If you have any questions regarding Clubhouse research, please contact:
Colleen McKay, Director
Program for Clubhouse Research
University of Massachusetts Medical School
55 Lake Avenue North
Worcester, MA 01655
(508) 856-8471
colleen.mckay@umassmed.edu
Below is a selection of recent Clubhouse research articles:
ICCD Clubhouses and Clubhouse Research Outcomes.
Abstract (from article)
A recent study found that Clubhose members were more likely to report being in recovery and having a higher quality of life compared with a group of participants from consuer run "drop in" centers ( Mowbray, Woodward, Holter, et al, 2009). Clubhouse members indicate that the Clubhouse provides valuable oportunities to pursue meaningful activities that help them address their mental health recovery at their own pace (Stoffel, 2008)...Read More
Floyd, M. & Lorenzo-Schibley, J. (2010). Academia and mental health practice evaluation partnerships: focus on the clubhouse model. Social Work in Mental Health, 8, 134-139.
Abstract (from journal):
In this article, the authors explore evaluation between a local mental health agency and a researcher from the local university with a focus on issues for ongoing inquiry in the unique clubhouse setting and special attention to maximizing member participation and comfort throughout the process. Due to grantor expectations and a growing culture of systematic evaluation of psychosocial rehabilitation, establishing and implementing outcome indicator protocols is important for the modern clubhouse. The authors and club members collaborated on developing a new outcome indicator protocol. After completing the process, information was gathered from members and the research team about their comfort level throughout the process. The university and the clubhouse can be effective evaluation partners; however, attention to important issues in clubhouse research must be a priority. Several important issues and tips for clubhouses considering program evaluation are included
Tsang, A.W.K., Ng, R.M.K., & Yip, K.C. (2010). A six-month prospective case-controlled study of the effects of the clubhouse rehabilitation model on Chinese patients with chronic schizophrenia. East Asian Archives of Psychiatry, 20, 23-30.
Abstract (from journal):
Objective: To investigate the effects of the 'clubhouse' model of rehabilitation on various psychosocial issues for Chinese patients with schizophrenia living in the community. Methods: A longitudinal, case-controlled and naturalistic design was used. A total of 92 participants were recruited via criteria-guided systematic sampling for a study lasting 6 months. Forty-six participants attending a local clubhouse program were matched for sex and age with a control group of patients recruited from a regional outpatient clinic who were not attending a clubhouse program. Case note reviews, standardized assessments of psychotic symptoms, depressive symptoms, quality of life, self-esteem, and locus of control were performed at baseline, 3 and 6 months. Results: Clubhouse participants showed significant improvements in their positive and negative scales, general psychopathology, and total scores after attending the clubhouse for 6 months. The clubhouse participants' employment rate also improved. Conclusion: The clubhouse model of rehabilitation may have beneficial effects on various psychiatric symptoms in Chinese patients with schizophrenia living in Hong Kong.
Available: http://hkjpsych.com/past1001.htm
For more information contact: Dr. Alfert Wai-kiu Tsang, Department of Psychiatry, Kowloon Hospital, Kowloon, Hong Kong, China. Tel: (852) 3129 7111; Fax: (852) 3129 6442; Email: tsanghy@ha.org.hk
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Niemeier, J. P., DeGrace, S. M., Farrar, L. F., Ketchum, J. S., Berman, A. J., & Young, J. A. (2010). Effectiveness of a comprehensive, manualized intervention for improving productivity and employability following brain injury. Journal of Vocational Rehabilitation, 33, 167-179.
Abstract (from journal):
Unemployment rates continue to hover at 39% for persons with brain injury because of persistent neurobehavioral deficits that limit their employability. This paper reports findings of a prospective, repeated measures design and controlled trial of a 20-session, manualized, employability-enhancing intervention for community-dwelling persons with acquired brain injury attending six work-centered clubhouses. A total of 71 clubhouse members were assigned, in order of their signing up to participate in the study, to either receive the 20 intervention sessions or to be in a waiting control group. Employment and productivity status were measured pre- and post-treatment. Analyses revealed modestly significant treatment effects for employment status and productivity. The program also appears to have a positive effect on job stability. These results were moderated by whether the participant had disability income and their ratings, by clubhouse staff, of their employability. Persons who had disability income and had high employability ratings from staff were less likely to be employed following treatment. There was not a significant difference between treatment and control participants in work-related knowledge, employability ratings, or a measure of effort in the rest of the clubhouse program activities.
Available: http://iospress.metapress.com/content/2n44506n03766875/?p=ea4d89056e7e46d8819449be54721a2c&pi=2
For more information contact: Janet P. Niemeier, Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA.
Niemeier, J. P., DeGrace, S. M., Farrar, L. F., Ketchum, J. S., Berman, A. J., & Young, J. A. (2010). Effectiveness of a comprehensive, manualized intervention for improving productivity and employability following brain injury. Journal of Vocational Rehabilitation, 33, 167-179.
Abstract (from journal):
Unemployment rates continue to hover at 39% for persons with brain injury because of persistent neurobehavioral deficits that limit their employability. This paper reports findings of a prospective, repeated measures design and controlled trial of a 20-session, manualized, employability-enhancing intervention for community-dwelling persons with acquired brain injury attending six work-centered clubhouses. A total of 71 clubhouse members were assigned, in order of their signing up to participate in the study, to either receive the 20 intervention sessions or to be in a waiting control group. Employment and productivity status were measured pre- and post-treatment. Analyses revealed modestly significant treatment effects for employment status and productivity. The program also appears to have a positive effect on job stability. These results were moderated by whether the participant had disability income and their ratings, by clubhouse staff, of their employability. Persons who had disability income and had high employability ratings from staff were less likely to be employed following treatment. There was not a significant difference between treatment and control participants in work-related knowledge, employability ratings, or a measure of effort in the rest of the clubhouse program activities.
Available: http://iospress.metapress.com/content/2n44506n03766875/?p=ea4d89056e7e46d8819449be54721a2c&pi=2
For more information contact: Janet P. Niemeier, Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA.
Tratnack, S. A. & Kane, C. (2010). Preventive health screenings in a clubhouse setting for persons with serious mental illness. American Journal for Nurse Practitioners, 14, 8.
Abstract (from journal):
WONG, K.F. (2010). Implementation of Clubhouse Model programme: perception of mental health nurses. Journal of Psychiatric and Mental Health Nursing, 17, 750-753.
Available: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2850.2010.01601.x/abstract
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Hackney, M. E. P. & Earhart, G. M. P. (2010). Social Partnered Dance for People with Serious and Persistent Mental Illness: A Pilot Study. Journal of Nervous & Mental Disease, 198, 76-78.
Abstract (from journal):
Individuals with serious mental illness (SMI) often experience isolation and poor health, but normalized social opportunities aid recovery. This study aimed to determine social dance's feasibility and effects on mood, functional mobility, and balance confidence in 12 people with SMI. Participants danced once per week in 1-hour lessons for 10 weeks. Before and after lessons, participants were evaluated for gait velocity and with one-leg stance, Timed Up and Go, and 6-minute walk tests. Participants self-completed Beck Depression II and Beck Anxiety Inventories and the Activities-specific Balance Confidence Scale. Post-testing included an exit questionnaire assessing participant experiences. Participants significantly improved on the Timed Up and Go, (p = 0.012, effect size = 0.68), and demonstrated non-significant improvements in anxiety, depression, and balance confidence (effect sizes of 0.41, 0.54, and 0.64, respectively). Participants reported enjoying classes, and interest to continue. Social dance is feasible and may benefit mobility for those with SMI. (C) 2010 Lippincott Williams & Wilkins, Inc.
For more information contact: Dr. Hackney, Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO. Send reprint requests to Gammon M. Earhart, PhD, PT, Program in Physical Therapy, Washington University School of Medicine, Campus Box 8502, 4444 Forest Park Blvd., St. Louis, MO 63108. E-mail: earhart@wusm.wustl.edu
Mowbray, C.T., Woodward, A.T., Holter, M.C., MacFarlane, P., & Bybee, D. (2009). Characteristics of Users of Consumer-Run Drop-In Centers Versus Clubhouses. Journal of Behavioral Health Services & Research, 36(3), 361-371.
Abstract (from journal):
Clubhouses and consumer-run drop-in centers (CRDIs) are two of the most widely implemented models of consumer-centered services for persons with serious mental illness. Differences in structure and goals suggest that they may be useful to different types of consumers. Information on what types of consumers use which programs would be useful in service planning. This study analyzes data from the authors’ NIMH-funded research on 31 geographically matched pairs of Clubhouses and CRDIs involving more than 1,800 consumers to address the following question: are there significant differences in the characteristics and outcomes of members of Clubhouses versus CRDIs? Results from multilevel analyses indicated that Clubhouse members were more likely to be female, to receive SSI/SSDI, to report having a diagnosis of schizophrenia, and to live in dependent care; and they reported both a greater number of lifetime hospitalizations and current receipt of higher intensity traditional MH services. Controlling for differences in demographic characteristics, psychiatric history, and mental health service receipt, Clubhouse members also reported higher quality of life and were more likely to report being in recovery. CRDI consumers were more likely to have substance abuse histories. Possible reasons for the differences are discussed. The results suggest that CRDIs are a viable alternative to more traditional mental health services for individuals who might not otherwise receive mental health services.
For more information contact: Carol T. Mowbray is deceased. For more information contact: Amanda Toler Woodward, PhD, School of Social Work, Michigan State University, 222 Baker Hall, East Lansing, MI 48824, USA. Email: awoodwar@msu.edu
McKay, C.E., Ziedonis, D., Seward, G., Williams, V., Bradley, K., Colburn, J. & Rocheleau, D. (2009, October). Issue Brief: Addressing Tobacco Use in Adult Mental Health Service Programs. Center for Mental Health Services Research, University of Massachusetts Medical School. Available at http://www.umassmed.edu/cmhsr/briefs_archive.aspx
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Hinden, B., Wolf, T., Biebel, K., & Nicholson, J. (2009). Supporting clubhouse members in their role as parents: necessary conditions for policy and practice initiatives. Psychiatric Rehabilitation Journal, 33(2):98-105.
Abstract (from journal):
OBJECTIVE: Given that the majority of adults with mental illness are parents, it is likely that a substantial number of members in the Clubhouse community are parents. Supporting members in their role as parents presents meaningful, philosophical and practical challenges for both individual Clubhouses and the Clubhouse movement. Supporting parents within the Clubhouse, however, is a necessary and logical step, consistent with the Clubhouse emphasis on rehabilitation and recovery. The current study explored the conditions necessary for supporting members in the parenting role in an existing Clubhouse. METHODS: A grounded-theory, ethnographic approach was used to collect data from multiple stakeholders including Clubhouse members, staff, and Board of Directors. A total of nine focus groups with 30 participants were conducted. RESULTS: Five themes emerged reflecting the conditions necessary to support parents in the Clubhouse: 1) securing stakeholder buy-in; 2) identification of shared values and principles; 3) clarification about how supporting parents will affect current Clubhouse activities; 4) facilitation of ongoing communication about changes; and 5) exploration of opportunities to maximize resources to support all Clubhouse members. CONCLUSIONS: Findings confirm the philosophical desirability and practical feasibility of supporting members in the parenting role, and identify fundamental challenges to philosophy and practice raised by the paradigm shift from thinking about individuals to thinking about families.
Available: http://prj.metapress.com/openurl.asp?genre=article&eissn=1559-3126&volume=33&issue=2&spage=98
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Pernice-Duca, F. & Onaga, E. (2009). Examining the contribution of social network support to the recovery process among clubhouse members. American Journal of Psychiatric Rehabilitation, 12, 1-30.
Abstract (from journal):
A structured interview was used to gather information pertaining to social network support and the recovery process among individuals participating in psychosocial clubhouses. Using a cross-sectional, longitudinal design, a sample of clubhouse members participated in an initial interview (n = 221). A follow-up interview with 80% of the participants was conducted approximately 14 months later. A social process model predicting recovery revealed that social network support as well as reciprocity with network members significantly contributes to understanding the recovery process over time. The study attempts to contribute to an earlier investigation of social network support and recovery from mental illness (Corrigan & Phelan, 2004)
For more information contact: Francesca M. Pernice-Duca, Division of Theoretical and Behavioral Foundations, Wayne State University, Detroit, MI, USA.
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Plotnick, D.F. & Salzer, M. (2008). Clubhouse costs and implications for policy analysis in the context of system transformation initiatives. Psychiatric Rehabilitation Journal, 32, 128-131.
Abstract (from journal):
Objective: Documenting service costs is important for psychiatric rehabilitation programs to make persuasive arguments to policymakers/funders about their role in system transformation efforts. The purpose of this study was to report program costs, annual costs per member, and costs per day over three years (2003-2006) for 29 clubhouses that are part of the Pennsylvania Clubhouse Coalition (PCC). Methods: This study utilized data elements that are submitted annually by coalition members to the Pennsylvania Clubhouse Coalition. Results: Our results indicate that clubhouses play a substantial role in the Pennsylvania mental health system, providing almost 180,000 units of contact to more than 2,400 people across the state. Conclusions: Most relevant to Pennsylvania's system transformation is our finding that clubhouse costs are substantially lower than the costs of partial hospital services. Clubhouses are likely serving an important role in lowering costs associated with supporting those who would otherwise utilize partial hospital programs. (PsycINFO Database Record (c) 2009 APA, all rights reserved) (journal abstract)
Available: http://prj.metapress.com/openurl.asp?genre=article&issn=1095-158x&volume=32&issue=2&spage=128
For more information contact: Debbie F. Plotnick, Mental Health Association of Southeastern Pennsylvania, 1211 Chestnut Street, Philadelphia, PA 19107. 215-751-1800.
Sheppard, K. (2008, June 23). Programs that Work. Clubhouses and ACT are proven successes. So why aren't they better known or funded. The American Prospect, 1-4.
Available: http://www.prospect.org/cs/articles?article=programs_that_work
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Staples, L. & Stein, R. (2008). The clubhouse model: Mental health consumer–provider partnerships for recovery (pp. 177-196). In Chambré & Goldner (Eds.) Patients, Consumers and Civil Society (Advances in Medical Sociology, Volume 10), Emerald Group Publishing Limited.
Abstract:
Purpose – This chapter examines the international Clubhouse movement, which features a unique "partnership model" that enables individuals who have serious and persistent mental illness to take an active role in their recovery. Consumer–provider and consumer–consumer supportive relationships are deepened through engagement in a range of cooperative activities both in the Clubhouse and in the local community. Methodology – Data for this study have been gathered via case materials, semi-structured interviews, review of official publications, direct experience, participant observation, primary and secondary sources. Findings – This study is consistent with other research demonstrating the efficacy of the Clubhouse model in providing mental health consumer assistance and support to gain paid employment, an education, and adequate housing. Research limitations – While data have been gathered from a variety of sources encompassing a large number of Clubhouses, this is a single case study that includes limited comparative analysis with other modalities. Practical implications – The Clubhouse model is an option that shows great promise for assisting mental health consumers to obtain employment, education, housing, and supportive relationships including peer support. It also promotes leadership development and participation in collective action for policy reform.
Originality/value – The Clubhouse approach is grounded in an empowerment paradigm of helping that emphasizes a strengths-based perspective, resiliency, activated consumers, collaborative partnerships with professionals, high expectations, self-help, mutual assistance, self-advocacy, and collective action for social change.
For more information contact: Lee H. Staples, Boston University - School of Social Work, 264 Bay State Road, Boston, MA 02215 Email: lstaples@bu.edu
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Pernice-Duca, F. (2008). The structure and quality of social network support among metal health consumers of Clubhouse programs. Journal of Community Psychology, 36(7), 929-946.
Abstract (from journal):
This study explored the structure and quality of social network support among a group of adult consumers of community-based mental health programs known as Clubhouses. The structure and quality of social network support was also examined by diagnosis, specifically between consumers living with and without schizophrenia. The study involved a sample of 221 consumers across 15 Clubhouse programs. Social network nominations were collected using a semistructured social network interview strategy. Over 97% of the participants identified at least one source of support in their social network with an average of five nominations. Family members were identified as the most common source of support whereas fellow Clubhouse members were least likely to be nominated. Clubhouse members with schizophrenia were less likely to identify family members and were more likely to rate their support networks as more important and engage in greater levels of contact than consumers with other diagnoses. The structure and quality of social network supports were not associated with level of social functioning, length of Clubhouse membership or level of participation or other selected demographic variables typically associated with the size and quality of support. C 2008 Wiley Periodicals, Inc.
Available: http://www3.interscience.wiley.com/cgi-bin/fulltext/121358358/PDFSTART
For more information contact: Francesca M. Pernice-Duca, Wayne State University, Detroit, MI.
E-mail: mailto:perniceduca@wayne.edu
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Waegemakers Schiff, J., Coleman H., & Miner, D. (2008). Voluntary Participation in Rehabilitation: Lessons Learned from a Clubhouse environment. Canadian Journal of Community Mental Health, 27(1), 65-78.
Abstract (from journal):
Clubhouses, as voluntary communities, can be excellent indicators of recovery environments for persons who have a mental illness. To understand why people become affiliated with a Clubhouse and others disengage, 4 focus groups with Clubhouse members and 1 with staff explored questions of membership retention. Responses encompassed 4 domains: personal, interpersonal, structure, and organizational environment. These domains were interwoven with values of acceptance without stigma, empowerment, self-determination, egalitarian relationships, independence, interdependence, dignity, respect, hope, and positive expectations. The domains and values correspond to elements that aid recovery. The presence and absence of such domains encouraged people to either attend or stay away from the organization. Overall analyses of the groups’ responses suggest that recovery-oriented values and organizational climate are important factors in determining attendance in a consumer-oriented program.
For more information contact: Jeanette Waegemakers Schiff, Ph.D., Faculty of Social Work, University of Calgary. Email: schiff@ucalgary.ca
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Stoffel, V.C. (2008). Perception of the Clubhouse experience and its impact on mental health recovery. Dissertation Abstracts International Section A: Humanities and Social Sciences. Vol 68(8-A), 2008, pp. 3300.
Abstract (from dissertation):
This phenomenological study investigated how members of a psychosocial Clubhouse perceived their Clubhouse experience as impacting on their recovery, while living with a serious mental illness. Mental health recovery is understood as a journey towards living a meaningful life and achieving personal life goals despite challenges posed by serious mental illness. Psychosocial Clubhouses provide an environment where members feel they belong and can return to, and offer opportunities to be engaged in work, school and other meaningful occupations. The Clubhouse environment facilitates active engagement through colleague relationships while building on member interests and strengths. The purpose of the study was to determine how adults with serious mental illness who are active members of a Clubhouse (attending for three or more months, an average of two times per week, minimum) perceive the Clubhouse experience as impacting their mental health recovery. Using a phenomenological approach to gain the perspective of the lived experience of Clubhouse engagement and mental health recovery, data measures included participant observation with a full continuum of Clubhouse activities and exposure to the Clubhouse context across a 10 month period, in-depth interviews and measures of recovery, empowerment, hope, and life satisfaction with four participants, and photovoice (participant-generated photos and narratives) workshop with nine participants. Results were analyzed using constant comparative methods, with themes and descriptive narratives derived from the interviews, triangulated with data from the photovoice workshop and field notes, and confirmed with selected data from measures of recovery, empowerment, hope and satisfaction with life. In addition, verification and trustworthiness was strengthened by use of a second coder. The study found that members valued Clubhouse opportunities to pursue meaningful activities in order to pursue mental health recovery at their own pace. Respect, hope and reaching out to members supported engagement in Clubhouse community and met the needs of members who struggled with the pain and challenge of living with a serious mental illness. Using solid evidence to build and create Clubhouse practices and programs conducive to genuine recovery, hopefulness, empowerment, and satisfaction with life are the mutual responsibility of mental health professionals and Clubhouse members. (PsycINFO Database Record (c) 2008 APA, all rights reserved)
For more information contact: Virginia Stoffel, Ph.D., Department of Occupational Therapy, University of Wisconsin-Milwaukee, P.O. Box 413, 2200 E. Kenwood Blvd. Milwaukee, WI 53201-0413. Email: stoffelv@uwm.edu
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Ng, Roger, M.K., Pearson, V., Lam, M., Law, C.W., Chiu, C.P.Y., & Chen, E.Y.H. (2008). What does recovery from schizophrenia mean? Perceptions of long-term patients. International Journal of Social Psychiatry, 54 (2), 118-130.
Abstract (from journal):
Background: The study investigated the meaning of recovery to eight people with chronic schizophrenia. Method: A qualitative methodology was used based on a 3-hour focus group. The material was transcribed and analysed into 18 subcategories and 4 categories; namely recovery as a multi-dimensional construct, the relationship of medication to recovery, a sense of hopelessness and helplessness about recovery, factors that promoted recovery. Discussion: Respondents believed that full recovery could not be said to have been achieved until they stopped medication and had a steady job. The support and care of family and friends were also vital, although sometimes problematic. Independent living has a different meaning in Chinese culture. Conclusions: Further research directions are suggested as well as ways to change attitudes to the inclusion of medication in recovery.
URL: http://www.sagepublications.com
For more information contact: Roger M.K. Ng, 7/F Main Block, Department of Psychiatry, Kowloon Hospital, 147A, Argyle Street, Hong Kong, China. Email: ngmk@ha.org.hk
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McKay, C.E. (2007).Clubhouse Characteristics: Results from an International Survey of Clubhouses. Commonwealth Medicine Academic Conference, Shrewsbury, MA.
This poster includes results from International Survey of Clubhouses to provide information regarding Clubhouse performance and characteristics in a variety of areas. This poster provides a glimpse into the dissemination of ICCD Clubhouses with results from Clubhouse programs across the world. Clubhouse Directors complete surveys designed to obtain information concerning organizational characteristics, the ways in which Clubhouse programs provide opportunities for their members, as well as individual outcomes for members utilizing Clubhouse services and supports. Areas addressed in the survey include funding, governance and administration, staffing and staff credentials, program structure, Clubhouse memberships and membership demographics, participation in training and/or research activities, and a variety of services provided by ICCD Clubhouses including employment and housing. The poster will also include evidence of similarities and differences between ICCD certified and non-certified Clubhouses, Clubhouses located in and out of the United States, as well as common characteristics of Clubhouses internationally.
URL: http://www.umassmed.edu/uploadedFiles/Poster_McKay.pdf
For more information contact: Colleen E. McKay, Program for Clubhouse Research, Center for Mental Health Services Research, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655. Telephone: 508-856-8471. Email: Colleen.McKay@umassmed.edu
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McKay, C.E. (2007).Clubhouse Characteristics: Results from an International Survey of Clubhouses. Commonwealth Medicine Academic Conference, Shrewsbury, MA.
This poster includes results from International Survey of Clubhouses to provide information regarding Clubhouse performance and characteristics in a variety of areas. This poster provides a glimpse into the dissemination of ICCD Clubhouses with results from Clubhouse programs across the world. Clubhouse Directors complete surveys designed to obtain information concerning organizational characteristics, the ways in which Clubhouse programs provide opportunities for their members, as well as individual outcomes for members utilizing Clubhouse services and supports. Areas addressed in the survey include funding, governance and administration, staffing and staff credentials, program structure, Clubhouse memberships and membership demographics, participation in training and/or research activities, and a variety of services provided by ICCD Clubhouses including employment and housing. The poster will also include evidence of similarities and differences between ICCD certified and non-certified Clubhouses, Clubhouses located in and out of the United States, as well as common characteristics of Clubhouses internationally.
URL: http://www.umassmed.edu/uploadedFiles/Poster_McKay.pdf
For more information contact: Colleen E. McKay, Program for Clubhouse Research, Center for Mental Health Services Research, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655. Telephone: 508-856-8471. Email: Colleen.McKay@umassmed.ed
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McKay, C.E. & Pelletier, J.R. (2007). Health Promotion in Clubhouse Programs: Needs, Barriers, and Current and Planned Activities. Psychiatric Rehabilitation Journal, 31(2), 155-159.
Abstract (from journal):
A survey was designed to obtain information concerning ways Clubhouses affiliated with the International Center for Clubhouse Development (ICCD) promote practices that improve the physical health of members. This study examined perceptions of the need for health promotion interventions, current and planned health promotion practices, and barriers to change and program development. The mean number of health promotion activities ICCD Clubhouses (N = 219) report providing was 5.24, SD = 2.42, range = 1 to 10. Despite barriers (e.g., cost), results indicate that every Clubhouse responding to this survey offers at least one health promotion activity.
URL: http://prj.metapress.com/link.asp?id=7511608jx37731q0
For more information contact: Colleen E. McKay, Program for Clubhouse Research, Center for Mental Health Services Research, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655. Telephone: 508-856-8471. Email: Colleen.McKay@umassmed.edu
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Lloyd, C., King, R., McCarthy, M. & Scanlan, M. (2007). The association between leisure motivation and recovery: A pilot study. Australian Occupational Therapy Journal 54, 33–41.
Abstract: (from journal):
Background and aims: Recovery from mental illness may be facilitated by participation in activities that provide meaning and purpose in the lives of consumers. Leisure participation can be a major source of enjoyment as well and mental and physical well-being. Methods and results: This study examined the association between consumers’ motivation to engage in leisure and their self-reported perception of recovery in a sample of 44 Clubhouse members. The Leisure Motivation Scale and the Recovery Assessment Scale were used to measure the association between leisure motivation and recovery. The results indicated a statistically significant association between leisure motivation and recovery. Conclusion: These findings have implications for service delivery within mental health settings, as occupational therapists may be able to design leisure-based programs more effectively if they can understand the needs and motives for participation. More emphasis should be placed on supporting consumers to re-integrate and be socially included within the community through leisure-based initiatives.
Available: http://www.blackwell-synergy.com/doi/pdf/10.1111/j.1440-1630.2006.00648.x
For more information contact: Chris Lloyd, Division of Occupational Therapy, University of Queensland, St Lucia, Qld. 4072, Australia. Email: lloyd@onthenet.com.au
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McKay, C.E. (2007, August). Issue Brief: Evidence Based Practices in Mental Health: Advantages, Disadvantages, and Research Considerations. Center for Mental Health Services Research, University of Massachusetts Medical School.
Available: http://www.umassmed.edu/cmhsr/briefs_archive.aspx
For more information contact: Colleen E. McKay, Program for Clubhouse Research, Center for Mental Health Services Research, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655. Telephone: 508-856-8471. Email: Colleen.McKay@umassmed.edu
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McKay, C., Yates, B., & Johnsen, M. (2007). Costs of Clubhouses: An International Perspective. Administration and Policy in Mental Health and Mental Health Services Research, 34(1), 62-72.
Abstract (from journal):
Costs of providing psychosocial rehabilitation services are analyzed . We explored effects of several program operating characteristics on total program cost per year, cost per member per year, and cost per visit using data from Clubhouse programs in 12 countries. We also examined the relationship between program costs and the range of services offered. Findings provide a more complete understanding of the operations and expenses of Clubhouses.
URL: http://www.springerlink.com/content/bq4753482qh4628r/fulltext.pdf
For more information contact: Colleen E. McKay, Program for Clubhouse Research, Center for Mental Health Services Research, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655. Telephone: 508-856-8471. Email: Colleen.McKay@umassmed.edu
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Rauch, E.S. (2007). A theory of the world: The writing practices of one woman with schizoaffective disorder, a combination of schizophrenia and bipolar disorder.
Abstract (Summary from ProQuest):
This qualitative study explores the writing practices of one woman afflicted with schizoaffective disorder. The research addresses how thirty-four years of writing helped her to form a theory of the world; how narratives can empower and act as therapy; and how schizoaffective disorder is a social, cultural, historical, as well as biological construct. The research discusses the benefits of participation in a psychosocial rehabilitation Clubhouse and shows how the woman's writing sheds light on the lives and writings of others with similar illnesses. Data were collected from the participant's writings, which included diaries, postcards, letters, essays, dialogue journals, and other artifacts. The research coded themes, including the woman's relationships with family, friends, psychiatrists, and psychologists; her health and illness since she was diagnosed; her philosophy of life and religious faith; her activities; and her education. The woman wrote, particularly, because she was an artist who wrote by necessity arising out of her own nature. The research demonstrates how writing can foster readers' empathy and develop the imaginations of both readers and writers of works written under conditions of mental illness. Literacy can suggest ways to create a more just, humane, and empathetic society. Stories can establish dialogue between the mentally ill and those without psychopathology to reduce the stigma of mental illness. Schizophrenia and bipolar disorder are found to identify the person with the illness. Narrative therapy and writing can "externalize" the person from the problem so that his/her psychopathology no longer obscures his/her basic humanity; rather, the individual can tell a valuable story. This study considers literacy as more than just reading and writing; rather, it involves a socio-cultural context that is inseparable from the individual's relationships. Considered is the relationship between the poetic and artistic sensibility and the psychopathology of people with mental illness. Writing is found to be a means of documenting and organizing one's life, empowering oneself, and navigating through a mental illness, with the hope of revaluing lives.
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Kelliher, S. (2006). Factors influencing member employment in International Center for Clubhouse Development (ICCD) Clubhouses.
Abstract (from ProQuest): This study examines programmatic factors in International Center for Clubhouse Development (ICCD) Clubhouses in relation to member employment by analyzing employment data from the ICCD's survey. Data related to employment outcomes, program organization and ICCD certification from a particular Clubhouse (Yahara House) in Madison, Wisconsin is also examined. The specific interventions assessed in this study are benefits counseling, medication administration, intensive case management and the presence of a dedicated vocational team. Staff tenure is also investigated in order to determine if length of staff employment affects member employment. Interviews conducted with members and staff from Yahara House are utilized to discern stakeholder impressions of how these programmatic factors influence member employment and model fidelity. Findings do not support a measurable impact on member employment associated with medication administration or reimbursed case management services occurring within the Clubhouse. Staff tenure at the high (5+ years) and low (0-1 year) end of the spectrum is associated with slightly enhanced member employment outcomes. A mild positive association between increased numbers of vocational supports and improved member employment outcomes is observed. Increased numbers of case management supports are found to have a weak, inverse relationship with member employment outcomes. There was insufficient data to quantitatively measure the effects of having a trained benefits counselor on staff. In assessing how fidelity to the ICCD Clubhouse model is influenced by the incorporation of these additional programmatic factors particular emphasis is granted to addressing the issue of medication services occurring within the Clubhouse. While it is not disputed, that inclusion of a medication component within a Clubhouse is in direct violation with the wording of one standard. Stakeholders from Yahara House contend that members benefit from inclusion of a voluntary medication component at the Clubhouse without compromising basic Clubhouse philosophy. Separate ICCD faculty noted in their certification reports that while the inclusion of the medication component at Yahara House is not in keeping with the wording of Standard 15, they did not observe a clinician patient hierarchy and there was little to no evidence of a medical influence on the Clubhouse by including this service.
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Macias, C., Rodican, C.F., Hargreaves, W.A. Jones, D.R., Barreira, P.J., & Wang, Q. (2006). Supported Employment Outcomes of a Randomized Controlled Trial of ACT and Clubhouse Models. Psychiatric Services 57(10):1406-15.
Abstract (from journal):
Objective: In a randomized controlled trial, a vocationally integrated program of assertive community treatment (ACT) was compared with a certified Clubhouse in the delivery of supported employment services. METHODS: Employment rates, total work hours, and earnings for 121 adults with serious mental illness interested in work were compared with published benchmark figures for exemplary supported employment programs. The two programs were then compared on service engagement, retention, and employment outcomes in regression analyses that controlled for background characteristics, program preference, and vocational service receipt. RESULTS: Outcomes for 63 ACT and 58 Clubhouse participants met or exceeded most published outcomes for specialized supported employment teams. Compared with the Clubhouse program, the ACT program had significantly (p<.05) better service engagement (ACT, 98 percent; Clubhouse, 74 percent) and retention (ACT, 79 percent; Clubhouse, 58 percent) over 24 months, but there was no significant difference in employment rates (ACT, 64 percent; Clubhouse, 47 percent). Compared with ACT participants, Clubhouse participants worked significantly longer (median of 199 days versus 98 days) for more total hours (median of 494 hours versus 234 hours) and earned more (median of $3,456 versus $1,252 total earnings). Better work performance by Clubhouse participants was partially attributable to higher pay. CONCLUSIONS: Vocationally integrated ACT and certified Clubhouses can achieve employment outcomes similar to those of exemplary supported employment teams. Certified Clubhouses can effectively provide supported employment along with other rehabilitative services, and the ACT program can ensure continuous integration of supported employment with clinical care. (Psychiatric Services).
URL: http://psychservices.psychiatryonline.org/cgi/reprint/57/10/1406
For more information: Cathaleene Macias, Ph.D. Community Intervention Research, McLean Hospital, 115 Mill Street, Belmont, MA 02478-9106. Email: cmacias@mclean.harvard.edu
Schonebaum, A.D., Boyd, J.K., & Dudek, K.J. (2006). A Comparison of Competitive Employment Outcomes for the Clubhouse and PACT Models. Psychiatric Services, 57(10):1416-20.
Abstract (from journal):
Objective: This study determined whether the Clubhouse model of community support and psychiatric rehabilitation can produce competitive employment outcomes that are comparable or superior to those of the Program of Assertive Community Treatment (PACT) model. METHODS: This longitudinal study followed a group of 170 individuals with severe mental illness who were randomly assigned either to the experimental design, a Clubhouse program (N=86), or to the control design, a PACT team (N=84). Study participants were tracked for 30 months, and employment outcome data were collected. RESULTS: After 30 months, 72 Clubhouse and 76 PACT participants remained active in the project. After 30 months, 74 percent of PACT participants and 60 percent of Clubhouse participants had been placed in at least one job. The average Clubhouse participant worked 21.8 weeks per job and earned $7.38 per hour, whereas the average PACT participant worked 13.1 weeks per job and earned $6.30 per hour. CONCLUSIONS: Participants from both the PACT and Clubhouse models achieved high employment levels, with no significant differences in weekly employment or 30-month job placement rates over the course of the study. During this time, Clubhouse participants earned significantly higher wages and remained competitively employed for significantly more weeks per job than PACT participants. (Psychiatric Services).
URL: http://psychservices.psychiatryonline.org/cgi/reprint/57/10/1416
For more information: Mr. Schonebaum. Fountain House, Inc., 425 West 47th Street, New York, NY 10036 Email: aschonebaum@fountainhouse.org
McKay, C., Johnsen, M., Banks, S. & Stein, R. (2006). Employment transitions for Clubhouse members. WORK, 26, 67-74.
Abstract (from journal):
Using a longitudinal dataset which followed 2195 individuals employed in 3379 separate job placements over a four-year period, this paper explores movement between the employment supports, [Transitional (TE), Supported (SE), and Independent Employment (IE)], offered by Clubhouses. Sixty-four percent of employed members held only one job (N=1395) and 36% held multiple jobs during the study (N=791). Patterns of movement were consistent for transitions between the first and second job and subsequent transitions. Forty-six percent of individuals holding multiple jobs moved from one employment type to another. When movement occurred, Clubhouse members were significantly more likely to move from employment types offering more supports to those that offer less supports.
URL: http://iospress.metapress.com/link.asp?id=3w6eqq8ttptq1egk
For more information contact: Colleen E. McKay, Program for Clubhouse Research, Center for Mental Health Services Research, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655. Telephone: 508-856-8471. Email: Colleen.McKay@umassmed.edu
Norman, C. (2006). The Fountain House movement, an alternative rehabilitation model for people with mental health problems, members’ descriptions of what works. Scandinavian Journal of Caring Sciences 20 (2), 184-192.
Abstract (from journal): The Clubhouse model is a method of rehabilitation where people suffering from mental health problems organise themselves in order to create change in their lives. Work is considered the main tool of rehabilitation within the Clubhouse. The aim of the study was to explore the members’ perception of the rehabilitation process. The study was participant oriented, which means that a group of members conducted the study in co-operation with the researcher. The study was explorative and research data were collected in a variety of ways including detailed notes, flipcharts, taped interviews and cognitive maps. As for ethical considerations, the members were guaranteed anonymity, voluntary participation and confidentiality in various ways. As a model of rehabilitation Göteborgsfontänen demonstrates a particular thematic subculture that has the goal of creating links between people that are characterised by mutual trust, habits of co-operation, solidarity and responsibilities undertaken voluntarily. Three keystones on which the thematic subculture rests were identified: meaningful relationships, meaningful work tasks and a supportive environment. The member must, in the first place, internalise the ideology as well as view differences between people as a resource rather than an obstacle. This was experienced as a turning point. The work ordered day functioned as a framework and a resource for members and staff to work intensively with relationships. Some members experienced their membership as too intense at times, which could result in a temporary withdrawal. A limitation of the study is that only members who experienced a turning point were involved in the study. This means that the data may lack some critical views of the ideology of the Clubhouse.
Correspondence: Christina Norman, Nordic School of Public Health, Stenshöjd pl 4669
Fjärå s 430 33, Box 12133 Göteborg 40242, Sweden.
Email: christina.norman@mbox302.swipnet.se
