Transcript The Clubhouse as an Evidence-Based Practice Model

THE CLUBHOUSE AS AN EVIDENCE
BASED PRACTICE MODEL
By The New York Clubhouse Coalition:
Carol Bentinck MCJ, B.S., Tyrone Garrett, CPWC, David Plotka LMSW,
Blaise Sackett LMSW
WHAT IS A CLUBHOUSE
WHAT IS A CLUBHOUSE?
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A Clubhouse is a community of people who are working together to achieve a common goal – recovery from
mental illness.
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A Clubhouse is first and foremost a local community center that offers people who have mental illness hope
and opportunities to achieve their full potential. Much more than simply a program or a social service, a
Clubhouse is most importantly a community of people who are working together to achieve a common goal.
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A Clubhouse is organized to support people living with mental illness. During the course of their participation
in a Clubhouse, members gain access to opportunities to rejoin the worlds of friendships, family,
employment and education, and to the services and support they may individually need to continue their
recovery. A Clubhouse provides a restorative environment for people whose lives have been severely
disrupted because of their mental illness, and who need the support of others who are in recovery and who
believe that mental illness is treatable
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A Clubhouse is a membership organization, and the people who come and participate in a Clubhouse are its
members. Membership in a Clubhouse is open to anyone who has a history of mental illness. This idea of
membership is fundamental to the Clubhouse concept: being a member of an organization means that an
individual has both shared ownership and shared responsibility for the success of that organization.
WHAT DO CLUBHOUSES OFFER?
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A work-ordered day in which the talents and abilities of members are recognized
and utilized within the Clubhouse
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Participation in consensus-based decision making regarding all important
matters related to operating the Clubhouse
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Opportunities to obtain paid employment in mainstream businesses and
industries through a Clubhouse-created Transitional Employment Program. In
addition, members participate in supported and independent programs
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Assistance in accessing community-based educational resources
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Access to crisis intervention services when needed
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Evening/weekend social and recreational events
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Assistance in securing and sustaining safe, decent and affordable housing
CLUBHOUSE EMPLOYMENT SERVICES
Transitional
Supported
Employment
Employment
Independent
Employment
TRANSITIONAL EMPLOYMENT (TE)
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With TE members can work in meaningful part-time jobs outside the
Clubhouse procured through partnerships with community entities and
businesses. The member selected by the Clubhouse community for these
position(s) are trained by a Clubhouse staff and/or member who are in
charge of that particular placement. As an incentive to the employer, job
attendance and performance are guaranteed, as a staff and/or member will
support or even fill-in for the Clubhouse member if he or she needs to be
absent for any reason. Each member contribution at a Transitional
Employment position is designed to be transitional and temporary, lasting
for six to nine months, as these positions belong to the Clubhouse, and are
designed in such a way so that ideally all members will have an opportunity
to work. Each member of a Clubhouse who participates in a TE position is
guaranteed to earn at least minimum wage. Additionally, all TE positions are
entry level so that many members have the opportunity to work. The most
important factor in placing members is the individual's desire to work.
SUPPORTED EMPLOYMENT (SE)
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With Supported Employment the Clubhouse community helps
an interested member obtain his or her own employment (parttime or full-time) and serves as a resource and support for
resume prep, interviewing skills, transportation, and employer
liaisons.
INDEPENDENT EMPLOYMENT (IE)
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With Independent Employment, the member is meaningfully
and gainfully employed (part-time or full-time) without the
intervention (but always with the support) of the Clubhouse
community.
WORK WORKS!
BRIEF HISTORY
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Fountain House: The First Clubhouse (1948)
Beginning of Clubhouse Training; Expansion of the
ICCD Clubhouse Model (1977)
National Clubhouse Expansion Project (1987)
Establishment of the Faculty for Clubhouse
Development (1988)
Development of International Standards for Clubhouse
Programs (1989)
Creation of ICCD (1994)
ABOUT ICCD: A GLOBAL RESOURCE
Today there 337 ICCD Clubhouses in 29 countries and
more than 20 new Clubhouse Working Groups. 55
thousand
individuals
served
worldwide.
North America:
218 Clubhouses
Europe: 71
Clubhouses
Asia: 30 Clubhouses
US Virgin
Islands
1
Clubhouse
Central
America:
1 Clubhouse
Middle East: 3 Clubhouses
Australia: 9 Clubhouses
Africa: 2 Clubhouses
New Zealand: 2 Clubhouses
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ABOUT ICCD: GLOBAL TRAINING INFRASTRUCTURE
10 International Training Bases,
ensuring continued quality improvement.
Helsingin
Fountain House,
NYC
Progress Place
Toronto, Canada Mosaic Clubhouse
London, England
Genesis Club, MA
Klubitalo
Helsinki, Finland
Taiwha Fountain House
Seoul, Republic of Korea
Gateway House, SC
Independence
Center, MO
Alliance House, UT
Stepping Stone,
Brisbane, Australia
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THE ICCD – AN INTERNATIONAL ORGANIZATION-STOCKHOLM
Fountain House-Sweden: Stockholm
THE ICCD – AN INTERNATIONAL ORGANIZATION-MANHATTAN
Fountain House: New York City
THE ICCD – AN INTERNATIONAL ORGANIZATION-THE BRONX
Geel Clubhouse:
The Bronx
THE ICCD – AN INTERNATIONAL ORGANIZATION-STATEN ISLAND
Sky Light Center: Staten Island
THE ICCD – AN INTERNATIONAL ORGANIZATION-FINLAND
Suvimaen Clubhouse - Finland
SUVIMAEN KLUBITALO
THE ICCD – AN INTERNATIONAL ORGANIZATION-MILWAUKEE
Grand Avenue Clubhouse
THE ICCD – AN INTERNATIONAL ORGANIZATION-CALGARY, CANADA
Potential Place
THE ICCD – AN INTERNATIONAL ORGANIZATION-FLORIDA
Vincent House
THE ICCD – AN INTERNATIONAL ORGANIZATION-BROOKLYN
East New York Clubhouse
THE INTERNATIONAL SEMINAR
The 16th International Seminar- Stockholm, Sweden:
July 2011
THE INTERNATIONAL SEMINAR
The 16th International Clubhouse Seminar:
Stockholm, Sweden
EVIDENCE BASED PRACTICE
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Evidence Based Practices or EBP’s, (also known as
empirically-supported treatments or EST’s) are
mental/behavioral health interventions, models or
programs in which scientific research is used to show
effectiveness.
The aim of EBP is that the best available evidence,
moderated by patient circumstances and preferences,
is applied to improve the quality of clinical judgments
and facilitate cost-effective care.
SAMHSA & NREPP
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SAMHSA – The Substance Abuse & Mental
Health Services Administration
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NREPP – National Registry of Evidence Based
Programs & Practices
AREAS OF REVIEW
1: Employment
2: Quality of life
3: Perceived recovery from a mental health problem
THE CLUBHOUSE AS A PATHWAY TOWARD RECOVERY
What is Recovery?
THE CLUBHOUSE AS A PATHWAY TOWARD RECOVERY
WHAT IS RECOVERY?
Recovery is often called a process, an outlook, a vision, a conceptual
framework, a guiding principle. There is no single agreed upon definition of
recovery. However, the main message is that hope and restoration of a
meaningful life are possible, despite serious mental illness. Recovery is …
“both a conceptual framework for under- standing mental illness and a
system of care to provide supports and opportunities for personal
development. Recovery emphasizes that while individuals may not be able
to have full control over their symptoms, they can have full control over their
lives. Recovery asserts that persons with psychiatric disabilities can achieve
not only affective stability and social rehabilitation, but transcend limits
imposed by both mental illness and social barriers to achieve their highest
goals and aspirations.” (Pat Deegan & Bill Anthony)
THE CLUBHOUSE AS A PATHWAY TOWARD RECOVERY
Top 10 Components of Recovery According to SAMHSA
1. Self-Direction
2. Individualized and Person-Centered
3. Empowerment
4. Holistic
5. Non-Linear
6. Strengths-Based
7. Peer Support
8. Respect
9. Responsibility
10. Hope
THE CLUBHOUSE AS A PATHWAY TOWARD RECOVERY
How does the Clubhouse fit in to a person’s
recovery????????????????????????????????
THE CLUBHOUSE AS A PATHWAY TOWARD RECOVERY
The Clubhouse Standards
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MEMBERSHIP
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RELATIONSHIPS
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SPACE
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WORK-ORDERED DAY
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EMPLOYMENT
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EDUCATION
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FUNCTIONS OF THE HOUSE
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FUNDING, GOVERNANCE & ADMINISTRATION
THE CLUBHOUSE STANDARDS & SAMSHSA’S RECOVERY PRINCIPLES
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Component #1-Self-Direction: Consumers lead, control, exercise choice over, and determine their own path
of recovery by optimizing autonomy, independence, and control of resources to achieve a self determined
life. By definition, the recovery process must be self-directed by the individual, who defines his or her own life
goals and designs a unique path towards those goals.
(Clubhouse Standards: #1, #3, #5 & # 19)
Component #2 Individualized and Person-Centered: There are multiple pathways to recovery based on an
individual’s unique strengths and resiliencies as well as his or her needs, preferences, experiences (including
past trauma), and cultural background in all of its diverse representations. Individuals also identify recovery
as being an ongoing journey and an end result as well as an overall paradigm for achieving wellness and
optimal mental health.
(Clubhouse Standard # s 15, 19, 28)
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Principle #3- Shared-Decision Making: Psychiatric rehabilitation practitioners engage in the processes of
informed and shared decision making and facilitate partnerships with other persons identified by the
individual receiving services.
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(Clubhouse Standard #s 5, 8, 11, 14, 15, 20, 27, 28, 36)
THE CLUBHOUSE STANDARDS & SAMHSA’S RECOVERY PRINCIPLES
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Component #3-Empowerment: Consumers have the authority to choose from a range of options
and to participate in all decisions—including the allocation of resources—that will affect their
lives, and are educated and supported in so doing. They have the ability to join with other
consumers to collectively and effectively speak for themselves about their needs, wants,
desires, and aspirations. Through empowerment, an individual gains control of his or her own
destiny and influences the organizational and societal structures in his or her life.
(Clubhouse Standards #1, #3, #5)
Component #4 - Holistic: Recovery encompasses an individual’s whole life, including mind,
body, spirit, and community. Recovery embraces all aspects of life, including housing,
employment, education, mental health and healthcare treatment and services, complementary
and naturalistic services (such as recreational services, libraries, museums, etc.), addictions
treatment, spirituality, creativity, social networks, community participation, and family supports
as determined by the person. Families, providers, organizations, systems, communities, and
society play crucial roles in creating and maintaining meaningful opportunities for consumer
access to these supports.
(Clubhouse Standards #21, #22, #23, #24, #25, #27, #28 #31 )
THE CLUBHOUSE STANDARDS & SAMSHSA’S RECOVERY PRINCIPLES
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Component #5-Non-Linear: Recovery is not a step-by step process but one based on continual
growth, occasional setbacks, and learning from experience. Recovery begins with an initial
stage of awareness in which a person recognizes that positive change is possible. This
awareness enables the consumer to move on to fully engage in the work of recovery.
(Clubhouse Standards #1 & #3)
Component # 6-Strengths-Based: Recovery focuses on valuing and building on the multiple
capacities, resiliencies, talents, coping abilities, and inherent worth of individuals. By building
on these strengths, consumers leave stymied life roles behind and engage in new life roles
(e.g., partner, caregiver, friend, student, employee). The process of recovery moves forward
through interaction with others in supportive, trust-based relationships.
(Clubhouse Standard #15)
Component #7 - Peer Support: Mutual support—including the sharing of experiential knowledge
and skills and social learning—plays an invaluable role in recovery. Consumers encourage and
engage other consumers in recovery and provide each other with a sense of belonging,
supportive relationships, valued roles, and community.
(Clubhouse Standards 27, 35 36)
THE CLUBHOUSE STANDARDS & SAMSHSA’S RECOVERY PRINCIPLES
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Component # 8 - Respect: Community, systems, and societal acceptance and appreciation of
consumers —including protecting their rights and eliminating discrimination and stigma—are
crucial in achieving recovery. Self-acceptance and regaining belief in one’s self are particularly
vital. Respect ensures the inclusion and full participation of consumers in all aspects of their
lives.
(Clubhouse Standards #4, #5, #7, #8, #14, #15, #20, #22, #26)
Component # 9 - Responsibility: Consumers have a personal responsibility for their own selfcare and journeys of recovery. Taking steps towards their goals may require great courage.
Consumers must strive to understand and give meaning to their experiences and identify
coping strategies and healing processes to promote their own wellness.
(Clubhouse Standards # 9, #11, #16, #27)
Component # 10 - Hope: Recovery provides the essential and motivating message of a better
future— that people can and do overcome the barriers and obstacles that confront them. Hope
is internalized; but can be fostered by peers, families, friends, providers, and others. Hope is
the catalyst of the recovery process.
(Clubhouse Standards – ALL!)
VIDEO PRESENTATION
One in Four
PERSONAL STORIES
Q&A
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THANK YOU!!!
The Clubhouse as an Evidence Based Practice Model
Carol Bentinck:
Tyrone Garrett:
David Plotka:
Blaise Sackett:
Geel Clubhouse
East New York Club
Venture House
East New York Club
Bronx
Brooklyn
Queens
Brooklyn
[email protected]
[email protected]
[email protected]
[email protected]