Introduction

The field of qualitative research in health includes the technical-operational, theoretical-methodological and ethical-political dimensions (^{Silva, Castro-Silva, & Moura, 2018}). This research approach can and should be adopted when what we intend to study encompasses the history, relationships, representations, beliefs, perceptions, opinions that people have about how they live, how they build their artifacts and themselves, feel and think in the context of the health, disease and care process (^{Minayo, 2014}).

As researchers and health professionals, our way of producing knowledge is implicated in the action research proposal that is based on intervention in the field of researched social reality (^{Amado & Cardoso, 2017}). Our prerogative of study is implied with the emancipation and protagonism of the workers of the mental health services of the Unified Health System (SUS), which is only possible through a participative paradigm that gives voice and visibility to all actors in the context investigated in a collaborative manner. Thus, we have used the human group and the dynamic interpersonal relationships that occur in it and from it for research that in its method proposes social intervention and knowledge production. The trajectory in the qualitative research in mental health brings us concerns about the great influence of the actors, whether they are researchers or subjects, who make up the social field in which the research process is inserted, from the conception of the project, through the methodological path and the dissemination of results.

For a better understanding of the interpersonal and group relationships that occur in the social field that constitutes our object of study in mental health, we have made use of the knowledge arising from the theoretical framework of Group Dynamics. This is a modern discipline within Social Psychology that aims to study the conduct of groups as a whole, as well as the alternations of individual action of its members for the elaboration of laws and techniques that increase the effectiveness of groups. The theory of Group Dynamics seeks to understand and explain the dynamics of collective life, the phenomena and the principles that govern its development process (^{Alcantara, 1972}; ^{Lewin, 1947}a; ^{Malhiot, 2013}; ^{Minicucci, 2002}).

The Group Dynamics theory seeks to understand and explain the dynamics of collective life, the phenomena and the principles that govern its development process (^{Silva et al., 2018}). Therefore, the researchers who authored this article have adopted Group Dynamics as a theoretical framework to support the development of research in mental health to achieve the desired excellence in qualitative investigations.

The group is configured as the union of two or more interdependent individuals in interactive action to achieve common goals through the existence of a task. It is a dynamic totality, accessible to observation and scientific experimentation. It represents the gross social cell, the micro context that conveys the meaning and functioning of the social milestone. Every group has its own dynamics resulting from the set of interactions that occur within the psychosocial space. Such interactions can manifest conflicts, repulsions, attractions, exchanges, communication or even coercion and pressure.

In this perspective, we understand Group Dynamics as an experiential process that allows for deeper and more elaborate reflections and learning and that, as a natural movement of interaction between subjects, in the context of action research, it can influence the whole process of investigation, both positive (if recognized and cared for) and negatively (if neglected).

Given the above, this article aims to discuss the multiple possibilities for applying the theories, methods, instruments and techniques in the field of Group Dynamics in the action research in the health-related context.

1.On what action-research do we speak?

The action research, which we address here, brings in its proposal the challenge of intervention in the social field. Our practice is marked by interventions aimed at health workers who work in SUS psychosocial care units with the aim of developing and qualifying those who work with users of mental health services and their families.

The action-research is based on the fact that the researcher needs to live and dive into the reality of the subjects involved in the research problem so that together, in a process of collective, cooperative and participative learning, build solutions that can change the investigated context , by encouraging action to transform reality(^{Amado & Cardoso, 2017}; ^{Melo, Maia Filho, & Chaves, 2016}; ^{Rocha, 2012}; ^{Thiollent, 2011}). It is cyclical and follows four operational steps: Data collection - moment when the field is explored to recognize the reality in which it is intended to intervene; reality diagnosis of reality - starting from the categorization and analysis of the data collected for the collective identification of the problems, it seeks to answer what is the current situation of the group and what it is desired to achieve with the group; action - after defining the diagnosis, an action plan is elaborated with alternative solutions that can reduce the distance between the desired situation and the identified problem situation and the evaluation - after the actions taken and the results obtained, a new diagnosis is made about the gaps that still exist in the reality (^{Lewin, 1948}; ^{Malhiot, 2013}; ^{Melo et al., 2016}; ^{Moscovici, 2008}; ^{Rocha, 2012}; ^{Thiollent, 2011}).

In opposition to the neutrality established by the positivist paradigm of doing science, in research-action the researcher - subject/object researched relationship is a determinant condition of the knowledge construction process. Thus, in action research, it is necessary to live the group context in which the subjects are inserted so that it is possible to understand and intervene in it. That is why this type of investigation is marked by two simultaneous movements: Acting in the field of practice and investigating about it. Thus, the knowledge that is produced is directly related to both the practice and the process of the investigation itself.(^{Tripp, 2005}).

2.Structure, process and content - planning the elements of group action

Based on our training and professional performance in both mental health and Group Dynamics, applied to the context of the clinic, education, organization and research, we found that to achieve methodological rigor in the process of collecting data from our research it would be necessary to associate the knowledge of the participatory action research method with the referential on group dynamics. To understand the dynamics of the groups, it is necessary to understand three elements that constitute it. They are: Group structure, process and content (^{Maré, 1974}; ^{Moscovici, 2008}; ^{Munari & Furegato, 2003}; ^{Nunes, 2013}).

a)Group structure

The structure refers to the spatio-temporal aspects of when, where and who will constitute the group. The selection criteria of the participants, the size of the group, the frequency, the duration of the meetings, as well as all the material and human resources necessary for the existence of the group, enter into this dimension (^{Castilho, 2002}; ^{Maré, 1974}; ^{Munari & Furegato, 2003}). The structure of the group must be in perfect harmony with the nature of the group itself and must be as accessible as possible to the participants.

Planning is essential for group work(^{Kaspary & Seminotti, 2012}a; ^{Lewin, 1947}a; ^{Malhiot, 2013}). It starts with the selection of participants, whether it will be an open group (with the reception of new participants at each meeting) or closed (with the same members remaining from the beginning to the end of the intervention). It is important to define well what are the criteria for entering the group, which in the research language we know by the inclusion criteria of the subjects.

After selection, it is essential to make a survey of the needs and profile of the group, considering age, gender, education level, socioeconomic conditions, interests and expectations. This information favors the recognition of the group's potential and the establishment of the objectives and goals that the group is willing to follow(^{Valentin, Sá, & Esperidião, 2013}).

In this regard, it is essential that the researcher clearly understand the objectives of the participants, the objectives of the research and their own objectives as the coordinator of the study. It is expected that there is consonance between them, if this does not occur, the group's objectives must be respected and prioritized, as the group's dynamics is always sovereign. And possible misunderstandings can be analyzed as research data (^{Leal, Motta, Munari, Freitas, & Martins, 2016}; ^{Lewin, 1947}b).

In preparing the venue for the meetings, access, comfort, secrecy and privacy must be considered so that activities are not interrupted. Thus, an airy, ample space with adequate lighting and mobile chairs is suggested. It is noteworthy that, however, the space for the research will not always be ideal, especially when one is in the real territory of a community or institution. During the meetings, we encourage siting in a circle, as this configuration facilitates eye contact, promotes a feeling of equality and greater social interaction (^{Barreto, 2008}; ^{Castilho, 2002}; ^{Nunes, 2013}).

Regarding the number of participants, the objectives of the work, the interest, availability and voluntary commitment to participation, the number of people must be sufficient for everyone to be able to expose their ideas and points of view in the time dedicated to the group's activities(^{Valentin et al., 2013}). And the time must be enough to allow the development of activities and participation of all, insufficient time can cause discomfort in the group(^{Moscovici, 2008}).

Providing water, coffee and, if possible, snacks, depending on the duration of each meeting, is a sign of important care for the well-being of the group. In addition, the snack often has organizing and agglutinated power, favoring the bonding of members. Making the costs of participants' transportation feasible is also an important strategy for promoting participation, since absences that at first glance appear to be group resistance may actually be difficulties with commuting. Frequency and duration of the group must be thought from the reality of the group, its objectives and agreed upon by all. Start-up and end-up times, delay tolerance, intervals, as well as commitments to data confidentiality must be agreed upon(^{Valentin et al., 2013}.

At the beginning of a new group it is essential that a contract is made, that guides the coexistence and work with the participants in a collective construction where they are established beyond the rules (start and end times, breaks, exits from the room, group period), the question of the confidentiality of the information that is shared there(^{Moscovici, 2008}). If the contract is breached or conflicts arise during the group, the rules initially agreed can be evaluated and discussed again by everyone. Because it is collectively built, any member of the group can monitor and demand compliance with the contract or its re-discussion(^{Castilho, 2002}; ^{Mota & Munari, 2006}; ^{Moscovici, 2008}; ^{Munari & Furegato, 2003}; ^{Nunes, 2013}; ^{Zimerman & Osorio, 1997}).

In research situations, following the prerogatives of the Ethics Committee in Research with Human Beings of the National Health Council, it is also necessary to fill out the Free and Informed Consent Term (FICF) that ensures the researcher consent to use the data produced there and the participant ensuring the confidentiality of what he said in addition to consenting to participate in the field of investigation(^{Motta, Nunes, Munari, & Medeiros, 2007}).

b)Group Process

The group process refers to the dynamic aspects that are activated within and between the elements of the group through the interpersonal relations of the members, it is the intimate and entire life of the group. It therefore involves communication, leadership, decision-making processes, motivation and adherence to the group(^{Maré, 1974}; ^{Munari & Furegato, 2003}). The group process takes place in the here (space) and now (time) of the group, it is a permanent movement that guarantees internal and external changes as it occurs(^{Ribeiro, 1994}).

The communication that is established between the participants, both verbal and non-verbal, must be authentic to ensure integration and adherence to the group. Thus, the coordinator must be aware of the existing relationships in the group, as they can mobilize different feelings. Sometimes it will be necessary for the coordinator to intervene directly in the handling of interactions, especially when movements of hostility, dispute and conflicts manifest(^{Lewin, 1947}c; ^{Malhiot, 2013}; ^{Mota & Munari, 2006}).

The notion of reciprocal and continuous interaction between each and every one is what most defines the group process and enables the understanding of the group as a unit, a dynamic and complex totality that constitutes a field of forces that drive the development of the group , at the same time these forces can restrict the movement of some members and even cause disintegration of the group (^{Andaló, 2006}; ^{Malhiot, 2013}; ^{Ribeiro, 1994}).

Identifying the driving and restrictive forces that act in the group is a powerful opportunity for diagnosis and social analysis that can support actions and changes in the group context. Examples of driving forces are: Favorable climate, participative leadership, commitment, trust, affection in relationships, technical competence for the group's task, among others. Examples of restrictive forces are: overcharging, pressure for results, communication failures and noises, disorganization, lack of planning, centralization and authoritarianism, to name a few examples(^{Leal et al., 2016}; ^{Moscovici, 2008}).

c)Group content

The group content is the dimension of the group that comprises the meaning, the message and the information transmitted in the process within its structure, it translates about what and how the group talks about its experiences. Essentially the content is individual and qualitative, as it reflects the attitudes and roles that each subject assumes in the group's participation. The content marks a relational structure that creates in the group a culture with a strong influence of the formal structure. The content's functions are: Establish cohesion, coherence and continuity; remodel the structure and provide reason, purpose and inspiration for reciprocal and engaging relationships in the group (^{Maré, 1974}).

Group interaction should be stimulated by the intervention coordinator/researcher while preserving the space of each individual within the group(^{Munari & Furegato, 2003}). As stated earlier, action research usually follows the cycle of collective activities: plan, implement an action/ intervention, describe and evaluate its results(^{Tripp, 2005}). In this way, the researcher who adopts this type of investigation assumes responsibility for the participation and engagement of the participants, since he depends on them to complete the process. The permanence of people from the beginning to the end of the investigation is a direct result of the investment of the researcher/coordinator of the group intervention in the bonding and cohesion of the members.

Cohesion is the force of attraction that unites and links the members of a group and therefore influences and determines the feeling of satisfaction in working and belonging to the group. The motivation for participation and involvement in collective activities is directly proportional to the the intensity of cohesion(^{Lewin, 1947}c; ^{Malhiot, 2013}; ^{Moscovici, 2008}).

Among the leadership characteristics of a good group coordinator are charisma, patience, respect, discipline, encouraging cohesion and collective decision-making in the group. The motivation to participate and remain in the group may also be due to the interest of the researcher/coordinator in each member individually, a fundamental movement that guarantees the adhesion of the subjects to the group(^{Rocha, Munari, Ribeiro, & Rego, 2017}).

The planned or unplanned contents that appear in the group must be handled by the coordinator in a way that can be resolved and at the same time give an account of the objective proposed by the investigation(^{Munari, 2006}; ^{Van Dijk et al., 2019}). All content must be welcomed and valued by the researcher/coordinator, although apparently it is not aligned with the objectives of the investigation, as the group talks about what is important to him, what he can express and not necessarily just what he is expected to address.

3. Planning for group intervention in action research

Planning is essential for group work(^{Kaspary & Seminotti, 2012}b; ^{Lewin, 1947}b, ¹⁹⁴⁷c). It begins with the selection of participants and with the definition of whether the group will be open or closed by defining clear criteria for ingression in the group. After the selection, it is possible to make a data survey with the needs and profile of the group, considering age, gender, education level, socioeconomic conditions, interests and expectations of the participants. Such information helps us to know the group and makes it possible to classify it as heterogeneous or homogeneous, establishing the objectives and goals of the group follows ahead(^{Valentin et al., 2013}). In this regard, it is essential that the objectives of the participants, of the coordinator/researcher are in line, if they are not the group's objectives, they must be prioritized and the data analyzed for the research(^{Lewin, 1947}a, ¹⁹⁴⁷c).

Regarding the number of participants, the objectives of the work, the interest, availability and commitment to participate spontaneously must be considered. The number of people must be sufficient for everyone to be able to expose their ideas and points of view in the time dedicated to the activity (^{Valentin et al., 2013}).

Within a group there are phenomena occurring at the intrapersonal and interpersonal level, not always clearly identified by direct observation, but there is an interdependence between the participants affecting everyone, even if it is a situation that occurred with one person(^{Moscovici, 2008}). It should also be noted that at the end of every meeting, a closure of what was experienced must be done, with a summary of the day, the conclusions and possible tasks. In a survey, coupled with this closure, it is essential to be careful with the registration of the meeting, which includes the verbal and non-verbal communications of the group(^{Valentin et al., 2013}). For the planning of the next meetings, the objectives of the group and the analysis of the previous meetings should be considered.

4. Researcher's competence for group coordination

The attention and importance given to the role of the group coordinator is a recurring concern of group researchers(^{Andaló, 2006}; ^{Lewin, 1947}a, ¹⁹⁴⁷c; ^{Zimerman & Osorio, 1997}). Emphasis is placed on the imperative need for researchers working in the logic of action research to develop skills for group coordination, among which we highlight the interest in group technologies; Personal skills, such as: Attentive listening to the speeches and behaviors of the group members, spontaneity, empathy, respect and acceptance of the differences and rhythm of each member, ethical sense, assertiveness, creativity, leadership. It is also expected to be welcoming, understanding and continent with the needs and anxieties of the group(^{Andaló, 2006}; ^{Zimerman & Osorio, 1997}).

In group-related contexts it is natural that there is a divergence of opinions, values, principles, behaviors and beliefs, in this sense ^{Motta et al., (2007}) warn that the group coordinator should not take sides or intervene in the situation directly, but it must enable the group to experience and mature with the process of dialoguing beyond differences and conflicts, building together solutions to the issues and impasses that arise. As a researcher, they may use the data of the submitted situation in order to understand the group movement.

There is a multiplicity of group work in the health context with a diversity of models and techniques. In this sense, ^{Andaló (2006}) warns on the importance of the coordinator not using the technique for the technique, without exploring the contents manifested by the group and much more not being contextualized. The author also emphasizes, it is essential that this leader knows, in addition to conducting the task, perceiving the phenomena that occurred there, organizing them and returning them to the group, favoring reflection and learning and enabling the closing of the learning cycle .

Conclusions

Group work offers several possibilities for interventions and research, for which it has a consistent method in addition to diversified techniques and instruments. Through its strategies, it enhances and stimulates the results and the construction of resources for integral mental health, both in the individual and collective dimensions. Action research proves to be effective in developing proposals and actions in group contexts by problematizing weaknesses, needs and potential, overcoming reality, and allowing new responses to the challenges that arise in health contexts, committing everyone to the processes of change.

Group contexts show are shown as promising spaces for autonomy, creativity and strengthening the interrelation of subjects with their territory, making them active and participants in the knowledge produced, agents that transform reality. The research’s results and responses to the group's objectives are strengthened not only by promoting changes in the short run but also in the long run.