Os problemas decorrentes do uso de álcool trazem impactos relevantes para o campo da saúde pública e levam ao desenvolvimento de políticas e propostas de tratamento baseadas em perspectivas e abordagens teórico-práticas que apresentam marcantes diferenças entre si, o que resulta na pluralidade de ofertas terapêuticas atuais. Tratase de questão complexa que envolve fatores de diversas ordens: socioculturais, econômicos, políticos, sócio-familiares e individuais. Tal complexidade deve ser considerada na construção das práticas de saúde e na compreensão dos processos de busca, escolha e adesão as propostas de tratamento, como interativos, relacionais e dotados de significados singulares. O presente estudo visou conhecer os itinerários terapêuticos de sujeitos com problemáticas decorrentes do uso prejudicial de álcool em um Centro de Atenção Psicossocial para usuários de álcool e outras drogas CAPSad. A pesquisa, de caráter qualitativo, foi orientada pela perspectiva etnometodológica, e empregou os procedimentos metodológicos de revisão bibliográfica, pesquisa documental, entrevistas semi-estruturadas, grupo focal, observação participante e construção de diário de campo. O trabalho de campo foi realizado no CAPSad Travessia, situado no município de Santana de Parnaíba/SP, no período de janeiro a março de 2009. Os resultados mostraram que os itinerários terapêuticos dos participantes foram compostos por um conjunto de ações sucessivas e muitas vezes sobrepostas. Os sujeitos tendem a recorrer simultaneamente a diversos lugares de tratamento e cuidado e chegam ao serviço de saúde sem a formulação clara do problema e nem tampouco com conhecimento sobre a proposta do serviço. Tal percurso não se configura como resultado de escolhas racionais prévias, mas da experiência construída no processo, que dota de significados as vivências e problemáticas relacionadas ao uso de álcool e a própria necessidade de busca de ajuda e enfrentamento do problema. Nesse processo, nota-se a importância das redes sócio relacionais, no contexto das quais são compartilhados os significados atribuídos às experiências e a orientação e sustentação dos processos de busca de ajuda. Concluímos que a preocupação em conhecer os saberes e práticas dos sujeitos na construção de seus itinerários terapêuticos deve compor as práticas de cuidado, desenvolvidas pelos profissionais nos serviços de saúde, comprometidas com o fortalecimento dos sujeitos individuais e coletivos, com a construção de direitos e cidadania e com a produção de saúde e de vida / Problems in consequence of the use of alcohol bring on relevant impacts to public health field and lead to the development of policies and treatment proposals based on perspectives and theoretical-practical approaches that present marked differences among them, resulting on the plurality of current therapeutic offers. This is a complex question that involves factors in several orders: sociocultural, economics, politics, socio-familiars and individuals. This complexity should be considered in the construction of health practices and understanding of the processes of search, choice and adherence to the treatment proposals, as interactive, relational and endowed of singular meanings. This study aimed to know the therapeutic itineraries of individuals with problems in consequence of harmful use of alcohol in a Psychosocial Care Center for users of alcohol and others substances CAPSad. The research used qualitative methods and was oriented by the ethnomethodological perspective. It employed the methodological procedures of bibliographical review, documental research, semi-structured interviews, focus group, participant observation and construction of field diary. The fieldwork was conducted in CAPSad Travessia, located in the city of Santana de Parnaíba/SP, from January to March of 2009. The results showed that the therapeutic itineraries of the participants were composed of a set of successive and often overlapping actions. The individuals tend to appeal simultaneously to several places of treatment and care and arrive to the health service without a clear formulation of the problem and neither informed about the proposal of the service. This pathway do not configure itself as a result of previous rational choices, but as the experience built during the process, which attributes meanings to the experiences and problems related to alcohol use and to the own necessity of help search and confrontation of the problem. In this process, it is possible to note the importance of social relational networks, in the context of which the meanings attributed to the experiences and the orientation and sustentation of process of help searching are shared. We conclude that the preoccupation in knowing the knowledge and practices of the individuals on the construction of their therapeutic itineraries must compose the care practices, developed by professionals in the health services, committed with the strengthening of individual and collective subjects, with the construction of rights and citizenship and with the production of health and life

Die vorliegende Masterarbeit ist ein erster Versuch, den Beitrag Reinhold Ruthes für die biblisch therapeutische Seelsorge in Deutschland wissenschaftlich zu untersuchen. Sie erforscht, wie der christliche Psychotherapeut Reinhold Ruthe in deutschen protestantischen Gemeinden prägte. In seinem integrativen und zugleich selektiven Ansatz macht Ruthe Erkenntnisse aus der Individualpsychologie und weiterer psychologischer Schulen für die christliche Seelsorge fruchtbar. Diese Quellen werden vorgestellt. Um seine Person und sein Werk besser zu verstehen, untersucht diese Arbeit Ruthes Biografie und zeigt den zeitgeschichtlichen Kontext auf. Dies wird durch ein Interview ergänzt, das Ruthe selbst zu Wort kommen lässt. Ein Überblick seiner Publikationen wird durch die Analyse ausgewählter Werke erweitert. Neben seiner Tätigkeit als Autor, prägte Ruthe die Seelsorgepraxis durch seinen Dienst als Lehrer und Seelsorger sowie indirekt durch seine Schüler. Aus all dem stellt diese Arbeit den besonderen Beitrag von Reinhold Ruthe für die Laienseelsorge und die Integration von Psychologie und Seelsorge im Gemeindealltag heraus This master dissertation is the first attempt to academically investigate Reinhold Ruthe’s shaping and influence on biblical therapeutical counseling in Germany. It explores how the Christian psychotherapist Reinhold Ruthe shaped German Protestant churches. Through his integrative and at the same time selective approach, Ruthe identifies insights, which he obtained from the individual psychology and other psychological schools, and makes them fruitful for Christian counseling. Such sources are presented. In order to better understand his person and his work, the dissertation examines Ruthe's biography, also giving insights on his historical context. This is enriched by an interview, which gives voice to Ruthe himself. An overview of his publications is also enhanced by the analysis of selected works. Besides his work as an author, Ruthe shaped the practice of pastoral care through his activities as teacher and counsellor and indirectly through his students. The dissertation presents through all this Reinhold Ruthe’s peculiar contribution for the laymen counseling and his efforts in the integration of psychology and pastoral care in daily church life / This master dissertation is the first attempt to academically investigate Reinhold Ruthe’s shaping and influence on biblical therapeutical counseling in Germany. It explores how the Christian psychotherapist Reinhold Ruthe shaped German Protestant churches. Through his integrative and at the same time selective approach, Ruthe identifies insights, which he obtained from the individual psychology and other psychological schools, and makes them fruitful for Christian counseling. Such sources are presented. In order to better understand his person and his work, the dissertation examines Ruthe's biography, also giving insights on his historical context. This is enriched by an interview, which gives voice to Ruthe himself. An overview of his publications is also enhanced by the analysis of selected works. Besides his work as an author, Ruthe shaped the practice of pastoral care through his activities as teacher and counsellor and indirectly through his students. The dissertation presents through all this Reinhold Ruthe’s peculiar contribution for the laymen counseling and his efforts in the integration of psychology and pastoral care in daily church life / Practical Theology / M. Th. (Pastoral Theology)

Statistics for sexually abused children are high. When children do not receive therapy, they may develop marital problems later in life. Survivors of sexual abused have difficulty letting other people come close to them. Because emotional and sexual intimacy is important components of a marital relationship, survivors of sexual abused experience conflict within their marriages. Intimacy in the marital relationship reminds them of the abuse situation and they would try to escape from it. If couples do not go through therapeutic intervention, they would have difficulty understanding the changes in their relationship after the marriage. Within a therapeutic environment partners are able to recognise the effects of abuse and are able to learn how to handle it in order to achieve a successful marriage. The changes in intimacy levels after marriage will be investigated in this study. The study will make recommendations towards professional principles for social workers in practice. / Social Work / M. A. (Social Sciences)

Statistics for sexually abused children are high. When children do not receive therapy, they may develop marital problems later in life. Survivors of sexual abused have difficulty letting other people come close to them. Because emotional and sexual intimacy is important components of a marital relationship, survivors of sexual abused experience conflict within their marriages. Intimacy in the marital relationship reminds them of the abuse situation and they would try to escape from it. If couples do not go through therapeutic intervention, they would have difficulty understanding the changes in their relationship after the marriage. Within a therapeutic environment partners are able to recognise the effects of abuse and are able to learn how to handle it in order to achieve a successful marriage. The changes in intimacy levels after marriage will be investigated in this study. The study will make recommendations towards professional principles for social workers in practice. / Social Work / M. A. (Social Sciences)