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. (Pschiatric 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.
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.
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
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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
Yau, E.F., Chan,C.H., Chan, A.S.F, & Chui, B.K.T. (2005). Changes in psychosocial and work-related characteristics among Clubhouse members: A preliminary report. WORK, 25(4) 287-296.
The aim of this study was to explore the changes in work-related abilities of members after attending the Clubhouse program for 12 weeks. The extent to which the changes would contribute to members' performance on simulated work tasks was also investigated. A total of 39 people with mental illnesses, primarily schizophrenia, attending Phoenix Clubhouse participated in the study. Seventeen were newly recruited members to the Clubhouse. The other 22, who served as the control group, were existing members who had been attending the Clubhouse for more than three months. All the participants were assessed by the McCarron-dial System (Observational Emotional Inventory-Revised, McCarron Assessment of Neuromuscular Development), Cognistat, Chinese Work Personality Profile, WHO Disability Assessment Schedule and WHOQOL-Bref-HK at the baseline and 12 weeks after attending the Clubhouse program. They were required to complete a set of simulated work tasks after 12 weeks. New members showed significant improvement in emotional-coping abilities (impulsive-frustration and depression-withdrawal) and work personality (task orientation, social skills, and team work) after attending the Clubhouse program for 12 weeks. The increase in emotional-coping skills (depression-withdrawal) was found to contribute to better performance on typing tasks, whereas emotional coping (anxiety) contributed to better performance on cleansing tasks. Three months' participation in the Clubhouse program appears to have positive effects on emotional-coping abilities and work personality. The emotional-coping abilities were found to predict good performance in simulated clerical and maintenance jobs. Recommendations and suggestions for further research are discussed.
URL: http://iospress.metapress.com/link.asp?id=8mbf3b9wqcathck4
McKay, C. (2005). CMHSR Issue Brief: Recent Research Findings from the Program for Clubhouse Research.
This brief highlights findings from four research studies conducted by the Program for Clubhouse Research and its collaborators, examining employment outcomes, Clubhouse costs, and wellness activities.
URL: http://www.umassmed.edu/cmhsr/uploads/brief18Clubhouse.pdf
Pelletier, J.R.; Nguyen, M.; Bradley, K.; Johnsen, M.; McKay, C. (2005).
A Study of a Structured Exercise Program with Members of an ICCD Certified Clubhouse: Program Design, Benefits, and Implications for Feasibility. Psychiatric Rehabilitation Journal, Vol. 29 Issue 2, p89-96.
URL: http://prj.metapress.com/
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