Introdução: Residências Terapêuticas ou Serviços Residenciais Terapêuticos são moradias inseridas preferencialmente na comunidade, com a finalidade cuidar de pessoas que passaram longos anos asiladas em hospitais psiquiátricos. As diferentes formas de morar são estruturadas no cotidiano de todo homem e é na vida cotidiana que o homem participa com toda a sua individualidade e personalidade. Do ponto de vista de estrutura social, é no desenvolvimento das habilidades do cotidiano que o homem firma-se enquanto ser social amadurecido. Assim, questiona-se de que forma os moradores de um Serviço Residencial Terapêutico apropriam-se de seu processo de morar e de seu cotidiano. Objetivo: analisar o processo de morar e o cotidiano dos moradores de um Serviço Residencial Terapêutico. Método: trata-se de um estudo de caso, com abordagem qualitativa. O referencial teórico que norteou este estudo foi a Teoria do Cotidiano e a Reabilitação Psicossocial. Utilizou-se como técnica de coleta de dados a entrevista semiestruturada e a observação participante. Foram sujeitos deste estudo, seis moradores de um serviço residencial terapêutico do município de São Paulo, que aceitaram participar e assinaram o Termo de Consentimento. Os dados foram analisados pela técnica de análise temática, considerando os aspectos históricos e sociais em que foram coletados. Os resultados evidenciaram: a caracterização sóciodemográfica dos moradores; os hábitos de vida e a percepção do morador em relação ao morar no Serviço Residencial Terapêutico; sua compreensão do processo saúde-doença; a reabilitação psicossocial e a vida cotidiana. Os moradores apropriaram-se de seus cotidianos, sendo que estes últimos, em alguns momentos os cotidianos ficaram alienados e foram utilizados mecanismos para superá-los. São necessárias estratégias constantes, para gestores profissionais, a fim de tornar o morar e o cotidiano destes moradores possível, entretanto, urge que o homem social (profissionais, gestores, moradores, comunidade) destrua em si, as amarras manicomiais que foram histórica e socialmente instituídas. / Introduction: Therapeutic Houses or Homecare Therapeutic Services are houses preferentially located into the community, aiming the care of people who stayed sheltered in psychiatric hospitals for many years. The different ways of living are structured in daily life of all persons. Men attend the daily life with all their individuality and personality. In the social structure point of view, men are firmed as a matured social being during the skills development of daily life. Thus, we ask how residents of a Homecare Therapeutic Service have been appropriated of their living process and daily life. Objective: to assess living process and daily life of people residing in a Homecare Therapeutic Service. Method: this is a case study with qualitative approach. Theoretical framework, which has guided this study, was the Theory of Daily life and Psychosocial Rehabilitation. Semi-structured interview and participant observation were used as data gathering method. Six residents of a Homecare Therapeutic Service located in Sao Paulo were subjects of this investigation, having agreed to participate of this research and signed the Free and Informed Consent Term. Data were analyzed through the thematic analysis technic, considering the historical and social contexts where data were gathered. The Research Ethical Committee approved this project, CAAE: 29721114.5.0000.5392. Results: data were grouped into the following empirical categories: sociodemographic characterization of Homecare Therapeutic Services residents; the narratives; the daily life features; and the daily life. The analysis highlighted that most of residents were female, with non-white skin, single, catholic, unemployed, without personal health insurance, and with unfinished basic school degree. Residents representations about facts of theirs lives showed that home is understood by most of them as the place where they live and get affects; where they are accept for everyone. Thematic sentences stand out that people have not only one concept of mental illness, being their daily life marked by manicomial precedents. Although residents tangibly aim their daily life, through the language, tools or uses and costumes, too many difficulties remains, including those that are relational; pragmatic, such as pay a bill; hierarchical as to decide what to do first; or, even when contradictorily, daily life is inducted to the alienation and to the overcoming for own health professionals, and also for residents. Conclusion: the Homecare Therapeutic Service is perceived as a place that may be habited for people who had manicomial experiences. However, professional actions and strategies need to be constantly rethought to avoid the replication of manicomial practices.

This research examined intersectoral relationships and community participation in policy processes across the mental health and housing sectors. The focus was on the development of suitable housing options for people with a psychiatric disability. The study period covered five years of mental health system reform in South Australia (2000-2005). The research found a shortage of housing and support options for people with psychiatric disability and lack of significant strategic policy coordination or ongoing cross-sectoral programmes. The problems faced by people in gaining access to housing and disability support services and the ways in which families provide housing or support in the absence of public services are documented. This case study used qualitative research methods which were triangulated across four stages: 1) a thematic analysis of national and state policies in the health, housing and disability sectors; 2) participant observation of NGO activity, a thematic analysis of NGO documents, and interviews and focus groups with NGOs; 3) interviews and focus groups with consumer and carer representatives and a thematic analysis of the minutes from state-level groups; 4) interviews with professionals from the health, housing and disability sectors The housing situation for people with psychiatric disability was explained in terms of a number of key issues in the policy environment; „X The overarching neo-liberal policy context synonymous with a decline in public housing resources and increasing tension between NGOs service provider and advocacy roles. „X The political nature of the local mental health policy context and lack of political commitment to ongoing resources. Broad community stigma reflected in the media and government, affecting ongoing political commitment to mental health and housing and the introduction and progress of housing ¡¥projects¡¦. „X The slow development of peak NGO and consumer organisations and alliances in South Australia which affected access to policy networks and contributed to the dominance of professional interests within policy processes. „X The separation of health, housing and disability policy and networks within and across levels of government. This was associated with bilateral agreements (between Australian and state governments) tied to resources within departments, the programme objectives and the goals of bureaucrats. „X The separation of policy networks by sector was also connected to the dominance of bio-medical discourses and interventions and associated professional interests in the health policy sector. Medical discourses on health and disability and ¡¥consumerist¡¦ discourses on participation also led to social determinants of health such as housing being overlooked within policy processes. „X Governance reform at a state level contributed to organisational instability within departments, causing some problems for cross-sectoral initiatives and protocols. Kingdon¡¦s (2003) multiple streams analysis of policy helped to explain what missed or reached political agendas within each policy sector of the case study. Kingdon predicts that the unity of policy networks is important for the realization of policy solutions, and the lack of unity in policy sectors was an obstacle to policy agendas on housing for people with a psychiatric disability. However, the way in which problems were being represented (Bacchi 1999) was also important to understanding this policy environment. For example, a medical discourse on disability (Fulcher 1989) tied to the health sector led to a narrow focus on clinical mental health services. Similarly, neo-liberal discourse (Dean 1999) supported private housing solutions and resources or NGOs advocating ¡¥within sectors¡¦ for the types of services they already provided or wished to provide. The case study suggested strategies for ¡¥policy change¡¦ need to address a number of factors across service delivery, policy and political realms. Firstly, better recognition is warranted of the difficulty experienced by many people with psychiatric disability in achieving stable housing, and the need for indicators on housing access and stability for this group. Secondly, processes to address stigma (particularly that perpetuated in the media) will be instrumental for policy change and political commitment. Thirdly, ongoing cross sectoral advocacy and alliances require development at both a national and state level and support by a political culture which encourages advocacy. Developing processes for working across sectors such as policy learning forums involving both experts and community groups could counter problems arising from professional culture and territories that were documented in this study. Finally, the cross-sectoral development of policy, programmes and accountability mechanisms and the stability of policy networks will be important to ensuring stable housing for people with psychiatric disability.

In general, people with severe psychiatric disability living in sheltered or supported housing lead passive, solitary lives. Current rehabilitative approaches often neglect considering an agentic perspective of the residents in sheltered or supported housing. Furthermore, the outreach and societal contexts are often not considered. Thus, practitioners tend to overlook the potential in providing support and rehabilitation that is adapted to their individual, collective and changing needs. My approach was to develop a model for Everyday Life Rehabilitation (ELR), which has a potential to promote agency while targeting recovery, meaningful daily occupations, social participation, and person-driven goals. We employed two occupational therapists (OT) and offered an intervention with ELR in a medium-sized municipality in northernSwedenand evaluated this intervention from the perspectives of residents and community care workers (CCW), using a combination of quantitative and qualitative methods. This thesis comprises four studies that focus on a home and community context, late rehabilitation efforts, daily occupations, and client-centredness. The overall aim is to understand and evaluate the impact of recovery- and occupation-oriented interventions in a home context for people with severe psychiatric disability. The study settings are sheltered and supported housing facilities. The first study (n=6) explores the significance of home for occupational transformations. The analysis reveals how residential conditions facilitate rehabilitative interactions, generating occupational transformations such as increasing social competence and taking charge of daily occupations. The second study evaluates occupation- and health-related outcomes of the ELR-intervention for residents (n=17). Pre-, post-, and follow-up differences in tests scores on goal attainment, occupation, and health-related factors indicate that important progress is made. The third study explores residents’ (n=16) narratives about occupational transformations in the context of everyday life and life history. Narrative analysis discloses stories of ‘rediscovering agency’, referring to occupational and identity transformations. The fourth study illuminates community care workers’ (n=21) experiences of collaborating with residents and OTs, using ELR. The CCW’ view on residents, rehabilitation, and the own role, along with organisational conditions in the housing facility, seem to characterise different outlooks influencing the CCWs responsiveness or resistance to the intervention. In conclusion, rehabilitation in a supported housing context appears paradoxical due to tensions between opposing values such as authentic versus artificial, and independence versus dependence. However, if residents are engaged in challenging these tensions, they can function as ‘progressive tensions’ generating change. Considering the personal and social meaning of home also appears to be valuable. The intervention studies on ELR, demonstrate its value for participants and indicates that a recovery approach applying ELR would promote shared perspectives among residents, CCWs, and OTs, while facilitating ‘agent-supported rehabilitation’ and ‘out-of-housing strategies’. The thesis provides initial support for the use of ELR-interventions and proposes continued research. / Vardagslivets Rehabilitering (Everyday Life Rehabilitation)

Introdução: Residências Terapêuticas ou Serviços Residenciais Terapêuticos são moradias inseridas preferencialmente na comunidade, com a finalidade cuidar de pessoas que passaram longos anos asiladas em hospitais psiquiátricos. As diferentes formas de morar são estruturadas no cotidiano de todo homem e é na vida cotidiana que o homem participa com toda a sua individualidade e personalidade. Do ponto de vista de estrutura social, é no desenvolvimento das habilidades do cotidiano que o homem firma-se enquanto ser social amadurecido. Assim, questiona-se de que forma os moradores de um Serviço Residencial Terapêutico apropriam-se de seu processo de morar e de seu cotidiano. Objetivo: analisar o processo de morar e o cotidiano dos moradores de um Serviço Residencial Terapêutico. Método: trata-se de um estudo de caso, com abordagem qualitativa. O referencial teórico que norteou este estudo foi a Teoria do Cotidiano e a Reabilitação Psicossocial. Utilizou-se como técnica de coleta de dados a entrevista semiestruturada e a observação participante. Foram sujeitos deste estudo, seis moradores de um serviço residencial terapêutico do município de São Paulo, que aceitaram participar e assinaram o Termo de Consentimento. Os dados foram analisados pela técnica de análise temática, considerando os aspectos históricos e sociais em que foram coletados. Os resultados evidenciaram: a caracterização sóciodemográfica dos moradores; os hábitos de vida e a percepção do morador em relação ao morar no Serviço Residencial Terapêutico; sua compreensão do processo saúde-doença; a reabilitação psicossocial e a vida cotidiana. Os moradores apropriaram-se de seus cotidianos, sendo que estes últimos, em alguns momentos os cotidianos ficaram alienados e foram utilizados mecanismos para superá-los. São necessárias estratégias constantes, para gestores profissionais, a fim de tornar o morar e o cotidiano destes moradores possível, entretanto, urge que o homem social (profissionais, gestores, moradores, comunidade) destrua em si, as amarras manicomiais que foram histórica e socialmente instituídas. / Introduction: Therapeutic Houses or Homecare Therapeutic Services are houses preferentially located into the community, aiming the care of people who stayed sheltered in psychiatric hospitals for many years. The different ways of living are structured in daily life of all persons. Men attend the daily life with all their individuality and personality. In the social structure point of view, men are firmed as a matured social being during the skills development of daily life. Thus, we ask how residents of a Homecare Therapeutic Service have been appropriated of their living process and daily life. Objective: to assess living process and daily life of people residing in a Homecare Therapeutic Service. Method: this is a case study with qualitative approach. Theoretical framework, which has guided this study, was the Theory of Daily life and Psychosocial Rehabilitation. Semi-structured interview and participant observation were used as data gathering method. Six residents of a Homecare Therapeutic Service located in Sao Paulo were subjects of this investigation, having agreed to participate of this research and signed the Free and Informed Consent Term. Data were analyzed through the thematic analysis technic, considering the historical and social contexts where data were gathered. The Research Ethical Committee approved this project, CAAE: 29721114.5.0000.5392. Results: data were grouped into the following empirical categories: sociodemographic characterization of Homecare Therapeutic Services residents; the narratives; the daily life features; and the daily life. The analysis highlighted that most of residents were female, with non-white skin, single, catholic, unemployed, without personal health insurance, and with unfinished basic school degree. Residents representations about facts of theirs lives showed that home is understood by most of them as the place where they live and get affects; where they are accept for everyone. Thematic sentences stand out that people have not only one concept of mental illness, being their daily life marked by manicomial precedents. Although residents tangibly aim their daily life, through the language, tools or uses and costumes, too many difficulties remains, including those that are relational; pragmatic, such as pay a bill; hierarchical as to decide what to do first; or, even when contradictorily, daily life is inducted to the alienation and to the overcoming for own health professionals, and also for residents. Conclusion: the Homecare Therapeutic Service is perceived as a place that may be habited for people who had manicomial experiences. However, professional actions and strategies need to be constantly rethought to avoid the replication of manicomial practices.

The topic of this diploma thesis is communication in adult clients with autism and its systematic support. The text itself consists of two main parts: theoretical and empirical. The theoretical part is further divided into four chapters which deal with the basic concepts of autism spectrum disorders and communication. In these chapters, autism spectrum disorders are analysed from the viewpoint of historical development, etiology, classification and symptomatology with regard to the manifestation of ASD in adulthood. The chapters which deal with the topic of communication first define communication as such and the important terms associated with it, and then describe the specific abnormalities that may occur in the communication of people with autism spectrum disorder. They also provide support options that can be used to communicate with people with ASD. The practical part is then conceived as a qualitative research whose main aim is to describe the communication of people with autism spectrum disorder, to show its specifics and to describe the intervention that was introduced in five individual subjects. In accordance with the main objective, partial objectives and research questions were set. The research part describes the environment in which the research took place and provides five case...

1 Abstract Thesis name: Persons with mental retardation and their quality of life in context of Social Services transformation. Purpose of this thesis is to describe process, history, progress and risks of transformation of Social Services in Czech Republic. Target of this thesis is not transformation of Social Sevices in Czech Republic generally but it is targeted on Nalžovický zámek organization, Social Services provider where transformation is in progress from 2013. In thesis I investigate how clients using supported housing perceive this service in context of quality of their life. My thesis includes theoretical base focused on mental retardation, social services, institutional care. Purpose of this thesis is not representative research or academic analysis of data. Used information are extract from professional literatury and Ministry of Labour and Social Affairs website. Main used method is narative interview. Thesis has six chapters. Results of my research are presented in chapter five and I consider this chapter as most important. Research shows clients of supported housing perceive this service in a very positive way and are satisfied. Feel this opportunity as a new way how to make quality of their life better.

Previous research shows that people with severe disabilities often are neglected in the work of enhancing user participation. It is shown that even though professionals increase the possibility for user participation in their work, it is not necessary that the users receive it. This study aims to show how professionals working for people with disabilities applies user participation in their everyday work. We used a qualitative exploratory method and interviewed ten social workers within service administration and supportive housing, located at three different municipalities in the region of Stockholm. Using Shier’s participation model in combination with theory of recognition we got similar results as previous research. The social workers have a great intention in enhancing user’s participation in their work, though organizational structures stand in their way. That drives them to use what is known as “silent knowledge”, a combination of their personality, previous experience and their ingenuity.

In this licentiate thesis studies how a systematic work of implementing a supported housing develops from idea to practice with the purpose to analyze collaboration and its impact on the development of the implementation. The study followed how the four organizations created a collaboration to implement a supported housing.; the social services in Kalmar municipality, the Swedish Prison and Probation Service in the form of the local probation service in Kalmar, the association KRIS (Kriminellas Revansch I Samhället, [Criminals' Revenge In Society]) in Kalmar and Kalmarhem AB a housing company,  The starting point for the study consists of a process evaluation of an implementation process, how collaboration established between the organizations, how collaboration as a way of working affects the process and finally the split-up of the project. The study conducted in two parts: partly during the years 2006-2008 when implementation studied, partly during the years 2014-2015 when the split-up of the project studied. The methods used was interviews, participatory observations and document studies. The empirical evidence collected during the two periods forms the basis for the analysis. The results indicate that collaboration created between the actors of the implementation is of crucial importance. That is, how the actors confronted and solved the problems that arose during the implementation and that both time and various forms of resources are required to create a comprehensive collaboration.  The concluding part of the study describes how a split-up of collaboration takes place. The change can attributed to a new arrangement with clear operational management in accordance with the impact of New Public Management [NPM]. A consequence for the supported housing, in line with this logic, was a separation and division of clients and contractors and division between businesses in accordance with a competitive mindset. At the time of writing, the supported housing remains, albeit in a different form. One explanation is that during the implementation, a close and sustainable collaboration was developed that could withstand some of the threats created through changed forms of governance. This indicates that the collaboration that developed between the four organizations can still provide some space if it is able to find forms that can fit into new control logics.

Det har skett en stor utveckling av vården med betydande förändringar för personer som har en psykiatrisk diagnos och funktionsnedsättning. Socialtjänstlagen och Lagen om stöd till vissa funktionshindrade har stiftats och boenden har iordningställts för att möta individuella behov. Förekomst av hot och våld är ett ökande problem inom arbetslivet och tidigare forskning visar att sjuksköterskor är särskilt utsatta. Det finns lite fokus på hot/våldsperspektivet inom kommunala verksamheter och sjuksköterskans roll i detta, varpå denna studie förlagts dit. Syftet var att beskriva sjuksköterskors uppfattning om och erfarenhet av att förebygga hot och våld inom socialpsykiatrin. En kvalitativ intervjustudie genomfördes. Med ändamålsenligt urvalsförfarande intervjuades sju sjuksköterskor som var verksamma vid stödboenden i tre kommuner. En kvalitativ dataanalys genomfördes och resulterade i fyra kategorier. Resultatet visade att relationen utgör grunden för det komplexa förebyggande arbetet och att rätt kompetens underlättar förståelsen för detta. Det fanns en förväntan av att sjuksköterskan har en central roll med motstånd. Sjuksköterskan hade lite utrymme till det förebyggande arbetet på grund av sin breda otydliga roll inom socialpsykiatrin. Slutsatser som drogs är att det finns förbättringspotential i det förebyggande arbetet. Det handlade främst om att tillgodose rätt kompetens samt att utarbeta gemensamma riktlinjer för det förebyggande arbetet.