'~Empowerment" connotes a process of gaining control over one's life and influencing the organizational and societal structures in which one lives. This study defines and validates three measures: the Personal Empowerment Scale, the Organizational Empowerment Scale, and the Extra-Organizational Empowerment Scale.Measurement efforts are based on observational work, baseline inter~iews (N = 310), and six month follow-ups (N = 241) in four client-run self-help agencies (SHAs) for persons with severe mental disabilities. All three study scales demonstrated strong internal consistency and stability. They were sensitive to user changes over time and have construct validity. 1 INTROD UCTION"Empowerment" is a developing but inconsistently-defined concept. In general, it connotes a process by which individuals with lesser power gain control over their lives and influence the organizational and societal structures within which they live. A growing segment of research has focused on the meaning and process of empowerment among per-

Objective: This study assessed the relationship between the outcomes of clients of client-run self-help agencies and attendance at the agency, satisfaction with the agency, psychological disability, and organizationally mediated empowerment, that is, the provision of opportunities for clients to meaningfully participate in decisions about their care and the care of others in the agency. The outcomes assessed were independent social functioning, assisted social functioning, and personal empowerment. Methods: A total of 255 long-term users of four self-help agencies were interviewed at baseline and six months later. Univariate descriptive analyses as well as t tests describing changes in outcomes were conducted. The relationship of each of the four determinants to the three outcomes, after controlling for baseline status on the given outcome and other covariates, was assessed with structural modeling using Amos software. Results: On average, personal empowerment among the clients of the selfhelp agencies increased, independent social functioning remained the same, and assisted social functioning decreased during the six-month follow-up period. Multivariate analyses showed a positive association between organizationally mediated empowerment and all three outcomes. Conclusions: The significant ingredient promoting positive outcomes for clients of self-help agencies appears to be the provision of opportunities for clients to meaningfully participate in decisions about their care and the care of others in the organization. (Psychiatric Services 53:304-309, 2002)

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Member-empowering SHAs run as participatory democracies in combination with CMHA services produced more positive recovery-focused results than CMHA services alone.

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