Department of Theoretical and Behavioral Foundations, College of Education, Wayne State University, 5425 Gullen Mall, Education Building, Room 351, Detroit, MI, 48202, USA.
Fountain House New York, 425 West 47Th Street, New York, NY, 10036, USA.
Psychiatr Q. 2023 Dec;94(4):569-604. doi: 10.1007/s11126-023-10051-w. Epub 2023 Oct 5.
Since the 1940s, the Clubhouse model of psychosocial rehabilitation has evolved towards a comprehensive practice of social theory and intervention. Despite the model's cost effectiveness and observational evidence of its efficacy, empirical research remains lacking. The current narrative review examines studies from recent years (2015-2021), not to assess study rigor, but to identify trends in research aims, findings, and methodology, as well as specify future research directions. A narrative review was conducted using PRISMA guidelines. Using the search term "Clubhouse," 194 articles were identified in online databases. 38 met criteria for inclusion. Most studies were qualitative (60.5%) and few utilized experimental or quasi-experimental designs (7.9%). Narrative synthesis revealed research aims and outcome variables falling into six key areas: social integration and connectedness, quality of life (QOL), recovery outcomes, relational dynamics, policy, and virtual adaptations of the model. Findings indicate that recent Clubhouse-related research trends have primarily involved studies of social connectedness, QOL, recovery, relationships, and policy, as well as studies examining the value of the virtual Clubhouse in maintaining well-being. However, heterogeneity of methodologies and measures present a critical limitation to assessing results across studies. Options for increasing experimental methodologies in this area are reviewed. Recommended future directions involve moving towards a biopsychosocial approach to clarifying the mechanisms through which the model promotes recovery-aims that may yield implications beyond the realm of serious mental illness.
自 20 世纪 40 年代以来，心理社会康复的会所模式已经朝着社会理论和干预的综合实践方向发展。尽管该模式具有成本效益，并且有观察到其疗效的证据，但实证研究仍然不足。当前的叙述性评论审查了近年来（2015-2021 年）的研究，不是为了评估研究的严谨性，而是为了确定研究目标、发现和方法的趋势，并指明未来的研究方向。使用 PRISMA 指南进行了叙述性评论。使用搜索词“会所”，在在线数据库中确定了 194 篇文章。有 38 篇符合纳入标准。大多数研究是定性的（60.5%），很少使用实验或准实验设计（7.9%）。叙述性综合揭示了研究目标和结果变量分为六个关键领域：社会融合和联系、生活质量（QOL）、康复结果、关系动态、政策以及该模型的虚拟适应。研究结果表明，最近与会所相关的研究趋势主要涉及社会联系、生活质量、康复、关系和政策的研究，以及研究虚拟会所在保持幸福感方面的价值。然而，方法和措施的异质性是评估研究结果的一个关键限制。审查了在该领域增加实验方法的选择。未来的建议方向包括朝着生物心理社会方法发展，以阐明该模式促进康复目标的机制，这些目标可能会产生超出严重精神疾病领域的影响。
