As comunidades terapêuticas para dependentes químicos são importantes recursos, descritos pela Secretária Nacional Antidrogas, na rede de atenção aos transtornos relacionados ao abuso de substâncias psicoativas. A equipe profissional nestas comunidades terapêuticas é representada, principalmente, por conselheiros em dependência química. É consenso entre os especialistas, pela complexidade desta problemática, que o tratamento deve abordar o paciente em seu contexto sociofamiliar (Stanton e Todd, 1990). O presente estudo tem como objetivo apresentar e avaliar um programa de tratamento e prevenção para dependentes químicos em comunidades terapêuticas com foco em seu contexto sociofamiliar, por nós denominado TRA: terapia de rede para adictos. Um programa destinado aos conselheiros em dependência química, que trabalham nestas comunidades. Fundamentados no pensamento-novo-paradigmático, de Esteves de Vasconcellos (2002), e na representação social, de Moscovici (2003), utilizamos como método uma pesquisa interventiva, com delineamento qualitativo construtivista, baseado em Pakman (1995), o que significa, no contexto deste trabalho, que o modelo de TRA foi construído em conjunto com os participantes: conselheiros e pacientes da comunidade terapêutica na qual realizamos a pesquisa. As principais técnicas empregadas foram: a família de origem do conselheiro e o discurso do sujeito coletivo (DSC), de acordo com Lefèvre e Lefèvre (2003). Para a análise dos resultados, usamos a técnica de triangulação de dados, segundo Denzin e Lincoln (2000). Os resultados obtidos contribuíram para conhecermos as representações sociais dos participantes sobre suas famílias e, sistemicamente, compreendermos os múltiplos aspectos envolvidos na complexidade do ciclo da drogadicção. As téc nicas interventivas auxiliaram no resgate dos aspectos resilientes e das competências dos sistemas familiares e no empoderamento da comunidade terapêutica, dos pacientes e de suas famílias, para lidar com os problemas da dependência química. Estas técnicas também colaboraram para a compreensão e a abordagem da imprevisibilidade ocorrida, em vários âmbitos, no desenvolvimento da pesquisa. As diferentes representações sociais nos DSC foram analisadas sob o olhar da intersubjetividade, proporcionando uma rica troca entre os participantes. A coparticipação, na elaboração deste modelo, contribuiu, principalmente, para a coconstrução de um novo saber em prevenção e tratamento para as comunidades terapêuticas, com um olhar mais amplo e globalizador, para o sistema familiar e outros sistemas envolvidos no problema da drogadicção / Therapeutic communities for chemical dependents are important resources, described by National Antidrug Secretary, to the network of care for disorders related to the abuse of psychoactive substances. The professional team in these therapeutic communities and represented, mainly, by advisers in chemical dependency. There is a consensus among the experts, the complexity of the problem, that treatment must approach the patient in their family environment (Stanton and Todd, 1990). The purpose of the present study is to present and assess a program of prevention and treatment for chemical dependents in therapeutic communities with a focus on their family environment, we called TRA: therapy of network for addiction. A program for counselor in chemical dependency, working in these communities. Based on thought-new-paradigmatic, Esteves de Vasconcellos (2002), and the social representation of Moscovici (2003), we used the method an interventional research, with qualitative design constructivist, based in Pakman (1995), which means, in the context of this work, that the model of TRA was built together with the participants, counselors, and patients in the therapeutic community where we have the research. The main techniques used were: the family of origin of the counselor and the collective subject discourse (DSC), according to Lefèvre and Lefèvre (2003). For the analysis of the results, we used the technique of data triangulation, second Denzin and Lincoln (2000). The results contributed to know the social representations of the participants on their families, and systemically, we understand the many aspects involved in the complexity of the cycle of drug-addiction. The interventional techniques helped with the rescue of the aspects resilient and the skills of the family systems and the empowerment of the therapeutic community, patients and their families to approach with the problems of chemical dependency. These techniques also collaborated for the understanding and approach of unpredictability that occurred in a number of areas in the development of the research. The different social representations in DSC were analyzed under the gaze of the intersubjectivity, providing a rich Exchange of views between the participants. The participation in colaboration, in drawing up this model contributed mainly to build together a new knowledge in treatment and prevention for the therapeutic communities, with a broader perspective and global vision, for the family system and other systems involved in the problem of drug-addiction

As comunidades terapêuticas para dependentes químicos são importantes recursos, descritos pela Secretária Nacional Antidrogas, na rede de atenção aos transtornos relacionados ao abuso de substâncias psicoativas. A equipe profissional nestas comunidades terapêuticas é representada, principalmente, por conselheiros em dependência química. É consenso entre os especialistas, pela complexidade desta problemática, que o tratamento deve abordar o paciente em seu contexto sociofamiliar (Stanton e Todd, 1990). O presente estudo tem como objetivo apresentar e avaliar um programa de tratamento e prevenção para dependentes químicos em comunidades terapêuticas com foco em seu contexto sociofamiliar, por nós denominado TRA: terapia de rede para adictos. Um programa destinado aos conselheiros em dependência química, que trabalham nestas comunidades. Fundamentados no pensamento-novo-paradigmático, de Esteves de Vasconcellos (2002), e na representação social, de Moscovici (2003), utilizamos como método uma pesquisa interventiva, com delineamento qualitativo construtivista, baseado em Pakman (1995), o que significa, no contexto deste trabalho, que o modelo de TRA foi construído em conjunto com os participantes: conselheiros e pacientes da comunidade terapêutica na qual realizamos a pesquisa. As principais técnicas empregadas foram: a família de origem do conselheiro e o discurso do sujeito coletivo (DSC), de acordo com Lefèvre e Lefèvre (2003). Para a análise dos resultados, usamos a técnica de triangulação de dados, segundo Denzin e Lincoln (2000). Os resultados obtidos contribuíram para conhecermos as representações sociais dos participantes sobre suas famílias e, sistemicamente, compreendermos os múltiplos aspectos envolvidos na complexidade do ciclo da drogadicção. As téc nicas interventivas auxiliaram no resgate dos aspectos resilientes e das competências dos sistemas familiares e no empoderamento da comunidade terapêutica, dos pacientes e de suas famílias, para lidar com os problemas da dependência química. Estas técnicas também colaboraram para a compreensão e a abordagem da imprevisibilidade ocorrida, em vários âmbitos, no desenvolvimento da pesquisa. As diferentes representações sociais nos DSC foram analisadas sob o olhar da intersubjetividade, proporcionando uma rica troca entre os participantes. A coparticipação, na elaboração deste modelo, contribuiu, principalmente, para a coconstrução de um novo saber em prevenção e tratamento para as comunidades terapêuticas, com um olhar mais amplo e globalizador, para o sistema familiar e outros sistemas envolvidos no problema da drogadicção / Therapeutic communities for chemical dependents are important resources, described by National Antidrug Secretary, to the network of care for disorders related to the abuse of psychoactive substances. The professional team in these therapeutic communities and represented, mainly, by advisers in chemical dependency. There is a consensus among the experts, the complexity of the problem, that treatment must approach the patient in their family environment (Stanton and Todd, 1990). The purpose of the present study is to present and assess a program of prevention and treatment for chemical dependents in therapeutic communities with a focus on their family environment, we called TRA: therapy of network for addiction. A program for counselor in chemical dependency, working in these communities. Based on thought-new-paradigmatic, Esteves de Vasconcellos (2002), and the social representation of Moscovici (2003), we used the method an interventional research, with qualitative design constructivist, based in Pakman (1995), which means, in the context of this work, that the model of TRA was built together with the participants, counselors, and patients in the therapeutic community where we have the research. The main techniques used were: the family of origin of the counselor and the collective subject discourse (DSC), according to Lefèvre and Lefèvre (2003). For the analysis of the results, we used the technique of data triangulation, second Denzin and Lincoln (2000). The results contributed to know the social representations of the participants on their families, and systemically, we understand the many aspects involved in the complexity of the cycle of drug-addiction. The interventional techniques helped with the rescue of the aspects resilient and the skills of the family systems and the empowerment of the therapeutic community, patients and their families to approach with the problems of chemical dependency. These techniques also collaborated for the understanding and approach of unpredictability that occurred in a number of areas in the development of the research. The different social representations in DSC were analyzed under the gaze of the intersubjectivity, providing a rich Exchange of views between the participants. The participation in colaboration, in drawing up this model contributed mainly to build together a new knowledge in treatment and prevention for the therapeutic communities, with a broader perspective and global vision, for the family system and other systems involved in the problem of drug-addiction

Les lieux de soin institutionnels ont été fortement transformés par les secousses qu’a connu le champ psychiatrique depuis un demi-siècle. Aujourd’hui, des équipes de soignants travaillent dans des centres de soin plus petits, à l’intérieur des villes, plutôt que dans les espaces disciplinaires des hôpitaux. Cette thèse conduit le lecteur dans l’un de ces lieux, un centre de jour pour adolescents à Bruxelles. Elle plonge dans les détails de ses aménagements matériels et ordinaires, et pose ces questions :Comment fonctionnent les espaces matériels dans la pratique quotidienne d’un centre psychiatrique ?Comment contribuent-ils au soin institutionnel ?Quelles en sont les potentialités, avec leurs tensions, leurs réussites, leurs échecs ?Au long de sept chapitres, la thèse décrit la manière dont ces espaces contribuent à faire émerger des attachements modestes. Les attachements modestes sont des inclinations modérées et variées, qui prolifèrent alors que les soignants tentent de susciter la moindre de ces appréciations par le biais de l’environnement matériel. Ces espaces jouent un rôle actif dans la constitution de diverses manières de devenir attaché, allant des petites affinités qui se manifestent au fil de la journée jusqu’aux goûts qui finissent par revêtir une grande importance. Le récit suit trois fils conceptuels enchevêtrés, chacun accentuant une dimension de l’enquête. Le premier fil est une ethnographie du soin institutionnel, hérité des communautés thérapeutiques. Ce travail communautaire est déconsidéré dans le champ psychiatrique actuel. Or il crée des possibilités pour les patients – particulièrement pour les plus réticents à la prise en charge :il les invite à répondre par le biais de leurs affinités et désintérêts, au lieu de se voir compris au prisme des déficiences d’une maladie. Cette thèse suit comme second fil le développement d’une approche des espaces matériels saisis du point de vue de leurs potentialités. Cette approche prête une attention ethnographique aux possibilités qu’ouvrent ou non les espaces dans leurs interactions avec ceux qui donnent ou reçoivent le soin. Elle développe par là une sensibilité matérielle-sémiotique à l’égard de la matérialité d’un lieu, afin de voir comment des idées prennent forme dans et avec les aménagements matériels, au cours de la pratique de soin. Le troisième fil met au travail le concept d’« attachement ». Celui-ci désigne la co-constitution d’affinités, de choses, d’engagements corporels et de collectifs, qui se développe quand une personne ou un groupe en vient à tenir à quelque chose. Dans le centre de jour, les attachements sont souvent des appréciations modestes, d’intensité tranquille, diffuses et diluées dans des moments informels et des activités journalières :une place assise devient familière, un regard s’attarde sur une peinture exposée ou encore un jeu vidéo déclenche un intérêt temporairement partagé. La thèse témoigne des potentialités des espaces matériels pour éveiller et renforcer de tels attachements modestes et montre comment ceux-ci contribuent de façon significative au travail de soin. / Institutional care buildings have been largely transformed as the psychiatric field has undergone significant changes over the last fifty years. Instead of the disciplining spaces of hospitals, teams of caregivers now work in smaller centres located in the community. This thesis brings the reader into one of these places, a psychiatric day care centre for teenagers in Brussels. It dives into the details of its everyday material arrangements, and asks, How do material spaces work in the everyday practice of a psychiatric centre? How do they contribute to institutional care? What are their potentialities, with their tensions, successes, and failures? Presented over seven chapters, the dissertation describes how these spaces help make modest attachments emerge. ‘Modest attachments’ proliferate as caregivers attempt to spark even the smallest appreciations by mediation of the material environment. Material spaces play active roles in enacting various ways of becoming attached, from small affinities in the everyday flow, towards appreciations that become of great concern. The narrative follows three conceptual threads, each accentuating a dimension of the inquiry. The first thread of the thesis is an ethnography of institutional care, shaped by the notion of therapeutic communities. This community work with patients is given less importance in today’s psychiatric field. Yet, such a care work creates possibilities for patients – especially for those most reluctant to being cared for: it invites them to respond with their specific affinities and disinterests, rather than being understood through the deficiencies of a disease. The thesis develops an approach towards the potentialities of material spaces. This approach pays ethnographic attention to the possibilities that material spaces unleash in interactions with those giving and receiving care. It therefore develops a material-semiotic sensibility regarding the materiality of a place, looking at how ideas take shape in and with the material arrangements of the space involved in the ongoing care practice.The third thread elaborates the concept of ‘attachments’, a term that designates the co-creation of affinities, things, bodily engagements, and collectives, that develop when a person or a group comes to strongly like something. In the day centre, attachments are often modest appreciations, of quiet intensity, diffuse and dilute in informal moments and daily activities: a seat that become familiar, a displayed drawing that draws a lingering gaze, or a videogame that spark a momentary shared interest. The thesis witnesses the potentialities of material spaces for awakening and strengthening such modest attachments and shows how these significantly contribute to the care work. / Doctorat en Art de bâtir et urbanisme (Architecture) / info:eu-repo/semantics/nonPublished

In April 1997 Kainos Community in HMP The Verne, Dorset, England became the first faith-based prison unit to be established in the Western world. The foundations and ethos of Kainos are based on Christian concepts of ‘loving your neighbour’ and forgiveness. The community operates as a hybrid therapeutic community (TC) and cognitive behavioural programme (CBP). It is open to and inclusive of prisoners of all faiths and none. The aim of this study is to explore the Kainos community ethnographically, guided by the principles of grounded theory and thematic analysis, in order to investigate whether or not Kainos ameliorates some of the de-humanising aspects of prison, and if so, how it rehumanises the prison space. Theoretically, this study highlights the dehumanisation of imprisonment, and illuminates the role that a holistic, Christian-based approach can play in terms of making the prison environment ‘more human’. My findings reveal that on Kainos there are physical, liminal and spiritual spatial mechanisms, in which a family of sub-themes interact to enable flourishing to occur. Kainos has created a physical space in which spaces of architecture and design; sensory experience; movement; and home interact to enable flourishing, whereby prisoners feel ‘more homely’, ‘free’, safe, and calm. Kainos has created a liminal space in which spaces of atmosphere; identity; home; and creativity interact to enable flourishing, empowering prisoners in their self-expression; as a cathartic tool; and as a means of regaining or creating a new identity. Kainos has created a spiritual space in which spaces of Christian activism, love, and forgiveness enable self-worth, healing, transformation, and meaningful change. The implication is that Kainos has created spaces of flourishing, safety and peace within an otherwise dehumanising carceral space, and this plays an important role in the process of transformational change imperative in the desistance process. If society must have prisons, this study concludes that Kainos provides a model for how they should be.