseqüentemente a uma prática assistencial mais humana e qualificada(AU)