Cuidados y acompañamiento educativo durante el confinamiento en los hogares por COVID 19. La perspectiva de las familias de escuelas públicas

La suspensión de la presencialidad escolar durante el período de confinamiento por motivo de la pandemia por COVID 19 alteró la vida cotidiana de las familias uruguayas y generó desafíos para el acompañamiento educativo de las infancias. Este artículo analiza las experiencias de las familias en este período, haciendo énfasis en la organización de los cuidados y las actividades de acompañamiento y sostén del tránsito escolar de niñas y niños, identificando obstáculos y oportunidades. Se trata de un estudio cualitativo, que utilizó como técnica inicial, un cuestionario autoadministrado que permitió identificar aspectos de las experiencias de las familias tomados como guía para la realización de grupos de discusión. Aquí se comparten los resultados del cuestionario online respondido por un total de 278 referentes familiares de niños y niñas que cursaron de 1ero a 3er año escolar en instituciones públicas durante los años 2020 y 2021. Como principales conclusiones se destaca que las familias participantes perciben como satisfactorio el acompañamiento desde los centros escolares. Las dificultades halladas se relacionan principalmente con el tipo de propuesta educativa y modo de comunicación establecido con las maestras, las condiciones materiales del hogar (disponibilidad de dispositivos electrónicos, conectividad, espacio físico, etc.), disponibilidad de tiempo, afectiva y cognitiva para enseñar o motivar al aprendizaje de sus hijos e hijas. Rescatando la oportunidad que significó compartir más tiempo con los niños y niñas, se presenta la preocupación por manifestaciones de malestar físico y psíquico ante la situación de distancia de la cotidianeidad escolar y sus exigencias.

A suspensão da presença escolar durante o período de confinamento devido à pandemia da COVID 19 alterou o cotidiano das famílias uruguaias e gerou desafios para o acompanhamento educacional das crianças. Este artigo analisa as experiências das famílias neste período, enfatizando a organização de cuidados e atividades para acompanhar e apoiar o trânsito escolar de meninas e meninos, identificando obstáculos e oportunidades. Trata-se de um estudo qualitativo, que utilizou como técnica inicial um questionário autoaplicável que possibilitou identificar aspectos das vivências das famílias tomadas para a condução dos grupos de discussão. Aqui são partilhados os resultados do questionário online respondido por um total de 278 representantes de famílias de meninos e meninas que frequentam o 1.º ao 3.º ano de escolaridade em instituições públicas durante os anos de 2020 e 2021. Destacam-se como principais conclusões que as famílias participantes percebem um acompanhamento das escolas como satisfatório. As dificuldades encontradas estão relacionadas principalmente ao tipo de proposta educativa e modo de comunicação estabelecido com os professores, às condições materiais do domicílio (disponibilidade de aparelhos eletrônicos, conectividade, espaço físico, etc.), disponibilidade de tempo, afetivo e cognitivo para ensinar ou motivar seus filhos e filhas a aprender. Resgatando a oportunidade que significou compartilhar mais tempo com os meninos e meninas, surge a preocupação por causa das manifestações de desconforto físico e psicológico devido à situação de distanciamento do cotidiano escolar e suas demandas.

The suspension of school attendance during the confinement period due to the COVID 19 pandemic, altered the daily lives of Uruguayan families and generated challenges for the educational accompaniment of children. This article analyzes the experiences of families in this period, emphasizing in the organization of care and activities to accompany and support the school of girls and boys, identifying obstacles and opportunities. In this qualitative study, was used as an initial technique, a self-administered questionnaire that identified aspects of the families experiences taken as a guide for conducting discussion groups. The online questionnaire was answered by a total of 278 family representatives of boys and girls who attended the 1st to 3rd year of public school institutions during the years 2020 and 2021. The main conclusions show that accompaniment from schools was perceived as satisfactory from the participating families. The difficulties encountered are mainly related to the type of educational proposal and mode of communication established with the teachers, the material conditions of the home (availability of electronic devices, connectivity, space conditions, etc.), and the disposition of time, affective and cognitive ability to teach or motivate their sons and daughters to learn. Rescuing the opportunity that meant sharing more time with the boys and girls, there is concern about manifestations of physical and psychological bother due to the situation of distance from daily school life and its requirements.

Acompanhamento escolar de crianças com entraves estruturais na constituição psíquica: contribuições e desafios / Acompañamiento escolar de niños con obstáculos estructurales en su constitución subjetiva: contribuciones y desafios / School accompaniment of children with structural barriers in their psychic constitution: contributions and challenges / Suivi scolaire des enfants présentant des entraves structurellesà la constitution psychique: apports et défis

Este artigo parte da contextualização do movimento inclusivo e das conquistas em termos de legislação no Brasil, para analisar, com a ajuda do referencial psicanalítico, cenas vividas em uma experiência de acompanhamento escolar de uma criança com entrave estrutural na sua constituição psíquica. Abordam-se contribuições e desafios do acompanhamento escolar na inclusão desses alunos e alunas, a importância da escola como local de subjetivação e a riqueza da interação entre os pares criança-criança nesse processo. Conclui-se que a inclusão escolar não pode se pautar na busca de que "tudo seja igual para todos"; há que se trabalhar com as diferenças para chegar à igualdade de oportunidades e ao direito fundamental à educação. Cabe à escola manter a elasticidade em seu currículo para que todos os estudantes possam acessá-lo, cada um a seu modo, construindo sentido e aprendizagem na sua experiência escolar

Este artículo parte de la contextualización del movimiento inclusivo y de los hitos legislativos en Brasil para analizar, desde una perspectiva psicoanalítica, escenas de una experiencia de acompañamiento escolar a niños con obstáculos estructurales en su constitución subjetiva. Se abordan contribuciones y desafíos del acompañante escolar en la inclusión de estos estudiantes, la importancia de la escuela como lugar de subjetivación y la riqueza de la interacción entre los pares en este proceso. Se concluye que la inclusión escolar no se puede basar en la búsqueda de que "todo sea igual para todos"; hay que trabajar con las diferencias para llegar ala igualdad de oportunidades y al derecho fundamental a la educación. Es responsabilidad de la escuela mantener una apertura en su currículum para que todos los estudiantes puedan accederlo; cada uno a su manera, construyendo sentido para su experiencia escolar

This article starts with the contextualization of the inclusive movement and the achievements in terms of legislation in Brazil, to then, with the help of psychoanalytic references, analyze scenes from a school accompaniment of a child with structural barriers in their psychic constitution. It discusses the contributions and challenges of school accompaniment in the inclusion of these students, the school's importance as a place of subjectivation, and the role played by peers' interaction in this process. It is concluded that school inclusion cannot be based on the premise that "everything must be the same for everyone". It is necessary to work with differences to achieve equal opportunities and the fundamental right to education. It is the school's responsibility to make space in its curriculum so that every student can access it in their way to build meaning to their school experience

Cet article propose quelques repères sur le mouvement inclusif et les acquis de la législation brésilienne pour ensuite, à partir du referentiel psychanalitique, analyser des scènes vécues dans le cadre de l'accompagnement scolaire d'un enfant présentant des obstacles structurels dans sa constitution psychique. Il aborde les contributions et les défis de cette pratique dans l'inclusion des enfants, l'importance de l'école comme lieu de subjectivation et la richesse de l'interaction entre les paires enfant-enfant dans ce processus. Nous montrons que l'inclusion scolaire ne peut pas être basée sur la notion que "tout est égal pour tous"; qu'il est nécessaire de travailler avec les différences pour atteindre une effective égalité des chances et le droit fondamental à l'éducation. Il appartient à l'école de maintenir une ouverture dans son programme afin que tous les élèves puissent y accéder, chacun à sa manière, en donnant un sens à leur expérience scolaire

Los desafíos del acompañamiento universitario a emprendimientos de gestión colectiva en procesos de desmanicomialización en Uruguay

Nos proponemos compartir resultados de una investigación que tuvo como objetivo estudiar los procesos de gestión colectiva en dos emprendimientos laborales autogestivos de Uruguay, que trabajan desde la perspectiva de la desmanicomialización. Se trató de una investigación cualitativa, situada y experiencial a partir del despliegue de una etnografía. En este artículo abordaremos los resultados de dos objetivos específicos, uno sobre las estrategias y metodologías universitarias vinculadas a los procesos de conformación y sostén de dichas experiencias y otro sobre las estrategias desplegadas para acompañar el padecimiento de lxs integrantes. Compartiremos algunos resultados en relación a las preguntas: ¿para qué y por qué se acompaña? ¿qué es lo que se acompaña? ¿cómo se acompaña?. Identificamos que ambos proyectos se llevan adelante desde la extensión universitaria, a partir de un proceso de incubación de emprendimientos cooperativos integrado solo por personas usuarias de servicios de salud mental, que denominamos: autogestión-solo-de-ellos. Este proceso implicó acompañar y sostener un doble pasaje, o sea generar ruptura con la lógica manicomial y con la lógica salarial para configurar y consolidar un emprendimiento de gestión colectiva. Esto significó para los equipos universitarios acompañar y desplegar distintas estrategias en relación a la triada: trabajo-acogida-vida. Destacamos tres componentes transversales del acompañamiento que fueron: no sustituir (hacer con), sostener otras temporalidades y abordaje interdisciplinario y en red.Durante el proceso de incubación se produce una metamorfosis a partir de que egresadxs universitarixs deciden integrar las experiencias como socixs/cooperativistas e inician un proceso que definimos como: autogestión-de-un-nosotrxs.

Propomos compartilhar resultados de uma pesquisa que teve como objetivo estudar os processos de gestão coletiva em duas empresas trabalhistas autogeridas no Uruguai, que funcionam na perspectiva da desmanicomalização. Tratou-se de uma investigação qualitativa, situada e experiencial baseada no desdobramento de uma etnografia. Neste artigo abordaremos os resultados de dois objetivos específicos, um sobre as estratégias e metodologias universitárias vinculadas aos processos de formação e sustentação dessas experiências e outro sobre as estratégias utilizadas para acompanhar o sofrimento dos membros. Compartilharemos alguns resultados em relação às questões: para que e por que é acompanhado? O que é acompanhado? E como é acompanhado? Identificamos que ambos os projetos são realizados pela extensão universitária, a partir de um processo de incubação de empreendimentos cooperativos formados apenas por usuários de serviços de saúde mental, o que denominamos: autogestão-só-deles. Este processo envolveu acompanhar e sustentar uma dupla passagem, ou seja, gerar uma ruptura com a lógica asilar e com a lógica salarial para configurar e consolidar um empreendimento de gestão coletiva. Isso significou que as equipes universitárias acompanhassem e implantassem diferentes estratégias em relação à tríade: trabalho-acolhimento-vida. Destacamos três componentes transversais do apoio, que foram: não substituir (fazer com), apoiar outras temporalidades e uma abordagem interdisciplinar e em rede. Durante o processo de incubação, ocorre uma metamorfose quando os graduados universitários decidem integrar as experiências como parceiros/cooperativistas e iniciam um processo que definimos como: autogestão-de-um-nós.

We propose to share results of a research that aimed to study the collective management processes in two self-managed labor enterprises in Uruguay, which work from the perspective of demanicomalization. It was a qualitative, situated and experiential investigation based on the deployment of an ethnography. In this article, we will address the results of two specific objectives, one on the university strategies and methodologies linked to the processes of formation and support of these experiences and another on the strategies deployed to accompany the suffering of the members. We will share some results in relation to the questions: why and what for is it accompanied? What is accompanied? And how is it accompanied? We identified that both projects are carried out by the university extension, based on an incubation process of cooperative ventures made up only of users of mental health services, which we call: self-management-only-of-them. This process involved accompanying and sustaining a double passage; that is, generating a break with the asylum logic and with the salary logic to configure and consolidate a collective management undertaking. This meant for the university teams to accompany and deploy different strategies in relation to the triad: work-welcome-life. We highlighted three transversal components of support, which were not substituting (doing with), supporting other temporalities, and an interdisciplinary and network approach. During the incubation process, a metamorphosis occurs when university graduates decide to integrate the experiences as partners/cooperativists and begin a process that we define as: self-management-of-an-us.

¿Necesitás abortar? Estés donde estés te acompañamos: pandemia y acompañamiento de abortos en la ciudad de Neuquén, Argentina, durante 2020 / Do you need to abort? Wherever you are, we accompany you: pandemic and abortions accompaniment in Neuquén, Argentina, during 2020 / Você precisa abortar? Onde quer que você esteja, nós te acompanhamos: pandemia e acompanhamento de abortos em Neuquén, Argentina, durante 2020

Objetivo: describir los cambios que impuso la irrupción de la pandemia por COVID-19 al dispositivo de acompañamientos de abortos durante el año 2020 en la ciudad de Neuquén, Argentina. Metodología: el trabajo tiene un diseño metodológico que combinó aspectos cualitativos y cuantitativos en el análisis. Por un lado, se analizaron documentos elaborados por Socorristasen Redy se realizaron entrevistas semiestructuradas a activistas de La Revuelta. Esto se complementó con análisis de datos estadísticos de los acompañamientos de abortos dentro del sistema de salud entre marzo y diciembre de 2020. Resultados: en el período de estudio, La Revuelta readecuó parte de su dispositivo de acompañamiento y acompañó 270 abortos dentro del sistema de salud. Conclusión: el artículo muestra que la irrupción de la pandemia y la restricción para circular implicaron respuestas rápidas por parte de las activistas de La Revuelta, para continuar acompañando abortos en un momento de gran incertidumbre.

Objective: this article delineates the modifications introduced to the abortion support system in the city of Neuquén, Argentina, during the outbreak of the COVID-19 pandemic in 2020.Methods:the research employs a methodological design incorporating both qualitative and quantitative elements. It involves the analysis of documents prepared by Socorristas en Red, semi-structured interviews with La Revuelta activists, and the examination of statistical data related to abortion accompaniment within the health system from March to December 2020. Results:during the study period, La Revuelta adjusted a segment of its support apparatus and facilitated 270 abortions within the health system. Conclusion: the article illustrates that the pandemic and associated movement restrictions necessitated prompt adaptations by La Revuelta activists to sustain abortion support services amidst a period of considerable uncertainty.

Objetivo: descrever as mudanças que a pandemia de COVID-19 impôs ao sistema de apoio ao aborto durante o ano de 2020 na cidade de Neuquén, Argentina. Metodologia: o trabalho possui um desenho metodológico que combinou aspectos qualitativos e quantitativos na análise. Por um lado, foram analisados documentos elaborados pelos Socorristas en Rede realizadas entrevistas semiestruturadas com ativistas de La Revuelta. Isto foi complementado com a análise de dados estatísticos de acompanhamento do aborto no sistema de saúde entre março e dezembro de 2020. Resultados: no período do estudo, La Revuelta reajustou parte do seu dispositivo de acompanhamento e acompanhou 270 abortos no sistema de saúde. Conclusão: o artigo mostra que a eclosão da pandemia e a restrição de circulação implicaram respostas rápidas por parte dos ativistas de La Revuelta, para continuarem a acompanhar os abortos num momento de grande incerteza

Indicadores qualitativos de processo e resultado no acompanhamento terapêutico / Qualitative indicators of process and outcome in terapeutic accompaniment / Indicadores cualitativos de procesos y resultados del acompañamiento terapéutico

Este estudo é voltado à construção de indicadores qualitativos de processo e resultado para a prática do Acompanhamento Terapêutico (AT). O artigo inicia apresentando a conceitualização e os fundamentos da prática do Acompanhamento Terapêutico e seu papel na clínica e nas políticas públicas em saúde mental. Revisa a literatura acerca dos métodos de avaliação de processo e resultado de psicoterapias e das metodologias de construção de indicadores qualitativos em saúde. Por fim, discute a possibilidade de formular indicadores qualitativos para a avaliação da prática do Acompanhamento Terapêutico com base no estado da arte do conhecimento sobre este dispositivo e propõe alguns indicadores clinicamente e teoricamente relevantes.

This study is aimed at the construction of qualitative indicators of process and outcome for the practice of Therapeutic Accompaniment (TA). the article begins by presenting the conceptualization and the foundations of the practice of Therapeutic Accompaniment and its role in the clinic and public policies in mental health. It reviews the literature about the methods of evaluating the process and results of psychotherapies and the methodologies for building qualitative health indicators. Finally, it discusses the possibility of formulating qualitative indicators for evaluating the practice of Therapeutic Accompaniment based on the state of the art of knowledge about this device and proposes some clinically and theoretically relevant indicators. (AU)

Este estudio tiene como objetivo la construcción de indicadores cualitativos de procesos y resultados para la práctica del compañamiento Terapéutico (AT). El artículo comienza presentando la conceptualización y los fundamentos de la práctica del Acompañamiento Terapéutico y su rol en la clínica y las políticas públicas en salud mental. Revisa la literatura sobre los métodos de evaluación del proceso y los resultados de las psicoterapias y las metodologías para la construcción de indicadores cualitativos de salud. Finalmente, se discute la posibilidad de formular indicadores cualitativos para evaluar la práctica del Acompañamiento Terapéutico a partir del estado del conocimiento sobre este dispositivo y propone algunos indicadores clínica y teóricamente relevantes. (AU)

Case Report: "I got my brain back" A patient's experience with music-induced analgesia for chronic pain.

Listening to music has progressively been proposed as a complementary alternative for chronic pain; understanding its properties and its neurobiological bases is urgent. We show a phenomenological investigation of a woman who has lived 20 years with chronic pain. The inquiry involved her experience of the context in which she listens to music, the intensity and quality of pain, body mapping, memories, emotions, and cognition. The participant listens to music for different reasons, such as pain and anxiety relief, motivation to exercise, and quality of sleep, but all seem to revolve around different strategies for pain management. Experiences in physiological and cognitive aspects included perceived restorative sleep that may have improved the participant's general wellbeing and improved cognitive and motor performance as well as communication skills. The music enabled the participant not only to relieve pain but also withdrawal effects after discontinuing her opioid-based treatment. These effects may encompass endogenous opioid and dopamine mechanisms involving natural analgesia associated with pleasurable experiences. Future studies could consider phenomenological case studies and therapeutic accompaniment to reorient subjective properties of pain and expand quantitative and qualitative knowledge for more comprehensive reports on music and analgesia.

Patient and provider perceptions of a community-based accompaniment intervention for adolescents transitioning to adult HIV care in urban Peru: a qualitative analysis.

INTRODUCTION: Adolescents living with HIV (ALWH) experience higher mortality rates compared to other age groups, exacerbated by the suboptimal transition from paediatric to adult HIV care, during which decreased adherence to antiretroviral therapy (ART) and unsuppressed viremia are frequent. Care transition-a process lasting months or years-ideally prepares ALWH for adult care and can be improved by interventions that are youth-friendly and address psychosocial issues affecting ART adherence; however, such interventions are infrequently operationalized. Community-based accompaniment (CBA), in which laypeople provide individualized support and health system navigation, can improve health outcomes among adults with HIV. Here, we describe patient and provider perceptions of a novel HIV CBA intervention called "PASEO" for ALWH in Lima, Peru. METHODS: PASEO consisted of six core elements designed to support ALWH during and after the transition to adult HIV care. During 2019-2021, community-based health workers provided tailored accompaniment for ALWH aged 15-21 years over 9 months, after which adolescent participants were invited to provide feedback in a focus group or in-depth interview. HIV care personnel were also interviewed to understand their perspectives on PASEO. A semi-structured interview guide probing known acceptability constructs was used. Qualitative data were analysed using a framework analysis approach and emergent themes were summarized with illustrative quotes. RESULTS: We conducted five focus groups and 11 in-depth interviews among N = 26 ALWH and nine key-informant interviews with HIV care personnel. ALWH participants included males, females and one transgender female, and those with both early childhood and recent HIV infection. ALWH praised PASEO, attributing increased ART adherence to the project. Improved mental health, independence, self-acceptance and knowledge on how to manage their HIV were frequently cited. HIV professionals similarly voiced strong support for PASEO. Both ALWH and HIV professionals expressed hope that PASEO would be scaled. HIV professionals voiced concerns regarding financing PASEO in the future. CONCLUSIONS: A multicomponent CBA intervention to increase ART adherence among ALWH in Peru was highly acceptable by ALWH and HIV programme personnel. Future research should determine the efficacy and economic impact of the intervention.

The influence of feminist abortion accompaniment on emotions related to abortion: A longitudinal observational study in Mexico.

Emotions can reflect how individuals internalize identities, social roles, and broader power structures, including abortion stigma. Abortion accompaniment, in the form of logistical, informational, and emotional support offered by individuals and organizations, takes a person-centered, feminist, and rights-based approach. We tested the extent to which abortion accompaniment may decrease negative and increase positive feelings an individual holds related to their abortion. Using observational longitudinal data collected between January 2017 and mid-2018, we compared negative and positive emotional responses to a personal abortion experience one month and six months following the abortion to emotions immediately prior to the abortion ("baseline"), among women travelling from outside of Mexico City to abortion clinics in Mexico City with and without support of the accompaniment organization, Fondo MARIA. We used doubly robust longitudinal mixed effects models with inverse probability weighting methods. At baseline, accompanied and unaccompanied participants experienced an average of 4.9 and 4.4 negative emotions out of eight respectively (i.e., anguish, nervousness, scared, anxious, sadness, guilt, anger, shame) and 1.7 and 1.9 positive emotions of out 4 respectively (happiness, calmness, decidedness, and relief). From our model results, women accompanied (n = 77) had larger decreases in negative feelings (p < .05) and larger increases in positive feelings (p < .01) toward their abortion compared to those who were not accompanied (n = 119) at six months. These changes led the majority of accompanied respondents to have primarily positive feelings about their abortion by endline. Abortion accompaniment through Fondo MARIA in Mexico City was associated with a larger decrease in negative feelings, particularly those related to stigma, and a larger increase in positive feelings six months after abortion. Accompaniment's focus on person-centered support, self-determination, and autonomy may enable people seeking abortion to view their decision as one that is valid and legitimate, and resist the predominant stigmatizing narratives framing abortion as something that is transgressive.

A qualitative exploration of how the COVID-19 pandemic shaped experiences of self-managed medication abortion with accompaniment group support in Argentina, Indonesia, Nigeria, and Venezuela.

Globally, people self-manage their medication abortions without clinical assistance. Feminist activist collectives (accompaniment groups) support people through self-managed abortion with evidence-based guidance. We sought to understand the impact of COVID-19 and related restrictions on the need for and experiences of self-managed abortion with accompaniment support across varied legal and social contexts. Between May and October 2020, we conducted in-depth interviews with individuals who self-managed abortions with support from accompaniment groups during the pandemic in Argentina, Indonesia, Nigeria, and Venezuela. We conducted a thematic analysis to understand the impact of COVID-19 on participants' experiences with accompanied self-managed abortions. Across 43 in-depth interviews, participants in all four countries described how the COVID-19 pandemic created challenges at each step of their abortion process, from confirming the pregnancy, accessing abortion pills, finding a private, comfortable place, and verifying abortion completion. For most people, conditions related to the pandemic made it harder to self-manage an abortion; for a minority, being at home made aspects of the experience somewhat easier. Nonetheless, all participants reported feeling supported by accompaniment groups, and COVID-19 and related lockdowns reinforced their preference for accompaniment-supported self-managed abortion. These findings highlight the essential role that accompaniment groups play in ensuring access to high-quality abortion care in a multiplicity of settings, particularly during the COVID-19 pandemic. Efforts are needed to expand the reach of accompaniment groups to increase access to the high-quality abortion support they provide, filling a critical gap left by health systems and legal infrastructure.

On Love, Dying Alone, and Community.

This paper examines the problem of dying alone in the context of no-visitors hospital policy during the COVID-19 pandemic. It critically analyses a rights-based solution, offering a democratized visitors policy alternative, premised on the value of legal justice. While an inclusive, participatory, and thoroughly justified visitors' policy, which takes into account the good of all stakeholders in the process, is indeed the right alternative to the paternalistic, top-down no-visitors policy, I argue that the democratized visitors' policy alternative ought to be grounded on reasons of both justice and love. Legal justice and claimable individual rights, though important, are limited and cannot fully capture the vicissitudes of mutual vulnerabilities and the moral stringency of duties of mutual care. In the context of suffering and death, instances of extreme vulnerability and interdependence, individual rights of autonomy and self-determination prove insufficient to meet our most basic needs for love, human presence, and accompaniment.

Perspectives on high-quality interpersonal care among people obtaining abortions in Argentina.

INTRODUCTION: Little is known about how people who have abortions describe high-quality interpersonal care in Argentina. This qualitative study aimed to understand preferences and priorities in their interactions with providers. STUDY DESIGN: We conducted 24 in-depth interviews with people who obtained abortions at a comprehensive reproductive health clinic or with support from a feminist accompaniment group in Buenos Aires and Neuquén, Argentina. We iteratively coded transcripts using a thematic analysis approach based on interpersonal domains present in current quality of care frameworks. RESULTS: Participants described high-quality abortion care as feeling acompañamiento and contención from their providers - terms that imply receiving kind, caring, compassionate and emotionally supportive care throughout their abortion. They described four key elements of interpersonal interactions: attentive communication from providers and accompaniers, clear and understandable information provision, non-judgmental support, and individualized options for pain management. CONCLUSIONS: People obtaining abortions in Argentina consistently identified receiving compassionate and supportive care throughout an abortion as a key aspect of care. The findings have implications for incorporating people's perspectives in the development of care guidelines, training of providers, and monitoring and improving of services. This is particularly important as the government of Argentina prepares to expand legal access to abortion.

Little is known about how people who have abortions perceive the quality of the care they receive and what aspects of interpersonal interactions with providers matter to them. This qualitative study aimed to understand preferences of  people who had abortions at both a reproductive health clinic and with an accompaniment group in Argentina. We interviewed 24 people who obtained abortion care in Buenos Aires and Neuquén, Argentina. We asked them about their preferences for and experiences of abortion care. Then we analyzed the interviews, specifically assessing aspects of interpersonal care based on quality of care frameworks from the literature. Participants described high-quality abortion care as feeling acompañamiento and contención from their providers­terms that imply receiving kind, caring, compassionate and emotionally supportive care throughout their abortions. They described four key elements of interpersonal interactions: attentive communication from providers and accompaniers, clear and understandable information provision, non-judgmental support, and individualized options for pain management. In conclusion, people obtaining abortions in two distinct models of care in Argentina consistently identified receiving compassionate and supportive care throughout an abortion as a key aspect of care. The findings have implications for incorporating people's perspectives in the development of care guidelines, training of providers, and monitoring and improving of services. This is particularly important as the government of Argentina prepares to expand legal access to abortion.

"Becoming the woman she wishes you to be": A qualitative study exploring the experiences of medication abortion acompañantes in three regions in Mexico.

OBJECTIVES: Acompañantes are activists who accompany women who have medication abortions outside of clinical settings. We describe models of accompaniment across 3 states in Mexico with diverse abortion laws, access, and acompañantes, and describe how acompañantes conceptualize the benefits and challenges of their work. STUDY DESIGN: In this exploratory, qualitative study, we conducted semi-structured interviews with 14 participants about their experiences as acompañantes, in 2 states with restrictive abortion legislation (Baja-California, Chiapas) at the time of research and Mexico City, where abortion is legal upon request in the first trimester. We used a feminist ethnography approach and analyzed data using a priori categories which included perceived benefits of and challenges of the accompaniment model. RESULTS: Participants described similar steps and general characteristics of the accompaniment process regardless of the setting, supporting the concept of an overarching definition of the holistic accompaniment model for these acompañantes. Holistic accompaniment is a horizontal model that involves trusting women, not asking for the reasons for their abortion, preventing criminalization, economic support, respecting autonomy, emotional accompaniment, and being flexible. Participants described perceived advantages, including safety, even in settings otherwise unsafe, such as where women may be stigmatized and / or criminalized. Participants described benefits of autonomous abortion compared to in-clinic medication abortion or surgical abortion, and benefits specifically related to accompaniment, such as the potential to make the abortion a positive experience. CONCLUSIONS: We describe components of a holistic accompaniment model in Mexico which has specific characteristics that may benefit women who opt for out-of-clinic abortion. IMPLICATIONS: We describe specific characteristics of a holistic accompaniment model in Mexico; this description facilitates learning across models and could be used to better understand the similarities and differences among accompaniment models, other self-managed medication abortion models, and provider-led abortion services.

Transitivismo e psicopatologia na infância / Transitivismo y psicopatologia em la infancia / Transitivism and psychopathology in childhood / Transitivisme et psychopathologie dans la enfance

No presente ensaio teórico, apresenta-se uma leitura da articulação do conceito de transitivismo com a psicopatologia do autismo na infância. Como objeto de pesquisa, utiliza-se um corpus textual composto por escritos de quatro autores que se dedicaram à discussão da psique infantil: Henri Wallon (1879-1962), Jacques Lacan (1901-81), Jean Bergès e Gabriel Balbo. Trabalha-se, ainda, a partir de recortes clínicos de acompanhamentos terapêuticos [AT] com crianças realizados com uma das autoras. A compilação dos recortes clínicos demarca a especificidade da intervenção no AT e aponta a importância de que o profissional psi considere o transitivismo na prática clínica e interrogue-se sobre os obstáculos que se interpõem na organização do transitivismo mãe-criança

En este ensayo teórico, se presenta una lectura de la articulación del concepto de transitivismo con la psicopatología del autismo en la infancia. Como objeto de investigación se utiliza un corpus textual elaborado por cuatro autores dedicados a la discusión de la psique infantil: Henri Wallon (1879-1962), Jacques Lacan (1901-81), Jean Bergès y Gabriel Balbo. También trabajamos a partir de recortes clínicos de acompañamientos terapéuticos [AT]con niños realizados con una de las autoras. La recopilación de recortes clínicos demarca la especificidad de la intervención en el AT y señala la importancia de que el profesional psi considere el transitivismo en la práctica clínica y pregunte por los obstáculos que se interponen en el camino de la organización del transitivismo madre-hijo

In this theoretical essay, the concept of transitivismis articulated with the psychopathology of autism in childhood. As a research object, we work with texts written by four authors who dedicated themselves to the discussion of the infantile psyche: Henri Wallon (1879-1962), Jacques Lacan (1901-81), Jean Bergès and Gabriel Balbo. We also work with clinical excerpts from therapeutic accompaniments [TA] with children that were conducted by one of the authors of this essay. The compilation of the clinical excerpts demarcates the specificity of the intervention in TA and points out how important it is for the psychologist to consider transitivism in the clinical practice and to consider the obstacles that stand in the way of the organization of the mother-child transitivism

Dans le présent essai théorique, nous présentons une lecture de l'articulation du concept de transitivisme avec la psychopathologie de l'autisme dans l'enfance. Comme objet de recherche, nous utilisons un corpus textuel composé pour les écrits de quatre auteurs que se dévoués à la discussion de la psyché infantile: Henri Wallon (1879-1962), Jacques Lacan (1901-81), Jean Bergès et Gabriel Balbo. Nous travaillons encore à partir de vignettes cliniques de les accompagnements thérapeutiques [AT] avec des enfants, réalisés par une de les autrices. La compilation des vignettes cliniques délimite la spécificité de l'interversion dans l'AT et indique l'importance de que le professionnel psy considère le transitivisme dans le pratique clinique et qu'il s'interroge sur les obstacles que s'interposent dans l'organisation du transitivisme mère-enfant

In-person later abortion accompaniment: a feminist collective-facilitated self-care practice in Latin America.

In Argentina, Chile and Ecuador, abortion at later durations of pregnancy is legally restricted. Feminist collectives in these contexts support people through self-managed medical abortion outside the healthcare system. The model of in-person abortion accompaniment represents an opportunity to examine a self-care practice that challenges and reimagines abortion provision. We formed a collaborative partnership built on a commitment to shared power and decision-making between researchers and partners. We conducted 28 key informant interviews with accompaniers in Argentina, Chile and Ecuador in 2019 about their model of in-person abortion accompaniment at later durations of pregnancy. We iteratively coded transcripts using a thematic analysis approach. Accompaniers premised their work in a feminist activist framework that understands accompaniment as addressing inequalities and expanding rights, especially for the historically marginalised. Through a detailed description of the process of in-person accompaniment, we show that the model, including the logistical considerations and security mechanisms put in place to ensure favourable abortion outcomes, emphasises peer-to-peer provision of supportive physical and emotional care of the accompanied person. In this way, it represents supported self-care through which individuals are centred as the protagonists of their own abortion, while being accompanied by feminist peers. This model of supported self-care challenges the idea that "self-care" necessarily means "solo care", or care that happens alone. The model's focus on peer-to-peer transfer of knowledge, providing emotional support, and centring the accompanied person not only expands access to abortion, but represents person-centred practices that could be scaled and replicated across contexts.

A clínica psicanalítica no acompanhamento terapêutico: experiência, escrita e transmissão / The psychoanalytic clinic in therapeutic accompaniment: experience, writing and transmission / La clínica psicoanalítica en acompañamiento terapéutico: experiencia, escritura y transmisión / La clinique psychanalytique en accompagnement thérapeutique: expérience, écriture et transmission

O artigo se refere à experiência clínica no dispositivo acompanhamento terapêutico (at) em um projeto de extensão universitária. O projeto em questão concerne à clínica ampliada e é sustentado pela psicanálise. Percorremos a dimensão da escrita: do sujeito, dos casos, da transmissão, destacando alguns fundamentos das teorizações freudianas e lacanianas, em diálogo com autores contemporâneos, que orientam a escuta e a construção dos casos. Salientamos a relação do sujeito com a cidade: a dinâmica de enlace com a rede, com a família e com a comunidade indica que a dinâmica do AT colabora com a reconfiguração de espaços e sentidos do viver. Dessa maneira, esse dispositivo se apresenta como uma possibilidade de compor e tecer estratégias antimanicomiais.

The article refers to the clinical experience in the therapeutic accompaniment (ta) device in a university extension project. The project in question refers to the expanded clinic and is supported by psychoanalysis. We covered the dimension of writing: of the subject, of the cases, of the transmission, highlighting some fundamentals of Freudian and Lacanian theorizations, in dialogue with contemporary authors, who guide the listening and construction of the cases. We emphasize the subject's relationship with the city: the dynamics of linking with the network, with the family and with the community indicates that the dynamics of the ta collaborates with the reconfiguration of spaces and meanings of living. Thus this device presents itself as a possibility to compose and weave anti-asylum strategies.

El artículo se refiere a la experiencia clínica en el dispositivo de acompañamiento terapéutico (at) en un proyecto de extensión universitaria. El proyecto en cuestión se refiere a la clínica ampliada y cuenta con el apoyo del psicoanálisis. Abordamos la dimensión de la escritura: del sujeto, de los casos, de la transmisión, destacando algunos fundamentos de las teorizaciones freudianas y lacanianas, en diálogo con autores contemporáneos, que orientan la escucha y construcción de los casos. Destacamos la relación del sujeto con la ciudad: la dinámica de vinculación con la red, con la familia y con la comunidad indica que la dinámica del AT colabora con la reconfiguración de espacios y significados de la vida. Así, este dispositivo se presenta como una posibilidad para componer y tejer estrategias antiasilo.

L'article fait référence à l'expérience clinique du dispositif d'accompagnement thérapeutique (at) dans un projet d'extension universitaire. Le projet en question fait référence à la clinique agrandie et avec le soutien de la psychanalyse. Nous abordons la dimension de l'écriture: le sujet, les cas, la transmission, en mettant en évidence certains fondamentaux des théorisations freudiennes et lacaniennes, en dialogue avec des auteurs contemporains, qui guident le choix et la construction des cas. Nous mettons en évidence la relation du sujet avec la ville : la dynamique de connexion avec le réseau, avec la famille et avec la communauté indique que la dynamique de l'at collabore avec la reconfiguration des espaces et des significations de la vie. Ainsi, ce dispositif se présente comme une possibilité de composer et d'avoir des stratégies anti-asile.

Acompanhamento Terapêutico e Direitos Sociais: Territórios existenciais e sujeito biopsico-político-social / Therapeutic Accompaniment and Social Rights: Existential territories and biopsico-political-social subject / Acompañamiento Terapéutico y Derechos Sociales: Territorios existenciales y sujeto biopsico-político-social

Este artigo surge da pesquisa de doutorado que teve como objetivo analisar como o exercício de Direitos Sociais (DS) incide nos processos subjetivos e terapêuticos em curso, na clínica em Psicologia, articulada às políticas públicas brasileiras. Subsidiado por registros de experiências de 28 casos clínicos em Acompanhamento Terapêutico (AT), além de documentos institucionais, registros em diário de campo, imagens, dentre outros, focaliza a discussão na relação entre o Acompanhamento Terapêutico, como modalidade da clínica, e o exercício dos Direitos Sociais. A pesquisa analisou o modo como o discurso dos DS - educação, saúde, alimentação, trabalho, moradia, transporte, lazer, segurança, previdência social, proteção à maternidade e à infância e assistência aos desamparados - emergiu nos materiais e forneceu elementos para pensar como os sujeitos produzem e conduzem a si, na vida e nos processos terapêuticos, como seres subjetivos. Mediante os resultados, em interlocução com autoras da área, propõem-se três linhas de pensamentos integrados: (1) o AT como via, em ato, de exercício do Direito Social à saúde; (2) a relação entre território, processos terapêuticos e os DS; e (3) a radicalidade da clínica do sujeito biopsico-político-social, que a prática do AT explicita.

This article arises from the doctoral research that aimed to analyze how the exercise of Social Rights (SD) affects the subjective and therapeutic processes in progress, in the Psychology clinic, linked to Brazilian public policies. Subsidized by records of experiences of 28 clinical cases in Therapeutic Accompaniment (TA), in addition to institutional documents, field diary records, images, among others, focuses the discussion on the relationship between Therapeutic Accompaniment, as a modality of the clinic, and exercise Social Rights. The research analyzed how the DS discourse - education, health, food, work, housing, transportation, leisure, security, social security, maternity and childhood protection and assistance to the destitute - emerged in the materials and provided elements to think about how the subjects produce and conduct themselves, in life and in therapeutic processes, as subjective beings. Through the results, in interlocution with authors from the area, three integrated lines of thoughts are proposed: (1) the TA as a way, in action, of exercising the Social Right to health; (2) the relationship between territory, therapeutic processes and SD; and (3) the radicality of the clinic of the biopsico-political-social subject, which the TA practice makes explicit.

Este artículo surge de la investigación doctoral que tuvo como objetivo analizar cómo el ejercicio de los Derechos Sociales (DS) afecta los procesos subjetivos y terapéuticos en progreso, en la clínica de Psicología, vinculados a las políticas públicas brasileñas. Subsidiado por registros de experiencias de 28 casos clínicos en Acompañamiento Terapéutico (AT), además de documentos institucionales, registros de diario de campo, imágenes, entre otros, enfoca la discusión sobre la relación entre el Acompañamiento Terapéutico, como una modalidad de la clínica, y el ejercicio Derechos sociales. La investigación analizó cómo el discurso de DS (educación, salud, alimentación, trabajo, vivienda, transporte, ocio, seguridad, seguridad social, protección de la maternidad y la infancia y asistencia a los indigentes) surgió en los materiales y proporcionó elementos para pensar cómo los sujetos producen y conducense, en la vida y en los procesos terapéuticos, como seres subjetivos. A través de los resultados, en la interlocución con los autores del área, son propuestas tres líneas de pensamientos integradas: (1) el AT como una forma, en acción, de ejercer el Derecho Social a la salud; (2) la relación entre territorio, procesos terapéuticos y DS; y (3) la radicalidad de la clínica del sujeto biopsico-político-social, que la práctica de TA hace explícita.

Acompanhamento terapêutico: considerações sobre uma clínica a céu aberto / Therapeutic accompaniment: considerations about an open-air clinic

O presente estudo pretende abordar o Acompanhamento Terapêutico (AT) e sua prática a partir do viés da psicanálise, o qual questionamos enquanto método para o AT. Discorreremos sobre a história da loucura, compreendendo quais posições o louco ocupou na sociedade e ressaltando o papel do discurso científico em seu tratamento. Veremos como a Reforma Psiquiátrica possibilitou a liberdade do tratamento, bem como o surgimento do AT. Considerando a especificidade do AT no encontro com o contingente, analisaremos o conceito aristotélico da prudência, que se articula com a contingência, visto que discursamos acerca de uma clínica em movimento que se depara com variáveis não controláveis. A prudência nos dirá de um saber que se manifesta a partir da contingência, logo, pensaremos nessa lógica a serviço de um método que se constrói na colocação em ato. Concluímos ressaltando a função política do AT de sempre reforçar o cuidado em liberdade.

The present study intends to approach Therapeutic Accompaniment (TA) and its practice from the perspective of psychoanalysis, which we question as a method for TA. We will discuss the history of madness, understanding what positions the madman occupied in society and emphasizing the role of scientific discourse in his treatment. We will see how the Psychiatric Reform enabled the freedom of treatment, as well as the emergence of TA. Considering the specificity of TA in the encounter with the contingent, we will analyze the Aristotelian concept of prudence, which is articulated with contingency, since we discuss about a moving clinic that is faced with uncontrollable variables. Prudence will tell us of a knowledge that manifests itself from contingency, so we will think of this logic at the service of a method that is built in putting into action. We conclude by emphasizing the political function of the TA, of always reinforce care in freedom.

Psicanálise e Acompanhamento Terapêutico: Quando a Cidade se Torna o Setting Analítico da Psicose / Psychoanalysis and Therapeutic Accompaniment: The City as Analytical Setting of Psychosis / Psicoanálisis y Acompañamiento Terapéutico: La Ciudad se Convierte en el Setting Analítico de la Psicosis

O Acompanhamento Terapêutico (AT) nasce no contexto da Reforma Psiquiátrica e, embora não figure na legislação como uma política pública oficial, integra-se a diversos serviços voltados para a saúde mental. O AT, que traz como característica dominante o deslocamento físico em espaços públicos e o setting móvel, vem ganhando cada vez mais protagonismo nos serviços que estão se constituindo no processo reformista brasileiro. Partindo de uma fundamentação psicanalítica a respeito da psicose, discutimos um aspecto que nem sempre vem em primeiro lugar nas teorizações produzidas a respeito do AT: sua dimensão clínica. Para isso, valemo-nos do método da psicanálise aplicada, pois este permite o estudo psicanalítico de fenômenos sociais, que estão além do setting clínico tradicional. Concluímos que o AT é um espaço para fazer a escuta subjetiva tão necessária à psicose, sem deixar de lado os aspectos políticos e sociais atrelados à loucura. (AU)

The Therapeutic Accompaniment (TA) rises in the context of the Psychiatric Reform and, although it does not fit into legislation as an official public policy, it ends up entering several services aimed at mental health. The TA, which has as dominant key the movement in public objects and the moving setting, has been gaining more and more prominence in the services that are being constituted in the Brazilian reform process. We discuss, from the psychoanalytic background about psychosis, an aspect that does not always come first in the theorizations produced about the TA: its clinical dimension. For this, we use the method of applied psychoanalysis, which allows the psychoanalytic study of social phenomena that are beyond the traditional clinical setting. We conclude that TA is a space of privilege to make the subjective listening that is so necessary to psychosis, without leaving aside the political and social aspects that are attached to madness. (AU)

El Acompañamiento Terapéutico (AT) nació en el contexto de la Reforma Psiquiátrica y, aunque no se configura en la legislación como una política pública oficial, adentra diversos servicios dirigidos a la salud mental. El AT, que trae como característica dominante la marcha en espacios públicos y el setting móvil, viene ganando cada vez más protagonismo en esos servicios que se están constituyendo en el proceso reformista brasileño. Discutimos, a partir del fundamento psicoanalítico acerca de la psicosis, un aspecto que no siempre viene en primer lugar en las teorizaciones producidas con respecto al AT: su dimensión clínica. Para ello, nos valemos del método del psicoanálisis aplicado, que permite el estudio psicoanalítico de fenómenos sociales, los cuales están más allá del setting clínico tradicional. Concluimos que el AT es un espacio de privilegio para hacer la escucha subjetiva tan necesaria a la psicosis sin dejar de lado los aspectos políticos y sociales que están ligados a la locura. (AU)

Implementation of guidelines to integrate the caregiver as a coassistant of health-care personnel during the hospital stay of COVID-19 pediatric patients: adaptation in a Mexican public pediatric hospital / Implementación de guías para integrar al cuidador como coauxiliar del equipo de salud durante la estancia hospitalaria del paciente pediátrico con COVID-19: adaptación en un hospital pediátrico público mexicano

Abstract This paper describes the experience in a public pediatric hospital when implementing the Mexican Health Ministry’s recommendations on the inclusion and importance of a chosen caregiver during the hospitalization of a coronavirus disease 2019 (COVID-19) pediatric patient. The implementation includes the adjustments, observations, and limitations made in real practice and process. In conclusion, the value and benefits of the accompaniment of hospitalized children with COVID-19 by a primary or chosen caregiver are evidenced and supported by family-centered care. Furthermore, the recommendations mentioned result in comprehensive bio-psycho-social care for the benefit of pediatric patients.

Resumen Se describe cómo el Hospital Infantil de México Federico Gómez pone en funcionamiento las recomendaciones publicadas por la Secretaría de Salud sobre la inclusión y la importancia del acompañamiento de un cuidador primario durante la hospitalización del paciente pediátrico con COVID-19. Se incluyen las adecuaciones, las observaciones y las limitaciones del proceso. Se concluye acerca de la importancia de la flexibilidad y el buen uso de los recursos en la implementación de la guía. Además, se examinan la atención biopsicosocial integral en beneficio de los menores y la importancia del acompañamiento, que se sustenta en la atención centrada en la familia y la integración del cuidador como auxiliar en el equipo médico.

Cultura de institucionalização de crianças e adolescentes: Um problema para a psicologia / The culture of institutionalization of children and adolescents: A problem for psychology / La cultura de institucionalización de niños y adolescentes: Un problema para la psicología

RESUMO Este ensaio traz para a pauta da Psicologia a problemática acerca da cultura da institucionalização de crianças e adolescentes. Para tanto, seguimos dois caminhos: o da pesquisa bibliográfica e da pesquisa documental. Analisamos o processo histórico da construção das políticas de acolhimento institucional de crianças e adolescentes, desde os anos 90. Identificou-se que se por um lado os textos legislativos e normativos, desde os anos 90, pretendem a desinstitucionalização das crianças e adolescentes, visando garantir-lhes seu direito à convivência familiar e comunitária, por outro, ainda é expressivo o índice de afastamento dos filhos de famílias em situação de pobreza, entretanto, velado como uma cortina de fumaça no discurso da família negligente, o que ainda tem caracterizado as instituições de acolhimento como um lócus da exclusão social e dado manutenção a uma cultura de institucionalização dos tidos "des-ajustados".

ABSTRACT This essay brings to Psychology's agenda the problem about the culture of institutionalization of children and adolescents. For this purpose, we follow two paths: bibliographic research and documentary research. We analyze the historical process of the construction of institutional policies for children and adolescents since the 1990s. We identified, on one hand, that legislative and normative texts have aimed the deinstitutionalization of children and adolescents since the 1990s, in order to guarantee their right to family and community coexistence. On the other hand, the rate of children removal from families in poverty is still significant, although it is disguised as a smoke screen in the discourse of the negligent family. This discourse has still been characterizing the hosting institutions as a locus of social exclusion and has been maintained by a culture of institutionalization of the so-called "maladjusted" ones.

RESUMEN Este ensayo trae a la pauta de la Psicología la problemática acerca de la cultura de institucionalización de niños y adolescentes. Por lo tanto, seguimos dos caminos: el de la investigación bibliográfica y la documental. Analizamos el proceso histórico de la construcción de las políticas de acogida institucional de niños y adolescentes desde los años 90. Identificamos que, por un lado, los textos legislativos y normativos, desde los años 90, pretenden la desinstitucionalización de los niños y adolescentes, buscando garantizarles su derecho a la convivencia familiar y comunitaria. Por otro lado, todavía es expresivo el índice de alejamiento de los hijos de familias en situación de pobreza, sin embargo, disimulado como una cortina de humo en el discurso de la familia negligente, lo que aún ha caracterizado a las instituciones de acogida como un locus de exclusión social y sostenido en una cultura de institucionalización que los cataloga como desajustados.