The inclusion of psychosocial rehabilitation in outpatient mental health services: the conflict between instrumental rationality and practical rationality

Abstract

This study was developed in Ribeirão Preto, SP, Brazil in two outpatient mental health services: a Regional Outpatient Mental Health service and a Psychosocial Care Center II and aimed to investigate the organization of the outpatient care services, the therapeutic projects of these services, and the inclusion of psychosocial rehabilitation in therapeutic projects. It was based on qualitative methodology and used semi-structured interviews and focus groups. Data analysis was based on the hermeneutic dialectic framework of Jürgen Habermas, according to a reconstructive interpretative technique. The results indicated that the organization of these services is focused on the clinical-psychiatric practice, emphasizes the diagnosis and pathology, treatment is medication-centered, and psychosocial rehabilitation is a secondary element addressed in projects and actions available to the services' users. This article discusses part of this larger study in relation to the inclusion of psychosocial rehabilitation in the studied services, addressing the subject in the light of the conflict between two types of rationality: instrumental and practical.