Skip to main content
SpringerLink
Log in

Understanding How Participation in a Consumer-Run Organization Relates to Recovery

  • Original Paper
  • Published:
American Journal of Community Psychology

Abstract

The goal of this study was to examine how different types of participation in a consumer-run organization (CRO) are related to recovery. More specifically, this study uses structural equation modeling to examine the relative impact of empowering and socially supportive participation experiences on progress towards recovery among 250 CRO members from 20 CROs. An empowering participation experience refers to involvement in leadership roles and contribution to organizational functioning. A socially supportive participation experience refers to social involvement in mutually supportive friendships with intimacy and sharing. Results indicate that both types of participation are associated with recovery, although a socially supportive participation experience maintains a stronger relationship with recovery than an empowering participation experience. Findings are consistent with the idea that CROs should encourage both types of participation. Drawing from over ten years of experience supporting CROs, the discussion section explores several strategies CROs can use to foster empowering and socially supportive participation experiences.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Barrera, M. (1986). Distinctions between social support concepts, measures, and models. American Journal of Community Psychology, 14, 413–445.

    Article  Google Scholar 

  • Berkman, L. F., Glass, T., Brissette, I., & Seeman, T. (2000). From social integration to health: Durkheim in the new millennium. Social Science and Medicine, 51, 843–857.

    Article  PubMed  Google Scholar 

  • Borkman, T. J. (1999). Understanding self-help/mutual aid: Experiential learning in the commons. New Brunswick, NJ: Rutgers University Press.

    Google Scholar 

  • Brown, L. D., Shepherd, M. D., Wituk, S. A., & Meissen, G. (2007). How settings change people: Applying behavior setting theory to consumer-run organizations. Journal of Community Psychology, 35, 399–416.

    Article  Google Scholar 

  • Burkholder, G., & Harlow, L. (2003). An illustration of a longitudinal cross-lagged design for larger structural equation models. Structural Equation Modeling, 10, 465–486.

    Article  Google Scholar 

  • Chamberlin, J. (1990). The ex-patients’ movement: Where we’ve been and where we’re going. Journal of Mind and Behavior, 11, 323–336.

    Google Scholar 

  • Clark, C. C., & Krupa, T. (2002). Reflections on empowerment in community mental health: Giving shape to an elusive idea. Psychiatric Rehabilitation Journal, 25, 341–349.

    PubMed  Google Scholar 

  • Coffman, D. L., & MacCallum, R. C. (2005). Using parcels to convert path analysis models into latent variable models. Multivariate Behavioral Research, 40, 235–259.

    Article  Google Scholar 

  • Cohen, S., Gottlieb, B. H., & Underwood, L. G. (2000). Social relationships and health. In S. Cohen, L. G. Underwood, & B. H. Gottlieb (Eds.), Social support measurement and intervention: A guide for health and social scientists (pp. 3–28). Oxford, England: Oxford University Press.

    Google Scholar 

  • Cohen, S., & McKay, G. (1984). Social support, stress, and the buffering hypothesis: A theoretical analysis. In A. Baum, J. E. Singer, & S. E. Taylor (Eds.), Handbook of psychology and health (Vol. 4, pp. 253–267). Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Cohen, S., & Wills, T. A. (1985). Stress, social support and the buffering hypothesis. Psychological Bulletin, 95, 310–357.

    Article  Google Scholar 

  • COSP. (2000). Consumer operated service program (COSP) multi-site baseline protocol 2.3. Retrieved August 1, 2006. http://www.cstprogram.org/consumer%20op/Multi-Site%20Activities/Common%20Protocol/BaselineProtocol.pdf.

  • Cowan, C. P., & Cowan, P. A. (1986). A preventive intervention for couples becoming parents. In C. F. Z. Boukyds (Ed.), Research on support for parents and infants in the postnatal period. New York: Ablex.

    Google Scholar 

  • Deegan, P. E. (1988). Recovery: The lived experience of rehabilitation. Psychosocial Rehabilitation Journal, 11(4), 11–19.

    Google Scholar 

  • Dickerson, F. B. (1998). Strategies that foster empowerment. Cognitive and Behavioral Practice, 5, 255–275.

    Article  Google Scholar 

  • Estroff, S. E. (1981). Making it crazy: An ethnography of psychiatric clients in an american community. Berkley, CA: University of California Press.

    Google Scholar 

  • Goldberg, R. W., Rollins, A. L., & Lehman, A. F. (2003). Social network correlates among people with psychiatric disabilities. Psychiatric Rehabilitation Journal, 26, 393–402.

    Article  PubMed  Google Scholar 

  • Hardiman, E. R., & Segal, S. P. (2003). Community membership and social networks in mental health self-help agencies. Psychiatric Rehabilitation Journal, 27, 25–33.

    Article  PubMed  Google Scholar 

  • Helgeson, V. S., & Gottlieb, B. H. (2000). Support groups. In S. Cohen, L. G. Underwood, & B. H. Gottlieb (Eds.), Social support measurement and intervention: A guide for health and social scientists (pp. 221–245). Oxford, England: Oxford University Press.

    Google Scholar 

  • Holter, M. C., Mowbray, C. T., Bellamy, C. D., MacFarlane, P., & Dukarski, J. (2004). Critical ingredients of consumer run services: Results of a national survey. Community Mental Health Journal, 40(1), 47–63.

    Article  PubMed  Google Scholar 

  • Hox, J. J., & Maas, C. J. M. (2001). The accuracy of multilevel structural equation modeling with pseudobalanced groups and small samples. Structural Equation Modeling, 8, 157–174.

    Article  Google Scholar 

  • Israel, B. A., House, J. S., Schurman, S. J., Heaney, C. A., & Mero, R. P. (1989). The relation of personal resources, participation, influence, interpersonal relationships, and coping strategies to occupational stress, job strains and health: A multivariate analysis. Work and Stress, 3, 163–194.

    Article  Google Scholar 

  • Kishton, J. M., & Widaman, K. F. (1994). Unidimensional versus domain representative parceling of questionnaire items: An empirical example. Educational and Psychological Measurement, 54, 757–765.

    Article  Google Scholar 

  • Lieberman, M. A. (1993). Self-help groups. In H. I. Kaplan & B. J. Sadock (Eds.), Comprehensive group therapy. Baltimore, MD: Williams & Wilkins.

    Google Scholar 

  • Luks, A. (1991). The helping power of doing good: The health and spiritual benefits of helping others. New York: Fawcett Columbine.

    Google Scholar 

  • Maton, K. I., & Salem, D. A. (1995). Organizational characteristics of empowering community settings: A multiple case study approach. American Journal of Community Psychology, 23, 631–656.

    Article  PubMed  Google Scholar 

  • Menard, S. (2002). Longitudinal research (2nd ed.). Thousand Oaks, CA: Sage.

    Google Scholar 

  • MHSIP. (2000). MHSIP consumer survey, version 1.1. Retrieved August 1, 2006. http://www.mhsip.org/MHSIP_Adult_Survey.pdf.

  • Mohr, W. K. (2004). Surfacing the life phases of a mental health support group. Qualitative Health Research, 14, 61–77.

    Article  PubMed  Google Scholar 

  • Moos, R. H. (1974). Evaluating treatment environments: A social ecological approach. New York: John Wiley.

    Google Scholar 

  • Moos, R. H., & Humphrey, B. (1974). Group environment scale form. Palo Alto, CA: Consulting Psychologists.

    Google Scholar 

  • Mowbray, C. T., Robinson, E. A., & Holter, M. C. (2002). Consumer drop-in centers: Operations, services, and consumer involvement. Health and Social Work, 27, 248–261.

    Google Scholar 

  • Mowbray, C. T., & Tan, C. (1993). Consumer-operated drop-in centers: Evaluation of operations and impact. Journal of Mental Health Administration, 20, 8–19.

    Article  PubMed  Google Scholar 

  • Muthén, L. K., & Muthén, B. O. (2006). Mplus (version 4.2) [Computer software]. Los Angeles, CA: Muthén & Muthén.

    Google Scholar 

  • Muthén, B., & Satorra, A. (1995). Complex sample data in structural equation modeling. In P. V. Marsden (Ed.), Sociological methodology (pp. 267–316). Washington DC: American Sociological Association.

    Google Scholar 

  • Nelson, G., Lord, J., & Ochocka, J. (2001). Shifting the paradigm in community mental health: Towards empowerment and community. Toronto, Canada: University of Toronto Press.

    Google Scholar 

  • Noordsy, D., Torrey, W., Mueser, K., Mead, S., O’Keefe, C., & Fox, L. (2002). Recovery from severe mental illness: An interpersonal and functional outcome definition. International Review of Psychiatry, 14, 318–326.

    Article  Google Scholar 

  • Peterson, N. A., & Zimmerman, M. A. (2004). Beyond the individual: Toward a nomological network of organizational empowerment. American Journal of Community Psychology, 34, 129–145.

    Article  PubMed  Google Scholar 

  • Rappaport, J. (1981). In praise of paradox: A social policy of empowerment over prevention. American Journal of Community Psychology, 9, 1–25.

    Article  PubMed  Google Scholar 

  • Raudenbush, S. W., & Bryk, A. S. (2002). Hierarchical linear models (2nd ed.). Newbury Park, CA: Sage.

    Google Scholar 

  • Riessman, F. (1965). The “helper” therapy principle. Social Work, 10, 27–32.

    Google Scholar 

  • Rook, K. (1990). Stressful aspects of older adults’ social relationships: Current theory and research. In J. H. Crowther, S. E. Hobfoll, & D. L. Tennenbaum (Eds.), Stress and coping in later-life families (pp. 221–250). New York: Hemisphere.

    Google Scholar 

  • Rook, K. (1992). Detrimental aspects of social relationships: Taking stock of an emerging literature. In H. O. Viel & U. Baumann (Eds.), The meaning and measurement of social support (pp. 157–169). New York: Hemisphere.

    Google Scholar 

  • Rosenberg, P. P. (1984). Support groups: A special therapeutic entity. Small Group Behavior, 15, 173–186.

    Article  Google Scholar 

  • Salzer, M. S. (1997). Consumer empowerment in mental health organizations: Concept, benefits, and impediments. Administration and Policy In Mental Health, 24, 425–435.

    Article  PubMed  Google Scholar 

  • Schulz, A. J., Israel, B. A., Zimmerman, M. A., & Checkoway, B. N. (1995). Empowerment as a multi-level construct: Perceived control at the individual, organizational and community levels. Health Education Research, 10, 309–327.

    Article  Google Scholar 

  • Segal, S. P., & Silverman, C. (2002). Determinants of client outcomes in self-help agencies. Psychiatric Services, 53, 304–309.

    Article  PubMed  Google Scholar 

  • Segal, S. P., Silverman, C., & Temkin, T. (1993). Empowerment and self-help agency practice for people with mental disabilities. Social Work, 38, 705–712.

    PubMed  Google Scholar 

  • Segal, S. P., Silverman, C., & Temkin, T. (1995). Measuring empowerment in client-run self-help agencies. Community Mental Health Journal, 31, 215–227.

    Article  PubMed  Google Scholar 

  • Skovholt, T. M. (1974). The client as helper: A means to promote psychological growth. Counseling Psychologist, 4, 58–64.

    Article  Google Scholar 

  • Solomon, P. (2004). Peer support/peer provided services: Underlying processes, benefits, and critical ingredients. Psychiatric Rehabilitation Journal, 27, 392–401.

    Article  PubMed  Google Scholar 

  • Teague, G. B., Ganju, V., Hornik, J. A., Johnson, J. R., & McKinney, J. (1997). The MHSIP mental health report card: A consumer-oriented approach to monitoring the quality of mental health plans. Evaluation Review, 21, 330–341.

    Article  PubMed  Google Scholar 

  • Thoits, P. A. (1985). Social support and psychological well-being: Theoretical possibilities. In I. G. Sarason & B. R. Sarason (Eds.), Social support: Theory, research, and applications (pp. 51–72). Dordrecht, The Netherlands: Martinus Nijhoff Publishers.

    Google Scholar 

  • Thoits, P. A. (1986). Multiple identities: Examining gender and marital status differences in distress. American Sociological Review, 51, 259–272.

    Article  Google Scholar 

  • Toseland, R. W., & Rossiter, C. M. (1989). Group interventions to support family caregivers: A review and analysis. Gerontologist, 29, 438–448.

    PubMed  Google Scholar 

  • Trainor, J., Shepherd, M., Boydell, K. M., Leff, A., & Crawford, E. (1997). Beyond the service paradigm: The impact and implications of consumer/survivor initiatives. Psychiatric Rehabilitation Journal, 21, 132–140.

    Google Scholar 

  • Ullman, J. B. (2001). Structural equation modeling. In B. G. Tabachnick & L. S. Fidell (Eds.), Using multivariate statistics (4th ed.). Boston: Allyn and Bacon.

    Google Scholar 

  • Wothke, W. (2000). Longitudinal and multi-group modeling with missing data. In T. D. Little, K. U. Schnabel, & J. Baumert (Eds.), Modeling longitudinal and multilevel data: Practical issues, applied approaches, and specific examples. Mahwah, NJ: Lawrence Erlbaum Associates.

    Google Scholar 

  • Zimmerman, M. A., & Rappaport, J. (1988). Citizen participation, perceived control, and psychological empowerment. American Journal of Community Psychology, 16, 725–750.

    Article  PubMed  Google Scholar 

Download references

Acknowledgement

Support for this research comes from Kansas Social and Rehabilitation Services, Division of Mental Health.

Author information

Authors and Affiliations

  1. The Pennsylvania State University, 135 E. Nittany Ave., Suite 402, State College, PA, 16801, USA

    Louis D. Brown

  2. James Bell Associates, 1001 19th Street, North Suite 1500, Arlington, VA, 22209, USA

    Matthew D. Shepherd

  3. Department of Psychology, Wichita State University, 1845 Fairmount, P.O. Box 34, Wichita, KS, 67260, USA

    Edgar C. Merkle

  4. Center for Community Support & Research, Department of Psychology, Fairmount College of Liberal Arts and Sciences, Wichita State University, 1845 Fairmount, P.O. Box 201, Wichita, KS, 67260, USA

    Scott A. Wituk & Greg Meissen

Authors
  1. Louis D. Brown
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Matthew D. Shepherd
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Edgar C. Merkle
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Scott A. Wituk
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Greg Meissen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Louis D. Brown.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Brown, L.D., Shepherd, M.D., Merkle, E.C. et al. Understanding How Participation in a Consumer-Run Organization Relates to Recovery. Am J Community Psychol 42, 167–178 (2008). https://doi.org/10.1007/s10464-008-9184-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10464-008-9184-x

Keywords

Search

Navigation