Academic journal article Journal of Mental Health Counseling

Person-Centered Therapy with Impoverished, Maltreated, and Neglected Children and Adolescents in Brazil

Academic journal article Journal of Mental Health Counseling

Person-Centered Therapy with Impoverished, Maltreated, and Neglected Children and Adolescents in Brazil

Article excerpt

This article reports on a program that provides person-centered therapy for impoverished, maltreated, and neglected children and adolescents in Brazil. The program, which is staffed by volunteer therapists, started in 2002. Since then, nearly 100 hundred children and adolescents have received therapy in three institutions, one residential and two nonresidential The general outcomes are described, leading to the conclusion that person-centered therapy is an effective strategy for the promotion of children's and adolescents' resilience, even in the context of multiple adverse conditions such as socioeconomic disadvantage, neglect, maltreatment, and abandonment. We conclude that the multicultural feature of person-centered therapy explains its effectiveness in this distinct population of Brazilian lower-class and non-White children and adolescents.

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Brazil is a country of 176 million. It is a highly stratified society resulting from colonialism and slavery. The relatively high GPD per capita (U.S. $2,593 in 2002) masks deep inequality because Brazil has a highly skewed income distribution, which is among the world s worst. Poverty is most pervasive in the lowest levels in the rural parts of the Northeast, but there are also pockets of urban poverty in the largest cities in the developed regions in the Southeast and South. The number of people who live below the national poverty line was estimated in 2001 to be about 17% of the country s total population. Twenty-two percent of the population survives on less than U.S. $2 a day. Due to the high unemployment levels and widespread informal economic activity, the lowest strata continue to be excluded from full participation in markets and full access to government services (Hudson, 1997; Human Development Reports, 2004). Moreover, as a result of the acceptance of interracial unions, Brazilians form one of the most heterogeneous populations in the world, constituting a trihybrid population with European, African, and Amerindian (i.e., South American Indian) roots. Based on self-declared ethnicity, in 1991, Brazilians were 55.3% White, 39.3% mixed-race (pardos), 4.9% Black, and 0.6% Asian (Parra, Amando, Lambertucci, Roca, Antunes, & Pena, 2003).

Regarding youth and their education, in Brazil, 28.3% of the population is below age 15. If compared with developed countries, Brazil has a relatively young population. There are 32 million children and adolescents who live in families with incomes of less than U.S. $40 a month. The widespread poverty creates a breeding-ground for social ills like malnutrition, abuse, maltreatment, and violence against children (Soca, 2004). Primary school is free and compulsory for children between the ages of 7 and 14, but high drop-out rates and grade repetition are endemic problems. In 1990, school enrollment reached about 90% of school-age children, although there was wide variation, with lower coverage among rural and low-income populations. However, only about one third of students enrolled in primary school finish eight years of mandatory schooling. Students in Brazilian public school receive an average of four hours of class time per day (Hudson, 1997; Human Development Reports, 2004).

Public access to medical care increased after Brazil's constitution of 1988 granted all Brazilian citizens the right to procure free medical assistance. The management and organization of health services was decentralized from the federal to the state and, especially, municipal level. Although the public domain oversees basic and preventive health care, the private nonprofit and for-profit health care sector delivers the bulk of medical services, including government reimbursement and subsidized inpatient care. Therapeutic treatment in hospitals tends to dominate funding at the expense of health promotion and disease prevention programs (Hudson, 1997).

Brazil's mental health care system has been traditionally based on large psychiatric hospitals and asylums. …

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