Psychosocial Clubhouses Research Articles

A factor analytic evaluation of the Self-Stigma Scale-Short (SSS-S) among psychosocial clubhouse members in the United States

The main purpose of this study was to examine the factor structure, the internal consistency, and other aspects of validity of the English version of the Self-Stigma Scale-Short (SSS-S). In the present study, the SSS-S was assessed in a sample of 194 adults with psychiatric disabilities from four Psychosocial Clubhouses in the Southern and Midwestern United States. Exploratory factor analysis (EFA; n = 98) supported a one-factor structure of the SSS-S, which accounted for 59% of the variance. Confirmatory factor analysis (CFA; n = 96) demonstrated that the factor structure of the SSS-S was satisfactory. The scale was also reliable, with a Cronbach's alpha of 0.93 and 0.91 for the EFA and CFA samples, respectively. The SSS-S showed adequate convergent and criterion-related validity, as indicated by statistically significant positive correlations between internalized stigma with perceived societal stigma, symptom severity, and functional impairment, as well as negative correlations between internalized stigma with perceived social self-efficacy, social support, and resiliency. Overall, these findings support the English version of the SSS-S as a valid and reliable tool for determining the internalized stigma of adults with psychiatric disabilities in clinical settings and similar research.

“Finally, I belong somewhere I can be proud of” – Experiences of being a Clubhouse member in Norway

ABSTRACT Purpose: The number of psychosocial Clubhouses is growing rapidly in Norway. However, more knowledge is needed about the subjective experience of Clubhouse members in terms of their recuperation processes and experiences in the Clubhouse context. Therefore, this qualitative study explored what it is like to be a Clubhouse member in Norway, and further discuss it in light of the theory of Salutogenesis on successful pathways to coping and well-being. Methods: Using a hermeneutic–phenomenological approach, the present study included in-depth, semi-structured individual interviews with 18 Clubhouse members from three accredited Norwegian Clubhouses. Analysis was conducted using systematic text condensation. Results: Three main themes emerged from the analysis: “Finally, I belong somewhere I can be proud of,” “I feel more like an ordinary citizen, just different,” and “I feel somewhat equal to others.” Overall, the participants experienced improved mental and social well-being owing to their membership of a Clubhouse. Conclusions: Our findings correspond with previous international research. Owing to the positive effect participation in the Clubhouse seem to have on members’ motivation, Salutogenesis might help explain helpful processes within the model. Moreover, the model might be a relevant example for policy and service development in mental health care and the labour market.

Beyond these walls: Can psychosocial clubhouses promote the social integration of adults with serious mental illness in the community?

The study examined factors associated with community integration experiences of adults with serious mental illness who were members of psychosocial rehabilitation clubhouses in New York City. Ninety-two clubhouse members completed an online survey. The study examined relative contribution of adults' reports of individual factors (self-reported psychiatric symptoms, self-esteem), community supports (self-reported employment status and perceived family support), and the clubhouse environment (self-reported time spent in the clubhouse, clubhouse supportiveness, and practical orientation) in accounting for variation in members' reports of social integration within the clubhouse and within the larger community. Hierarchical linear regression results suggest a differential pattern of variables associated with participants' experience of social integration within the clubhouse versus outside the clubhouse with the larger non-mental-health consumers. Adults' reports of more time spent in the clubhouse and perceptions of clubhouse environment as having a more practical orientation were associated with adults' reports of greater social integration within the clubhouse. In contrast, greater self-esteem and being independently employed were associated with greater social integration outside the clubhouse. Perceived family support was associated with higher levels of social integration both within and outside the clubhouse setting. Conclusion and Implication for Practice: Greater social integration of clubhouse members both in and outside the clubhouse environment is essential in understanding community integration. Recommendations for the clubhouse model to improve community integration experiences of its members are discussed. (PsycINFO Database Record

"Work is Love Made Visible": Purpose and Community in Clubhouses

What does work mean to people socially defined by their inability to work? This article explores "work" in Psychosocial Clubhouses, strengths-based programs for people experiencing psychiatric disability, where members – not clients or patients – work at operating their clubhouse alongside staff. I draw upon three years of experience in a Michigan clubhouse, as a volunteer, social work intern, and ethnographer. I explore the meaning of work – defined as "purposeful activity that builds community," challenging the narrow neoliberal definition of work as "paid employment" – from the perspective of clubhouse members. In the clubhouse, "dis-ability" becomes a misnomer, as members demonstrate remarkable "ability" within the clubhouse's work environment. Interestingly, this work environment demands close, authentic relationships between members and staff, which dismantle conventional hierarchies between professionals and clients in mental health programs. In this work environment, members come to feel needed and valued, countering common feelings associated with psychiatric disability such as dependence and a lack of self-efficacy. Through developing a sense of purpose and community – arguably human needs – many members are able to live self-defined meaningful lives, in spite of their marginalized social position.

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.

WPA Project on Partnerships for Best Practices in Working with Service Users and Carers.

WPA Project on Partnerships for Best Practices in Working with Service Users and Carers.

Implementation of the thinking skills for work program in a psychosocial clubhouse.

Cognitive remediation programs aimed at improving role functioning have been implemented in a variety of different mental health treatment settings, but not in psychosocial clubhouses. This study sought to determine the feasibility and preliminary outcomes of providing a cognitive remediation program (the Thinking Skills for Work program), developed and previously implemented in supported employment programs at mental health agencies, in a psychosocial club-house. Twenty-three members with a history of difficulties getting or keeping jobs, who were participating in a supported employment program at a psychosocial clubhouse, were enrolled in the Thinking Skills for Work program. A neurocognitive battery was administered at baseline and 3 months later after completion of the computer cognitive training component of the program. Hours of competitive work were tracked for the 2 years before enrollment and 2 years following enrollment. Other work-related activities (school, volunteer) were also tracked for 2 years following enrollment. Twenty-one members (91%) completed 6 or more computer cognitive training sessions. Participants demonstrated significant improvements on neurocognitive measures of processing speed, verbal learning and memory, and executive functions. Sixty percent of the members obtained a competitive job during the 2-year follow-up, and 74% were involved in some type of work-related activity. Participants worked significantly more competitive hours over the 2 years after joining the Thinking Skills for Work program than before. The findings support the feasibility and promise of implementing the Thinking Skills for Work program in the context of supported employment provided at psychosocial clubhouses.

Examining the Contribution of Social Network Support to the Recovery Process Among Clubhouse Members

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).

Recovery From Disability: Manual of Psychiatric Rehabilitation

Back to table of contents Previous article Next article Book ReviewFull AccessRecovery From Disability: Manual of Psychiatric RehabilitationYad M. Jabbarpour M.D.Yad M. Jabbarpour M.D.Search for more papers by this authorPublished Online:13 Jan 2015https://doi.org/10.1176/ps.2009.60.2.270AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail With historic vision, clinical sensibility, and scientific tenacity, Dr. Robert P. Liberman has been a founding father of psychiatric rehabilitation, developing it to form a cornerstone of treatment for persons with serious mental illness. He is a distinguished professor at the University of California, Los Angeles (UCLA), where he has been a member of the faculty since 1970 and where he has directed since 1977 the UCLA Center for Research on Treatment and Rehabilitation of Psychosis, funded by the National Institute of Mental Health. With Recovery From Disability, Liberman has provided a guiding resource to help clinicians bridge the gap between science and clinical services, thereby helping patients bridge the gap from disabling illness to recovery. The initial section of the book provides the conceptual and evidence-based foundations for psychiatric rehabilitation, from terminology to discussions on the recovery movement. The main theories are reviewed, ranging from the vulnerability-stress-protective factors model of mental disorders, to social learning theory, to life span developmental psychology. The review provides a framework for the driving principles and practices of psychiatric rehabilitation. The midsection contains the core focuses for psychiatric rehabilitation: illness management, functional assessment, social skills training, family involvement strategies, and vocational rehabilitation. This section is the manual's principal substance, formatted to bring psychiatric rehabilitation home to the clinician and on behalf of the patient.The last chapters address specific vehicles for the delivery of rehabilitative services and emphasize special service situations. Liberman discusses the applications to case management and personal support specialists and thereafter tackles the further applications to housing, assertive community treatment, and psychosocial clubhouses. Integrated mental health care is underscored. Given the complex needs of persons served in our fragmented systems of care, the author attends to special rehabilitation services for special populations, ranging from those of diverse ethnic and cultural backgrounds to those with severe mental illnesses who are incarcerated in jails and prisons. Rehabilitation for persons with treatment-refractory mental illnesses and co-occurring substance use disorders, as well as for older adults, is discussed. Liberman ends by spotlighting future developments for rehabilitation and recovery, including prevention, cognitive remediation, the use of technology, and the integration of consumers into rehabilitation with peer support specialists and other supports.Each chapter offers not only direct content but also clinical examples and learning exercises to engage the reader. The author ends each section with summaries and key points that pull together the salient, take-home elements. These teaching techniques help readers incorporate knowledge through multiple formats of learning. The manual also provides a complementary resource that pulls together Liberman and colleagues' multiple modules for psychiatric rehabilitation, as exemplified by medication management, community re-entry, symptom management, and family modules. The manual would have benefited from the use of electronic media—by including a CD-ROM, for example—to provide links to the modules and more elaborative applications. Liberman provides a large—over 600 pages—yet practical handbook that brings theory into practice for the reader. With this manual, recovery is no longer simply a values-based vision. Recovery From Disability improves our function in psychiatric services by providing pragmatic, evidence-based tools to improve our utility as providers. Clinicians from all disciplines who serve persons with severe mental illnesses will benefit by including this book in their library. Dr. Jabbarpour is clinical assistant professor at the University of Virginia School of Medicine and chief of staff at Catawba Hospital, Catawba, Virginia. FiguresReferencesCited byDetailsCited ByNone Volume 60Issue 2 February, 2009Pages 270-270PSYCHIATRIC SERVICES February 2009 Volume 60 Number 2 Metrics PDF download History Published online 13 January 2015 Published in print 1 February 2009

Consumers and Alliances United for Supported Education (CAUSE): Building and Maintaining Successful Collaborative Relationships

Consumers and Alliances United for Supported Education (CAUSE) has assisted people with psychiatric disabilities to attend the postsecondary educational institution of their choice in the greater Boston metropolitan area since 1991. This article provides the unique grassroots history of CAUSE and describes the components of this supported education program. In keeping with the consumer involvement fundamental to its development, CAUSE has a significant number of staff members who are consumer-providers. Staff and participants attribute the program's empirically supported success to the quality of relationships between staff and clients, to strong advocacy, and to mutually beneficial collaborations among multiple stakeholders including consumers, psychosocial clubhouses, mental health agencies, supported employment programs, higher education settings, mental health advocacy groups, and vocational rehabilitation agencies.

Gender-related concerns of rural women with severe and persistent mental illnesses

This study used focus groups to investigate the perceptions of rural women with severe and persistent mental illness (SPMI) about their gender-related health concerns. In a series of five focus groups conducted with 16 women at rural psychosocial clubhouses, women with SPMI discussed many gender-related issues, including unresolved grief over loss of children, isolation from family members, lack of sexual partners, diminished sexuality, and bodily changes secondary to medication side-effects. Women with mental illness felt like their roles as women was superseded by their role as mentally ill individuals. Rural women with SPMI have unmet needs for women's health. Psychiatric nurses have the optimal background for addressing gender-related concerns of rural women with SPMI. Copyright 2003, Elsevier Science (USA). All rights reserved.

Deriving service costs for a clubhouse psychosocial rehabilitation program.

This article (a) discusses "function cost," a concept to estimate costs where consumers are involved both in delivery and receipt of services; (b) develops a methodology for costing service units for psychosocial rehabilitation clubhouses; and (c) presents a case study of a clubhouse program. Using function cost to estimate the value of member time leads to costs being on average about 10% higher than when using opportunity cost. Because the case-study clubhouse is typical in key dimensions, the methods used here appear generalizable to other programs and should have utility for other rehabilitation-based services for individuals with mental illness.