Clubhouse Community Support for Life: Staff–Member Relationships and Recovery

Abstract

With signs that early interventions for severe mental illness have at best only a modest impact on longerterm outcome, a need for a long-term care and support system that facilitates recovery is resurfacing. This article describes a well-established long-term support program, the clubhouse model, drawing on qualitative interview data from 105 users and 25 staff from five clubhouses in the U.S. and Finland, which was analyzed using a grounded theory approach. Recurrent patterns of transformative life changes emerged. Central to these processes was a sense of equality between staff and members that transcended social roles and mental health status and was experienced as embodying trust in human potential and respecting member's choice. This staff-member relationship can be framed by the Aristotelian notion of friendship for life. The clubhouse, offering a home base to which members can return in times of need, may provide a viable safety net for recovery.

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

“…Finally, the results of this study correspond with those of previous international research in the field (Biegel et al, 2013;Jung & Kim, 2012;Norman, 2006;Pardi & Willis, 2018;Roth, 2017;Tanaka et al, 2015;Tanaka & Davidson, 2015a, 2015b, suggesting that being a Clubhouse member is a similar experience across countries, social systems, and cultures.…”

“…However, our results also show that staff members play a decisive role in whether members feel comfortable in the community. Similarly, previous studies indicated that poor relationships with staff, especially related to disruption of egalitarian status within the Clubhouse, is a major reason for members having a negative perception of the community (Roth, 2017;Tanaka et al, 2015), thus their existential stability.…”

“…Second, the existential aspect of meaningfulness is the ability to cope with one's failures and shortcomings, death, conflicts, and isolation (Antonovsky, 1987, p. 23). Perceiving the Clubhouse setting as a safe and inclusive environment (Kang & Kim, 2014;Kennedy-Jones et al, 2005;Kinn et al, 2018;Tanaka et al, 2015) seems to play a crucial role in coping with these existential challenges by improving the availability of RRs and enabling their use. Consistent with previous findings (Biegel et al, 2013;Carolan et al, 2011;Hancock et al, 2013;Jung & Kim, 2012;Norman, 2006;Roth, 2017;Waegemakers Schiff et al, 2008), our participants experienced acceptance and inclusion in the community and felt reassured that they would receive ongoing and unconditional support from the Clubhouse.…”

“…In addition, several studies have examined aspects of the Clubhouse community such as reciprocity, which was found to create bonds and facilitate a sense of equality (Coniglio, Hancock, & Ellis, 2012;Pernice-Duca & Onaga, 2009;Tanaka & Davidson, 2015b). Conversely, inequality was considered to disrupt the community (Roth, 2017;Tanaka, Craig, & Davidson, 2015;Waegemakers Schiff, Coleman, & Miner, 2008), so the relationship between staff and members was found to be crucial in terms of the perceived quality of the Clubhouse environment.…”

Social Networks and Social Interaction among People with Psychiatric Disabilities-Comparison of Users of Day Centres and Clubhouses

“…family, friends, staff) was more influential in these respects. Access to enabling social environments such as those available in DC and clubhouses can, through the long-term support they offer, provide a safety net from which the users can benefit in their recovery process (Tanaka, Craig, & Davidson, 2015). Several researchers argue, however, that there is a risk in relying on relationships tied to programmes and that the programmes should facilitate support systems in the community (Bonavigo, Sandhu, Pascolo-Fabrici, & Priebe, 2016).…”