The Clubhouse as an evidence based practice model

1. By The New York Clubhouse Coalition: Carol Bentinck MCJ, B.S., Tyrone Garrett, CPWC, David Plotka LMSW, Blaise Sackett LMSW The Clubhouse as an evidence based practice model

2. What is a clubhouse

3. A Clubhouse is a community of people who are working together to achieve a common goal – recovery from mental illness. 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. 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 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 is a clubhouse?

4. A work-ordered day in which the talents and abilities of members are recognized and utilized within the Clubhouse • Participation in consensus-based decision making regarding all important matters related to operating the Clubhouse • 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 • Assistance in accessing community-based educational resources • Access to crisis intervention services when needed • Evening/weekend social and recreational events • Assistance in securing and sustaining safe, decent and affordable housing . What do clubhouses offer?

5. Transitional Employment Supported Employment Independent Employment Clubhouse Employment services

6. 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. Transitional Employment (TE)

7. With Supported Employment the Clubhouse community helps an interested member obtain his or her own employment (part-time or full-time) and serves as a resource and support for resume prep, interviewing skills, transportation, and employer liaisons. Supported Employment (SE)

8. 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. Independent Employment (IE)

9. Work Works!

10. 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) Brief History

11. 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 Middle East: 3 Clubhouses Australia: 9 Clubhouses Africa: 2 Clubhouses Central America: 1 Clubhouse New Zealand: 2 Clubhouses

12. About ICCD: Global Training Infrastructure 10 International Training Bases, ensuring continued quality improvement. Helsingin Klubitalo Helsinki, Finland Fountain House, NYC Genesis Club, MA Gateway House, SC Independence Center, MO Alliance House, UT Progress Place Toronto, Canada Mosaic Clubhouse London, England Taiwha Fountain House Seoul, Republic of Korea Stepping Stone, Brisbane, Australia

13. The ICCD – An International organization-Stockholm Fountain House-Sweden: Stockholm

14. The ICCD – An International organization-Manhattan Fountain House: New York City

15. The ICCD – An International organization-The Bronx Geel Clubhouse: The Bronx

16. The ICCD – An International organization-Staten Island Sky Light Center: Staten Island

17. The ICCD – An International organization-Finland Suvimaen Clubhouse - Finland

18. SuvimaenKlubitalo

19. The ICCD – An International organization-Milwaukee Grand Avenue Clubhouse

20. The ICCD – An International organization-Calgary, Canada Potential Place

21. The ICCD – An International organization-Florida Vincent House

22. The ICCD – An International organization-Brooklyn East New York Clubhouse

23. The international seminar The 16th International Seminar- Stockholm, Sweden: July 2011

24. The 16th International Clubhouse Seminar: Stockholm, Sweden The international seminar

25. 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. Evidence based practice

26. SAMHSA – The Substance Abuse & Mental Health Services Administration NREPP – National Registry of Evidence Based Programs & Practices SAMHSA & NREPP

27. 1: Employment 2: Quality of life 3: Perceived recovery from a mental health problem Areas of Review

28. the Clubhouse as a pathway toward recovery What is Recovery?

29. 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 What is Recovery?

30. Top 10 Components of Recovery According to SAMHSA 1. Self-Direction2. Individualized and Person-Centered3. Empowerment4. Holistic5. Non-Linear6. Strengths-Based7. Peer Support8. Respect9. Responsibility10. Hope The Clubhouse as a pathway toward recovery

31. How does the Clubhouse fit in to a person’s recovery???????????????????????????????? The Clubhouse as a Pathway Toward Recovery

32. The Clubhouse Standards MEMBERSHIP RELATIONSHIPS SPACE WORK-ORDERED DAY EMPLOYMENT EDUCATION FUNCTIONS OF THE HOUSE FUNDING, GOVERNANCE & ADMINISTRATION The Clubhouse as a pathway toward recovery

33. 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) 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. (Clubhouse Standard #s 5, 8, 11, 14, 15, 20, 27, 28, 36) The Clubhouse Standards & SAMSHSA’s Recovery principles

34. 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 & samhsa’s recovery principles

35. 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

36. 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 self-care 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!) The Clubhouse Standards & SAMSHSA’s Recovery principles

37. One in Four Video presentation

38. Personal Stories

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40. The Clubhouse as an Evidence Based Practice Model Carol Bentinck: Geel Clubhouse Bronx carolbentinck@yahoo.com Tyrone Garrett: East New York Club Brooklyn tygarr13@yahoo.com David Plotka: Venture House Queens dplotka@venturehouse.org Blaise Sackett: East New York Club Brooklyn bsackett@wearebcs.org Thank you!!!