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L’empowerment des usagers en santé mentale. Satisfaction du club thérapeutique : quel lien avec la qualité de vie et le soutien social perçus ? ANNALES MÉDICO-PSYCHOLOGIQUES, REVUE PSYCHIATRIQUE 2022. [DOI: 10.1016/j.amp.2022.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Li XH, Zhang TM, Yau YY, Wang YZ, Wong YLI, Yang L, Tian XL, Chan CLW, Ran MS. Peer-to-peer contact, social support and self-stigma among people with severe mental illness in Hong Kong. Int J Soc Psychiatry 2021; 67:622-631. [PMID: 33059491 DOI: 10.1177/0020764020966009] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Self-stigma exerts a range of adversities for persons with severe mental illness (SMI), however, little is known about the association between peer contact, social support and self-stigma. AIMS This study aimed to explore the mediating role of social support on the relationship between peer contact and self-stigma among persons with SMI in Hong Kong. METHODS A total of 159 persons with SMI (schizophrenia and mood disorder) in community service centres participated in the study through completing a survey on self-stigma, social functioning, social support, perception of peer contact and mass media. Logistic regression was utilised to explore the influencing factors of self-stigma among the participants. RESULTS The results showed that 81.1% of participants reported moderate to severe levels of self-stigma. Self-stigma was significantly associated with diverse factors (e.g. social functioning). Importantly, positive peer contact was significantly associated with lower self-stigma of persons with SMI. Social support acted as a mediator between peer contact and self-stigma. CONCLUSION The results of this study suggest that contact-based interventions, such as enhancing positive peer-to-peer contact, should be conducted for reducing self-stigma among persons with SMI.
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Affiliation(s)
- Xu-Hong Li
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
| | - Tian-Ming Zhang
- Department of Social Work, Shanghai University, Shanghai, China
| | - Yuen Yum Yau
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
| | - Yi-Zhou Wang
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
| | - Yin-Ling Irene Wong
- School of Social Policy & Practice, University of Pennsylvania, Philadelphia, PA, USA
| | - Lawrence Yang
- School of Global Public Health, New York University, New York, NY, USA.,Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Xiao-Li Tian
- Department of Sociology, University of Hong Kong, Hong Kong SAR, China
| | - Cecilia Lai-Wan Chan
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
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Fekete OR, Langeland E, Larsen TMB, Davidson L, Kinn LG. Recovery at the Clubhouse: challenge, responsibility and growing into a role. Int J Qual Stud Health Well-being 2021; 16:1938957. [PMID: 34126865 PMCID: PMC8208115 DOI: 10.1080/17482631.2021.1938957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose: To explore how people with mental illness experience recovery in the Clubhouse context, and which ingredients of the model they find active in promoting recovery. Methods: Hermeneutic–phenomenological design. Individual, semi-structured interviews with 18 Norwegian Clubhouse members. Systematic text condensation was used in analysis. Results: Three main themes emerged: “Balancing unlimited support with meeting challenges”, with two sub-themes: “Unlimited membership: space for self-agency or hindering development?” and “Becoming a Clubhouse member: concerns and positive experiences”. The second main theme was: “Learning how to build new skills and roles in the community”. The third main theme was: “Getting better through and for work”, with two sub-themes: “Work at the Clubhouse as a means to recovery” and “Preparing for a working life in society”. Overall, participants experienced improved mental and social wellbeing and work readiness. Conclusions: Recovery in the Clubhouse context requires members’ personal initiative, thus people having poor mental health might struggle with utilizing the Clubhouse. However, participants reported that lack of challenges within the community thwarted their recovery. Based on Salutogenesis, conscious application of challenge in Clubhouse activities might enhance members’ recovery. Furthermore, participants’ all-round involvement in their recovery journeys suggests the importance of shared decision-making in recovery-oriented services.
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Affiliation(s)
- Orsolya Reka Fekete
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.,Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Eva Langeland
- Department of Health and Caring Sciences, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Torill M B Larsen
- Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Larry Davidson
- Yale Program for Recovery and Community Health, Yale University, New Haven, CT, USA
| | - Liv Grethe Kinn
- Department of Welfare and Participation, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
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Clubhouses Response to COVID-19: Member Challenges and Clubhouse Adaptations. Community Ment Health J 2021; 57:424-437. [PMID: 33387181 PMCID: PMC7776279 DOI: 10.1007/s10597-020-00753-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 11/27/2020] [Indexed: 11/02/2022]
Abstract
Clubhouses have been found to improve a variety of psychosocial outcomes for individuals with mental health concerns. Due to the barriers encountered during COVID-19, Clubhouses adapted their programming to meet member's needs. The purpose of the present study was to document and synthesize Clubhouse member's needs and Clubhouse adaptations during COVID-19. Clubhouse members, staff, and directors (n = 29) from five accredited Clubhouses across Canada participated in interviews about their experiences within Clubhouses during the pandemic. Interview notes were analyzed using thematic analysis through an iterative process until consensus occurred. The results indicated a number of challenges that Clubhouse members experienced including increased mental health symptoms, isolation and loneliness, and difficulty accessing services. Clubhouse adaptations included increased communication, expansion of the meal program, and sustained program delivery through technology. The results suggest that COVID-19 has provided an opportunity for Clubhouses and other community-based organizations to innovate to meet their member's needs.
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Yan H, Ding Y, Guo W. Clubhouse Model of Psychiatric Rehabilitation in China to Promote Recovery of People With Schizophrenia: A Systematic Review and Meta-Analysis. Front Psychiatry 2021; 12:730552. [PMID: 34589010 PMCID: PMC8473690 DOI: 10.3389/fpsyt.2021.730552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 08/16/2021] [Indexed: 01/08/2023] Open
Abstract
Background: Whether the clubhouse model of psychiatric rehabilitation is well-implemented in China and whether patients with schizophrenia successfully achieve symptom remission and functional recovery through engaging in the clubhouse remain unclear. Methods: Seven electronic databases were searched for relevant articles from inception to April 21, 2021. Quality assessment, data synthesis, and subgroup analysis were performed on the included studies. Results: Seven randomized controlled studies with 682 participants were included in the present meta-analysis. The clubhouse model of psychiatric rehabilitation has a significant effect on promoting the remission of psychiatric symptoms, especially negative symptoms. However, it does not show a definite effect on promoting recovery of positive symptoms. The clubhouse model of psychiatric rehabilitation has a significant effect on promoting social functioning recovery, reducing the family burden, improving the quality of life, and promoting the remission of depressive and anxiety symptoms of patients with schizophrenia in China. Conclusions: Our findings suggest that the clubhouse model of psychiatric rehabilitation can promote the remission of symptoms and functional recovery of Chinese with schizophrenia. It may be suitable to address the urgent need for better mental health services in China.
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Affiliation(s)
- Haohao Yan
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yudan Ding
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Wenbin Guo
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,Department of Psychiatry, The Third People's Hospital of Foshan, Foshan, China
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Fekete OR, Langeland E, Larsen TMB, Kinn LG. "Finally, I belong somewhere I can be proud of" - Experiences of being a Clubhouse member in Norway. Int J Qual Stud Health Well-being 2020; 15:1703884. [PMID: 31877109 PMCID: PMC6968664 DOI: 10.1080/17482631.2019.1703884] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2019] [Indexed: 11/06/2022] Open
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.
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Affiliation(s)
- Orsolya Reka Fekete
- Department of Health and Caring Sciences, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Eva Langeland
- Department of Health and Caring Sciences, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Torill M B Larsen
- Department of Health Promotion and Development Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Liv Grethe Kinn
- Department of Welfare and Participation, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
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Fekete OR, Kinn LG, Larsen TMB, Langeland E. Salutogenesis as a theoretical framework for psychosocial rehabilitation: the case of the Clubhouse model. Int J Qual Stud Health Well-being 2020; 15:1748942. [PMID: 32249690 PMCID: PMC7170324 DOI: 10.1080/17482631.2020.1748942] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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.
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Affiliation(s)
- Orsolya Reka Fekete
- Department of Welfare and Participation, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences and Department of Health Promotion and Development Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Liv Grethe Kinn
- Department of Welfare and Participation, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Torill M B Larsen
- Department of Health Promotion and Development Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Eva Langeland
- Department of Health and Caring Sciences, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
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Fulginiti A, Frey LM. Are the "Right" People Selected for First Disclosures About Suicidal Thoughts? Exploring What We Know About Advance Care Planning in the Context of Safety Planning. Community Ment Health J 2020; 56:174-185. [PMID: 31512079 DOI: 10.1007/s10597-019-00457-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 09/07/2019] [Indexed: 11/28/2022]
Abstract
Nominating primary confidants (i.e., safety plan nominees) is central to safety planning for suicide but there is a dearth of research about such confidants-a serious oversight given their high-leverage position to affect pathways into clinical care. Informed by advance care planning (ACP) work, this study examined differences between social network members who were and were not identified as primary confidants on attributes that could impact their effectiveness in a helping role. Using social network methodology, information was collected from 41 individuals with affective disorders about the 332 people and relationships in their networks. Logistic regression analysis revealed that being perceived as capable of managing stress and prioritizing the participant's best interests over one's own increased the odds of being a primary confidant. Clinicians working with suicidal individuals may benefit from integrating ACP principles-which recognize the thoughtful selection of nominees based on specific attributes-into their safety planning procedures.
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Affiliation(s)
- Anthony Fulginiti
- Graduate School of Social Work, University of Denver, 2148 S. High St., Denver, CO, 80208, USA.
| | - Laura M Frey
- Kent School of Social Work, University of Louisville, 136 Burhans Hall, Shelby Campus, Louisville, KY, 40292, USA
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Mutschler C, Rouse J, McShane K, Habal-Brosek C. Developing a realist theory of psychosocial rehabilitation: the Clubhouse model. BMC Health Serv Res 2018; 18:442. [PMID: 29914458 PMCID: PMC6004683 DOI: 10.1186/s12913-018-3265-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 05/31/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Psychosocial rehabilitation is a service that supports recovery from mental illness by providing opportunities for skill development, self-determination, and social interaction. One type of psychosocial rehabilitation is the Clubhouse model. The purpose of the current project was to create, test, and refine a realist theory of psychosocial rehabilitation at Progress Place, an accredited Clubhouse. METHOD Realist evaluation is a theory driven evaluation that uncovers contexts, mechanisms, and outcomes, in order to develop a theory as to how a program works. The current study involved two phases, encompassing four steps: Phase 1 included (1) initial theory development and (2) initial theory refinement; and Phase 2 included (3) theory testing and (4) refinement. RESULTS The data from this two-phase approach identified three demi-regularities of recovery comprised of specific mechanisms and outcomes: the Restorative demi-regularity, the Reaffirming demi-regularity, and the Re-engaging demi-regularity. The theory derived from these demi-regularities suggests that there are various mechanisms that produce outcomes of recovery from the psychosocial rehabilitation perspective, and as such, it is necessary that programs promote a multifaceted, holistic perspective on recovery. CONCLUSIONS The realist evaluation identified that Progress Place promotes recovery for members. Additional research on the Clubhouse model should be conducted to further validate that the model initiates change and promotes recovery outcomes.
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Affiliation(s)
- Christina Mutschler
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, ON M5B 2K3 Canada
| | - Jen Rouse
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, ON M5B 2K3 Canada
| | - Kelly McShane
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, ON M5B 2K3 Canada
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McKay C, Nugent KL, Johnsen M, Eaton WW, Lidz CW. A Systematic Review of Evidence for the Clubhouse Model of Psychosocial Rehabilitation. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2018; 45:28-47. [PMID: 27580614 PMCID: PMC5756274 DOI: 10.1007/s10488-016-0760-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
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.
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Affiliation(s)
- Colleen McKay
- Department of Psychiatry, Program for Clubhouse Research, Systems and Psychosocial Advances Research Center, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA.
| | - Katie L Nugent
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, PO Box 21247, Baltimore, MD, 21228, USA
| | - Matthew Johnsen
- Department of Sociology, Worcester State University, 486 Chandler Street, Worcester, MA, 01602, USA
| | - William W Eaton
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Room 880B, 624 North Broadway, Baltimore, MD, 21205, USA
| | - Charles W Lidz
- Department of Psychiatry, Systems and Psychosocial Advances Research Center, University of Massachusetts Medical School, Worcester, MA, 01655, USA
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Rouse J, Mutschler C, McShane K, Habal-Brosek C. Qualitative participatory evaluation of a psychosocial rehabilitation program for individuals with severe mental illness. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2017. [DOI: 10.1080/00207411.2017.1278964] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Jennifer Rouse
- Department of Psychology, Ryerson University, Toronto, Ontario, Canada
| | | | - Kelly McShane
- Department of Psychology, Ryerson University, Toronto, Ontario, Canada
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Campos F, Sousa A, Rodrigues V, Marques A, Queirós C, Dores A. Directrices prácticas para programas de apoyo entre personas con enfermedad mental. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2016; 9:97-110. [DOI: 10.1016/j.rpsm.2014.06.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 05/14/2014] [Accepted: 06/16/2014] [Indexed: 11/28/2022]
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Campos F, Sousa A, Rodrigues V, Marques A, Queirós C, Dores A. Practical guidelines for peer support programmes for mental health problems. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.rpsmen.2016.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Tanaka K, Davidson L. Meanings associated with the core component of clubhouse life: the work-ordered day. Psychiatr Q 2015; 86:269-83. [PMID: 25417121 DOI: 10.1007/s11126-014-9330-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Despite the clubhouse model's 60-year existence internationally, the central nature of its core program, the "work-ordered day" (WOH) (Beard et al. in Psychosocial Rehabilitation Journal 5:47-53, 1982), is not well understood; hence, the primary focus of the present study was to explore members' experiences of the nature and meaning of the WOH. The study drew on qualitative interview data collected in 2009-2013 through open-ended questions and probes with 102 members and 24 staff from 5 Clubhouse International-certified clubhouses (2 US and 3 Finnish). Participant observation supplemented the interviews and all data were analyzed using a grounded theory approach (Charmaz in Rethinking methods in psychology, 1995; Glaser and Strauss in The discovery of grounded theory: strategies for qualitative research, 1967). Two major themes clustered around: (a) WOH in service of autonomy (things to do, sense of accomplishment, respite, development of occupational skills) and (b) WOH in service of relationships (receiving support; collaboration; and making contributions to the clubhouse community). Clubhouse members appeared to experience the WOH as meaningful because it helps them, as its best, reconstruct a life, develop their occupational self and skill sets, and experientially learn and live what parallels a good life in the general community. It appears that these experiences, interconnecting with the fundamental human needs for autonomy and relationship, point to wellbeing and recovery as part of personal growth. These findings can guide clubhouse daily practice in assessing members' psychosocial strengths and needs pertaining to recovery. Future research should elaborate on influences of sources of meaning, including work designs and the contributions of everyday socio-cultural interactive and reciprocal processes to these meanings.
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Affiliation(s)
- Kimiko Tanaka
- Marywood University School of Social Work & Administrative Studies, 2300 Adams Avenue, Scranton, PA, 18509, USA,
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Abstract
PURPOSE OF REVIEW Considering international diversity in the implementation of mental health peer support and an increasing research interest in peer support work (PSW), this review focuses on priorities in current research and practice. With grassroots in informal services for people with mental health problems, peer support has been strengthened by the recovery paradigm in mental health policy, and there are steps towards integration in statutory services. RECENT FINDINGS Current issues include benefits of peer support, its efficacy and effectiveness. The value of peer support in formal and informal settings is discussed, and organizational change processes and the challenges in peer support implementation are discussed. Recent studies have identified the need for a clarification of roles, competencies and job structure and for adequate training and supervision. Along with reported benefits for consumer and PSW involvement in care revealed by mixed method studies, destigmatization at the personal and system level is a crucial PSW component. SUMMARY Various types of peer support merit further evaluation. Assessing the impact of peer support on service users, peer providers and organizations require complex intervention studies, using mixed methods designs with qualitative exploration of underlying processes and experiences to complement high-quality controlled trials.
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