Emotional Distress in the Relationship of Caregivers and Institutionalized Babies.

Institutionalization is an exceptional and temporary measure that occurs when there is a violation of rights; lasting until the family reintegration or, in the impossibility of this, the placement in a substitute family through adoption. Among the main reasons for institutionalization in Brazil are the financial difficulties, abandonment, domestic violence, drug addiction, homelessness of the responsible for the child, sexual abuse, and the loss of parents by death or imprisonment. Although children and adolescents have their rights assured when they are institutionalized, the care provided in these spaces does not include all their needs and demands, which may damage their affective-relational development. Maternal deprivation in the first years of life can be detrimental to the development of these children, if not provided by adequate substitute care. Therefore, to understand which place the institutionalized baby occupies in the imaginary of the social caregivers and, from this, how is established the relationship regarding the care, is of fundamental importance to assess and address the risk factors in child development at this stage of life and in situation of institutionalization. This is an exploratory and descriptive study, developed in a childcare institution, located in the city of São Paulo, Brazil, capable of accommodating up to 20 babies between 0 and 2 years old. Data collection was performed with nine employees, eight social caregivers and one general service assistant who work directly in the care of the institutionalized babies. Drawing-Story with Theme (DS-T) procedures were used. Qualitative analysis was based on Interpretative Phenomenological Analysis. The appreciation of the nine applied Drawing-Story procedures allowed the establishment of three discussion axes representations of baby, baby care, and early separation process. This study concluded that the difficulties that permeate the context of caregivers' work are the high turnover of institutionalized children, as well as employees, the difficulty of dealing with processes of bonding and breaking bonds and no recognition of the profession. We highlight that the place that these babies occupy in the imaginary of these caregivers influences the bond they establish with the children hence the care offered to the babies. It is also noteworthy that these caregivers exhibited anguish and suffering from the reasons they believed led the children to be institutionalized.

A clínica transcultural: cuidando da parentalidade no exílio / The transcultural clinic: Caring of parenthood in exile

As famílias desenraizadas podem se perder nos caminhos traçados pelo exílio. Fatores genéticos, culturais e ambientais podem afetar o equilíbrio psíquico desses migrantes, principalmente quando confrontados a doenças ou sofrimentos inexplicáveis em seus filhos. A migração e o desenraizamento podem implicar perdas das raízes ligadas às tradições, deixando as famílias desprovidas de suas bagagens interpretativas e explicativas, necessárias à realização de leituras culturais dos sofrimentos psíquicos e físicos de seus filhos, sobretudo quando estes são considerados especiais. Este artigo propõe uma reflexão sobre tais questões, a partir de um estudo de caso, resultante da experiência da primeira autora em uma clínica interdisciplinar, como exige o enquadre transcultural, que se faz variável e complementar, respeitando a diversidade cultural. Observam-se, ainda, os discursos etiológicos construídos sobre esses sofrimentos psíquicos, que invadem o desenvolvimento da criança e o equilíbrio familiar.

Uprooted families can get lost in the ways of exile. Genetic, cultural and environmental factors can affect the psychic balance of these migrants, especially when faced with unexplained illness or suffering in their children. Migration and uprooting may involve loss of roots linked to traditions, leaving families deprived of their interpretive and explanatory baggage, which are necessary for the cultural readings of their child's psychic and physical suffering, sometimes considered as special. We propose a reflection on these issues, based on a case study, resulting from the experience of the first author with an interdisciplinary clinic, as required by the transcultural framework, which becomes variable and complementary, respecting cultural diversity. We also observe the etiological discourses constructed on these psychic sufferings that invade the development of the child and the family balance.

O procedimento de desenhos-estórias como modalidade de intervençäo nas consultas terapêuticas infantis / Draft stories procedure as a modality of intervention in children therapeutic consultation

O objetivo deste trabalho é apresentar uma nova modalidade de atendimento psicoterápico entre crianças e seus familiares. Esta técnica consiste na utilizaçäo do procedimento de desenhos-estórias com tema e sem tema nas consultas terapêuticas infantis, o qual é uma adaptaçäo do procedimento de desenhos-estórias desenvolvido por Trinca (1976). A base teórica foi de Winnicott, principalmente os conceitos de espaço potencial. Foi utilizada a sua noçäo de espaço potencial como um espaço e um tempo que permitem abordar, näo somente a realidade interna individual e grupal, mas também a realidade externa, por intermédio da criatividade. Ao longo deste trabalho foram retomados os conceitos de consultas terapêuticas, objetos e fenômenos transicionais e do jogo do rabisco, que norteiam esta técnica. Foi feita uma reflexäo a respeito do papel do profissional, tanto enquanto analista quanto como pesquisador. Esta técnica facilita a aliança terapêutica, pela expressäo subjetiva, verbal e emocional, entre a criança e seus pais. Ela se mostrou útil, tanto na investigaçäo e elaboraçäo de um diagnóstico, quanto na facilitaçäo da comunicaçäo e elaboraçäo psíquica. Este trabalho é fruto da reflexäo de doze anos de prática clínica. Säo apresentados quatro casos clínicos que a demonstram