"O Caps me deu voz, me deu escuta" : um estudo das dimensões da clínica nos Centros de Atenção Psicossocial na perspectiva de trabalhadores e usuários

Esta pesquisa teve como objeto de estudo as dimensoes da clinica nos Centros de Atencao Psicossocial a partir da perspectiva dos trabalhadores e usuarios envolvidos no cotidiano do cuidado dos Caps. Para tanto situa-se no ambito das pesquisas qualitativas e avaliativas em Psicologia Clinica e Saude Mental. Utilizamos como metodo os Grupos de Discussao (GDs) com trabalhadores e a tecnica de Entrevistas Narrativas (ENs) com usuarios de tres CAPS III da Rede de Atencao Psicossocial de Aracaju (SE). Buscamos percorrer os temas que foram se configurando como centrais para o entendimento das dimensoes da clinica em cada um dos Caps. Assim, tomamos cada servico como um caso, no sentido de aprofundar o estudo das suas singularidades, no cotidiano do cuidado. Atraves desta pesquisa destacamos a multidimensionalidade da clinica da atencao psicossocial que envolve a trajetoria dos servicos, dos profissionais, a formacao para o trabalho em saude mental, a complexidade das praticas terapeuticas, do cuidado nas crises e das relacoes com o territorio. Assim como, apontamos a importancia do relacionamento entre os profissionais, dos profissionais com os usuarios e com os familiares, no cotidiano dos Caps, considerando a dimensao etica e politica destas relacoes e o desafio da participacao mais efetiva dos usuarios. Destacamos as perspectivas sobre as praticas terapeuticas e consideracoes sobre as concepcoes de clinica, vigentes entre os trabalhadores. Outro aspecto destacado foi a avaliacao que profissionais e usuarios fazem sobre os Caps. Constatamos tambem a coexistencia de procedimentos do modelo clinico tradicional com concepcoes e praticas da atencao psicossocial e a tensao existente nos trabalhadores, entre o preconizado e o praticado. As narrativas dos usuarios evidenciaram o Caps como um lugar de referencia e mediacao para suas vidas, de escuta, de organizacao do cotidiano, de producao de vinculo e cuidado diferenciado. A avaliacao dos usuarios sobre os Caps tambem apontou lacunas, principalmente nas relacoes cotidianas com os profissionais, nas ofertas terapeuticas, nas relacoes com as familias e na participacao dos usuarios nos Caps. _________________________________________________________________________________ ABSTRACTThis study had as its main object the clinical dimensions of the Psychosocial Care Centers in the Brazilian Psychiatric Reform, from the perspective of workers and users involved in the daily care of these services. It is therefore an evaluative and qualitative research in Psychology and Mental Health. It was used the Discussion Groups (DGs) with workers and the Narrative Interview technique (ENs) with users as privileged methods in three CAPS-III of the Network for Psychosocial Care in Aracaju (SE). Each service was taken as a case study in order to deepen it in their singularities in daily service, aiming to cover the issues that were shaping up as central to understand the clinical dimensions in each one. It was emphasized the multidimensionality of psychosocial clinical approach that involves the trajectory of services, professional training for work in mental health, the complexity of therapeutic treatment, care in crisis and relations within the territory. It was pointed out the importance of the relationship between health professionals, professionals and users and with their families in Caps everyday routine, considering the ethical and political dimension of these relations and the challenge of more effective users´ participation. It was evidenced the perspectives of the therapeutic practices and clinical conceptions used by the workers, highlighting professionals and users evaluations of the Caps. It was found the coexistence of traditional clinical model with concepts and practices of psychosocial care and tensions between the recommended and practiced by the workers. The users’ narratives indicated the Caps as a place of reference and mediation for their lives, listening, organization of daily life, production of links and special care. The users’ evaluations of the Caps also noted gaps, especially between professionals’ therapeutic services in their daily relationships and their families and the involvement of users in the Caps