From an ethical and political commitment to the design of a professional occupational therapy project: a debate necessary for social assistance work

Abstract

Occupational therapists compose technical teams in social assistance services before the formalization of their insertion in the Unified Social Assistance System (SUAS), which occurred in 2011. As a result, the discussion about the work in this sector and the social question has gained relevance in the profession from an interventional and theoretical-academic point of view. In this study, from a Marxist perspective, we reflect on how the social question determines the demands observed in social assistance work. Next, we present the concepts of societal projects - understood as collective projects that express class intentions for society, and of professional projects - defined as collective projects related to professions composed of ethical and political principles, which are theoretical and methodological references for professional practice, and that establish bases for their relationships with service users, other professions, and organizations and institutions. We conclude by proposing that social occupational therapy is a theoretical and methodological framework that can be adopted to construct a critical-transformative professional project: critical of the structure and dynamics of capitalist society that continually replace the expressions of the social question, touching the everyday life of subjects; critical of the neoliberal model of State management that weakens rights and makes people’s lives precarious; critical of the conservative trends of work in social assistance that individualize, medicalize, psychologize, and moralize the reading of problems presented as professional demands; critical of the role and social function of occupational therapy in its relationship with society, breaking with a technical and supposedly neutral view of the profession.

Keywords:
Occupational Therapy/Trends; Social Services; Projects; Professional Practice

Resumo

Terapeutas ocupacionais compõem as equipes técnicas da assistência social anteriormente à formalização de sua inserção no Sistema Único de Assistência Social (SUAS), ocorrida em 2011. Com isso, a discussão sobre o trabalho nesse setor e sobre a questão social ganhou relevância na profissão do ponto de vista interventivo e teórico-acadêmico. Neste estudo, refletimos, a partir da perspectiva marxista, sobre a forma como a questão social determina as demandas que requisitam o trabalho na assistência social. Em seguida, apresentamos as concepções de projetos societários - entendidos como projetos coletivos que expressam intencionalidades de classe para a sociedade, e de projetos profissionais - definidos como projetos coletivos relacionados às profissões, constituídos de princípios éticos e políticos, que são referenciais teórico-metodológicos para o exercício profissional e que estabelecem bases para suas relações com os usuários dos serviços, com outras profissões e com organizações e instituições. Finalizamos propondo que a terapia ocupacional social é um referencial teórico-metodológico que pode ser adotado para construir um projeto profissional crítico-transformador: crítico à estrutura e à dinâmica da sociedade capitalista que repõem continuamente as expressões da questão social, tangenciando os cotidianos dos sujeitos; ao modelo neoliberal de gestão do Estado que fragiliza os direitos e precariza a vida das pessoas; às tendências conservadoras do trabalho na assistência social que individualizam, medicalizam, psicologizam e moralizam a leitura das problemáticas que se apresentam como demandas profissionais; e ao papel e função social da terapia ocupacional na sua relação com a sociedade, rompendo com uma visão tecnicista e pretensamente neutra da profissão.

Palavras-chave:
Terapia Ocupacional/Tendências; Assistência Social; Projetos; Prática Profissional

Introduction

Social assistance policy must identify with values of freedom, equality, and justice, and this must be a commitment that its workers fall in love with from head to toe. (Prof. Joaquina Barata Teixeira as cited in Braga, 2014).

The work of occupational therapists in social assistance services dates back to the institutionalization of the profession in Brazil. Initially, the category was part of technical teams in institutions linked to this sector, mostly civil society organizations that provided services aimed at assisting specific population groups, still marked by disability¹ . Later, in the 1970s, occupational therapists were included in services aimed at coping with social problems unrelated to the field of health, such as the situation of children, older people and, at that time, the so-called juvenile offenders under institutional care (Galheigo, 2016).

Although the liaison between occupational therapy and social assistance was present in the historical development of the profession in the country, only in 2011 were occupational therapists formally recognized as a professional category capable of composing social assistance teams. As a result, the discussion about work in this sector and the social question has gained relevance in the profession both from the interventional and theoretical-academic points of view. There is recognition that this work requires the incorporation of theoretical and methodological frameworks suitable for the understanding of the needs of the populations followed up and for the development of social assistance work. In addition, technical action must be contextualized in the social policies in which they are included, maintaining the ethical-political horizon of professional practice committed to the guarantee of rights.

This text—based on the theoretical framework of the Marxist tradition—intends to initiate a reflection on the creation of a professional project for occupational therapy, considering the ethical-political dimensions brought to light through work in social assistance, as well as of the societal project to be supported. To this end, the text is organized into three parts: the first addresses how the expressions of the social question determine the demands observed in social assistance work; the second discusses the concepts of societal and professional projects; the third proposes a debate on the construction of a professional project for the work of occupational therapists in the social assistance sector, outlining the contributions of the theoretical-methodological framework of social occupational therapy.

The Expressions of the Social Question and Social Assistance

In social assistance, professional work is required to achieve politically agreed social protection in the country. From a Marxist perspective, it is about intervening in the expressions of the social question that determine the production and reproduction of the social life of the working class.

According to Paulo Netto (2013), the term social question began to be used in the third decade of the 19th century to refer to pauperism since, for the first time in history, poverty grew at the same rate as the production of wealth, enabled mainly by the technological advances resulting from the Industrial Revolution. Pauperism differed from the poverty of previous societies, as there was not only an unequal distribution of resources, but also a scarcity of these resources due to the low development of technological conditions to produce material goods in society. The social question is, therefore, a phenomenon typical of capitalism, and it continues to exist even in a society of abundance, where there are technical conditions to eliminate it (Paulo Netto, 2013; Pimentel, 2016; Pastorini, 2004).

In general, the social issue can be defined as the set of expressions of inequalities in a capitalist society that are rooted in its structural logic, which is based on the exploitation of classes and the appropriation, by a minority class, of the wealth produced by a working majority (Iamamoto, 2000). In society, the social question is materialized in the everyday life of people through different expressions: poverty, misery, violence, unemployment, indigence, inequality, lack of social policies, etc., which, in the capitalist mode of production, require the structuring of social policies to face it, one of which is the social assistance policy - the focus of this study.

Paulo Netto (2013) emphasizes that the social question can be discussed from different theoretical and political perspectives that can be categorized into two large blocks: conservative and critical-revolutionary. The first block interprets it as a natural phenomenon that can be eliminated in a capitalist society, either through moral measures or through public management planning in the allocation of resources in social policies. The second block understands it as impossible to be eliminated under capitalism because its origin is linked to the production logic of this system, which continually replaces its various expressions.

Netto also points out that the recognition both of the structural relationships between the social question and capitalism and that of the impossibility of eliminating the former within the framework of the latter does not nullify the importance of its reformist measures of confrontation through social policies. He claims that:

Confronting the social question without considering its economic and social foundations is like drying ice. But this does not mean immobilism. [...] the alternative reform (posed by conservatives) or revolution is wrong. It is not an exclusive alternative. The adequate formulation of the problem would be reform and revolution, for a simple reason: historical experience has shown that struggles that had as a target, as objective, only the recognition of political and social rights had extremely significant impacts on the set of capitalist social organizations (Paulo Netto, 2013, p. 91).

In Brazil, social assistance actions to deal with the expressions of the social question have historically been anchored in the assistance, clientelist and disciplinary logic, which consists of sporadic, fragmented, and discontinuous actions, with little or no professionalization, based on benevolence and goodwill, and are implemented according to the interests of elites and political groups (Silveira, 2014). The universalization of rights in the 1988 Constitution marks the institutionalization of another logic for this and other policies, now understood as a claimable right of the populations that need it and as a duty of the State to guarantee their access to it (Brasil, 1993).

Its consolidation as a public, universal, non-contributory social policy of State responsibility is built from some juridical-legal frameworks: the Organic Law of Social Assistance (LOAS) of 1993, the National Policy of Social Assistance (PNAS) of 2004, and the Basic Operational Norm (NOB/SUAS) of 2005, which implemented the Unified Social Assistance System (SUAS).

The PNAS aims to ensure social protection for people and their families and provide them with their minimum social needs through organized actions, in addition to acting in an integrated manner with other sectoral policies to combat poverty, meet social contingencies, and universalize social rights (Brasil, 2004). These objectives demand work that has the horizon of building a radically democratic and less unfair society. Silveira (2014, p. 217) points out that qualified social work is “the fundamental mediation in response to human needs, to the repercussions of structurally unequal logic, in facing the social question”.

The work at SUAS is performed by professional categories established by Resolution No. 17 of the National Council for Social Assistance (CNAS) in 2011, which include occupational therapists, who can be part of the reference teams and/or compose the SUAS management, contributing to carrying out social assistance services (Brasil, 2011). It is understood that the professionals who work at the PNAS respond on the front line to the expressions of the social question in the life of the population followed up. Moreover, Silveira (2014) reflects that working in social policy services involves actions that democratize and qualify access to rights, requiring alignment between technical, ethical, and political qualifications, because operating social assistance policy involves recognizing and knowing the contradiction of its nature in mediating the expressions of the social question.

Social policies are instruments through which, in a capitalist society, the State responds to the social needs of access to public goods and services of the working class. The characteristics of these policies are directly determined by the ideologies that underlie the understanding of the role played by the State in society, the perspectives on citizenship and social rights, and the ways of understanding and facing the social question (Höfling, 2001).

As noted by Lopes (2016, p. 35), “despite not eliminating the regime’s exploitative devices”, social policies—and, consequently, the social work resulting from them—combine not only technical dimensions but also, and fundamentally, ethical and political dimensions, since professional action is part of professional projects that operate, in a dialectical way, with ideologies that support projects for society.

The Inseparability Between Corporate Projects and Professional Projects

According to Paulo Netto (2006), societal projects can be understood as collective projects that express class intentions for society, even if they have determinations of other natures, such as cultural, ethnic, gender, etc. These projects present an image of society to be built, advocate certain values to justify this image, and privilege certain means (material and cultural) to materialize it and gain the adherence of citizens. Thus, societal projects are essentially political, involve power relations, and are flexible, renewing themselves according to historical and political circumstances.

In concrete reality, we observe that the neoliberal project is the currently dominant and ongoing societal project in Brazil. Worldwide, it has gained visibility as of the 1970s, being employed as the main strategy to overcome the structural crisis of capitalism. The neoliberal project is characterized by a resumption of the fundamentals of economic liberalism, which emphasize individual freedoms, criticize State intervention, and praise the virtues of the market. It is mainly characterized by the idea of a smaller State and a larger market, encouraging the transfer of State responsibilities to the private sector. It advocates that the role of the State is to promote favorable conditions for individual competitiveness, without interfering in the spheres of public and economic life. From this perspective, social policies are seen as obstacles to individual initiatives and the market, and should only be aimed at those who cannot access goods and services via the market (Höfling, 2001).

In addition to these aspects more suited to the economic dimension, the neoliberal project also brings up new values and rules of behavior aimed at responding to the needs of capitalist production and reproduction. In the ideological field, fragmented and superficial concepts about the most diverse aspects of social life are disseminated, with attacks against critical perspectives of understanding reality in an attempt to devalue ideas that highlight the inherent contradictions of capitalism. Thus, the strengthening of conservative agendas, the criminalization of social movements, and the criticism of social rights unfold in social life (Quinalha, 2016; Gallego, 2018).

In Brazil, neoliberal ideas were introduced in the 1990s; however, in recent years, they have taken on a harder line. Since the Temer government (2016-2018) and that of his successor Jair Bolsonaro (2019-2022), there has been a long cycle of strategic reforms in favor of the market, carried out under the allegation of warming up the economy, in which the working class and the poorest populations are the most affected (Iasi, 2018).

In this context, although we recognize the normative advances of social assistance as a social policy, including the professionalization of work in the sector, there are many contradictions and challenges present in its materialization in the context of the advancement of the neoliberal societal project. Social assistance, which was already the fragile link in social security policies, is experiencing critical situations when it has to establish itself as a public policy in the context of dismantling rights and social services. Campos & Ferraz (2020) emphasize that the PNAS has been suffering from the budget constraints that have caused the precariousness of services and work at SUAS, the greater focus of actions, as well as from the moralizing attacks on poverty and the poor in Brazil, governed by an unprecedented moral and religious fundamentalism in our new and fragile democracy. These trends, which do not concern only the PNAS, express a project for a conservative and liberal society that re-updates historical issues of the development of social assistance in the country.

Faced with the validity of a societal project that directly attacks the populations assisted by occupational therapists in social assistance, deteriorates the services where we work, and dismantles our rights as workers, there is an urgent need to discuss professional projects for work at SUAS.

Professional projects are also collective projects, but related to professions² . They are composed of values, delimit ethical and political principles, offer theoretical and methodological frameworks for professional practice, and establish bases for the relationships with service users, other professions, and organizations and institutions (Yazbek, 2019). With these elements, they are not simply professional action plans for a given intervention, but rather broader projects that explicitly include ethical and political dimensions for a profession and define its intentions toward society. In other words, professional projects are in liaison with societal projects, either reinforcing the maintenance of the current order - having a conservative character, or advocating the rupture of that order as the ethical-political horizon of a profession - being critical-transformative. Thus, in the words of Paulo Netto (2006, p. 4):

Professional projects present the self-image of a profession, elect the values that legitimize it socially, delimit and prioritize its objectives and functions, formulate the requirements (theoretical, practical, and institutional) for its exercise, prescribe norms for the behavior of professionals, and establish the bases of their relations with the service users, other professions, and private and public social organizations and institutions (including the State, which is responsible for the legal recognition of professional statutes).

Just like societal projects, professional projects are dynamic, as they respond to economic, historical, and cultural changes, as well as to those in the social needs with which professions work. They are also modified according to their theoretical and practical development.

We emphasize that given the heterogeneity of the members of a profession - composed of subjects from different origins, positions, and social expectations, theoretical, ideological, and political behaviors, and preferences are present in the same category of diverse individual and societal projects, configuring it as a plural space from which different professional projects can arise (Paulo Netto, 2006). Thus, even if a project is institutionalized, as professions are a field of struggle, there will always be tension to build new projects in opposition to the dominant project.

This debate leads us to reflect on how we can discuss this idea in occupational therapy, especially by encouraging reflection on a professional project for the work of occupational therapists in social assistance.

Ethical-Political Commitment, Professional Project, and Occupational Therapy

We start from the understanding that occupational therapy is not only the result of the interests of the subjects who have built it as a profession, but it also responds to a need for the social and technical division of work in monopoly capitalism, acting within the scope of class relationships and interests. This concept has been used by several authors in the field since the 1980s, including Soares (1987), Lopes (1991), and Bezerra (2011).

From this perspective, there is also the understanding that, by acting mostly through social policies, occupational therapists respond to antagonistic interests of the dominant class and the working class, which are also expressed in the State, but directly serve the latter, which uses the social services to minimize the impacts of expressions of the social question in the everyday life of members. Therefore, professional work occurs in a concrete and contradictory social context, with a confluence of factors that interfere in professional practice, such as the configuration of social policies at a given historical moment, social legislation that can expand or restrict rights, configurations of power relations in the workplace, working conditions, employment relationships that allow greater or lesser autonomy in professional practice, among other issues (Bezerra et al., 2022).

These dimensions concretely and objectively constitute the professional practice, setting limits but also offering possibilities for work capable of promoting changes in the reality of the populations followed up (Bezerra et al., 2022). We understand that, for this, the work must be guided by a critical-transformative professional project.

The transformation of the reality of the assisted populations depends on the capacity of the occupational therapist to make a critical reading of their demands and needs and exercise their professional practice to transform them and their everyday life, adopting values such as freedom (Farias & Lopes, 2022) and human emancipation (Godoy-Vieira, 2021) as the ethical horizon of this action.

Thus, as professionals working amid contradictions and limits of State social policies, the work of occupational therapists involves provoking individuals and groups to identify the contradictions in which they live, and “these subjects return to the social environment, beyond the moment of occupational therapy follow-up, with new questions”, enhancing their possibilities of transforming the social processes that determine their particular condition, which at the same time is collective because it is a manifestation of social reproduction (Godoy-Vieira, 2021, p. 159). Thus, Godoy-Vieira (2021) proposes the notion of radical participation as a product of the work process in occupational therapy, which focuses on transforming the way individuals place themselves in the world through their daily activities, considering the dialectic between singularity and social totality.

Farias & Lopes (2022) discuss the construction of an occupational-therapeutic thinking/doing that is attentive to combating structures of oppression and intended for freedom. Taking the everyday life of subjects and groups as central, those authors propose thinking/doing in occupational therapy along three processes: production of righteous anger that causes indignation with the inequalities and violence experienced, understanding that, in indignation, one can produce movements directed to freedom; suspension of everyday alienation, which produces reflections on the contradictions experienced, having a critical understanding of what is experienced; transformation of reality through the appropriation of the means to exercise citizenship and produce life in a critical way before the world. Thus, it is understood that, in this awareness movement regarding oppression processes, there is the possibility of building action for the “transformation of concrete reality, even within the imposed limits” (Farias & Lopes, 2022, p. 11).

In this sense, despite the existence of structural determinations that impose limits to work in social policies, including social assistance, Rizzotti (2014) states that the professional condition of the members of the SUAS reference teams, characterized by the intellectual dimension of the work, safeguards a field of freedom and autonomy. The mixture of technical knowledge and ethical-political commitments forms, in daily work, a field where it is possible to combine and define common objectives capable of integrating team professionals, enabling the construction of a social assistance worker identity (Braga, 2014).

This SUAS worker identity goes beyond a certain professionality and dialogues with societal projects. This implies that, among the professional categories of SUAS, there is a sharing of a worldview that values freedom and emancipation of the assisted subjects, equality in differences, real conditions of social justice, and contextualized understanding of vulnerability and social risk, allowing the overcoming of the differences arising from the formation of their origins (Braga, 2014).

In occupational therapy, the debate about professional projects is not common; however, the profession is concerned with the need for an ethical-political commitment in professional practice. This discussion started in the 1970s, when, under the influence of Franco Basaglia’s formulations about the technician’s social mandate inspired by the debate on the organic intellectual in Antonio Gramsci, occupational therapists began to reflect on the role of the delegates of society’s hegemonic values, exercised by its technical practice in the total institutions (Barros et al., 2002).

From this period, there is also the criticism of the medicalization practices to the social question, the institutional segregation of population groups, and the social control implicit in technical work. This movement of criticism of and reflection on the ideological and political implications of professional practice and the approach and follow-up of people and groups under conditions of social vulnerability and risk unfolded, according to Bezerra (2011), in a critical turn taken by Brazilian occupational therapy toward recognizing the close relationship between the technical, ethical, and political dimensions of professional work.

Galheigo et al. (2018, p. 729) states that this historical moment marks the beginning of the “incorporation of critical thinking into Brazilian occupational therapy, inaugurating a process of decolonization of its knowledge and practices, and shifting from a purely technical and procedural role to a social position with technical-political commitment”.

Reflections on the ethical-political commitment of occupational therapists involve, in general, the questioning of scientific knowledge as a statute of truth, the problematizing interpretation of the macro processes that directly affect the everyday life of the assisted populations, the understanding of the social question and its expressions from a sociohistorical perspective, the appreciation of diversity and culture, and the legitimation of different types of knowledge, in addition to the recognition of inequality in power relations, with a horizon transform society (Galheigo, 2016).

These elements that constitute the ethical-political dimension in the profession are recurrently discussed in a direct combination between the structural and relational dimensions, understanding that this commitment occurs:

through empathetic listening to the subjects and groups with whom it develops projects and through a critical perspective of social and political contexts. Empathetic for accepting the ideas, affections, and experiences of these subjects; critical for the problematizing interpretation of the macro processes in which their everyday life is intertwined. An ethical commitment, for intervening in the plan of life, in its movements of resistance and affirmation; a political commitment, for the continuous explication of the existing macro and micropolitical power games, for the defense of autonomy, citizenship, and rights, and for the search of new strategies to build and/or strengthen social groups (Galheigo, 2016, p. 65, author's highlights).

These elements, contained in the idea of ethical-political commitment, dialogue with and integrate the discussion of a professional project. However, the concept of a professional project also involves, as pointed out by Yazbek (2019), explicit directions for the category regarding its ethical norms, professional rights and duties, political-organizational resources of the profession, and education.

We understand that the ethical-political commitment needs to be included in a collective professional project that, in turn, is related to societal projects. The concept of professional project advances concerning the idea of ethical-political commitment because, depending on how this idea is incorporated by professionals, there is a risk that it will be assumed as a set of individual values for professional action. On the other hand, the professional project is a collective consensus around a set of issues that are even expressed in documents of the professional category (code of ethics, curriculum guidelines, positions of class entities, etc.).

Given the plurality that constitutes a profession and the disputes around which a professional project will be institutionalized by the category, in addition to the debates and constructions previously carried out in social assistance by other categories that work in the sector, it is opportune to reflect on which professional project occupational therapy needs to build to work on this policy to respond to the social needs of the assisted populations.

We advocate that the work of occupational therapists in social assistance should be guided by a critical-transformative professional project; but critical of what? Critical of the structure and dynamics of capitalist society that continually replace the expressions of the social question, creating impediments to social participation and touching the everyday life of subjects; critical of the neoliberal model of State management that impacts the PNAS, weakens rights, and makes people’s lives and work precarious; critical of the conservative trends of work in social assistance that impact the PNAS, individualize, medicalize, psychologize, and moralize the understanding of problems presented as professional demands; critical of the role and social function of occupational therapy in its relationship with society, breaking with a technical and supposedly neutral view of the profession, and one that assumes freedom and human emancipation as core values.

We can state that a critical-transformative project enables occupational therapists to become aware of the macro social issues that cross their work at SUAS and, with that, be able to provide their actions with differentiated technical quality, aiming to defend social and human rights, considering them as historical achievements of the struggles of social movements. In other words, this project connects and responds to a demand from classes subordinated by capitalism, the main demanders of the work of occupational therapists in social assistance.

This differentiated quality is manifested through a practice that favors the universalization of rights and that questions focused criteria, which treat rights as privileges; that democratizes access to information that can strengthen subjects and groups, favoring their political mobilization; which reframes institutional requests that often call for uncritical and emergency responses to user demands; that does not comply with institutional productivism and the fulfillment of merely bureaucratic demands.

The criticism we are referring to is only possible through the theoretical-methodological framework adopted within the professional project because, according to Yazbek (2019), knowledge and theoretical choices, the design of research and investigations, and practical choices are components that fundamentally comprise professional projects and give them a conservative or critical-transformative characteristic.

In occupational therapy, different perspectives and frameworks have characteristics that can inform a critical-transformative professional project: discussions on occupational therapies of the Global South (Valderrama Núñez, 2019), the so-called critical perspectives in occupational therapy (Galheigo, 2012), community occupational therapy (Palacios Tolvett, 2017), discussions about human rights (Guajardo & Algado, 2010), the feminist perspective (Testa & Spampinato, 2010), Brazilian social occupational therapy (Barros et al., 2002), among others.

A non-systematic approach to the literature in the area shows that investigations addressing the theme of occupational therapy at SUAS, to a large extent, incorporate the social occupational therapy framework. We have found from the history of militancy to include occupational therapists as a working category at SUAS (Almeida et al., 2012), to the continuous bibliographical productions on professional practices and the development of strategies, resources, and social technologies to intervene in the various devices of the SUAS network (Araújo et al., 2011; Perez et al., 2014; Neves & Macedo, 2015; Morais & Malfitano, 2016; Borba et al., 2017; Oliveira & Malfitano, 2021).

According to Malfitano (2016), this framework focuses on working with individuals and groups whose socioeconomic condition determines, in their everyday life, difficulties and impediments to social inclusion and participation in conditions of equal rights. It advocates, in a dialectical movement, the inseparability between the micro and macro social dimensions to understand the reality of the assisted population, in a work logic that abdicates individualizing interpretations and interventions, but does not cease to act in the individual sphere:

In the individual sphere, strategies that assist the subjects to obtain support for their social inclusion and participation will be developed, respecting their choices and autonomy. In the collective sphere, work is connected to social policies and action in public spaces by maintaining and/or expanding the social recognition of certain needs, and intervening by expanding services and other spaces that allow access to the rights of that group (Malfitano, 2016, p. 126).

From this theoretical place, social resources and technologies are proposed to operationalize the work for acting in these two spheres: a) Workshops of Activities, Dynamics, and Projects: professional actions that conceive the activities as a mediating resource to approach, follow up, apprehend the demands, and strengthen the individuals and groups assisted by occupational therapists; b)Individual Territorial Follow-ups: strategies that enable a more real perception of and interaction with the everyday life of the subjects, interconnecting their histories and trajectories, current situation, and network of relationships; c) Articulation of Resources in the Social Field: a range of actions carried out with subjects, groups, and policy management involving the use of possible resources, understood as financial, material, relational and affective, either in the micro or macrosocial spheres, to compose the interventions; d) Dynamization of the Service Network: mapping, disseminating, and consolidating all programs, projects, and services aiming to encourage interaction and integration between them, combining the different sectors and levels of intervention (Lopes et al., 2014).

These work methodologies dialogue with the objectives of the social assistance policy, which proposes to provide groups, families, and individuals who need social protection with guaranteed security: survival security (income and autonomy), acceptance security, and family life security (Brasil, 2004).

Furthermore, the construction of work from the principles and methodologies of social occupational therapy, associated with the recognition of the inadequacy of health models to inform the practice in social assistance, avoid interventions that individualize, medicalize, and psychologize the expressions of the social question because, as pointed by Almeida & Soares (2016, p. 169), the “products of social inequality have repercussions on different levels of human experience, forcefully and devastatingly penetrating the large and small movements and actions of everyday life”.

Thus, social occupational therapy is a theoretical-methodological framework that can be adopted to construct a critical-transformative professional project for work in social assistance. Among its contributions, this framework substantiates a professional practice detached from the health area, discusses the contradictory role of social policies, combines the micro and macro social dimensions in understanding demands and social reality, presents social resources and technologies with a rationale consistent with the work required at SUAS, advocates the inseparability of the technical, ethical, and political dimensions of professional practice, and makes use of theoretical references common to the professions that work in this sector, thus providing a common ground discuss social phenomena.

Final Remarks

The constitution of occupational therapy as a profession is linked to the unfolding of the social question and State strategies to face its expressions, which are presented as demands for the work in social assistance and which, from the Marxist perspective, are insoluble in the order of capital.

The work at SUAS has an ethical-political dimension and is influenced by ideologies that support societal and professional projects, which can be conservative or critical-transformative. The purpose of thinking about professional projects for SUAS lies in the need to:

ethically guide the professions [...] by streamlining politics, adding anticipated purposes. While overcoming historical marks, it can strengthen work committed to the expansion of rights, to human emancipation (Silveira, 2014, p. 229).

We argue that social occupational therapy is a theoretical-methodological framework that can coherently subsidize the construction of a professional project for occupational therapy at SUAS, in line with the essential and fundamental skills for working in the sector. This can favor the category with greater incorporation and recognition of its professional practice in social assistance and with the overcoming of its identity as an exclusive health profession, enabling the construction of a working identity shared with the other professions that compose the work teams in the sector.

• 1
  Reference to Non-Governmental Organizations (NGOs), especially the Associations of Parents and Friends of People with Disabilities (APAEs) and Sociedade Pestalozzi, whose agreements with the social assistance sector enabled access to funding.
• 2
  As an example, we point out the experience of Social Work, a category that between the 1970s and 1980s built and publicized its professional project, called the Ethical-Political Project of Social Work, outlining technical, ethical, and political aspects that guide professional education and work, whose juridical-legal frameworks are the Regulatory Law, the Code of Ethics, and the National Curriculum Guidelines (NCGs) of the profession (Yazbek, 2019).
• How to cite: Bezerra, W. C., & Basso, A. C. S. (2023). From an ethical and political commitment to the design of a professional occupational therapy project: a debate necessary for social assistance work. Cadernos Brasileiros de Terapia Ocupacional, 31(spe), e3387. https://doi.org/10.1590/2526-8910.ctoARF259333872

Referências

• Almeida, M. C., & Soares, C. R. S. (2016). Terapia Ocupacional e assistência social: subsídios para uma inserção crítica no campo. In R. E. Lopes & A. P. S. Malfitano (Orgs.), Terapia ocupacional social: desenhos teóricos e contornos práticos (pp. 155-178). São Carlos: EdUFSCAR.
• Almeida, M. C., Soares, C. R. S., Barros, D. D., & Galvani, D. (2012). Processos e práticas de formalização da Terapia Ocupacional na Assistência Social: alguns marcos e desafios. Cadernos Brasileiros de Terapia Ocupacional, 20(1), 33-41.
• Araújo, L. S., Oliveira, T. S., & Patrício, T. A. S. (2011). Estudo sobre a prática da terapia ocupacional no Sistema Único de Assistencial Social (SUAS) no município de Belém. Revista do NUFEN, 3(2), 69-96.
• Barros, D. D., Ghirardi, M. I. G., & Lopes, R. E. (2002). Terapia ocupacional social. Revista de Terapia Ocupacional da Universidade de São Paulo, 13(3), 95-103.
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Edited by

Guest editor

Profa. Dra. Rosângela Gomes Mota de Souza

Publication Dates

• Publication in this collection
  10 July 2023
• Date of issue
  2023

History

• Received
  04 Aug 2022
• Reviewed
  19 Aug 2022
• Reviewed
  22 Nov 2022
• Accepted
  31 Jan 2023