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ABSTRACTA close examination of the experience of collaboration established over the past 25 years between the Clinique communautaire de Pointe-St-Charles - which has the primary care mandate of a CLSC (local community services), and the Douglas Hospital, a centre specialized in psychiatry, - has allowed to document a particular type of partnership for adult mental health services. With the support of a team of psychiatric consultants, first line multidisciplinary teams of professionals are responsible for the treatment plan established as well as ensuring, if necessary, continuity of long-term care. This approach also counts on the fact this clinic is deeply-rooted in the neighborhood as well as on the tradition of collaboration with many community organizations servicing people treated at this clinic. This model of organization is submitted to pressures caused by the transformation of the health and social services system. This study realized during the transformation period, has allowed to shed new light on the conditions of realization of the intervention model at the Pointe-St-Charles community clinic and identify points of improvement by considering the perspective of consumers and professionals involved.

ABSTRACTThe author reports on the opinions of doctors Louis Guérette and Jean-Pierre Rodriguez, both psychiatrists - one working at the Pavillon Notre-Dame of the Centre hospitalier universitaire de Montréal (CHUM) - the other at the Pavillon Albert-Prévost (PAP) of the Hôpital du Sacré-Coeur de Montréal, - on the place of specialized psychiatric clinics in the organization of care in psychiatry. Dr Guérette who practices general psychiatry thinks specialized clinics are not an appropriate mode of care delivery. Dr Rodriguez, answering to Dr Guérette's arguments, presents the organizational system of specialized clinics put in place at the PAP. The questions raised by the author and the psychiatrists' answers are reported. Finally, the author, a resident doctor in psychiatry, presents his own personal opinion on the issue.

AbstractHomelessness, mental health and occupational therapy Persons who are homeless with a mental illness constitute a significant portion of the homeless population. They have a myriad of occupational performance problems and are further compromised by systemic and political issues. There is growing evidence that occupational therapy can make a contribution to the health and quality of life of this marginalized, under served population. This paper describes the process and challenges providing occupational therapy services to persons who are homeless with mental health problems, addictions, and serious mental illnesses using the Canadian Model of Occupational Performance. There is a goodness of fit between the values and beliefs of the occupational therapy profession and the needs and occupational performance issues of persons who are homeless. Through helping people to develop meaningful occupations and gain control of their lives, people may be able to make permanent and positive changes in their lives. Within this dynamic is a great deal of potential learning and growth for human beings regardless if they are providers or recipients of service.

AbstractClinical case management of severely mentally ill homeless people The aim of this clinical case management project was to improve the health and quality of life of homeless mentally ill people and to help them use more appropriately health and welfare services. During a descriptive study that lasted 12 months, data was collected concerning the case manager's intervention as well as the assessment of these interventions on the clients' health and behavior and on community resources' services. Although limited in scope and length, the project shows some positive results. Recommendations are made concerning essential collaboration between all health and welfare professionals working with this population.

ABSTRACT Care oriented toward rehabilitation requires the intervention of an interdisciplinary team to ensure a multidimensional therapeutic strategy within the institutional network. The ecosystemic approach is useful to understand the operation of the institutional apparatus and to study the organization and the evolving dynamics within the complex care system. On the grounds that rehabilitation is viewed as a developmental process, varied experiences demonstrate the need to adapt the institutional apparatus in favor of more creativity within the care system. Indeed, greater creative leeway will allow the care giver to be sufficiently differenciated and autonomous to co-evolve with the care receivers by adapting to the latter's needs without being trapped by the institutional routine.

SummaryFrom among the most common of childhood games, playing with dolls and hide and seek were selected for observation. Groups of children two years of age, three and four years of age, five and six years of age, and seven years of age were observed in non-structured situations with the objective of tracing the evolution of each age group. The analysis of behavior patterns by age group and by game reveals conduct common to each age group and parallel from one game to another. The interpretation of these observations shows the increasing distance between the child and his surroundings, the process of progressing from the mastery of gestures to their integration within a role, and the exploration of objects' properties and their coordination within an integrated system.

AbstractThis article examines the various relationships existing among the new therapies, consciousness-raising techniques and the "new-culture". Having defined the "new-culture" movement in terms of the elaboration of a new model of social change, the author analyses the new therapies as techniques for deprograming the effects of sexual repression and of rationalistic and authoritarian behavior. Consciousness-raising techniques are then considered as strategies for psychosociological reprogram-ing leading to the setting up of a new society. In conclusion, a general hypothesis is presented concerning the possible links existing between non-genital sexuality and the development of psychic powers.

AbstractThis article suggests a few directions for epistemological reflection on the social configuration of the individual through the theories of human behaviour that constitute the basis of social research and intervention. These social configurations, according to perspectives stemming from neo-positivism, the symbolic universe, or from a project of social transformation, are effected through, among other things, language understood as the modeling of a social knowledge. Moreover, the study of human behaviour is related intrinsically to the study of the subject/object relation. The reciprocity inscribed at the core of the praxis of clinical sociology transcends the restrictive nature of the theories.

Located at the edges of Equatorial Rainforest of Congo, the Mbindo Lala Hospital has the appearance of a small village comprised of thirty huts typically for patients and their families. This article describes the daily life of this hospital-village with a focus on highlighting the philosophy of Ngbandi medicine and healers, which structures care practices in the hospital-village. Similarly, the author shows how the social structure and the cultural universe of Angbandi are incorporated in this hospital-village with therapeutic activities organized around three altars (one for the ancestors, another for the spirits of the forest and water, and one to block witchcraft activities), all places where patients gather each day to receive their treatment. It is within the horizon of a politics of authenticity, put forward by President Mobutu between 1972 and 1977, that the status of the village hospital and, more broadly, medicine and healers are discussed. Further, the limits associated with the politics of valorization of a Zairian therapeutic tradition are underlined.

Keywords: Bibeau, Zaïre (Congo), politique de l'authenticité, guérisseur traditionnel, village-hôpital, Ngbandi, Bibeau, Zaïre (Congo), Politics of Authenticity, Traditional Healer, Hospital-Village, Ngbandi, Bibeau, Zaire (Congo), política de la autenticidad, curandero tradicional, aldea-hospital, Ngbandi

Keywords: MTE, approche inductive, pensée associative, psychanalyse