Psychosocial Rehabilitation Model Research Articles

Psychosocial Outcomes of Canadian Clubhouse Members: A Multi-Site Longitudinal Evaluation.

The Clubhouse model of psychosocial rehabilitation supports individuals with mental health challenges using a person centered and recovery-oriented approach. Clubhouses around the world have been found to be effective in supporting their member's recovery. However, there is a lack of multi-site and longitudinal studies on the Clubhouse model. Therefore, the purpose of the present study was to longitudinally assess the psychosocial outcomes of Clubhouse members across six accredited Clubhouses in Canada. Due to the COVID-19 pandemic occurring midway through the study, a secondary aim was to assess the impact of the pandemic on the psychosocial outcomes of Clubhouse members. A total of 462 Clubhouse members consented to participate in the study. Members completed a questionnaire battery every 6months over a 2-year period (five data points total). The last three data points were collected during the COVID-19 pandemic.Psychosocial outcomes included mental health symptoms, substance use, community integration, and satisfaction with life, and were analyzed using multilevel growth models. The results indicated that satisfaction with life and psychological integration increased over the study period, while mental health symptoms, substance use, and physical integration decreased. Examining Clubhouse participation, length of Clubhouse membership and frequency of Clubhouse use predicted higher life satisfaction, lower substance use, and fewer mental health symptoms over the study period. The results of the present study provide invaluable insight into the psychosocial impact of Clubhouses on Canadian Clubhouse members, particularly during COVID-19.

Supplemental Material for Confirmatory Factor Analysis of the 12-Item World Health Organization Disability Assessment Schedule 2.0 (WHODAS-2.0) Within the Clubhouse Model of Psychosocial Rehabilitation for Serious Mental Illness

Supplemental Material for Confirmatory Factor Analysis of the 12-Item World Health Organization Disability Assessment Schedule 2.0 (WHODAS-2.0) Within the Clubhouse Model of Psychosocial Rehabilitation for Serious Mental Illness

Confirmatory factor analysis of the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS-2.0) within the clubhouse model of psychosocial rehabilitation for serious mental illness.

Confirmatory factor analysis of the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS-2.0) within the clubhouse model of psychosocial rehabilitation for serious mental illness.

AContemporary Review oftheClubhouseModel of Psychosocial Rehabilitation:Past, Present, and Emerging Directions.

Since the 1940s, the Clubhouse model of psychosocial rehabilitation has evolved towards a comprehensive practice of social theory and intervention. Despite the model's cost effectiveness and observational evidence of its efficacy, empirical research remains lacking. The current narrative review examines studies from recent years (2015-2021), not to assess study rigor, but to identify trends in research aims, findings, and methodology, as well as specify future research directions. A narrative review was conducted using PRISMA guidelines. Using the search term "Clubhouse," 194 articles were identified in online databases. 38 met criteria for inclusion. Most studies were qualitative (60.5%) and few utilized experimental or quasi-experimental designs (7.9%). Narrative synthesis revealed research aims and outcome variables falling into six key areas: social integration and connectedness, quality of life (QOL), recovery outcomes, relational dynamics, policy, and virtual adaptations of the model. Findings indicate that recent Clubhouse-related research trends have primarily involved studies of social connectedness, QOL, recovery, relationships, and policy, as well as studies examining the value of the virtual Clubhouse in maintaining well-being. However, heterogeneity of methodologies and measures present a critical limitation to assessing results across studies. Options for increasing experimental methodologies in this area are reviewed. Recommended future directions involve moving towards a biopsychosocial approach to clarifying the mechanisms through which the model promotes recovery-aims that may yield implications beyond the realm of serious mental illness.

Community-based psychosocial rehabilitation model for people with schizophrenia

Schizophrenia is a mental disorder that triggers the occurrence of impaired function in the human brain, behavior, cognitive, and emotional functions. This disorder has become a problem in the study of mental health, which must be treated comprehensively by using empirical treatment combined with rehabilitation. Hopefully, increasing the maximum level of healing and reducing recurrence rates can improve social function and quality of life. Thus, this review aims to narrate the model and effective community-based psychosocial rehabilitation center. The articles of the studies published from 2017-2021 were collected and analyzed in this literature review. The keywords used were community-based rehabilitation for schizophrenia. The results show that in addition to pharmacological therapy, six community-based psychosocial non-pharmacological therapy methods are considered effective for intervention in patients with schizophrenia. The methods are club methods in elderly schizophrenic patients, community-based methods, direct patient decision-making methods, case and club management methods, psychoeducational and social skills methods, and community care unit methods. All of the above methods analyzed showed significant effectiveness in community-based psychosocial rehabilitation treatment in developing countries.

The Impact of COVID-19 on Clubhouse Employment Programs.

The Clubhouse model of psychosocial rehabilitation provides several employment opportunities to individuals who experience mental health concerns, including transitional, supported, and independent employment. The COVID-19 pandemic resulted in Clubhouses having to adapt existing programs to online formats. Employment programs were further impacted, as many workplaces in the community closed or reduced capacity. The present study aimed to examine the rates of involvement in transitional, supported, and independent employment across six Clubhouses in Canada throughout the pandemic. 462 members completed surveys at five time points pertaining to participation in Clubhouse employment programs. The data was analyzed using Cochran's Q tests to determine differences in employment rates across time points. The results demonstrated an overall decrease in transitional and supported employment rates throughout the pandemic. Conversely, rates of independent employment were unchanged. It is evident that Clubhouse employment programs assist members in obtaining employment.The results suggest Clubhouses may benefit from exploring novel employment opportunities to support their members, such as remote work.

Conflicts and tensions in dual roles

Those living with mental illness have benefitted from non-clinical recovery organisations, such as the Clubhouse Model of Psychosocial Rehabilitation. Research conducted for a Clubhouse brings many benefits to it. However, the model is governed by cultural practices. These practices create beliefs that influence the conduct of the research despite the benefits it can bring. This autoethnographic account is about my involvement as a member and researcher within a Clubhouse. How cultural practices and beliefs influenced the research is detailed from observation notes and memory work. The conflicts and tensions I experienced were shaped by such cultural factors. This account concludes with reflections on how I felt about the events. It advises other ethnographers to research the mental illness field before attempting a project in it.

The Impact of the COVID-19 Pandemic on the Clubhouse Model

The COVID-19 pandemic posed challenges to the traditional Clubhouse Model of Psychosocial Rehabilitation (Clubhouse). The COVID-19 pandemic forced many Clubhouses around the world to rapidly pivot from face-to-face services and support programs at the Clubhouse to hybrid or virtual services. The Clubhouse community quickly mobilized to establish new structures to maintain connections with Clubhouse members and provide them with essential supports. This brief describes adaptations that Clubhouses made during the COVID-19 pandemic. We also describe supports offered by Clubhouse International to inform their international network about innovative approaches and best practices for Clubhouses during the COVID-19 pandemic.

Model of complex rehabilitation for patients with a simple form of schizophrenia

Psychosocial rehabilitation for patients with mental disorders is one of the priority areas of scientific research in modern psychiatric discourse. The key to solving this problem is a multidisciplinary approach, within which it becomes possible to select congruent rehabilitation and psychoeducational techniques, taking into account the clinical and psychopathological content of this nosological form. In this context endogenous procedural mental disorders deserve special attention, as they are characterized by the highest level of social and labor maladjustment. Aim. To investigate the effectiveness of the developed model of complex psychosocial rehabilitation for patients with schizophrenia. Materials and methods. On the basis of Municipal Non-Commercial Enterprise “Regional Clinical Institution for Provision of Psychiatric Care” of Zaporizhzhia Regional Council, 80 patients with a simple form of schizophrenia were selected at the outpatient stage of treatment for the purpose of further examination. Clinical diagnostics of the studied mental pathology was carried out in accordance with the differential diagnostic criteria of the International Classification of Diseases 10 revision (ICD-10). The inclusion criteria for the study contingent were: informed consent to participate in the study, the absence of severe somatic pathology and information about craniocerebral trauma. In order to analyze the effectiveness of the developed model, the study contingent was randomized into the study group (SG) – 40 patients who received complex therapy within the framework of the developed model of psychosocial rehabilitation, and the comparison group (CG) – 40 patients who received treatment in accordance with the current protocols. Results. Based on the formed principles of psychosocial rehabilitation for patients with a simple form of schizophrenia, a comprehensive model of psycho-rehabilitation support for this patient contingent was generated including four stages: psychopharmacological, family intervention, cognitive-behavioural and ergotherapeutic. Analysing the effectiveness of the developed model, statistically significant differences (P < 0.05) were established between the average indicators in the studied groups according to the criteria “socially useful activity, including work and study” (4.18 ± 0.25 and 3.33 ± 0.27 points in SG and CG, respectively) and “relationships with family and other social relations” (4.35 ± 0.24 and 3.60 ± 0.25 points in SG and CG, respectively) in the absence of statistically significant differences in the criteria for “self-care” and “bothering others and aggressive behaviour”. Conclusions. The effectiveness of the complex model of psychosocial rehabilitation for patients with a simple form of schizophrenia in the areas of socially useful activities (study and work) and social relations was developed and proved, which made it possible to increase the effectiveness of therapy for this contingent of patients.

Salutogenesis as a theoretical framework for psychosocial rehabilitation: the case of the Clubhouse model

ABSTRACT Purpose: This study explored whether the holistic theory of salutogenesis may be a suitable theoretical framework for the Clubhouse model of psychosocial rehabilitation, a pioneer among psychosocial rehabilitation programmes. Methods: A systematic examination of elements of the Clubhouse model, as prescribed by the Clubhouse standards, was performed within the context of the theory of salutogenesis including its basic salutogenic orientation and the main concepts of sense of coherence and resistance resources. Results: We found that several standards and practices within the Clubhouse model can be understood as applications of salutogenesis. We have hypothesized that the Clubhouse model promotes peoples’ sense of coherence and mental health. However, our investigation also showed that, to enhance the recovery of Clubhouse members, more explicitly incorporating some salutogenic principles, such as “appropriate challenges” and “active adaptation as the ideal in treatment”, may benefit Clubhouse practice. Conclusions: The Clubhouse model of psychosocial rehabilitation is very consistent with the salutogenic orientation and main salutogenic concepts. The present study suggests that salutogenesis may be a suitable theoretical framework for the Clubhouse model and possibly in the psychosocial rehabilitation field in general.

A 6-Month Randomized Controlled Pilot Study on the Effects of the Clubhouse Model of Psychosocial Rehabilitation with Chinese Individuals with Schizophrenia.

To investigate the effectiveness of the Clubhouse Model of Psychosocial Rehabilitation on psychosocial functions and recovery of native Chinese individuals with schizophrenia in a community sample. A randomized controlled design was used. A total of 56 participants were recruited from a community sample for a study lasting 6months, but five participants dropped out. Twenty-eight participants attended the Clubhouse program, and twenty-three participants served as controls. Standardized assessments were performed on three areas at the baseline and the 6-month follow-up: 1. symptom reduction; 2. social function, self-determination, and quality of life; and 3. rehospitalization rate. Compared to the controls, the Clubhouse participants showed reductions in psychiatric symptoms and better social function, self-determination, and quality of life (p < .05), but with no difference in the rehospitalization rate between Clubhouse members and the controls. The Clubhouse Model demonstrates its effectiveness and shows its viability as a service delivery model in psychosocial rehabilitation for individuals with schizophrenia in mainland China.

Psychosocial rehabilitation:a model by Rajah Rehabilitation Centre

‘Thanal’- Rajah Rehabilitation Centre (RRC) is a nonprofit voluntary organization established in 2001 dedicated to the people suffering from psychiatric illness. RRC adopts an interdisciplinary team approach for the upliftment of the disabled. RRC follows the recovery model of psychosocial rehabilitation. The psychiatric rehabilitation program is initiated with the assessment and trial stay under the supervision of the multidisciplinary treatment team. Rajah Rehabilitation Centre provides the following programs for the service recipients of sheltered workshop; individual consultations, activity scheduling, psychoeducation classes, living skill training, culinary skill training, social skill training, cognitive retraining, yoga training, recreation therapy, music training & therapy, dance training & therapy, work skill training, craft & artwork training, computer training program, on-job training, supported employment, supported housing etc. RRC also offers treatment for substance abuse, SS & Al-Anon groups and peer support groups for patients with mental illness, and crisis intervention program for elderly women with distress (Shanti Bavan) etc. Services at RRC facilitate individuals with psychiatric disability to increase their level of functioning and quality of life.

Psychosocial rehabilitation:a model by Rajah Rehabilitation Centre

‘Thanal’- Rajah Rehabilitation Centre (RRC) is a nonprofit voluntary organization established in 2001 dedicated to the people suffering from psychiatric illness. RRC adopts an interdisciplinary team approach for the upliftment of the disabled. RRC follows the recovery model of psychosocial rehabilitation. The psychiatric rehabilitation program is initiated with the assessment and trial stay under the supervision of the multidisciplinary treatment team. Rajah Rehabilitation Centre provides the following programs for the service recipients of sheltered workshop; individual consultations, activity scheduling, psychoeducation classes, living skill training, culinary skill training, social skill training, cognitive retraining, yoga training, recreation therapy, music training & therapy, dance training & therapy, work skill training, craft & artwork training, computer training program, on-job training, supported employment, supported housing etc. RRC also offers treatment for substance abuse, SS & Al-Anon groups and peer support groups for patients with mental illness, and crisis intervention program for elderly women with distress (Shanti Bavan) etc. Services at RRC facilitate individuals with psychiatric disability to increase their level of functioning and quality of life.

METHODOLOGICAL APPROACHES TO MODELING THE SYSTEM OF ORGANIZATION OF THE SERVICEMEN THE COMBATANTS’ COMPLEX REHABILITATION

The experience of combatants participating in hostilities in the east of Ukraine proves the high level of their traumatism. There is a need for complex rehabilitation. In order to increase the level of the combat’s capability and preserve physical and mental health. There is a need to normalize the psycho-emotional sphere of the servicemen. The purpose of the article is theoretical substantiation and modeling of the system of organization of the servicemen of the armed forces of Ukraine, the combatants’ complex rehabilitation. The research methods used: theoretical – the analysis of psychological and pedagogical, philosophical and methodological literature on the study issue, synthesis, comparison, generalization, abstraction, forecasting. The method of classification is to determine the essence of the basic concepts of research. The modeling is for developing a model of the organization of complex rehabilitation of the servicemen of the armed forces of Ukraine, the combatants.It is defined on the basis of the analysis of modern psychological and pedagogical literature of the study issue such concepts as “system”, “model”. It is simulated the system of organization of complex rehabilitation of the servicemen the combatants. There are distinguished the blocks in the structure of the author’s model. There are such blocks methodological (purpose, tasks, psychosocial rehabilitation models, methodological approaches, principles). The content (types of complex rehabilitation, specialized rehabilitation institutions). The procedural (the technology of rehabilitating the servicemen with distinct stages. It is a complex of innovative psychotherapeutic methods and various technologies - art-therapeutic, training, gaming). The productive (components, levels, result). The systematic element is determined organizational and pedagogical conditions. The following five conditions were attributed to them. The first one the implementation of integrated rebellion of the combatants with the distinction of the key species and taking into account the “individual case”. The second is the organization and implementation of rehabilitation of the servicemen the combatants by a multidisciplinary team of specialists. The conducting an early diagnosis of the needs and problems of the servicemen (according to the developed complex program) is the third one. The development of an individual rehabilitation program for the combatants is the forth. The fifth is the social and psychological support of the servicemen in the post-rehabilitation period. The article presents the justification and mechanism of their implementation.

Recovery, citizenship, and psychosocial rehabilitation: A dialog between Brazilian and American mental health care approaches

ABSTRACTOver the past 30 years, the Brazilian psychiatric reform, based on the anti-asylum social movement and the psychosocial rehabilitation model of care, transformed radically the country’s system of mental health care. Even though tremendous gains were made, people with serious mental illness continue to have limited access to citizenship. In the United States the recovery movement has enhanced the central role of people with serious mental illness as an active and responsible agent in their recovery process, encouraging a more collaborative role for service users, but, still, there are challenges to citizenship. This article first identifies commonalities between these two movements, central to mental health advances in the two distinct cultures of Brazil and the United States. Then, though celebrating the cultural differences between the two societies, the authors consider the possibility of cross-fertilization and propose a set of suggestions that could help both countries to overcome the remainin...

Психосоциальная реабилитация несовершеннолетних, попавших в юридически значимые ситуации, как задача культурно-исторической психологии

The article analyses psychosocial rehabilitation of adolescents caught in legally significant situations in relation to the professional standard. Most often, the term "rehabilitation" is defined as a system of certain measures and/or arrangements aimed at the restoration, correction, compensation of impaired mental functions or qualities. However, this approach does not allow to formulate the goal and tasks of the rehabilitation process that are relevant to legal psychology as a science and to providing practical psychological assistance to adolescents in legally significant situations. Basing on the key categories of cultural-historical psychology (such as social situation of development, new psychological formations, zone of proximal development, etc.) a model of psychosocial rehabilitation based on the replacement of the social situation of development is proposed. The article describes the process of psychosocial rehabilitation consisting of a cycle of activities of a legal psychologist and compares it to the job functions listed in the professional standard for specialists in social rehabilitation.

Recovery-Oriented Mental Health Practice in a Community Care Unit: An Exploratory Study.

A recovery-oriented model of care has become the major focus of mental health service delivery in the state of Victoria, Australia. However, there is a total absence of knowledge of recovery-oriented mental health practice in community care units (CCUs). Therefore, the aims of this exploratory study were to: (a) describe what aspects of the current model of care fit within the domains of recovery; and (b) describe the pragmatic processes that staff use to mold their care within the domains of recovery. Twenty-one key stakeholders provided informed voluntary consent to participate in one-to-one interviews. Six content domains evolved to include: (a) a common vision: "a continuous journey"; (b) promoting hope; (c) promoting autonomy and self-determination; (d) meaningful engagement; (e) holistic and personalized care; and (f) community participation and citizenship. The CCU appeared to be on a journey of transformation toward personal recovery. However, clinicians were grappling with an identified tension among personal recovery and clinical recovery. The tension among personal recovery and clinical recovery may be attributed to the psychosocial rehabilitation model of care, which was previously systemic in Victorian CCUs.

A Systematic Review of Evidence for the Clubhouse Model of Psychosocial Rehabilitation

The Clubhouse Model has been in existence for over sixty-five years; however, a review that synthesizes the literature on the model is needed. The current study makes use of the existing research to conduct a systematic review of articles providing a comprehensive understanding of what is known about the Clubhouse Model, to identify the best evidence available, as well as areas that would benefit from further study. Findings are summarized and evidence is classified by outcome domains. Fifty-two articles met the selection criteria of Randomized Clinical Trials (RCT’s), quasi-experimental studies, or observational studies for domains of employment (N = 29); quality of life/satisfaction (N = 10); reductions in psychiatric hospitalization(s) (N = 10); social relationships (N = 10); education (N = 3); and health promotion activities (N = 2). RCT results support the efficacy of the Clubhouse Model in promoting employment, reducing hospitalization(s), and improving quality of life. Quasi-experimental and observational studies offer support in education and social domains. The findings from this review indicate that Clubhouses are a promising practice but additional studies using rigorous methods that report the strength of the outcomes are needed to evaluate Clubhouse programs with fidelity to the Clubhouse Model.

Economical and social return of psychosocial rehabilitation model based in needs. The SROI project

Introduction Psychosocial Rehabilitation has demonstrated to be a key factor in the process of deinstitutionalisation, recovery and social inclusion of people affected by a Severe Mental Disorder. Nevertheless, there are few studies about social and economical return of this rehabilitation. The Fundacion Agustin Serrate is a Non-Governmental Organization (NGO), which has been working, since 1995, with psychosocial rehabilitation in Huesca, a small province in the north of Spain. Objective The aim of this study is to determine and recognize the return and the impact that a rehabilitation and intervention model has in people with a severe mental disorder, on their families and on society. Methods Three services in its model of rehabilitation: day care centre, integration work centre and supervised houses. The SROI (Social Return Of Investment) methodology is a tool to make decisions based on the optimization of the social and work impacts of social projects. The study was done by meetings, workshops, interviews and questionnaires with all groups of interest (patients, families, psychiatrist…) Results A total of 208 users were attended in different services (65% men and 35% women). The age average was 45.8years. Sixty-eight percent of people had a diagnosis of schizophrenia and schizoaffective disorder. For each euro of investment, the organization returned to society 3.15euros (social return and economic). The users and their families improved their quality of life (individual and familiar). Conclusions The principal conclusion is that Psychosocial Rehabilitation is financially profitable for the society and governments; and it is useful for improving the quality of life of patients and their families.

The contribution of case study design to supporting research on Clubhouse psychosocial rehabilitation.

BackgroundPsychosocial Clubhouses provide recovery-focused psychosocial rehabilitation to people with serious mental illness at over 300 sites in more than 30 countries worldwide. To deliver the services involved, Clubhouses employ a complex mix of theory, programs and relationships, with this complexity presenting a number of challenges to those undertaking Clubhouse research. This paper provides an overview of the usefulness of case study designs for Clubhouse researchers; and suggests ways in which the evaluation of Clubhouse models can be facilitated.ResultsThe paper begins by providing a brief explanation of the Clubhouse model of psychosocial rehabilitation, and the need for ongoing evaluation of the services delivered. This explanation is followed by an introduction to case study design, with consideration given to the way in which case studies have been used in past Clubhouse research. It is posited that case study design provides a methodological framework that supports the analysis of either quantitative, qualitative or a mixture of both types of data to investigate complex phenomena in their everyday contexts, and thereby support the development of theory. As such, case study approaches to research are well suited to the Clubhouse environment. The paper concludes with recommendations for future Clubhouse researchers who choose to employ a case study design.ConclusionsWhile the quality of case study research that explores Clubhouses has been variable in the past, if applied in a diligent manner, case study design has a valuable contribution to make in future Clubhouse research.