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Journal of Human Growth and Development
versión impresa ISSN 0104-1282
Rev. bras. crescimento desenvolv. hum. vol.22 no.3 São Paulo 2012
ORIGINAL RESEARCH
Methodological routes to apprehend universes of adolescents and youngsters: a focus on the drug issue*
Paulo Estevão Pereira; Ana Paula Serrata MalfitanoII
IOccupational Therapist, Public Health Expert with emphasis in Mental Health - Universidade Estadual de Campinas (UNICAMP), MsC in Occupational Therapy from Occupational Therapy Post graduation Program of the Universidade Federal de São Carlos (UFSCar), CAPES-ReUni fellow
IIOccupational Therapist, PhD in Public Health - Universidade de Paulo (USP), Associate Professor - Department of Occupational Therapy; Occupational Therapy Post graduation Program at the Universidade Federal de Carlos (UFSCar)
ABSTRACT
INTRODUCTION: the drug issue has been gaining importance especially with respect to deprived youths, identified as very vulnerable to this matter. However, actions proposed, mostly by health services, have not been able to meet the specific demands of this population, leading to low adherence to services. It turns out that the application of research methodologies based only on clinical, statistical and/or epidemiological data, in the study of poor youths, is not enough to apprehend the diverse social contexts, their singular experiences, either their understanding of these phenomena, requiring most appropriate methods.
OBJECTIVE: discuss the use of participatory research methodologies to apprehend youth universes.
METHODS: data from a qualitative research among poor youngsters who attend a Youth Center ("Centro da Juventude") in a midsize city of the State of Sao Paulo were used, applying the following methodological resources: participatory observation for nine months; interviews with nine youngsters - young men and women, aged 15 to 29; and workshops on the research themes. The contributions of Social Occupational Therapy were the theoretical framework for this study.
RESULTS: the application of participatory methodologies to apprehend people's universes allowed for the access of contents and meanings about their perceptions on drugs.
DISCUSSION: The theme of drugs and its insertion in the lives of these deprived youngsters emerged full of nuances not yet perceived or accessed by health services. Therefore, it is worth considering the necessity to apprehend the youth experience in an expanded perspective, if these issues are to be faced.
Key words: adolescent; occupational therapy; qualitative research; methods.
INTRODUCTION
The concept of youth is the result of a social construction1,2,3 and, therefore, subject to stereotypes and specific historical moments, defined from multiple references and determined based on different and diverse situations such as gender, ethnies or group1.
Such diversity of views over this segment of the population leads to multiple proposals to limit and classify it, either by age group (in Brazil ranging from 15 to 29 years old4), psychological or biological aspects (maturity/immaturity), socioeconomic criteria (average income, schooling, paternity, maternity, rural or urban environment, and financial independence), or state of mind, lifestyle or cultural segment2.
This multiplicity of approaches to the same population group reinforces the dynamic condition of permanent evolution / involution of youth as a concept3, which cannot be thought of as a temporal and ahistorical continuum5. Furthermore, there is the reflection on the complexity and intensity of the social issues raised by this segment of the population, which has held the hopes for a better future, as well as the responsibility for society's diversions6.
From this perspective, the juvenile experience should be addressed under two main aspects: the youth condition and the social situation of youngsters7, 3. The first aspect, as a sociological and anthropological category, refers to youth's particular values and culture; while the second, remits to the ways the subjects experience their youth condition at a given space and time3.
Thus, there are different ways of experiencing youth depending on social, historical and economic contexts; gender; social class; ethnie; place of residence (rural or urban, downtown or in the outskirts); etc. Although the youth condition could be somehow defined, the situation of being young requires the pluralization3 of discourses and actions, so that one does not take the risk of generating "blind spots" when approaching this universe. Hence, the matter of youth and youngsters, with all its dilemmas, has come up as a social issue8 that should be assisted by public policies in the past years.
From this point of view, it is possible to observe that the young in our society, especially those coming from the lower classes, have taken on a risk group discourse, as a challenge to social integrity. If, by one side, they are charged as the "nation's future"2; at the same time, within the logic of the salaried society and the increase of the vulnerability zone due to social precariousness8, they are deprived of material and cultural assets, as well as of quality work and education, generating a huge mass of segregated people8, with all the problems arising from this condition.
A "schizophrenic discourse"5 around youth is then created, generating a series of uncertainties and contributing to an increase of the vulnerabilities that youngsters are subjected.
Within the contemporary scenario, youngsters living in precarious areas of cities, with no access to culture and leisure, fewer interchange possibilities, parted from social institutions and consumer goods in a consumerist society, end up finding shelter and belonging in other so called marginal (or marginalized) social structures, developing sociability and life production and reproduction ways that reinforce an imaginary social that looks down on them.
If the phenomenon of drug addiction is added to the youth category, the burden placed on deprived youngsters increases considerably, since the association between poverty and drugs is seen as almost "natural" in the imaginary social. In response to such questions, society has been interfering through its institutions, normally through health institutions, tending to medicalize the objects of their assistance9, 10, 11.
The Ministry of Health, in a document where the National Policy for Integral Assistance to Users of Alcohol and other Drugs was instituted, considers the issue of drug addiction as a public health problem and takes on the institutional and civil society actions concerning the matter12. Regarding assistance provision, the document establishes a line with the Policy of Mental Health in force, regulated and supported by Law # 10,216, sanctioned on Apr 6, 200112, based on the Centers for Psychosocial Assistance ('CAPS'), linked to the mental health assistance network and the rest of the health network, functioning under the logic of the territory and seeking to consider the needs and demands of the clientele12.
However, it is necessary to discuss, beyond the construction of an assistance network, the elements that surround the issue and their social complexity, in the involvement of the daily life aspects of such groups. In this sense, studies have indicated that health services do not provide appropriate assistance to the young or are not prepared to assist them accordingly13, 14, 15. Thus, there is the need to create specific planning and discussion scopes for them, in order to guarantee and respect their specificities15. In the context of Psychiatric Reform, assistance guidelines and strategies elaborated according to a more general view of the theme end up hindering the consideration of their particular demands15. From this perspective, studies indicate that the Centers for Psychosocial Assistance ('CAPS') in the country still do not address the youth issue differentially, not taking into account the specificities of this population13.
The literature shows that, regarding the young population of psychoactive substances users, the adherence rate to the treatments offered is lower than that among users in general 14, 16 and that such fact can be explained both by factors related to the juvenile dynamics itself, since they seldom seek help on their own and hardly associate their problems to the use of substances, as well as by the inadequacy and unpreparedness of services in assisting this specific population14. It is worth adding the fact that there is a superficial thought on the drug use dynamics of this population, based on attempts to explain the situation contextualized only in the clinical scope, which, although necessary, move away from the many social aspects that go along with the use of drugs by youngsters contemporaneously.
The predominance of the "disease model" in the treatments developed can lead to excessive emphasis on the addiction issue at the expense of the "unconscious motivation of subjects, as well as on the social milieu role on addiction installation"17. It is also worth noticing that the focus of attention lies strongly on the picture of the young as a "social problem", blaming them for the social demands imposed on themselves15.
From this point of view, there is the discussion that, in order to provide answers to contemporary social problems, such as the drugs phenomenon, both the clinical resources as well as the production of epidemiologic data are not enough3, 13. New social technologies need to be used so that the theme is embraced in an extended way, in all its complexity, including the development of social technologies that enable the listening of the target population about itself and its relation with drugs.
Nevertheless, to actually approach the youth universe and be truly able to listen to youngsters' perspectives requires changes in the way to interact with this universe and its actors. Discourses constructed "about" them must be abandoned and a new one, "with" them, must be built. A second aspect to be considered is in the very nature of the drug issue, marked by prohibitions (concealed or explicit), target of discourses from varied nuances, which have encouraged academic, political and civil societal discussions.
Due to the complexity of the theme, the use of participatory methodologies is needed, as well as the establishment of new bonds between researchers and actors, building a more democratic interaction from the standpoint of knowledge, requiring the researcher to abandon the position of established knowledge and be willing to learn and learn the reality from the viewpoint of others, planning strategies that are fundamental to address issues as the ones proposed herein.
As an aid to such challenges, there is the need to rely on Social Occupational Therapy assumptions, which insofar seek to act directly on the social area18,19, try to understand the social interaction that act on the subjects, determining several forms and intensities of dissolution of bonds, vulnerability of social networks and underemployment20, in order to empower the subjects and lead them to appropriate their reality, finding ways to transform it and becoming co-responsible for the necessary social changes.
Under this perspective, the actions of Occupational Therapy in the social field aim at the subjects' autonomy and citizenship, through the intervention in their everyday lives, trying to promote changes18 that are always contextualized in the limits of this highly uneven reality. To this end, the complexity of social relations must be understood from the interpretation of their actors, identifying and recognizing the singular experiences of such actors, as well as the representations they make of these experiences19.
METHODS
A qualitative survey was carried out with youngsters between 15 and 29 years old, who lived in the outskirts of a medium-sized city in the interior of the State of Sao Paulo and attended a municipal Youth Center (CJ) for the development of actions connected to the culture, leisure and sports. This territory, regarded not only geographically, but also for its historical constitution and the socioeconomic and cultural relations developed therein21, was chosen based on a research strategy that sought a greater diversity of subjects with respect to the drug issue, avoiding side views from the health approach (like the Centers for Psychological Assistance for Users of Alcohol and other Drugs - CAPS-AD) and the justice (adolescents serving social-educational time or in educational institutions due to offense).
The participation in the survey field was made possible through the insertion in the activities developed in the region since 2005 by the 'UFSCar Center - METUIA Project', an institutional research group with actions in Social Educational Therapy that combines students, technicians and researchers linked to the University of Sao Paulo (USP) and the Federal University of Sao Carlos (UFSCar)22.
Thus, based on the theoretical framework of Social Occupational Therapy, the methodological resources utilized to assess the subjects studied were the following: participatory observation for a time period of 8 months, twice a week, by means of the accompaniment of community activity workshops; writing of field diaries during the process; semi-conducted interviews with the youngsters; and workshops of activities, structured by theme (identity, daily life and drugs).
The main aspect of participatory observation is the fact that researchers "plunge headlong"23 in the field and, both observe from the perspective of members and influence what is observed because of their participation on spot. Favoring researchers with more time in contact with the people and contexts observed, enables the development of the research as a process adjusted according to the manifestations of the field itself, allowing researchers more methodological flexibility and appropriability in conducting it23.
During the interactions, personal observations and perceptions were field diarized; these diaries provided an important thinking source and became the basis for interpretation.
However, not all study field phenomena can be observed, so that participatory observation itself does not favor the assimilation of biographic processes and events that seldom occur23. Therefore, it is important to add interviews with participants to the observation in order to learn reality aspects that may be available through the subjects' verbal reports23.
To this end, semi-conducted interviews were proposed together with nine youngsters - seven female and two male, average aged 17 - during the observation period. The set of interviews, sequentially conducted with a guiding of addressed issues, was composed based on the issues gathered by the bibliographic review carried out on the theme of deprived youth and drug use; these interviews sought to address the topics inherent to the youngsters living in the outskirts, their everyday life, the way drugs appear to them day-to-day, and their perception of the phenomenon.
All ethical aspects regarding research procedures were satisfied, so that the interviewees had their responses privacy guaranteed, preserving their identities, access to the information concerning the study, and making it explicit to the participants their total control with respect to their participation, or not, in the survey. Once the youngsters agreed to take part in the survey, they received and signed a Statement of Free and Informed Consent.
In order to obtain a more comprehensive perspective of the theme studied, data were collected at the Activity Workshops, which were realized as spaces of experimentation, learning and free expression, where participants are perceived as active beings of their self-construction processes, allowing for democratic and egalitarian experiences with other subjects24.
Within the perspective of Occupational Therapy, the grassroots of this study's researchers, human activities are the centralizing element of professional practices, precisely for the daily life organizing and structuring characteristic played by those activities25.
Having said that, when addressing the research issues by means of the youngsters' "doing" (supplementing what was assessed through their "saying"), it is possible to seek the learning of the perceptions and concepts of participants in face of the themes proposed (juvenile identity, daily life in the outskirts, and drug use), aiming to approach their view of their own experiences.
RESULTS
The composition of the research data through this system of methodological resources, all based on active interaction and participation, both of subjects and researchers, allowed for the construction of the universe scenario where those youngsters and the several ways through which the drugs theme appears in their daily life are inserted. Quantitative data, although of great importance to indicate general events, are insufficient to collect the nuances and singularities of daily experience. Therefore, actions directed to the young public, based on clinical, statistic and epidemiological data, most of the time, cannot access this population's specificities, especially concerning youngsters from deprived classes3.
Thus, the drugs phenomenon, with respect to both the use as well as the dealing, constantly appears, full of ambiguities, in the lives of these youngsters. The theme is present in the relations of friendship and kinship, the community's modes of organization, and behavior codes adopted and reaffirmed daily. Such aspects would hardly be accessed without the presence in the territory and the contact with youngsters through a horizontal and close relation, learning the matter from their view. Aspects that comprise the complex relation between the drugs phenomenon and the daily life of poor youngsters cannot be apprehended from therapeutic and institutional settings or by means of more direct or directive methodologies.
J. - Oh, I see it all the time, children like that, already...smoking...drinking, doing the wrong stuff, but... it ain't coming out of the blue, right? 'Cause they offer it and guys don't hide to smoke, it's out there, in front of everyone... Some kids see it 'n' they wanna do the same. Then, they keep at it; they keep at it till...
Question - And do you see this in the places you go to, closer to your home, how is it?
J. - Closer to home. There's places that sell it. Especially in my aunt's house. There's lots of kids at home. Then I wonder about their future, right? They live there! So...
J., male, 16 years old
Living together with the theme of drugs, in the families or at their front doors, evinces the vulnerability level to which those youngsters are exposed. However, the representations that this living together assumes to the subjects are many times ambiguous, going beyond moral judgment. Let's see what J. says about it.
Question - How do you fell about that [your uncles selling drugs]?
J. - Uh, I don't think that's nice 'cause... it's a risk to them, ain't it? They've got three sons that were arrested. But they don't think about it at the time and everyone... Know somethin', once you're there [doing time] and get out, then want come back, and then it's too late, ain't it? We don't say nothing, though, 'cause it ain't no use. So...
This youngster's concerns are not with his relatives' activities for themselves, but indeed with the consequences of these activities. Some relation with the theme can be perceived from the speech as a "choice of life", respected, although not having the youngster's consent. This is an important nuance to be highlighted.
The researchers' presence in the territory and the daily interaction with the youngsters allowed for the assessment of the practical explanations they use to justify or make intelligible, to themselves and the others, the presence of drug dealing and use in their day-to-day lives. The access to the explanations, although limited to the single experiences of the youngsters studied, enables the understanding of the issue from a different perspective.
There's that, too, that's it. Can't find no job, then ya get desperate and say: "No way, I gotta do somethin'! I'm gonna push drugs! Can I sell some for you?" Then the guy say: "Here you go, man! Take it!" Then the guy push it, and make 100 bucks a day or two! And it's cool, it's cool, and you begin to buy things, clothes... And say: "I'm sharp! Guys respect me! "'Cause of the drugs. And so on! Go on till the top! And then, it's tough!
C., male, 22 years old
Question - Why do you think people choose this kind of job?
G. - [Silence] 'Cause it's the easiest way to make money, isn't it? Easy! They choose the easiest way, right? Easier than studying, working all day long [pause]. Get the money right away, there, right? That's it!
G., female, 17 years old
Question - Why do you think people choose this kind of job?
F. - No way man, some got no choice, right? But there's others that, it's easy money, they see it's easy... "Oh, no! Just today!" Then they get used to it, don't wanna leave no more! Then, it's too late!
Question - So, there are no opportunities?
F. - Not everyone! Some guys have opportunities, got a good Mom, a working Dad, but they wanna live this life!
F., male, 15 years old
These statements coexist in these youngsters' relational universe; expressing ways through which the subjects seek explanations for themselves and their realities.
The immersion in the research universe allowed for the apprehension of the community's modes of operation and behavior codes that structure the lives of those people. It has enabled to understand how sociability is established and how subjectivities are built in that social space. Two excerpts from the field diaries illustrate such idea.
Accompanied by the 'METUIA' trainees and C., a neighboring resident, we have started an incursion through the neighborhood to analyze the territory. C. is our guide. He introduces us to the environment, the problems they face and the community's modes of operation. Discretely, he points at someone and explains, carefully, that 'that person and others' are responsible for keeping the order in the neighborhood. ''Cause here we can't call the cops', he says. 'Those guys solve the problems here'.
Field Diary, Jul 23, 2010
This is the third visit to the Youth Center ('C.J.'), since the closing of the activities of the 'METUIA's group on Nov 25; it is an attempt to contact some of the youngsters that we have interviewed, partly to solve the matters suggested on field, partly to see them. However, the youngsters have not been coming to the Youth Center for about a month, according to the Center's staff. I have arranged with the Center's coordination to help them disseminate the opening of a Young and Adult Education ('EJA') class, for Sixth Grade students, at the Youth Center, through a "face-to-face" incursion in the neighborhood. The plan was to hand out leaflets to people in the streets and door-to-door, as well as to post signs in places of large circulation and concentration of people. I thought of taking the chance of this incursion together with the Center's staff members to make contact with the youngsters. We got together in front of the Youth Center, divided the material and walked down [the neighborhood]. I was surprised with the misgiving of the staff members while walking down the neighborhood. I thought that, since they knew and were known by the residents, especially by the young, their walking around would happen more "naturally". On the contrary, the coordinator decided that we would only course the streets at the beginning of the neighborhood, and would not go down to the center area. Along this way, we were able to observe "activities" of drug dealing. At 8AM, we identified people "dealing" close to a car. Some "caves" ("biqueiras") [drug selling spots] were already operating. The direct approach to the residents, as objectively as possible, was the strategy adopted, handing out the leaflets while explaining the reason of our visit. Nobody walks around the place for no reason. As we walked around, the streets, at the beginning with few people, began to receive more people, mostly the young. At every corner we passed by, the residents started to crowd, "checking out" our presence, "dominating" the territory. The young would cluster; some would call out each other's names and then say expressions like "Here we are! Here we are!"
Field Diary, Feb 3, 2011
Another nuance evinced in this process refers to the limits established between those who are members of the community and those who are not. What can be said and what interests only to those belonging to that place. Although we have accessed important content on this universe, a lot of information was concealed, because we do not belong in that context. It is, doubtless, a limitation of this research, but it is explained and justified by the methodological choices we have made.
R. - So, we see things, so, 'cause we see things, so, we can't say nothing. Can't say nothing! So, there's somethin' I learned, my Old Man always tell me, if you see somethin' wrong, you don't say nothing! Make believe you saw nothing! So, I mean, down there [in the neighborhood] I know everybody, I know the guys that deal with that stuff, know everyone there, so, they respect me, I respect them, so, that's my living.
Question - Why did your father advise you not to say anything in case you saw something?
R. - My Old Man don't want me...I mean, want no bad to no one, want no bad to my mates, nor to me neither, sure? 'Cause there's guys starting, but that's it, you say a wink wrong, you're screwing yourself. So, think twice 'fore you open your big mouth.
R., male, 24 years old
Nevertheless, beyond the issues raised and the relationships established with and through the theme of drugs, other youngsters' concerns could be evidenced, indicating necessities that are often not noticed by the public policies directed to them.
Question - How do you picture your future?
C. - I worry, 'cause it's hard to get a job. I'm gonna be 23 now. So, I wish I was 21 and wasn't living with my Mom anymore. It's alright to live with Mother, but with my wife too, and so... It's no good, right? I've got a little experience. I worked; I did some "moonlighting" ("bico") in lots of places. Every time there's "moonlighting" I take it. Already worked with [installation of] pools, hodman [for mason], butcher 'n' in brickworks. Lots of places, we send resumes to the market, stuff like that, but people don't..."
C., male, 22 years old
G. - I wanna go to college! I don't know what to study yet, I'm still thinking, but I like it, I wanna go to college, that's for sure! Study more! Have a better future!
G., female, 17 years old
The youngsters interviewed presented varied perspectives with respect to future projects, about what the future will bring to their lives. They face, daily, the difficulties of integration to the labor market, suffer the stigma linked to the areas where they live and experience being young within a deprived social condition, exposed to the vulnerabilities intrinsic to this condition.
Two youngsters with different future perspectives and, somehow, present perspectives, were aforementioned.
C. : 22 years old (bound to be 23!); little schooling (he has completed Sixth grade). He at the age that, especially for poor youngsters, he is expected to be integrated in the formal labor market, but whose insertion possibilities are becoming more restrict to certain positions, little qualified; he ends up living on the edge between the two realities. He longs for a position in society through a job that would allow him not only to reproduce life, but also to produce in other ways, so that he could build his future; but this seems increasingly distant along time. In the meantime, he lives with the seduction of drug dealing, more inclusive and profitable. So far, C. has been equilibrating in this interstice, this neutral zone between the two places. For how long, though?
Following, there is G., 17 years old. She works days at a public institution and studies nights. She is a senior at High School. She dreams of going to college and getting a degree, but still does not know what to major in, but it is the future she wants for herself. She sees education as a possibility for a brighter future.
G. represents another form of sociability, guided by working and studying, aiming at the construction of a life project that would guarantee a differentiated social insertion. In her neighborhood, she is in familiar terms with the drug issue, just as the other youngsters resident in the outskirts of the city. She has her "gang" that, as she says, "it's calmer than the others", they have fun going to pizza parlors, talking in the square, going out once in a while. Her daily life is structured around her job and school, with weekends free, when she prefers to stay at home.
Unlike C., the uncertainty about her future resides in the possibility to choose the career she likes best, that it is personally and professionally satisfactory. The uncertainty lies on the existence of options, not on their shortage or lack, as in C.'s case. She has got the possibility to think about what she will do in the future, while C. must hold on to whatever shows up. Faced with the uncertainties inherent to tomorrow, they are more uncertain for some than for others.
The use of participatory methodologies in the apprehension of the universe of the studied subjects allowed for the assessment of other contents, linked to the daily life of those young men and women.
There is a remarkable difference between addressing deprived youngsters as if they comprised a single homogeneous category, and approaching them as from their singularities. Each juvenile group has specificities that need to be considered when proposing actions that intend to be effective.
Being a poor youngster in the outskirts of a metropolis is certainly different from the same situation in a country city. The sociabilities are distinct; the vulnerabilities may be presented in several manners. It is evident that diversities, in order to be considered and apprehended, require more participatory access methodologies, such as those presented in this article.
The researchers' presence in the territory of the youngsters studied, with the purpose of sharing interactions in the context (or in part of it) where they are inserted, has allowed for an expanded analysis over the drugs issue with respect to those young men and women. Being with them, looking around as from their view; actually listening to them, trying not to make use of preconceived notions; trying to favor the creation of an expression space free of perceptions, by means of activities, all that has made all the difference for a more comprehensive view of that universe and how to approach it.
Rather than what the official statistical figures indicate, the programs to combat drugs, the media, the public opinion, in short, the drug issue, although strongly present in the day-to-day of the youngsters studied, is not the main problem of their lives. Other matters, underlying the theme of drugs, are revealed from the interactions with the youngsters in their universe. The horizontal analysis of the object studied (yes, object, but not objectified, reified), besides enhancing the understanding of the theme, for it was built jointly, favors the proposition of actions and public policies that can, in fact, access the population they are directed.
Thus, the drug issue and its insertion in the daily lives of the youngsters studied appears, in the researchers' view, full of nuances not perceived or assessed by the public policies regarding the theme. Issues related to those youngsters' daily lives, beyond the drugs theme, emerge from the data collected, leading to consider, in accordance with the literature, the need to apprehend the juvenile experience from an extended perspective, if this universe is to be addressed effectively.
Finally, there is the necessity for a real approximation, living together and understanding of these subjects through interventions and researches directed to the youth, so that a horizontal, respectful and effective relation with contributions to contemporaneity could actually occur.
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Corresponding author:
estevao.paulo@gmail.com
Manuscript submitted Jan 20 2012
Accepted for publication Aug 10 2012
* This research was supported by the Coordination for Improvement of Higher Education Personnel - CAPES, through the Restructuring and Expansion Program of Federal Universities (ReUni).