A Systematic Review of Evidence for the Clubhouse Model of Psychosocial Rehabilitation

Colleen McKay
Katie L Nugent
Matthew Johnsen
William W Eaton
Charles W Lidz
Peer-Reviewed Article
August 2016
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“Clubhouses” for people with serious mental illness are effective at promoting employment, reducing hospitalizations, and improving quality of life.


The clubhouse model is a form of psychosocial rehabilitation.  It takes the form of a physical space — a “clubhouse” — where people with serious mental illness can choose to become members and contribute to the daily operations of running the space and participate in activities designed to enhance self-esteem, self-efficacy, and improve social relationships. This systematic review and quantitative synthesis summarize evidence on the effectiveness of clubhouses to improve members’ health and well-being in the following domains: (1) obtaining employment; (2) reducing hospitalizations; (3) improving quality-of-life outcomes; and (4) enhancing social relationships.


The authors examined evidence on the effectiveness of clubhouses across 52 randomized clinical trials, quasi-experimental studies, and observational studies. The strongest findings suggested that clubhouses are effective at helping members to obtain employment and to reduce or delay hospitalization and lower associated costs. Less strong findings suggest that clubhouses have a positive impact on quality of life.

The authors note that more research is needed to better understand the impact of clubhouses across all of the aforementioned domains — including employment attainment, as there are many different types of supported employment to compare across clubhouses.


This systematic review reveals strong evidence for positive impacts of clubhouses in the domains of employment and rehospitalization. Although more evidence is needed to further evaluate the impacts of clubhouses, these findings can assist policymakers, payers, and providers seeking impactful community-based models to support people with serious mental illness.

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