Therapeutic Communities and Psychosocial Care: a study at the Psychosocial Care Center for Alcohol and Drugs (CAPS AD III) in Ceilândia, Federal District

Abstract

This article analyzes the relationship between Therapeutic Communities (TCs) and the Psychosocial Care offered to users of psychoactive substances treated at a Psychosocial Care Center for Alcohol and Drugs (CAPS AD III) in the Federal District, problematizing the alignment of these practices with the principles of the Psychiatric Reform (PR), Harm Reduction (HR), and the Psychosocial Care Network (RAPS). This is a qualitative, exploratory study, developed from a focus group with adult users who had a history of two or more hospitalizations in TCs affiliated with the public sector between 2020 and 2024. The data were subjected to Content Analysis, allowing the construction of analytical categories: Between autonomy and coercion; When faith ceases to be a choice: Religious coercion; The dimensions of Psychosocial Care; Social determinants of treatment: territory, inequality, and the production of social suffering; Therapeutic Communities: Challenges, Weaknesses, and Possibilities. The results highlight the predominance of practices marked by institutional control, moral and religious coercion, a weak multidisciplinary team, and the absence of fundamental psychosocial care devices, such as the Individual Therapeutic Project (ITP). In contrast, the CAPS (Psychosocial Care Center) emerges as a space for welcoming, bonding, and care in freedom. It is evident that, although the Therapeutic Communities precariously fill gaps in the face of insufficient public policies, their practices present significant misalignments with the psychosocial model, reinforcing the need to strengthen the Psychosocial Care Network (RAPS) and care policies centered on the individual and the guarantee of rights.