The trademark of mental health clubhouses is that members and staff work side-by-side in partnership to enhance members’ autonomy, competency, and recovery. To explore the intricacies of this unique approach, the author conducted 53 in-depth interviews and 262 h of participant observation in 41 visits over a five-month period in a clubhouse. Findings indicated that staff members built the clubhouse as a “working community” by skillfully integrating three practice domains: social relationships, unit work, and individuals’ needs and pursuits. Distinctive skillsets helped to develop genuine relationships with members and facilitate community building, suggesting a model of generalist practice with specific intentionality.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
There is no “supervisor” position according to the International Standards for Clubhouse Programs. However, for the purpose of this research, the author defined “supervisors” as the Fountain House personnel who were deeply involved in organizational human resource activities related to supervision, training, hiring, and termination. The interviews with supervisors aimed to capture a more comprehensive understanding of staff training and quality control of staff practices.
Anderson, S. (1985). The role of staff at fountain house. The Fountain House Annual, 3, 1–3.
Beard, J. H., Propst, R. N., & Malamud, T. J. (1982). The fountain house model of psychiatric rehabilitation. Psychosocial Rehabilitation Journal, 5(1), 47–53.
Clubhouse International (2016a). What is a Clubhouse? Retrieved from http://www.iccd.org/whatis.html
Clubhouse International (2016b). International Directory, retrieved from http://www.clubhouse-intl.org/search_form.php
Clubhouse International (2016c). International Standards for Clubhouse Programs. Retrieved from http://www.iccd.org/quality.html
Clubhouse International (2016d). Resources, retrieved from http://www.clubhouse-intl.org/resources.html
Clubhouse International (2016e). How Clubhouses Function, retrieved from http://www.iccd.org/function.html
Davey, J. (1995). Engaging Members in Clubhouse Activities: Getting From “Will You?” to “I Want To”. Retrieved from http://www.iccd.org/20davey.htm
Di Masso, J., Avi-Itzhak, T., & Obler, D. R. (2001). The clubhouse model: an outcome study on attendance, work attainment and status, and hospitalization recidivism. Work, 17, 23–30.
Dougherty, S. J. (1994). The generalist role in clubhouse organizations. Psychosocial Rehabilitation Journal, 18(1), 95–108.
Doyle, A., Lanoil, J., & Dudek, K. (2013). Fountain house: Creating community in mental health practice. New York: Columbia University Press.
Finch, E. S., & Krantz, S. R. (1991). Low burnout in a high-stress setting: a study of staff adaptation at Fountain House. Psychosocial Rehabilitation Journal, 14(3), 15–26.
Herman, S. E., Onaga, E., Pernice-Duca, F., Oh, S., & Ferguson, C. (2005). Sense of community in clubhouse programs: member and staff concepts. American Journal of Community Psychology, 36(3–4), 343–356.
Leff, H. S., McPartland, J. C., Banks, S., Dembling, B., Fisher, W., & Allen, I. E. (2004). Service quality as measured by service fit and mortality among public mental health system service recipients. Mental Health Services Research, 6, 93–107.
Macias, C., Rodican, C. F., Hargreaves, W. A., Jones, D. R., Barreira, P. J., & Wang, Q. (2006). Supported employment outcomes of a randomized controlled trial of ACT and clubhouse models. Psychiatric Services, 57, 1406–1415.
McKay, C. E., Johnsen, M., Banks, S., & Stein, R. (2006). Employment transitions for clubhouse members. Work., 26(1), 67–74.
Mowbray, C. T., Woodward, A. T., Holter, M. C., MacFarlane, P., & Bybee, D. (2009). Characteristics of users of consumer-run drop-in centers versus clubhouses. Journal of Behavioral Health Services & Research, 36(3), 361–371.
Payne, M. (2011). Humanistic social work: Core principles in practice. Chicago: Lyceum Books.
Pernice-Duca, F. M. (2010). Staff and member perceptions of the clubhouse environment. Administration and Policy in Mental Health and Mental Health Services Research, 37(4), 345–356.
Propst, R. (1992). Standards for clubhouse programs: How and why they were developed. Psychosocial Rehabilitation Journal, 16(2), 25–30.
Schatzman, L. (1991). Dimensional analysis: Notes on an alternative approach to the grounding of theory in qualitative research. In D. Maines (Ed.), Social organization and social process: Essays in honor of Anselm Strauss (pp. 303–314). New York: Aldine de Gruyter.
Schonebaum, A. D., Boyd, J. K., & Dudek, K. J. (2006). A comparison of competitive employment outcomes for the Clubhouse and PACT models. Psychiatric Services, 57(10), 1416–1420.
The US Psychiatric Rehabilitation Board. (September 2007). USPRA definition of psychiatric rehabilitation. Retrieved from https://uspra.ipower.com/Board/Governing_Documents/Definition_of_Psychiatric_Rehabilitation.pdf
Tratnack, S. A., & Kane, C. (2010). Preventive health screenings in a clubhouse setting for persons with serious mental illness. American Journal for Nurse Practitioners, 14(4), 8–17.
Tsang, A. W. K., Ng, R. M. K., & Yip, K. C. (2010). A six-month prospective case-controlled study of the effects of the clubhouse rehabilitation model on Chinese patients with chronic schizophrenia. East Asian Archives of Psychiatry, 20, 23–30.
Vorspan, R. (1999) Clubhouse relationships need work! Paper presented at the 10th International Clubhouse Seminar, Toronto, Canada. Retrieved from http://www.fountainhouse.org/sites/default/files/ftp/articles/clubhouse-relations-need-work.pdf
Waegemakers Schiff, J., Coleman, H., & Miner, D. (2008). Voluntary participation in rehabilitation: Lessons Learned from a clubhouse environment. Canadian Journal of Community Mental Health, 27(1), 65–78.
An earlier version of the paper was presented at the 19th Annual Conference of the Society for Social Work and Research, New Orleans, LA, USA, the 6th European Conference for Social Work Research, Lisbon, Portugal, and the 8th International Conference on Social Work in Health and Mental Health, Singapore. The author thanks staff and members at Fountain House for their support of this research. The author also thanks Hans Oh, Kathleen O’Hara, and Laura Cordisco Tsai for their assistance with initial data analysis.
This research received no funding support.
Conflict of interest
Fang-pei Chen declares that she has no conflict of interest regarding this research.
Human and Animal Rights
The Institutional Review Boards at Fountain House and Columbia University approved this research. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committees and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed written consent was obtained from all individual participants interviewed in the study.
About this article
Cite this article
Chen, Fp. Building a Working Community: Staff Practices in a Clubhouse for People with Severe Mental Illness. Adm Policy Ment Health 44, 651–663 (2017). https://doi.org/10.1007/s10488-016-0757-y
- The clubhouse model
- Generalist practice
- Psychosocial rehabilitation
- Working community
- Mental health recovery