Integrative community therapy (Brazil)

Domain V · Systemic, relational, group & community · Adalberto de Paula Barreto, Airton Barreto · 1987 · Pirambu favela, Fortaleza, Brazil

What it is

TCI is a structured, open community circle, not a psychotherapy. Its authors say plainly that it is "not a group psychotherapy" and "not a clinical practice". It began in Pirambu, a large favela in Fortaleza, Ceará, Brazil. Adalberto Barreto, a psychiatrist and anthropologist at the Federal…

Format

• TCI has no course of treatment with phases across sessions. The structure that matters is the order of stages inside each roda, sometimes called its "liturgia". Rodas are open and ongoing, usually weekly, and each one stands alone.
• Format:

Who practises it, and how they are trained or regulated

• Version followed: the in-person roda (circle) of Terapia Comunitária Integrativa (TCI) as set out by its creator Adalberto de Paula Barreto and ABRATECOM (Associação Brasileira de Terapia Comunitária Integrativa). The sources are Silva, Barreto et al. (2020), ABRATECOM's social-technology submission to Fundação Banco do Brasil (c. 2023), the Ministry of Health's Portaria 849/2017 and the Goiás state protocol (2022,…
• Who may run it. Only therapists who are trained or in training at ABRATECOM-recognised training poles (Polos Formadores) may run rodas under the TCI name. Each roda needs a therapist and a co-therapist.
• Training totals at least 240 hours at an ABRATECOM-recognised training pole. Many poles offer it as a 360-hour specialisation instead. Theory may be taught in person or hybrid, but the practical and experiential parts must be in person.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• people who drop off after a disclosure. Follow up by message.
• later breaches. Refer back to the rules gently and neutrally (see 5.3).
• people report learning from others' stories, not from the facilitators.
• a summary that interprets rather than reflects. Use the speaker's words.
• generic praise. Name a specific strength that each person said or showed.

Problems the guide addresses

• Nobody wants to speak, or the circle goes silent
• Low or falling attendance
• Advice-giving, sermons, interpreting, or talking about others
• One person dominates, or the protagonist keeps re-entering
• Overwhelm: crying, panic, dissociation, a surge in blood pressure
• Disclosure of suicidal thoughts, self-harm, violence or abuse
• Stuck sharing: the group stays in complaint or problem-solving
• The therapist's urge to rescue or to act as the expert
• Ruptures: a participant feels unheard, judged, or exposed
• Conflict between members, or concerns about known people in a small community

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.