From Pedestal to Personhood: Staff in the Clubhouse

by Lawrence Hallinan & Helen Nistico

Presented at National Mental Health Services Conference 1994

Abstract
In many traditional clinical settings there are often certain beliefs regarding the staff. These beliefs distinguish staff from consumers and are identified as the elements that make up the "professional pedestal".

By contrast the Clubhouse Model promotes an entirely different understanding of staff. Furthermore the model contains certain attributes that actively work to subvert the development of a "professional pedestal". In the Clubhouse, staff lose the expectation and status of being professional and gain "personhood", the freedom to be people who are learning and growing. The description of "personhood" has also many challenges, personal and work related .

The experience of the Clubhouse staff shows that involvement with consumers can be one of inspiration and fulfillment for staff as well as consumers.

Introduction
Sometime ago a paper called "From Patienthood to Personhood" ( Peckoff ,1992) was written describing the experience of members in a Clubhouse. We have found our experience of being staff in a Clubhouse is also one involving a journey towards a state of personhood albeit from a different starting point. This starting point, for many, is what we have referred to as the "professional pedestal."

What is the professional pedestal?
There seems to be some more traditional beliefs about staff that are still held today by both mental health staff and consumers. It is this set of beliefs that lead to the development of the "professional pedestal". Some of these beliefs are that: (1) they have special training for their position; (2) they possess skills, values, and knowledge that are more effective and pure than those of lay people; (3) while at work they are self sufficient in emotional and practical terms; (4) they will not share their personal issues with consumers. Our experience as Clubhouse staff has constantly challenged these notions. We believe these beliefs about staff are not the most effective ones for staff or consumers.

Components of the Clubhouse Model which subvert the "professional pedestal"
There are several inbuilt components in the Clubhouse Model which help to subvert or impede these views.

Staff selection
The first is the nature of staff selection. In our Clubhouse staff come from a diversity of backgrounds including: psychology, social work, youth work, theology, philosophy, occupational therapy and teaching. The emphasis on staff selection is not on background and qualifications. Rather, it is interpersonal skill and the ability to relate to others in a genuine way that is of greater significance (Freund, 1994). As a consequence we do not possess all the practical skills to perform the work required of us. So from the beginning of our employment it was not possible for us to be viewed the "all knowing" professionals.

Volume of work
The "professional pedestal" is again subverted by the volume of work that exists in a Clubhouse. A typical Clubhouse requires the completion of a large amount of work.

Each day the phones must be answered, lunch prepared and served, newsletters produced, meetings planned, conducted and minutes typed. New and existing members require support on a whole variety of issues including accommodation, employment and Illness. Staff need to seek out the talents and abilities of members so that this works.

No matter how small a member‰ s contribution, it can make a big difference to whether we will achieve our work for the day . While we feel we are service providers we also feel we are the recipients of the services provided by members.

Three forms of equity
One of the most central tenets of the Clubhouse Model is that staff and members are regarded as being equal. This is an ambiguous term and one which we often struggle with. Nevertheless we interpret it in three main ways: (a) equal say in decisions, (b) equal opportunity to do Clubhouse work, and (c) equal access to Clubhouse space.

Equal in say
Staff and members make decisions that affect the Clubhouse together.

The opinion of members has equal weight to that of staff. In this way the model communicates to us all that staff do not know all the answers. Members often have great insight into Clubhouse issues. This form of equality challenges the view that staff know best.

Equal opportunity
Equal opportunity to all aspects of Clubhouse work also helps to impede the perception of staff as more able. Members are invited to do anything from writing a report or submission for funding to washing the dishes. The person who performs a particular job is determined by their skill and interest not by their status as a staff or member.

For example, we have many wonderful speakers on Clubhouse amongst our membership who speak on Clubhouse much more often than most staff because they do it so well. Staff are not seen as the only people capable of doing important work. We are all recognized for our expertise in a given area.

Equal access to space
The Clubhouse Model is insistent that all staff and members have equal access to all parts of the building. Staff do not have offices, desks, or a staff room. We also share our lunch with our co- workers, and the members. Having a shared space, we believe, helps to contribute to the community and warmth that is experienced in our Clubhouse. Having designated staff areas could give the message that staff are somehow privileged. The message we want to give is that we are all equal in value and importance.

These are some of the ways in which the Clubhouse Model defines the staff role and communicates things about staff that are contrary to the notion of the "professional pedestal." Staff are therefore brought down from the "professional pedestal" to the same level as members. This level we have referred to as personhood.

Personhood Counter Cultural
In the Clubhouse we are creating a community that is people centered and in this way is counter cultural in its philosophies and practices. We have become aware of how some aspects of society do not provide the time and place to value people. It seems to us that society upholds a possessions and end products as being of greater value than people and process. In the Clubhouse environment this is overturned. Staff exist to be in relationship with members: to value them and bring out their best. This leaves us feeling enormously positive about ourselves and the potential in humanity. The days we go home feeling satisfied and thrilled are the days when we have been able to connect with and engage someone in the club.

Personal Honesty & Integration
As staff are also participants in club, we benefit from this supportive community. The Clubhouse is an environment that facilitates the development of relationships between staff and members that lead to mutual growth rather than dependence or domination. There is a tremendous feeling of integration and truth that comes from the similarity between our relationships with people in the club and who we are in the rest of our lives. A large part of this is the sense of freedom that comes from being honest about our needs and abilities.

Commonality with members
Probably the biggest impact from working in the club has come as a consequence of seeing how much we have in common with members, that is people with psychiatric disability. Having worked and socialized with many members we find people who share our taste in music, films, gossip. As we talk of our futures we hope for the same things, holidays in the sun, satisfying personal relationships, a home to call ones own. As Vorspan says:
 

"Before we are schizophrenics, or behavioral therapists, or manic-depressives, or commissioners of mental health, we are all simply human beings." (Vorspan, 1988)

Seen in this way we share the common needs of: relationships, meaningful activity, opportunities to learn and grow and a balance between work and leisure.

Challenges for staff
While the Clubhouse Model is not complicated, to be an effective staff member one must meet certain ongoing challenges. What are some of these challenges?

1. Assertion of boundaries and needs
The open, shared and egalitarian way we work challenges us with regards to maintaining our boundaries and asserting our needs. With no barriers of appointment times and offices to hide behind we feel more exposed to the often constant needs and demands of members and other staff. As a consequence the onus is on us to look after ourselves.

2. Challenges to let go of the work ethic
Clubhouse staff are often challenged with learning to place more value on the process by which work is done as opposed to valuing the end product. This is quite a request in light of the high value usually placed on attaining your work goal quickly and flawlessly in the workplace. We must constantly remind ourselves that it is the process of a member learning they have valuable skills and contributions that is more important than the speed of attaining the end product.

3. Unpredictability
Unpredictability is certainly part of the staff experience. We are not sure which members will come to the Clubhouse on a particular day and therefore how much help we will have in achieving the unit‰s work goal for the day. As participation is voluntary, members may choose to come to the Clubhouse but not to work. Consequently, staff are left open to not knowing whether we will finish work which often has a deadline and consequences.

As members and staff decide together how the work will be done, staff do not have exclusive control. We are challenged to adjust and adapt to different ways of approaching the work. We may know we need to produce a newsletter but we do not know who will be involved or what the finished product will look like. Paradoxically, this unprejudiced approach to how we do a piece of work seems to encourage more and more often creative contributions from members.

4. New skills
Many of the challenges in our work come from the diverse range of work we do. We are constantly having to tackle new experiences and find previously untapped skills and imagination within ourselves and our member coworkers. We need to find ways to make work meaningful, fun, interesting, or rewarding.

5. Neither domination nor dependence
There are many subtle ways in which we as staff can inadvertently dominate our less assertive members. We need to frequently check our pulse to determine whether we are standing in the way of members‰ opportunity to speak, work, or even care. We need to ask what is the effect of us jumping to answer a phone, express our every opinion in a meeting, or not pausing before responding to a question or request. It is important that we share the opportunities that help us feel good about ourselves.

In the same way we need to ask whether we are encouraging members to develop an unhealthy dependence on us. There are times when some sort of dependence is appropriate (Fromm 1960). Many new members are frightened by involvement in decision making, assisting in unfamiliar work, and supporting themselves. This is also somewhat true for members who are acutely ill or in early recovery. These members look for someone strong and dependable who they can go to for support and security. It is usually the staff to whom they turn and it is unrealistic for us to trivialize these concerns by deserting the member or impatiently attending to them. These members need to find stability and a person who can nurture them. In our club we expect that members will also take on these roles. The reality is that not all members will want to or always be able to provide this support to other members. However by seeking out and encouraging members to support each other we show that strength and dependability are qualities that can be found in members.

We find our motivation and inspiration to meet these challenges comes from seeing members grow in self confidence and skill everyday. It is the stimulation of the stimulation of the Clubhouse environment that leaves us feeling fully alive.

Members changing their ideas about staff
It can take time for a member to feel comfortable in seeing the staff as people who are fallible and have needs. Much as we staff may want to have the freedom of personhood can we demand it? We think members will treat staff as equals when they are ready. It is often only once members have started to believe in themselves that they can allow staff down from the pedestal they have created in their minds. The empowerment of everyone in the Clubhouse requires an ongoing effort from members and staff. To quote Belinda, a club member:

"Every time a member automatically asks a staff to do something for them instead of asking the member standing beside them, we are reinforcing the old ingrained habits left over from hospital and sickness. We are reinforcing our perceived inabilities and our lack of faith in each other as members and we inadvertently raising the staff to a level of infallibility that they can no more achieve than we can." (Thurlough 1994:10)

Conclusion
The Clubhouse model promotes a role of staff and supports it with a series of ideals and practices that work to subvert the development of the "professional pedestal" but in its place we have gained personhood and all the challenges and joys that go with it. Our experience as staff has shown that the Clubhouse can be a place of healing and growth for staff as well as members.

References
Paul Freund (1993) "Professional Role(s) In The Empowerment Process: Working With People With A Psychiatric Disability" Psychosocial Rehabilitation Journal 16(3) January 1993 pp 65-73

Erich Fromm (1960) The Fear of Freedom (org. 1942) London Routledge & Kegan Paul Ltd.

Belinda Thurlough (1994) "Staff and Members Equality" in News At Ten May pp 10-11

Roberta Vorspan (1992) "You Can‰t Vacuum In A Vacuum: Activities of Daily Living" in Psychosocial Rehabilitation Journal 12(2) October 1988

Jacqueline Peckoff (1992) "Patienthood to Personhood" in Psychosocial Rehabilitationyes Journal16(2) October 1992 pp 5-7