Factors influencing member employment in International Center for Clubhouse Development (ICCD) clubhouses
Stephen Kelliher (2006)
This study examines programmatic factors in International Center for Clubhouse Development (ICCD) Clubhouses in relation to member employment by analyzing employment data from the ICCD's survey. Data related to employment outcomes, program organization and ICCD certification from a particular clubhouse (Yahara House) in Madison, Wisconsin is also examined. The specific interventions assessed in this study are benefits counseling, medication administration, intensive case management and the presence of a dedicated vocational team. Staff tenure is also investigated in order to determine if length of staff employment affects member employment. Interviews conducted with members and staff from Yahara House are utilized to discern stakeholder impressions of how these programmatic factors influence member employment and model fidelity. Findings do not support a measurable impact on member employment associated with medication administration or reimbursed case management services occurring within the clubhouse. Staff tenure at the high (5+ years) and low (0-1 year) end of the spectrum is associated with slightly enhanced member employment outcomes. A mild positive association between increased numbers of vocational supports and improved member employment outcomes is observed. Increased numbers of case management supports are found to have a weak, inverse relationship with member employment outcomes. There was insufficient data to quantitatively measure the effects of having a trained benefits counselor on staff. In assessing how fidelity to the ICCD Clubhouse model is influenced by the incorporation of these additional programmatic factors particular emphasis is granted to addressing the issue of medication services occurring within the clubhouse. While it is not disputed that inclusion of a medication component within a clubhouse is in direct violation with the wording of one standard. Stakeholders from Yahara House contend that members benefit from inclusion of a voluntary medication component at the clubhouse without compromising basic clubhouse philosophy. Separate ICCD faculty noted in their certification reports that while the inclusion of the medication component at Yahara House is not in keeping with the wording of Standard 15, they did not observe a clinician patient hierarchy and there was little to no evidence of a medical influence on the clubhouse by including this service.