Meanings Associated with the Core Component of Clubhouse Life: The Work-Ordered Day

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.

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

“…Previous studies corroborate our findings that the Clubhouse community is of great importance to its members and offers a family-like emotional experience (see for example, Biegel et al, 2013). In addition, it promotes an increased sense of self-worth, optimism, and hope (Biegel et al, 2013;Hancock et al, 2013;Tanaka & Davidson, 2015a).…”

“…In other words, positive experiences have a dynamic and mutually reinforcing relationship leading to further positive change. Similar to previous research (see for example, Hancock, Bundy, Honey, Helich, & Tamsett, 2013;Kennedy-Jones, Cooper, & Fossey, 2005;Norman, 2006;Tanaka & Davidson, 2015a), this study revealed that participating in the Clubhouse community provided individuals with regular and meaningful activities. In fact, consistent with our results, Clubhouse members generally report that their work at the Clubhouse made them feel "useful" and promoted their inclusion by allowing them-in the words of our participants-to contribute to "something bigger than themselves," which constitutes an important experience improving selfperception (Antonovsky, 1987;Norman, 2006;Pardi & Willis, 2018;Tanaka & Davidson, 2015a).…”

“…Since the late 1990s, the number of qualitative studies investigating the model has increased, including research focusing on members' experiences of participation in the Clubhouse community. For example, Clubhouse membership has been found to expand individuals' networks, enhance their personal lives (Roth, 2017;Tanaka & Davidson, 2015a), and improve their social skills and sense of belonging. Moreover, some informants called the Clubhouse community their family in several studies (Biegel, Pernice-Duca, Chang, & D'Angelo, 2013;Carolan, Onaga, Pernice-Duca, & Jimenez, 2011;Roth, 2017).…”

“…Moreover, qualitative studies have revealed that members find participation in the Clubhouse community to be a stepping-stone to vocational recovery (Roth, 2017;Tanaka & Davidson, 2015a). For example, participation in the work-ordered day has been found to increase members' self-confidence (Norman, 2006;Tanaka & Davidson, 2015a), apparently resulting in increased faith in their ability to (re)enter the labour market (Chen & Oh, 2019).…”

Barriers to dilation & evacuation practice among Maternal-Fetal Medicine subspecialists: quantitative and qualitative results from a national survey

“…Using grounded theory approach [17][18][19], we analyzed those open-ended comments for themes related to barriers to D&E practice. Three authors (JK, JT, LL) participated in the iterative process of coding and sorting the data, collapsing and expanding themes as the data were analyzed.…”