Psychosocial Rehabilitation for Schizophrenia

Overseen By Jessica A Wojtalik, PhD

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: Case Western Reserve University

Must be taking: Psychotropic

Disqualifiers: Severe substance use, Suicidal, Autism, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 6

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how different types of community-based mental health care affect thinking skills, daily life activities, and brain function in adults with schizophrenia. It compares the Clubhouse Model of Psychosocial Rehabilitation for Serious Mental Illness, a supportive community approach, with standard mental health services. Participants will attend six study visits involving interviews, memory tests, and one MRI brain scan. Individuals diagnosed with schizophrenia or related conditions, who have not changed their medication in the last month, and can read and speak English well, may be suitable for this trial. As an unphased trial, this study provides a unique opportunity to enhance understanding and improve mental health care approaches.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but it requires that you have not changed your primary psychiatric medication in the last month. This suggests you should continue your current medication without changes.

What prior data suggests that the Clubhouse Model of Psychosocial Rehabilitation is safe for individuals with serious mental illness?

Research has shown that the Clubhouse Model of Psychosocial Rehabilitation is well-received by participants. Studies have found that this approach helps individuals with serious mental illnesses by supporting job placement and reducing hospital visits. Reports of harmful side effects are absent, indicating safety. The Clubhouse Model emphasizes building a supportive community, which many find beneficial for mental health. Participants in past studies noted improvements in quality of life and fewer symptoms of psychosis. This suggests the treatment is both effective and safe for individuals with mental health conditions. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Clubhouse Model of Psychosocial Rehabilitation for schizophrenia because it offers a unique, community-focused approach. Unlike traditional treatments that often emphasize medication and structured therapy sessions, the Clubhouse Model creates a supportive, voluntary community where members actively participate in daily operations through a "work-ordered day." This approach empowers individuals by prioritizing their choice and involvement, breaking down the typical provider-patient hierarchy. By fostering real-world skills and social connections, the Clubhouse Model aims to enhance quality of life and independence for those with serious mental illness.

What evidence suggests that this trial's treatments could be effective for schizophrenia?

Studies have shown that the Clubhouse Model, a treatment option in this trial, can help people with serious mental illness. It effectively increases job opportunities and reduces hospital visits. Research indicates that it also improves quality of life and social skills. This model creates a supportive community where members engage in daily activities. It reduces symptoms of psychosis, a mental disorder where people lose touch with reality, and lowers the chances of hospital readmission. Overall, evidence suggests that the Clubhouse Model can greatly enhance daily life for those with serious mental illness. ^{1 3 5 6 7}

Who Is on the Research Team?

Jessica A Wojtalik, PhD

Principal Investigator

Case Western Reserve University

Are You a Good Fit for This Trial?

This trial is for adults with schizophrenia or related conditions like psychotic episodes and schizoaffective disorder. Participants should be willing to undergo interviews, cognitive tests, and MRI brain scans over six study visits within a six-month period.

Inclusion Criteria

* (1) have a DSM-V diagnosis of schizophrenia, schizoaffective disorder, or schizophreniform confirmed by diagnostic assessment and medical record review

* (2) between the ages of 18-50

* (3) stabilized on psychotropic medication as indicated by no changes to the primary psychiatric medication in the last month

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Assessment

Participants complete initial assessments including interviews, questionnaires, cognitive testing, and an MRI brain scan

1-2 weeks

3 visits (in-person)

Intervention

Participants engage in either the Clubhouse Model or usual community-based mental health care

6 months

Follow-up Assessment

Participants complete follow-up assessments including interviews, questionnaires, cognitive testing, and an MRI brain scan

1-2 weeks

3 visits (in-person)

Follow-up

Participants are monitored for changes in cognitive and functional outcomes

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Clubhouse Model of Psychosocial Rehabilitation for Serious Mental Illness
• Usual Community-Based Mental Health Care

Trial Overview The REACH Study is comparing the Clubhouse Model of Psychosocial Rehabilitation—a supportive community approach—to usual mental health care in how they affect thinking abilities, daily functioning, and brain activity.

How Is the Trial Designed?

Group I: Clubhouse Model of Psychosocial Rehabilitation for Serious Mental Illness Experimental Treatment 1 Intervention

The Clubhouse Model (CM) is a strengths-focused, evidence-based, and comprehensive approach to psychosocial rehabilitation for serious mental illness. The CM uses an intentional community of support to create a safe and holistic setting to practice real-world functioning. The core of the CM is the 'work-ordered day', a concept where members, as opposed to patients, are integral to and needed for the successful daily operation of the Clubhouse. Members choose a 'work unit' each day of attendance. Most clubhouses have four work units, such as (1) Administration (e.g., database management); (2) Hospitality (e.g., Clubhouse cafe); (3) Membership (e.g., employment programs); and (4) Communications (e.g., newsletter). Other unique aspects include its voluntary and humanistic nature, prioritization of member choice, unrestricted and flexible membership, and the elimination of provider-patient hierarchy. The CM has a sophisticated accreditation process based on 37 international standards.

Group II: Usual Community-Based Mental Health Care Active Control 1 Intervention

Usual care includes services typically available in the community at mental health agencies, including case management, including Assertive Community Treatment, counseling, peer support services, psychoeducational support groups, family support groups, supported education/employment, permanent supportive housing, and medication management.

Who Is Running the Clinical Trial?

Case Western Reserve University

Lead Sponsor

Trials

314

Recruited

236,000+

The Centers

Collaborator

Magnolia Clubhouse

Collaborator

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5756274/

A Systematic Review of Evidence for the Clubhouse Model ... RCT results support the efficacy of the Clubhouse Model in promoting employment, reducing hospitalization(s), and improving quality of life.

2. clubhouse-intl.org clubhouse-intl.org/recent-research/

Recent Research RCT results support the efficacy of the Clubhouse Model in promoting employment, reducing hospitalization(s), and improving quality of life.

3. psycnet.apa.org psycnet.apa.org/record/2025-28270-001

The growth and diversity of the evidence base ... - APA PsycNet The Clubhouse Model is a long-standing form of psychosocial rehabilitation that has been in existence for over 75 years.

4. psychiatrictimes.com psychiatrictimes.com/view/the-clubhouse-model-for-depression-and-serious-mental-illnesses

The Clubhouse Model for Depression and Serious Mental ... Further, Clubhouses are credited with reducing psychiatric hospitalizations and readmission, reducing symptoms of psychosis, improving social ...

5. umassmed.edu umassmed.edu/sparc/isparc-turns-30/programs--centers/clubhouse-program/

Program for Clubhouse Research There is evidence and support for the Clubhouse Model in improving quality of life and social functioning, reducing hospitalization(s) and/or psychiatric ...

6. chcs.org chcs.org/the-clubhouse-model-in-action-at-fountain-house-designing-communities-for-people-with-serious-mental-illness/

The Clubhouse Model in Action at Fountain House A 2018 systemic review of randomized controlled trials found solid evidence that clubhouses increase employment, reduce hospitalizations, and ...

7. nature.com nature.com/research-intelligence/nri-topic-summaries/clubhouse-model-of-psychiatric-rehabilitation-micro-413897

Clubhouse Model of Psychiatric Rehabilitation Over recent decades, robust evidence has demonstrated that Clubhouse programmes contribute to reduced hospitalisations, improved quality of life and greater ...