Clubhouse Members' Family Social Networks and Recovery From Severe Mental Illness
Findings from caregiving research of persons with severe mental illness demonstrate the important role of family caregivers of adults with mental illness as well as the burdens of family caregiving. Furthermore, data from research on social networks of at-risk individuals indicate the critical roles in mental and physical well-being played by confidants. Two significant limitations of the previous research on family networks and recovery from mental illness are: 1) the grouping together of social network data from the family network as a whole without separate identification of the role of the most supportive family member and 2) a focus of studies on either positive or negative aspects of support but not both. Thus, the present study aims to examine the contribution of family social network and the most supportive family member to recovery and its selected dimensions, controlling for psychosocial functioning.
One hundred and twenty six randomly selected respondents from a Midwestern urban Clubhouse agreed to in-person interviews. The refusal rate was low (24%). Participants without family members in contact with were excluded from the analyses, leaving a final sample size of 118. The dependent variables, Recovery and three selected dimensions (Personal Confidence and Hope, Reliance on Others, and Willingness to Ask for Help), were assessed using the Recovery Assessment Scale. Four multiple regression analyses were conducted. For each analysis, psychosocial functioning, as the covariate, was entered in the first block. Overall family support, criticalness from family members, satisfaction with family relationship, positive quality of relationship with, and undermining from, the most supportive family member were entered in the final block.
The final regression model significantly explained 26% of the variance in overall Recovery. Higher positive quality of relationship with the most supportive family member was associated with higher levels of overall Recovery as well as greater Personal Confidence and Hope, greater Willingness to Ask for Help, and higher Reliance on Others. Greater overall family support was associated with higher levels of overall Recovery, greater Personal Confidence and Hope and higher Reliance on Others, but not with the Willingness to Ask for Help. Psychosocial functioning was associated with higher levels of overall Recovery and Personal Confidence and Hope. Criticalness from family members, satisfaction with family relationship and undermining from the most supportive family member were not associated with overall Recovery or any of the Recovery dimensions.
Given that the positive quality of relationship with the most supportive family member was associated with higher overall and three dimensions of recovery, Clubhouses could play important roles in helping to address these family members’ needs as well as helping family caregivers develop better quality relationships with Clubhouse members. Undermining behaviors from family members were not associated with recovery in our sample which differs from previous research with persons with severe mental illness. This may be due to greater involvement by Clubhouse members with their family members in this sample than is true for individuals with severe mental illness overall.