A terapia cognitivo-comportamental no Centro de Atenção Psicossocial Álcool e Outras Drogas/CAPS ad: um estudo exploratório

Abstract

Introduction: CAPS ad (alcohol/drugs) aims to treat people with alcohol and drugs abuse. Cognitive Behavioral Therapies represent treatment approaches for drug dependence that have extensive scientific research, with results verified in multiple meta-analyzes and systematic reviews. Health systems around the world have been struggling to improve the cost-effectiveness of mental health care by seeking to identify and implement "evidence-based practices." Despite recognition of the efficacy of cognitive-behavioral therapies, there are few studies reporting their use in CAPS ad. Objectives: To perform two articles: 1) A review of literature on the use of cognitive and/or behavioral approaches to the treatment of alcohol and other drug addiction in CAPS ad; 2) Perform a descriptive exploratory research in order to know the perception about the use and insertion of cognitive-behavioral strategies by psychologists who work in CAPS ad, using these approaches. Methods: In the first study, an integrative review was performed including 28 articles that dealt with the use of cognitive-behavioral therapies in CAPS ad, as well as articles reviewing the results on treatment for alcohol dependence and other drugs using these approaches. In the second study, we interviewed sixteen psychologists working in CAPS ad in Rio de Janeiro and Minas Gerais states who reported using cognitive and/or behavioral therapies in the treatment of alcohol and other drug addiction. Data analysis was performed through thematic content analysis, with definition of analysis categories after the exploration of the material. Results: the participants reported playing a variety of roles in their clinical practice, coupled with challenges related to the lack of infrastructure of the institution, lack of investment in capacity building, and a high demand for short-term care. In the field of studies and discussions present in the CAPS ad, it lacks capacities regarding tools for the treatment of alcohol and other drug dependence and practices are basically directed by the policy of mental health and Harm Reduction. Psychoanalysis continues to present itself with a reference, although it does not present available evidence of its results. Although cognitive-behavioral strategies are recognized as evidence-based interventions and have several important public health advantages, there are still obstacles to the adoption of these tools as a reference for the treatment of psychoactive substance dependence in mental health services in Brazil.