Made available in DSpace on 2016-04-29T14:16:34Z (GMT). No. of bitstreams: 1 Flavia Rodrigues Lima da Hora.pdf: 1038593 bytes, checksum: 62eebd06f1b3ba8c695c64c34a9642b2 (MD5) Previous issue date: 2014-09-23 / This dissertation deals with the professional practice of social workers in Creas-Paefi of São Paulo (SP). Its preparation began with a question: how has it been the social workers professional practice in Creas-Paefi, particularly with regard to work with families? According to the 2004 National Social Assistance Policy, the Specialized Reference Center for Social Assistance (Creas) is the main equipment of the services provided under the special social protection. A Creas is responsible to develop the actions of Specialized Care and Protection Services to Families and Individuals (named by the acronym Paefi). This study seeks to present the current structure and teams' characteristics of Creas working at São Paulo state's capital. The Paefi's main goal is to care of families and individuals under rights violation risk or vulnerability. To develop their actions the social worker is surrounded by challenges within the social assistance policy and rights guarantee system as a whole. In addition to the challenges in the structure of public policy and their joints, there are challenges related specifically to professional practice of social workers in this context. In an attempt to answer the original question, this presented research was developed with professionals who work and have worked in Paefi and professionals involved with the proposed Suas employees continuing education. Thus, the subjects and the course of the study were identified based on the understanding that the professional has the potential to reflect and construct knowledge in their daily lives when they established the necessary mediations / Esta dissertação trata da prática profissional do assistente social nos Creas-Paefi da cidade de São Paulo (SP). Sua elaboração partiu de uma pergunta: como tem se dado a prática profissional dos assistentes sociais nos Creas-Paefi, sobretudo no que diz respeito ao trabalho com famílias? De acordo com a Política Nacional de Assistência Social, de 2004, o Centro de Referência Especializado de Assistência Social é o principal equipamento dos serviços prestados no âmbito da proteção social especial. Cabe ao Creas o desenvolvimento das ações do Serviço de Proteção e Atendimento Especializado a Famílias e Indivíduos, denominado pela sigla Paefi. Este estudo busca apresentar elementos sobre a atual estrutura dos Creas da capital do estado de São Paulo e sobre as características das equipes. O Paefi tem como característica principal o atendimento a famílias e indivíduos em situação de risco e vulnerabilidade por violação de direitos. Para desenvolver suas ações, o assistente social se encontra envolto por desafios no âmbito da política de assistência social e no sistema de garantia de direitos como um todo. Além dos desafios na estrutura da política pública e suas articulações, existem desafios relacionados especificamente à prática profissional do assistente social neste contexto. Na tentativa de responder à pergunta original, a pesquisa aqui apresentada foi desenvolvida com profissionais que trabalham e já trabalharam no Paefi e com profissionais envolvidos com a proposta de educação permanente dos trabalhadores do Suas. Assim, os sujeitos e o percurso da pesquisa foram definidos a partir do entendimento de que o profissional possui potencial de refletir e construir conhecimento em seu cotidiano quando estabelecidas as necessárias mediações

Research has indicated that offering support and services for people who experience mental health problems and their families is a complex and contested area. Despite the controversies surrounding therapeutic interventions with families, it has now been recognised that relatives and other supporters of people with mental health problems should be included in their care. Whole- family interventions and partnership working with carers and families is now central to secondary care UK mental health policies and clinical practice guidelines. However, for many families/ carers this remains an aspiration rather than a reality. The way in which we successfully developed family focused mental health practice, as well as specialist family interventions (FI) for people who have been given a diagnosis of psychosis, has therefore aroused considerable interest. The Somerset Partnership NHS Foundation Trust has adopted a Strategy to Enhance Working Partnerships with Carers and Families, developed best practice guidance and has established two complementary workforce development projects - the development of specialist family intervention services and the widespread training of mental health staff to create a ‘triangle of care’ with service users and their families. This has resulted in widespread adoption of systemically informed, ‘whole-family’ practice. In response to the widespread difficulties experienced following other staff- training initiatives we developed specialist family interventions (FI) services by means of an innovative one-year course delivered in partnership with Plymouth University. This training initiative has been widely acknowledged for its novel integration of psycho-educational and systemic approaches and the effective in-situ, multi-disciplinary service development model. An advantage of this approach is that by the end of the course a local FI Service has been established and staff experience fewer difficulties in applying their new skills than people trained in other programmes. We then ensure the continued development of clinical skills by means of a service structure that emphasises on-going supervision. Regular audits of the service and in-depth research studies clearly indicate that the service is effective and highly valued by users. Our ‘cognitive-interactional’ approach, which integrates systemic therapy with psychosocial interventions (individual- and family-CBT) within a collaborative therapeutic relationship, enables us to meet the needs of families in a flexible, tailored manner. The FI teams are able to deliver early interventions for people with first episode psychosis, as well as meeting the NICE guidelines for people with longstanding symptoms. Recognising that many families do not require formal family interventions/ therapy, we also have been designing ‘stepped-care’ family intervention services. We have developed, and extensively evaluated, short training packages to enhance working partnerships with families throughout our mental health services. We have used this three-day package to train a range of community and inpatient teams. We have also encouraged family- inclusive practice with the establishment of a trustwide steering group, practice guidelines and the establishment of ‘family liaison’ posts to facilitate family meetings on inpatient units, as part of the assessment process. Both training initiatives explicitly focus on developing systemic thinking, by integrating CBT and systemic therapy. The involvement of families/ carers in the design and delivery of both training initiatives is also crucial.