Salutogenesis as a theoretical framework for psychosocial rehabilitation: the case of the Clubhouse model

Abstract

Purpose: This study explored whether the holistic theory of salutogenesis may be a suitable theoretical framework for the Clubhouse model of psychosocial rehabilitation, a pioneer among psychosocial rehabilitation programmes. Methods: A systematic examination of elements of the Clubhouse model, as prescribed by the Clubhouse standards, was performed within the context of the theory of salutogenesis including its basic salutogenic orientation and the main concepts of sense of coherence and resistance resources. Results: We found that several standards and practices within the Clubhouse model can be understood as applications of salutogenesis. We have hypothesized that the Clubhouse model promotes peoples' sense of coherence and mental health. However, our investigation also showed that, to enhance the recovery of Clubhouse members, more explicitly incorporating some salutogenic principles, such as "appropriate challenges" and "active adaptation as the ideal in treatment", may benefit Clubhouse practice.Conclusions: The Clubhouse model of psychosocial rehabilitation is very consistent with the salutogenic orientation and main salutogenic concepts. The present study suggests that salutogenesis may be a suitable theoretical framework for the Clubhouse model and possibly in the psychosocial rehabilitation field in general.

Sense of Coherence and Burnout in Healthcare Professionals in the COVID-19 Era

“…In line with previous studies ( 28 , 30 , 33 ), we have identified GRR in relevant vulnerable groups as a critical premise in designing mental health intervention programs. The concept of SOC can influence some psychotherapeutic modalities and psychological counseling approaches.…”

“…We expected a substantial association and prognosis of SOC both in line with burnout and in line with personal accomplishment as an aspect to mental health. The need for proactive research to identify GRR in this group is outlined ( 28 , 30 , 32 , 33 ).…”

Suffering and Salutogenesis: A Conceptual Analysis of Lessons for Psychiatry From Existential Positive Psychology (PP2.0) in the Setting of the COVID-19 Pandemic

“…Constructs related to salutogenesis, such as measures of the SOC, have also been found to predict mental health outcomes in patients with chronic medical illnesses such as inflammatory bowel disease (Freitas et al, 2015) and cancer (Sales et al, 2014). Finally, researchers examining the effectiveness of a salutogenic approach to specific mental health problems have reported positive outcomes in child and adolescent emergency psychiatry settings (Johansson et al, 2018), and in psychosocial rehabilitation (Fekete et al, 2020).…”

“…Patients with chronic mental illness often show only partial responses to standard pharmacological therapies, and rehabilitation is often essential to improving their quality of life, functioning, and social inclusion (Farkas and Anthony, 2010). In a paper describing the implementation of a comprehensive psychosocial rehabilitation program in Norway, Fekete et al (2020) have drawn on five key principles derived from the salutogenic framework: (1) health as a continuum, (2) focus on the "story" of an individual as whole rather than on a medical diagnosis, (3) GRRs, (4) the potentially adaptive aspect of tension or stress, and (5) the need for active adaptation to current circumstances. A focus on the holistic "story of a person" is of particular importance during the COVID-19 pandemic.…”

“…PP2.0-like PP1.0-is not exclusively an approach related to health, as it also addresses questions such as organizational health and resilience (Mayer and Oosthuizen, 2020) and collaboration between cultures in a changing world (Barmeyer and Mayer, 2020); however, in this paper, it is the health-related aspects of this framework that will be discussed. A central aspect of PP2.0 is the acknowledgment that suffering and adversity, rather than being seen as "problems" to be "solved, " are an integral part of human existence-an insight that replicates the traditional wisdom of both Western and Eastern religious traditions (Fitzpatrick et al, 2016) as well as the salutogenic principle that tension or stress can be adaptive (Fekete et al, 2020). In other words, attempts to prevent or minimize suffering-as per the conventional medical modelmay lead to a minimization or even a negation of the value of suffering, particularly in settings where such minimization is not feasible (Wong and Tomer, 2011;Wong, 2020).…”