Clubhouse model

Domain V · Systemic, relational, group & community · Hiram Johnson, Elizabeth Schermerhorn, John Beard · 1943 · New York

What it is

The Clubhouse model is a community programme and service model for adults with serious mental illness, not a psychotherapy. A Clubhouse is a separate community where "members" (people with a history of mental illness) and a small staff jointly run the whole operation through a structured…

Format

• The Clubhouse has no treatment phases, sessions or end date: membership is voluntary and has no time limit (Std 1). What follows is the member's typical pathway as the sources describe it, plus the programme's own development cycle. Movement between elements is driven by the member's choice, never…
• Format and dose.

Who practises it, and how they are trained or regulated

• Programme cycle (for a clinician or agency starting a Clubhouse). Join Clubhouse International → director, members, staff and others complete Comprehensive Clubhouse Training at an authorised Training Center (Std 31; the 2025 text gives two weeks) → accreditation within four years of joining: members' and staff's written self-study against the Standards → 3–4 day site visit by a two-person faculty (one member, one…
• Origins (verified). The model began with a patients' group at Rockland (State) Psychiatric Center, New York (1943), named "We Are Not Alone" (WANA) in 1944, supported by psychiatrist Hiram Johnson and volunteer Elizabeth Schermerhorn; it became Fountain House on West 47th Street, Manhattan, in 1948. Social worker John Beard became executive director in 1955 and built the approach around members and staff doing…
• Phoenix Clubhouse, Hong Kong. Run within the Hong Kong West Cluster and linked to the psychiatric day hospital of Queen Mary Hospital, it converted from a professional-led day-hospital style service to the Clubhouse model in 1998, is described as Hong Kong's first Clubhouse, and has been accredited by Clubhouse International since 2001. It adds a "Group Placement" employment step and acts as an orientation hub for…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Sending only staff; the Standard names members too.
• Wellness becoming a clinic-style treatment programme.
• Decisions made beforehand in staff corridors. Working: members raise and win changes.
• In-house classes run by staff as a school. Working: members enrol in outside courses.
• Token membership on panels. Working: members' views change outcomes (a hire, a policy).

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.