Depression in adolescence is a major health problem, associated with poor psychological function and key risk factors both for later illness and suicidal behaviours. The antidepressant fluoxetine is commonly used in this population and it is shown to have a favourable benefit-to-risk profile. However, controversy still exists about the use of antidepressants in young people and there is little research focusing on underlying mechanisms of wanted and unwanted actions in this group. This doctoral thesis aims to investigate, for the first time, the acute effects of fluoxetine on emotional processing, using a combination of behavioural and neuroimaging techniques. The aim is to achieve a greater understanding of the mechanisms underlying fluoxetine use in depressed adolescents, in light of differences seen in their clinical presentation and response to antidepressant drugs. In the first study (Chapter Two), a single dose of fluoxetine was shown to decrease the recognition of anger in a sample of young adult volunteers, an effect not previously seen in acute studies of older participants. This effect may be particularly relevant for the treatment of adolescent depression, in which symptoms of anger and irritability are often prominent. Beyond this, fluoxetine was shown to increase the recognition of positive vs. negative facial information, and also exerted an anxiolytic-like influence, eliminating the emotion-potentiated startle effect. However, no influence was seen in measures of attentional vigilance to threat. In an attempt to overcome methodological limitations of this study, a paradigm was developed that is particularly sensitive to the detection of automatic biases towards threatening information (Chapter Three). Chapter Four describes a neuroimaging study with depressed adolescents, in which a single dose of fluoxetine was found to reduce amygdala activity in response to anger. Early changes in amygdala activity to fear correlated with decreased symptoms of anxiety and depression in the first 7-10 days of treatment. Chapter Five explores the effects of acute fluoxetine in a sample of high trait anger males. This study replicated the finding that fluoxetine acts to increase the recognition of positive information, whilst showing preliminary evidence for a reduction in attentional vigilance to angry faces. Overall, fluoxetine was found to decrease the processing of anger across studies. This effect was seen alongside a broader influence on positive vs. negative information and anxiolytic-like properties. Together, these results indicate that fluoxetine has direct effects on processes that are especially relevant to adolescent depression and suggest a potential cognitive mechanism for the efficacy of this particular antidepressant in adolescent patients.

Master of Science / Department of Family Studies and Human Services / Sandra M. Stith / This investigation explored a relatively understudied aspect of mindfulness: the experience of ninth graders in a public school classroom who practice a brief, daily mindfulness activity. The mixed-method study utilized both qualitative and quantitative research methods. Semi-structured interviews investigated the experience of those students and gleaned further information surrounding the question, ―What was the experience of mindfulness like for you?‖ The data from these interviews was analyzed using thematic analysis and was cross-coded by two outside researchers not part of the data collection. This study also explored the effects of classroom mindfulness activities through the Child and Adolescent Mindfulness Measure (Greco, Dew, & Baer, 2005). The participating students and a control group of students within the same school building and subject area took the measure before and after the study to determine the effects, if any, of participating in classroom mindfulness activities on adolescent mindfulness. These results were analyzed using paired sample T-tests using SPSS software. Results from both the interviews and the survey showed that students participating in the mindfulness activities had a consistently positive experience with the mindfulness exercise and increased their level of mindfulness. While unfamiliar with mindfulness at the beginning of the study, students in the experimental condition reported they found the experience beneficial in terms of personal growth, classroom environment, and adaption to other areas of their life. Any negative experiences concerning the mindfulness exercises centered around the initial unfamiliarity with mindfulness and specific components of one exercise. These results were further confirmed by the entries in a daily journal kept by the teacher.

Att barn blir utsatta för våld är i dagens samhälle inte ovanligt. Våld är ett komplicerat ämne att prata om med barn då barnen behöver lita på den som frågar, inte känna sig trängda och samtidigt åsidosätta sin lojalitet till en nära person för att våga berätta. Syftet med vår studie har varit att utifrån en triangulering, en kombination av kvalitativ och kvantitativ metod, undersöka hur yrkesverksamma inom barn- och ungdomspsykiatrin arbetar i kontakten med barn för att upptäcka om barnet utsätts för våld i hemmet och att uppmärksamma om eventuellt glapp finns mellan riktlinjer och verklighet. Undersökningen gjordes genom en enkät med 23 svarande som redovisas genom en deskriptiv analys av de kvantitativa frågorna samt en innehållsanalys av de kvalitativa frågorna. Resultatet visar att yrkesverksamma inom barn- och ungdomspsykiatrin idag frågar barn om de har utsatts för någon typ av våld när misstanke uppstår snarare än på rutin. Arbetsplatsens riktlinjer är bekanta för de flesta svarande och de vet hur de ska gå vidare om de får reda på att ett barn utsatts för våld. De yrkesverksammas upplevelser kring att fråga skiljer sig mellan olika typerna av våld och det är svårare att närma sig ämnet sexuellt våld än att prata om fysiskt våld. Trots olika svar på våra frågor kring att fråga om det förekommer våld i hemmet finns det ett genomgående tema: Det handlar om att fråga på ett sådant sätt att ingen känner sig trängd eller kränkt. / That children are exposed to violence is nothing unusual in the society of today. Violence is a complicated topic to talk about with children because the child has to trust the person who asks, not feel repressed and also, to tell someone about what has happened means to override their loyalty to a person close to them. The aim of our study has been, through a triangulation, a combination of qualitative and quantitative method, to investigate how the child and adolescent psychiatry work in the contact with children to discover if there is violence in the family, and whether they have knowledge of the workplace guidelines in the subject. The survey was conducted through a questionnaire with 23 respondents reported by a descriptive analysis of the quantitative material and a content analysis of the qualitative. The result shows that professionals in child and adolescent psychiatry today ask children if they have suffered any kind of violence when the suspicion arises rather than routine. Workplace guidelines are familiar to most respondents, and they know how they should proceed if they find out that a child is exposed to violence. The professionals' experiences on the issue differ between different types of violence and it is difficult to approach the topic of sexual violence than it is to talk about physical violence. Despite the various answers to our questions around the topic to ask if there is violence in the family, there is a consistent theme: It's all about to question in such a way that no one feels cornered or offended.

A violência doméstica é uma realidade evidenciada com grande frequência e apontada como um grave problema de saúde pública em nosso país. Ela se concretiza, sobretudo contra pessoas em fase de desenvolvimento como crianças e adolescentes. Nosso estudo teve como objetivo conhecer e descrever as ações na Atenção Primária à Saúde prestadas pelo(a) enfermeiro(a) às crianças e aos adolescentes vítimas de violência doméstica em Unidades de Saúde da Família localizadas no Distrito Oeste do Município de Ribeirão Preto - SP. Trata-se de um estudo com abordagem qualitativa, se delineando como pesquisa social estratégica, com modalidade de estudo de caso. Para a coleta de dados, foram realizadas entrevistas semiestruturadas, diário de campo e uma visita na Secretaria Municipal de Saúde de Ribeirão Preto, especificamente a Divisão de Vigilância Epidemiológica no Núcleo de Violência e Acidentes. Participaram do estudo 05 enfermeiras que atuam nos 05 Núcleos de Saúde da Família no Distrito Oeste da cidade de Ribeirão Preto. A análise dos dados foi realizada por meio da análise de conteúdo, modalidade temática. Emergiram dois núcleos temáticos principais: Ações Municipais na Atenção à Criança e ao Adolescente Vítima de Violência Doméstica e Enfermagem na Atenção Primária à Saúde: barreiras no combate à violência doméstica. No primeiro núcleo foi abordado as ações no Município de Ribeirão Preto para o combate à violência doméstica em crianças e adolescentes. Embora os esforços da Secretaria Municipal de Saúde promovendo eventos com o objetivo de promover à capacitação e educação permanente dos profissionais de saúde, muitas vezes, há dificuldade destes eventos serem inseridos nas agendas dos enfermeiros atuantes no Núcleo de Saúde da Família. Como rede de apoio social à criança e adolescente vitimizadas foram ressaltadas pelas entrevistadas à comunidade, os vizinhos e a escola. Encontramos em uma entrevista o tráfico de drogas atuando na proteção das vítimas de violência doméstica, o que nos evidenciou certa falência da atuação dos meios de proteção. No segundo núcleo foram apontados alguns fatores que dificultam a ação dos(as) enfermeiros(as) no combate à violência doméstica tal como a falta de capacitação dos conselheiros tutelares, que dificultam a articulação e o estabelecimento de vínculo com os profissionais de saúde. O medo dos(as) enfermeiros(as) em relação ao agressor, a falta de capacitação dos(as) enfermeiros(as) para executar ações contra a violência doméstica, tais como a prevenção, a notificação, o encaminhamento e acompanhamento das vítimas são fatores que dificultam o combate à violência contra crianças e adolescentes. Entendemos que estas considerações acerca das ações no combate à violência doméstica devem ser valorizadas não só pelos(as) enfermeiros(as), mas também por todos os profissionais que atuam nos serviços de atenção à infância e adolescência. / Domestic violence is a reality very common manifested and indicated as serious problem of health public in our country. It happens, mostly, against people in developing as children and adolescents. The aim of our study is to know and to describe the actions in primary health care accomplished by the nurses to children and adolescents victims of domestic violence in Family Health Center in the West District of the municipality of Ribeirão Preto - SP. In this study is used a qualitative approach, in which is considerate a strategy of social research, a modality of case study. For data collection, it was used semi structured interviews, field diary and one visit to Health Municipal Department in Ribeirão Preto, especially the Division of Epidemiological Surveillance in the Violence and Accident Center. The study included 5 nurses which work in 5 family health centers in west district of Ribeirão Preto. The analysis of data was made through the content analysis, thematic modality. Two main theme centers appeared: \"Municipal Actions in Attention to Child and Adolescent Victims of Domestic Violence\" and \"Nursing in Primary Health Care: limits in the domestic violence combat\". On the first center was discussed the actions in the city of Ribeirão Preto to combat the domestic violence against children and adolescents. Although the Municipal Department of Health`s effort to realize events to promote the permanent professional training and education of health professionals, often, there is a difficult to the nurses of Family`s Health Center to include in their agenda. The interviewed emphasized as social support network the community, the neighbor and school. The drug traffic was cited in the interview as protection of domestic violence\'s victims, what reveal failures in actions of protection. On the second center was pointed out some factors which difficult the action of nurses in the combat domestic violence such as lack of professional training of tutelaries, what make difficult the articulation and the establishment of the bond with health professionals. The fear of nurses in relation of aggressor, the lack of professional training of nurses to execute actions against domestic violence, such as prevention, notification, routing and follow up victims are factors which make difficult the combat violence in child and adolescent. Such considerations in relation the actions against domestic violence must be valued not only by the nurses, but also by all the professionals which deal in the attention services to children and adolescents.

Introdução: O atual modelo de saúde mental infantojuvenil tem como um dos seus pilares a transformação da postura dos profissionais da área. Espera-se que eles se coloquem de corpo inteiro e se impliquem subjetivamente no trabalho. Esses profissionais têm papel fundamental nas direções tomadas ao longo dos anos, contudo são historicamente desvalorizados e pouco estudados. Objetivo: Descrever e analisar a subjetividade, as experiências de formação e a trajetória de vida de trabalhadores de Centros de Atenção Psicossocial Infantojuvenis (CAPSi) e suas relações com o processo de inserção e prática nesse campo. Método: Foi realizado um questionário com perguntas semi abertas e entrevistas narrativas com 8 trabalhadores de diferentes categorias profissionais lotados em 2 CAPSis do Município de São Paulo, um deles gerenciado diretamente pela Prefeitura e outro por Organização Social de Saúde (OSS). Para análise das entrevistas narrativas foi utilizada a proposta de Shutze. O Referencial Teórico foi construído a partir de diferentes autores que dialogam entre si, dentre eles Dejours e Schwartz. Resultados: Constaram-se importantes diferenças entre os trabalhadores do CAPSi gerenciado por OSS e pela Prefeitura no que se refere ao perfil profissional, às motivações para o trabalho, ao tipo de formação que buscam e aos sentidos atribuídos ao trabalho. No entanto, todos os trabalhadores revelam características comuns: impacto recíproco que a vida pessoal e o trabalho na saúde mental exercem entre si; passagem prévia por hospital, escola ou consultório, de forma que essas instituições marcam sua atuação profissional; carência de capacitação oferecida pelos serviços e grande distância entre as necessidades reais do serviço e os treinamentos oferecidos. Conclusão: A tendência atual do mundo do trabalho caminha em sentido oposto às propostas da Reforma Psiquiátrica, fazendo com que os profissionais mais antigos encontrem dificuldades e os mais jovens se afastem dos pressupostos da Reforma Psiquiátrica. Junto a isso, a complexidade das propostas de tratamento nos CAPSis e a falta de espaços de discussão e potencialização do trabalho, que deviam ser oferecidos pelas instituições, faz com que ambos os grupos de profissionais sintam-se perdidos e sozinhos. A formação transcende o espaço técnico no qual ela se delimita inicialmente e se espraia para diversos setores da vida do indivíduo / Introduction: The current model of child and adolescents Mental Health Care are in transformation concerning the professionals approach. It is expected that they get deeply involved in a subjective way in their work. These professionals are very important in the directions taken in that field over the years, however, they are historically unevaluated and understudied. Objective: Describe and analyze subjectivity, as well as training experiences and life trajectories of employees of Psychosocial Care Centers for Children and Adolescents (CAPSi) and their relation to the process of professional insertion and practice in this field. Method: A semi-structured questionnaire and narratives interviews were conducted with 8 workers from 2 CAPSi from São Paulo City, Brazil; one managed directly by the City and one managed by Social Health Organizations- OSS. The narratives interviews have been subjected to Shutze analysis techniques. The Theoretical Framework was built from different authors who interact with each other, including Dejours and Schwartz. Results: It was found important differences between work team from CAPSi managed by the OSS and CAPSi managed directly by the City concerning professional profile, motivations for work, type of training searched and meanings attributed to work. However, all employees reveal common features: reciprocal impact that personal life and work in mental health influences on each other; previous works in hospitals, schools and office, so these institutions marked their professional performance; lack of training services and large distance between the real needs of the service and the training offered. Conclusion: It was found that the current trend in the field goes in opposite direction to the proposals of the Psychiatric Reform, causing the older professionals do not fit in and younger professional deviate from the Psychiatric Reform proposed. Along with this, the complexity of treatment proposed in CAPSi and lack of opportunities for discussion and empowerment work team of labor, which should be offered by institutions, makes both groups of professionals feel lost and alone. The technical training transcends space in which it delimits initially and spreads to various sectors of the life of the individual

O presente trabalho propõe refletir sobre o instituto jurídico da guarda e da adoção, contribuindo com alguns elementos teóricos da psicanálise que possam elucidar como esse processo ocorre subjetivamente, sem deixar de fora, nesse raciocínio, a questão do gozo, central na psicanálise e o contexto trazido pelas modificações dos referenciais simbólicos iniciados na modernidade. Inicialmente, expõe-se o conceito de lei jurídica na história a fim de se levantar uma reflexão sobre a lei na atualidade, dentro do ordenamento jurídico brasileiro, trazendo problemáticas do direito em relação ao seu papel na sociedade. Posteriormente, aborda-se o conceito de Lei na psicanálise, marcando a diferença entre essas áreas. Num segundo momento, o foco recai sobre o instituto da guarda e da adoção no sistema jurídico, pensando, principalmente o primeiro instituto como um meio para se concretizar a adoção. Logo em seguida, trouxemos a guarda e a adoção pela ótica da psicanálise, utilizando-se como referencial teórico basicamente a teoria de Lacan, especialmente as modificações trazidas pela última clínica deste autor, momento em que desloca a dialética do desejo do centro da teoria para a questão do gozo. A pesquisa revelou que a adoção não opera somente no registro simbólico, como a maioria dos trabalhos encontrados se restringem, mas ocorre nos três registros psíquicos: real, simbólico e imaginário. Ao final retomamos a adoção na psicanálise dentro do contexto pós-moderno, apontando as influências sofridas pelo discurso capitalista, que produz ilusões narcísicas de completude diariamente e esclarecemos a diferença entre Lei do bem dizer e lei do dizer o bem / The proposal of this paper is to contribute to the custody and adoption legal institute, seeking some theoretical elements of psychoanalysis to elucidate how this process occurs subjectively. For that, we approache Lacan´s concept of Lust - a central topic in psychoanalysis - and the context brought by the changes in the symbolic references which emerged in modernity. The starting point of this investigation is the concept of law in the history, in order to raise a debate on the law nowadays within the Brazilian legal system, discussing some issues of law in relation to its role in society. Subsequently, the focus places on the institution of guardianship and adoption in the legal system, considering the first institute as a means for achieving adoption. To work on these themes - custody and adoption - by the psychoanalytic perspective, we use primarily theoretical teachings of Lacan, especially the changes brought about by the last clinic of Lacan, at which shifts the dialectic of desire from the heart of his theory to the question of Lust. The survey revealed that the adoption does not work only in the symbolic dimension, like most works found claims, but occurs in all three records: real, symbolic and imaginary. At the end we return to the adoption in psychoanalysis within the postmodern context, pointing out the influences experienced by capitalist discourse that produces narcissistic illusions of wholeness. For this purpose we clarify the difference between the Law of well say and the Law of say good

Made available in DSpace on 2015-03-04T20:06:52Z (GMT). No. of bitstreams: 0 Previous issue date: 25 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Nesta dissertação analisamos resultados de uma investigação empírica que teve por objetivo problematizar o Estatuto da Criança e do Adolescente - ECA junto a adolescentes e professores, identificando representações por eles (com) partilhadas e os efeitos dessas representações na dinâmica da vida escolar. A pesquisa teve como fundamentação principal Moscovici (1978, 1994), Gatti (2005), Bobbio (2004), Arroyo (2002, 2004) e Freire (2000, 2003, 2006). Metodologicamente, a pesquisa caracterizou-se como um estudo de natureza qualitativa, utilizando-se dos “grupos focais” como principal procedimento de pesquisa para problematizar as representações. As questões que balizaram a pesquisa foram: quais são as representações partilhadas por adolescentes e professores a respeito do ECA? Que efeitos as representações de adolescentes e professores sobre o ECA têm sobre a dinâmica da vida escolar? Como se aproximam ou distanciam as representações de adolescentes e professores? Os resultados mobilizaram uma série de reflexões

Chronic health problems are hypothesised to be a risk factor to child and adolescent mental health, due the consistent and continuing stress these health problems pose to normative patterns of development. However, this theory remains to be substantiated by empirical research. Moreover, a systematic review conducted as part of this research indicated that the empirical body is not one on which the validity of this theory can be adequately tested. The major question posed is whether the lack of high quality epidemiological data in the field is obscuring a true psychiatric risk associated with chronic illness in childhood and adolescence, or whether, in contrast, the theory of chronic health problems as a particular risk factor to child and adolescent mental health, is based on false premises. In order to provide a stronger insight into the association of chronic health problems to mental ill-health across the late childhood and adolescent period, this study used data from a large, representative British sample (the Avon Longitudinal Study of Parents and Children (ALSPAC)) and sensitive measures of mental health outcomes. Mediating factors in these associations were also identified, and a model of the association of chronic health problems to poor mental health outcomes in early adolescence was developed. In order to ensure that all findings were applicable across chronic health conditions, outcomes over this period for children with chronic illness more generally were compared to outcomes for children with asthma diagnoses. Children with chronic health problems presented with a disproportionate rate of psychiatric illness at 10 years, and these chronic health problems continued to be associated with poor mental health outcomes across the early to mid-adolescent period. The outcomes at 10 and 13 years were suggested to be mediated by factors non-specific to any diagnosis, specifically peer victimisation and health-related school absenteeism. Limitations to external validity in the research, and implications for public health and future research are discussed.

O Estatuto da Criança e do Adolescente (ECA) criado em 1990, ampliou a atuação do estado brasileiro na implementação das políticas públicas aos adolescentes. Há muitas instituições que visam atender esta população, entretanto, o sinergismo delas é pouco conhecido. Este estudo tem por objeto o projeto político de atenção aos adolescentes no nivel municipal e visa subsidiar a sua renovação. A partir do ECA, houve a ampliação da compreensaõ deste grupo social. Os objetivos são: conhecer os programas de atendimento aos adolescentes, verificar como se apresentam configurados e delinear as possibilidades e limites de execução de um planejamento da atenção aos adolescentes. A metodologia utilizada é quali-quantitativa, na perspectiva do materialismo histórico e dialético. Os dados empíricos foram coletados junto aos programas existentes no município, através de entrevistas e documentos. Vinte e sete programas institucionais foram identificados cadastrados de forma oficial no Conselho ou nas secretarias municipais, dezenove instituições participaram do estudo, representando quarenta e sete projetos. Os resultados mostraram que os programas são diferentes entre si em termos de tamanho, motivação do projeto, orientação laica ou religiosa, qualificação e quantidade dos trabalhadores e público alvo, porém possuem em semelhança o viés assistencialista. Enquanto a maioria delas está centrada em complementação escolar e ensino profissionalizante, outras atendem exclusivamente os adolescentes autores de atos infracionais. Embora presente numericamente, as instituições de atenção ao adolescente não se encontram ainda orquestradas em prol da consecução do ECA. / In Brazil since the Child and Adolescent Statute (ECA) was established in 1990, the state has been allowed to amplify public policies toward such social group. We assumed Oliveira’s point of view that adolescence is a social phenomenon. Adolescents can show in terms of quality of life and health-disease distinct profile according to their social group or family origins. Since ECA many institutions have created to attend adolescents. The objective of this study was to comprehend how these institutions have been organized in the City of São Carlos, setting northeast of São Paulo State, Brazil. The methodology was descriptive and the data was collected by interviews with the directors of the institutions and their proposals and reports. Twenty institutions have been studied. They have showed differences in terms of objectives, age of the target public, religious orientation, type and amount of workers. While most institutions have focused on leisure activities and professional education, some of them only assist adolescents who have committed any kind of illegal action, Although there are many different projects to assist adolescents, it seems that their actions still are not integrated towards the implementation of the Child and Adolescent Statute.

Introdução: O atual modelo de saúde mental infantojuvenil tem como um dos seus pilares a transformação da postura dos profissionais da área. Espera-se que eles se coloquem de corpo inteiro e se impliquem subjetivamente no trabalho. Esses profissionais têm papel fundamental nas direções tomadas ao longo dos anos, contudo são historicamente desvalorizados e pouco estudados. Objetivo: Descrever e analisar a subjetividade, as experiências de formação e a trajetória de vida de trabalhadores de Centros de Atenção Psicossocial Infantojuvenis (CAPSi) e suas relações com o processo de inserção e prática nesse campo. Método: Foi realizado um questionário com perguntas semi abertas e entrevistas narrativas com 8 trabalhadores de diferentes categorias profissionais lotados em 2 CAPSis do Município de São Paulo, um deles gerenciado diretamente pela Prefeitura e outro por Organização Social de Saúde (OSS). Para análise das entrevistas narrativas foi utilizada a proposta de Shutze. O Referencial Teórico foi construído a partir de diferentes autores que dialogam entre si, dentre eles Dejours e Schwartz. Resultados: Constaram-se importantes diferenças entre os trabalhadores do CAPSi gerenciado por OSS e pela Prefeitura no que se refere ao perfil profissional, às motivações para o trabalho, ao tipo de formação que buscam e aos sentidos atribuídos ao trabalho. No entanto, todos os trabalhadores revelam características comuns: impacto recíproco que a vida pessoal e o trabalho na saúde mental exercem entre si; passagem prévia por hospital, escola ou consultório, de forma que essas instituições marcam sua atuação profissional; carência de capacitação oferecida pelos serviços e grande distância entre as necessidades reais do serviço e os treinamentos oferecidos. Conclusão: A tendência atual do mundo do trabalho caminha em sentido oposto às propostas da Reforma Psiquiátrica, fazendo com que os profissionais mais antigos encontrem dificuldades e os mais jovens se afastem dos pressupostos da Reforma Psiquiátrica. Junto a isso, a complexidade das propostas de tratamento nos CAPSis e a falta de espaços de discussão e potencialização do trabalho, que deviam ser oferecidos pelas instituições, faz com que ambos os grupos de profissionais sintam-se perdidos e sozinhos. A formação transcende o espaço técnico no qual ela se delimita inicialmente e se espraia para diversos setores da vida do indivíduo / Introduction: The current model of child and adolescents Mental Health Care are in transformation concerning the professionals approach. It is expected that they get deeply involved in a subjective way in their work. These professionals are very important in the directions taken in that field over the years, however, they are historically unevaluated and understudied. Objective: Describe and analyze subjectivity, as well as training experiences and life trajectories of employees of Psychosocial Care Centers for Children and Adolescents (CAPSi) and their relation to the process of professional insertion and practice in this field. Method: A semi-structured questionnaire and narratives interviews were conducted with 8 workers from 2 CAPSi from São Paulo City, Brazil; one managed directly by the City and one managed by Social Health Organizations- OSS. The narratives interviews have been subjected to Shutze analysis techniques. The Theoretical Framework was built from different authors who interact with each other, including Dejours and Schwartz. Results: It was found important differences between work team from CAPSi managed by the OSS and CAPSi managed directly by the City concerning professional profile, motivations for work, type of training searched and meanings attributed to work. However, all employees reveal common features: reciprocal impact that personal life and work in mental health influences on each other; previous works in hospitals, schools and office, so these institutions marked their professional performance; lack of training services and large distance between the real needs of the service and the training offered. Conclusion: It was found that the current trend in the field goes in opposite direction to the proposals of the Psychiatric Reform, causing the older professionals do not fit in and younger professional deviate from the Psychiatric Reform proposed. Along with this, the complexity of treatment proposed in CAPSi and lack of opportunities for discussion and empowerment work team of labor, which should be offered by institutions, makes both groups of professionals feel lost and alone. The technical training transcends space in which it delimits initially and spreads to various sectors of the life of the individual