The Clubhouse Model: Empowering Applications of Theory to Generalist Practice

Abstract

"The Clubhouse Model: Empowering Applications of Theory to Generalist Practice," by R. L. Jackson, is reviewed.

THE CLUBHOUSE MODEL: EMPOWERING APPLICATIONS OF THEORY TO GENERALIST PRACTICE, by R. L. Jackson. Belmont, CA: Wadsworth, 2001. 210 pp.

The clubhouse model began in Fountain House New York in 1948 when a group of men and women with major mental illnesses joined together to support one another to adjust to life outside the hospital. The goal of Fountain House, the very first clubhouse, was to provide an atmosphere where even the most severely mentally ill could find some recovery. The year 1948 was before the deinstitutionalization of the mentally ill of the 1960's, before the popularity of the "community" approach to social problems of the 1970's, and before the mental health consumer movement of the 1980's. The clubhouse as a model of support for the mentally ill is amazing in that it has been able to adapt to and incorporate years of changes in the mental heath system and continue to serve the needs of its members.

Why does the clubhouse model of recovery work? What lessons can be learned from the clubhouse model and how can they be applied to other areas of mental health practice? In his book The Clubhouse Model: Empowering Applications of Theory to Generalist Practice, Robert L. Jackson puts the practice of the clubhouse into theory in an effort to provide his readers with theories they can apply to their practices.

There are eleven chapters in the book that cover everything from the concept of having and using a theoretical framework to understand the clubhouse model, to chapters that focus principles of the clubhouse. Principles covered include the work ordered day and developing identity through membership in the clubhouse community.

A good example of the approach of the book is found in chapter four which describes the work ordered day. Central to the clubhouse model is the concept that work provides more than an income, that it is both a generative and regenerative force in a person's life. Work can provide for things that mental illness can remove like outcomes for selfevaluation, structures for time and tasks, socially acceptable channels for aggression. Work can determine social status and build natural social ties.

Dr. Jackson uses the concept of the work ordered day as it an opportunity to discuss theoretical reasons that such a concept might be therapeutic. For instance he discusses role theory in which people can be seen to function in a number of roles including culturally prescribed social roles, subjective roles, enacted roles based on a particular position held. He then describes clubhouse functions in terms of interactions around roles. Similarly he describes the basic concepts of a self-efficacy theory and how the clubhouse develops and then enhances a sense of self-efficacy. In this way he puts the practice of the clubhouse into theory, and enhances both our understanding of why the practices of the clubhouse may be therapeutic and what the potential might be for putting these theories into practice in other situations.

Each chapter includes a brief summary, a short list of questions to test knowledge of key concepts, suggested class projects, and a glossary of new vocabulary. There are three appendices to the book. Appendix I is authored by Rudyard N. Prost and discusses the growth and expansion of the Clubhouse system beginning in the late 1970's. Appendix II describes the standards for clubhouse programs and the ideals of the clubhouse system including: voluntary membership, voluntary participation, a work-ordered day, evening and weekend social program, case management, and community support program. Appendix III gives contact information for clubhouse model training bases located throughout the world.

This book would be appropriate as a textbook for college undergraduates in social work, psychology, and other mental health fields when supplemented with other texts. The book is somewhat abstract at times. However, it is made more concrete by frequent descriptions of what occurs in a typical clubhouse and by a sprinkling or quotes from clubhouse members and staff. It should be remembered that theoretical frameworks described are not necessarily those that the clubhouse model was founded on. That said, this book nicely demonstrates how multiple theoretical frameworks can be used to explain why the clubhouse model has been so successful.