A Contemporary Review of the Clubhouse Model of Psychosocial Rehabilitation: Past, Present, and Emerging Directions.

Since the 1940s, the Clubhouse model of psychosocial rehabilitation has evolved towards a comprehensive practice of social theory and intervention. Despite the model's cost effectiveness and observational evidence of its efficacy, empirical research remains lacking. The current narrative review examines studies from recent years (2015-2021), not to assess study rigor, but to identify trends in research aims, findings, and methodology, as well as specify future research directions. A narrative review was conducted using PRISMA guidelines. Using the search term "Clubhouse," 194 articles were identified in online databases. 38 met criteria for inclusion. Most studies were qualitative (60.5%) and few utilized experimental or quasi-experimental designs (7.9%). Narrative synthesis revealed research aims and outcome variables falling into six key areas: social integration and connectedness, quality of life (QOL), recovery outcomes, relational dynamics, policy, and virtual adaptations of the model. Findings indicate that recent Clubhouse-related research trends have primarily involved studies of social connectedness, QOL, recovery, relationships, and policy, as well as studies examining the value of the virtual Clubhouse in maintaining well-being. However, heterogeneity of methodologies and measures present a critical limitation to assessing results across studies. Options for increasing experimental methodologies in this area are reviewed. Recommended future directions involve moving towards a biopsychosocial approach to clarifying the mechanisms through which the model promotes recovery-aims that may yield implications beyond the realm of serious mental illness.

Community as therapy: The theory of social practice.

OBJECTIVE: Though the efficacy of the Clubhouse model's interventions and practices in supporting recovery from serious mental illness (SMI) have been demonstrated by prior research, the causal mechanisms and theory driving these outcomes have yet to be comprehensively defined. This theory article aims to synthesize existing knowledge of these methods to define a unified theory of social practice, outline its role in SMI recovery, and discuss future implications. METHOD: Historical, theoretical, and practical foundations of social practice were synthesized to define a current theory of social practice and expand the term to apply to the methods and interventions that define the Clubhouse model. RESULTS: Based on prior theory and findings, we define social practice as "the informed application of a specialized form of environmental therapy that utilizes an intentional community to assist people in their recovery." Key facets of social practice in the Clubhouse model of SMI recovery are discussed, including the efficacy of the practice in addressing SMI outcomes such as isolation and low self-efficacy, as well as its impact on both internal and external motivational forces. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The theory of social practice describes a process of engaging people to become collaborators and contributors to a social environment. This article describes the philosophy and practices of Clubhouses and introduces the theory of social practice as an empirical means of unifying and communicating the methods, practices, and outcomes of both the Clubhouse model and the broader implications of intentional community as therapy. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Clubhouses as Essential Communities During the COVID-19 Pandemic.

Intentional recovery communities, such as Clubhouses, exist as physical spaces for individuals living with Serious and Persistent Mental Illness. Due to the COVID-19 pandemic, it was necessary for these facilities to rapidly convert to virtual platforms. The aim of this study was to assess the extent to which virtual Clubhouse communities impacted the well-being of their members during the initial weeks of pandemic-related closures. Two hundred and eighty nine Clubhouse members across 19 countries responded to weekly measures of Clubhouse engagement, contact with other members, and well-being. A repeated measures multivariate analysis of covariance indicated that members with high levels of Clubhouse engagement reported higher mental and physical health ratings over time than those with low levels of engagement. These findings support the virtual Clubhouse model and highlight the efficacy of Clubhouses' rapid adaptations to the pandemic.

Responding to the Global Pandemic: A Pulse of the Well-Being of Clubhouse Communities Moving Virtual.

Clubhouse communities rapidly responded to the COVID-19 pandemic to keep members connected as psychosocial rehabilitation programs were globally disrupted. This investigation aims to elucidate how Clubhouse directors responded to the pandemic and their members' needs, while also directly assessing the needs and well-being of members. This study utilized secondary data from Director and Member surveys designed to capture Clubhouse status, member engagement, and measures of well-being. Descriptive statistics and correlation coefficients were computed across data from directors (n = 140) and members (n = 1136). Directors across 19 countries indicated that the majority of Clubhouses closed and were engaging with members using a variety of technologies, primarily Zoom videoconferencing. For members, greater levels of virtual Clubhouse engagement were positively correlated with physical and mental well-being and negatively correlated with hospitalization rates. This study provides support for an association between virtual Clubhouse engagement and well-being. Repeated measures studies are needed to further investigate this association.