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Bouvet C, Battin C, Cappelaere C, Leroy-Hatala C. Psychosocial Change in Members of Clubhouse Paris (France) Over an 18-Month Period: A Longitudinal Mixed Methods Study. Community Ment Health J 2021; 57:853-863. [PMID: 32504150 DOI: 10.1007/s10597-020-00654-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 05/31/2020] [Indexed: 10/24/2022]
Abstract
The community-based mental health organizations known as "Clubhouses" have existed since the 1940s in the United States, and the model has since spread to many countries. The present study investigates the psychological and social trajectories of 33 members of Clubhouse Paris, the first Clubhouse in France. The study used a pre-post, mixed methods design, with three assessments over an 18-month period. A participatory action research approach was taken to ensure compatibility with Clubhouse principles. The results showed improvements in Clubhouse members' labor market integration, quality of life, sense of self-efficacy, psychosocial skills, symptoms, and hospitalization. The other variables studied (life satisfaction, social support, self-esteem) did not change over the study period. In addition to the statistical results, analysis of interviews highlights the diversity of individual patterns of change and the complexity of the interactions between the variables. These results confirm previous findings from the international literature, and the robustness of the Clubhouse model across different cultures.
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Affiliation(s)
- Cyrille Bouvet
- Department of Psychology, EA 4430, Université Paris Nanterre, 200 Ave. de la République, 92001, Cédex, Nanterre, France.
| | - Clémence Battin
- Department of Psychology, EA 4430, Université Paris Nanterre, 200 Ave. de la République, 92001, Cédex, Nanterre, France
| | - Camille Cappelaere
- Department of Psychology, EA 4430, Université Paris Nanterre, 200 Ave. de la République, 92001, Cédex, Nanterre, France
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Enticott JC, Shawyer F, Brophy LM, Russell G, Mazza D, Wilson-Evered E, Weller PJ, Slade M, Edan V, Meadows GN. REFOCUS-PULSAR Recovery-Oriented Practice Training in Adult Primary Mental Health Care: Exploratory Findings Including From a Pretest-Posttest Evaluation. Front Psychiatry 2021; 12:625408. [PMID: 33790816 PMCID: PMC8006334 DOI: 10.3389/fpsyt.2021.625408] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 01/20/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: Australian general practitioners (GPs) are pivotal in mental health care. The REFOCUS-PULSAR (Principles Unite Local Services Assisting Recovery) primary care study aimed to improve personal recovery outcomes in adults with mental health problems consulting GPs. Design: Modified from an intended stepped-wedge cluster study, an exploratory (pre- and post-intervention) design employed cross-sectional surveys of patients consulting GPs. Setting: Eighteen primary care sites (clusters) in Victoria, Australia in 2013-2017. Participants: From 30 GPs recruited, 23 participated (76%), with 235 patient surveys returned from adults aged <75 years receiving mental health care. Intervention: A co-delivered face-to-face training intervention for GPs in recovery-oriented practice (ROP), with personal recovery a key focus, used multimedia, mnemonics, and targeted interview schedules to encourage ROP-with availability of support sessions for 1 year. Outcome Measures: Primary: the Questionnaire about the Process of Recovery full-scale score (outcome). Secondary: INSPIRE (experience), Warwick-Edinburgh Mental Well-being Scale (WEMWBS) and Kessler Psychological Distress Scale (K10) (outcomes). Other: General-practice-Users Perceived-need Inventory (experience). Results: Small positive significant effects indicated primary-outcome post-intervention improvements [t-test (233) = -2.23, p = 0.01], also improvement in two secondary outcomes (WEMWBS t(233) = -2.12, p = 0.02 and K10 t(233) = 2.44, p = 0.01). More patients post-intervention reported "no need" for further help from their GP; but in those reporting needs, there was greater unmet need for counseling. Conclusions: ROP implementation, internationally influential in specialist mental health care, here is explored in primary care where it has had less attention. These exploratory findings suggest better patient outcomes followed introducing GPs to ROP in routine practice conditions. Higher unmet need for counseling post-intervention reported by patients might be a sign of limited supply despite ROP facilitating better identification of needs. Challenges in project implementation means that these findings carry risks of bias and flag the importance establishing research infrastructure in primary care. Clinical Trial Registration: www.clinicaltrials.gov/, The Australian and New Zealand Clinical Trial Registry Identifier: ACTRN12614001312639.
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Affiliation(s)
- Joanne C Enticott
- Southern Synergy, Department of Psychiatry, Monash University, Melbourne, VIC, Australia.,Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC, Australia
| | - Frances Shawyer
- Southern Synergy, Department of Psychiatry, Monash University, Melbourne, VIC, Australia
| | - Lisa Mary Brophy
- School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC, Australia.,Centre for Mental Health, School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Grant Russell
- Department of General Practice, Monash University, Melbourne, VIC, Australia
| | - Danielle Mazza
- Department of General Practice, Monash University, Melbourne, VIC, Australia
| | | | - Penelope June Weller
- Graduate School of Business and Law, College of Business, RMIT University, Melbourne, VIC, Australia
| | - Mike Slade
- School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Vrinda Edan
- Southern Synergy, Department of Psychiatry, Monash University, Melbourne, VIC, Australia.,Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, VIC, Australia
| | - Graham Nicholas Meadows
- Southern Synergy, Department of Psychiatry, Monash University, Melbourne, VIC, Australia.,Centre for Mental Health, School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.,Monash Health, Clayton, VIC, Australia
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Chen Y, Yau E, Lam C, Deng H, Weng Y, Liu T, Mo X. A 6-Month Randomized Controlled Pilot Study on the Effects of the Clubhouse Model of Psychosocial Rehabilitation with Chinese Individuals with Schizophrenia. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2019; 47:107-114. [PMID: 31617138 DOI: 10.1007/s10488-019-00976-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
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 6 months, 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.
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Affiliation(s)
- Ying Chen
- Mental Health Center, West China Hospital, Sichuan University, 28# Dian Xin Nan Jie, Chengdu, China
| | - Eva Yau
- Mental Health Center, West China Hospital, Sichuan University, 28# Dian Xin Nan Jie, Chengdu, China.,University of Hong Kong, Hong Kong, China
| | - Chow Lam
- Department of Psychology, Illinois Institute of Technology, Chicago, USA
| | - Hong Deng
- Mental Health Center, West China Hospital, Sichuan University, 28# Dian Xin Nan Jie, Chengdu, China.
| | - Yiting Weng
- "Hope" Clubhouse, West China Hospital & Qingyang Disabled People's Federation, Chengdu, China
| | - Tong Liu
- "Hope" Clubhouse, West China Hospital & Qingyang Disabled People's Federation, Chengdu, China
| | - Xiaohong Mo
- "Hope" Clubhouse, West China Hospital & Qingyang Disabled People's Federation, Chengdu, China
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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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Raeburn T, Schmied V, Hungerford C, Cleary M. The use of social environment in a psychosocial clubhouse to facilitate recovery-oriented practice. BJPsych Open 2016; 2:173-178. [PMID: 27703771 PMCID: PMC4995550 DOI: 10.1192/bjpo.bp.115.002642] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 03/11/2016] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Recovery-oriented language has been widely adopted in mental health policy; however, little is known about how recovery practices are implemented within individual services, such as psychosocial clubhouses. AIMS To explore how recovery practices are implemented in a psychosocial clubhouse. METHOD Qualitative case study design informed by self-determination theory was utilised. This included 120 h of participant observation, interviews with 12 clubhouse members and 6 staff members. Field notes and interview transcripts were subject to theoretical thematic analysis. RESULTS Two overarching themes were identified, each comprising three sub-themes. In this paper, the overarching theme of 'social environment' is discussed. It was characterised by the sub-themes, 'community and consistency', 'participation and opportunity' and 'respect and autonomy'. CONCLUSIONS Social environment was used to facilitate recovery-oriented practice within the clubhouse. Whether recovery is experienced by clubhouse members in wider society, may well depend on supports and opportunities outside the clubhouse. DECLARATION OF INTERESTS None. COPYRIGHT AND USAGE © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.
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Affiliation(s)
| | - Virginia Schmied
- , RN, RM, PhD, School of Nursing & Midwifery, Western Sydney University, Sydney, NSW, Australia
| | - Catherine Hungerford
- , RN, NP, PhD, FACMHN, School of Nursing, Midwifery, and Indigenous Health, Faculty of Science, Charles Sturt University, Bathurst, NSW, Australia
| | - Michelle Cleary
- , RN, PhD, School of Health Sciences, University of Tasmania, Sydney, NSW, Australia
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