Meanings Associated with the Core Component of Clubhouse Life: The Work-Ordered Day
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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.
KeywordsPsychiatric recovery Clubhouse model Work-ordered day Work Autonomy Relationships
Conflict of interest
All authors declare that they have no conflict of interest.
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.
- 3.Davidson L, Harding C, Spaniol L: Recovery from severe mental illnesses: Research evidence and implications for practice (Vol. 1). Boston, Center for Psychiatric Rehabilitation, Boston University, 2005.Google Scholar
- 5.Edward K, Welch A, Chater K: The phenomenon of resilience as described by adults who have experienced mental illness. Journal of Advanced Nursing 14:587–595, 2008.Google Scholar
- 11.Doyle A, Dudek K, Lanoir J: Fountain House. New York, Columbia University Press, 2013.Google Scholar
- 12.Clubhouse International: International Standards for Clubhouse Programs. 2014. http://www.iccd.org. Accessed 13 Oct 2014.
- 13.Hänninen E: Choices for recovery: Community-based rehabilitation and the Clubhouse Model as means to mental health reforms. Helsinki, National Institute for Health and Welfare, 2012.Google Scholar
- 14.Beard J, Propst R, Mulamud T: The Fountain House model of psychiatric rehabilitation. Psychosocial Rehabilitation Journal 5(1):47–53, 1982.Google Scholar
- 15.Beard J, Goertzel V, Pearce AJ: The effectiveness of activity group therapy with chronically regressed adult schizophrenics. The International Journal of Group Psychotherapy 8(2):123–136, 1958.Google Scholar
- 16.Anderson SB: We are not alone: Fountain House and the development of clubhouse culture. New York, Fountain House, Inc, 1998.Google Scholar
- 19.Hietala O: Fluid orientations and multiple meanings: Three complementary modes of membership at Clubhouse. In T. Craig (Chair): The 2nd International Clubhouse Research Symposium at Ersta Sköndal högskola/Ersta Sköndal University College, Stockholm, Sweden, 2013.Google Scholar
- 21.Biegel D, Pernica-Duca F, Chang CW, et al.: Correlates of peer support in a Clubhouse setting. Community Mental Health Journal 49(3):249–259, 2013; doi:10, 1007/s10597-012-9502-5.Google Scholar
- 23.Karlsson M: Fountain House. In: Borkman T, Karlsson M, Munn-Giddings C, Smith L (Eds.): Self-help and mental health: Case studies of mental health self-help organizations in US, England and Sweden. Stockholm, Sköndalsinstitutes Research Department, 2005, pp. 95–106.Google Scholar
- 26.Riessman F: The “helper” therapy principle. Social Work 10:27–32, 1965.Google Scholar
- 27.Fetterman DM: Ethnography. New York, Sage Publications, 1998.Google Scholar
- 28.Charmaz K: Grounded theory. In Smith JA, Harrè R, Van Langenhove L (Eds): Rethinking methods in psychology. New York, Sage Publications, 1995.Google Scholar
- 29.Charmaz K: Constructing grounded theory: A practical guide through qualitative analysis. New York, Sage Publications, 2014.Google Scholar
- 30.Glaser BG, Strauss AL: The discovery of grounded theory: strategies for qualitative research. New York, Sage Publications, 1967.Google Scholar
- 31.Marx K: Capital: A critique of political economy. Volume 1: The process of capitalist production. Translated from the third German edition by Samuel Moore and Edward Aveling. Edited by Engels, F. NY: International Publishers, 1867.Google Scholar
- 32.Weber M: The protestant ethic and the spirit of capitalism, transl. Talcott Parsons. London, G. Allen & Unwin, Ltd, 1930.Google Scholar
- 35.College of Occupational Therapists: Recovering ordinary lives: the strategy for occupational therapy in mental health services 2007–2017, Literature review. London, COT, 2006.Google Scholar
- 37.Young J, Passmore A: What is the occupational therapy role in enabling mental health consumer participation in volunteer work? Australian Occupational Therapy Journal 54(1):66–69, 2007.Google Scholar