Miranda Anderson, Jordan Fish, Tim Harker

Clubhouse camping: Leisure programming development for adults with serious

mental illnesses

Significance
Population
Mental illness and its effects on quality of life (QOL) and community integration is a
common concern nationwide (National Institute of Mental Health, 2019). Approximately one in
five Americans have mental health problems every year and 3.4 million Americans live with
serious mental illnesses (SMIs) (Wharton, 2014). Serious mental illness, as defined by the
National Institute of Mental Health is “a mental, behavioral, or emotional disorder resulting in
serious functional impairment, which substantially interferes with or limits one or more major life
activities” (National Institute of Mental Health, 2019). The process of recovery for those with
SMIs can include several components such as connections to the social world, hope, healing,
seeing illness as only a part of oneself, and empowerment (Herman, Onaga, Pernice-Duca, Oh,
& Ferguson, 2005).

Current Programming and Gaps

Recovery programs for those with SMIs are present worldwide in the form of
clubhouses. Clubhouses are mental health organizations that offer opportunities for competitive
employment, education and peer support for those living with mental illness (Chung, 2016).
Participation is voluntary and clubhouses are intentionally understaffed so that member
participation is essential to keep the clubhouse running. Skills learned through participation can
further help with community integration (Ritter, Fekete, Nordli, & Bonsaksen, 2018).
Alliance House is a rehabilitation center in Salt Lake City that is based on the
psychosocial clubhouse model. The mission of Alliance House is to “assist adults with a mental
illness in developing the skills and confidence necessary to lead satisfying and productive lives
in their community” (Alliance House, n.d.). Participation at Alliance House can occur in areas of
housing, education, employment, culinary services and clubhouse maintenance. There is a
place/role for everyone regardless of mental illness severity, which means a large range of
people are able to contribute meaningfully.
Alliance House covers several aspects of mental health including competitive
employment, education and socialization. However, this also begs the question, what do
psychosocial clubhouses offer outside of productive societal integration such as leisure and
restorative opportunities? Research suggests that health promotion in persons living with mental
illness is greatly strengthened by active participation in enjoyable, expressive and meaningful
leisure experiences (Iwasaki et al., 2014). Similarly, participation in leisure activities has been
shown to contribute to a positive and effective sense of self-worth and belonging while also
counteracting mental illness symptoms (Iwasaki, Messina, Shank, & Coyle, 2015). Participation
in leisure activities has been well studied even outside of persons with mental health illnesses,
including aging adults and people with spinal cord injuries. Increased meaning, satisfaction and
enjoyment in their lives were common themes among these populations when participating in
leisure activities (Iwasaki, 2015). Combining programs that also focus on leisure pursuits may
be beneficial in the clubhouse model to further enrich the lives of those living with serious
mental illness.

Camp Programming
In an effort to increase leisure participation, we have developed a member-led program
for Alliance House. After gathering data through semi-formal meetings with the staff and
members, camping proved to be the leisure activity most motivating for members. Our program
will focus on how to go about planning and executing an annual camping trip for the clubhouse.
The program focuses on addressing clubhouse-identified barriers such as insufficient planning
Miranda Anderson, Jordan Fish, Tim Harker

knowledge, limited access to transportation, a lack of necessary camping equipment/setup, and

overall safety concerns. For our Camp Planning Program, we are providing participants with an
outline that will help with the planning process. This includes planning worksheets, guiding
questions, and critical factors to take into consideration when planning a campout. By providing
a structured but flexible plan, we believe that members will further develop autonomy,
competence, self-help skills, and increase interpersonal relationships as they work towards
recovery.
In order to address these factors, we have developed our program around the
Psychosocial Clubhouse Model of Recovery and the Self-Determination Theory. The Clubhouse
Model is essential as it is the guiding philosophy for Alliance House. This model focuses on
facilitating member autonomy, interpersonal relationships, and self-help skills during recovery.
Our program will integrate this focus by supporting Alliance House members as they exercise
their autonomy to work together to organize and implement camping trips, and develop their
self-help skills along the way. The Self-Determination Theory, which focuses on competence,
autonomy, and relatedness, also integrates into our program as its theoretical foundation
supports the aims of the Clubhouse Model. Our program uses the theoretical perspective of the
Self-Determination Theory to focus on improving member competence through education,
supporting member autonomy through program flexibility, and facilitating member relatedness
through group work and purpose.
Our program is also in line with the Utah Health Improvement Plan, which highlights
improving mental health and making Utah a place where “all people can enjoy the best health
possible, where all can live and thrive in healthy and safe communities” (Utah Department of
Health Office of Public Health Assessment, 2018). Through participation in this program,
members will have opportunities to be included in leisure activities that not only benefit their
mental health but also create a greater sense of inclusion to enjoy the beauty and resources
that Utah has to offer.

Innovation
Our camping program is innovative in the scope and focus of the service it provides.
Typical programming within a mental health clubhouse excludes leisure-based programming,
and integration into local leisure communities. Our program challenges this typical clubhouse
paradigm. Our camping program relies more heavily on community resource usage and
integration than past programming. By educating clubhouse members on generalizable leisure
skills, our program seeks to empower members to more frequently utilize local resources
outside of clubhouse programming.

Novelty
The novelty of our program stems for the breadth of its education and applicability.
Clubhouse members receive daily programming designed to support clubhouse demands, but
the applicability of this programming is limited to clubhouse tasks. Our program facilitates
leisure community integration and member independence by providing generalizable education
designed to support each member’s unique outdoor leisure interests. Instead of task-specific
training, our program provides broad outdoor leisure skill training and a template to follow for
planning other leisure activities. Typical clubhouse programs teach a narrow set of skills for
each task; however, our program provides a broader skill education into areas such as
organization, time management, event planning, community resource use, first aid, budgeting,
shopping, cooking, meal prep, etc.

Difference
In addition to the differences outlined above, our program differs from leisure
programming for individuals with SMIs at other mental health facilities because it exists within
Miranda Anderson, Jordan Fish, Tim Harker

the clubhouse model of psychosocial recovery. Instead of having staff lead programming to
provide leisure opportunities for those with SMIs, as facilities outside of the clubhouse model
often do, our program is designed to be member driven; clubhouse members with SMIs are
responsible for the program’s implementation and execution. Staff members are available to
consult with, but they do not run the program for the members. This philosophy mirrors real-
world expectations, and facilitates member growth and education.

Approach
Needs Assessment & Justification
Due to the current status of COVID-19, an online video chat focus group was conducted
with four members of Alliance House and several staff members to complete a needs
assessment. Identified occupational interest of the members at Alliance House included help
with meal preparation/planning, dance lessons, sewing, further community involvement, and
financial management. Members expressed interest in having a gym membership but do not
have the means to afford one. Acquiring gym/exercise equipment at Alliance House was
mentioned but it is not a priority for the majority of members and staff. An annual camping trip
had long been an expressed interest for several members as confirmed by this needs
assessment. Alliance house has never organized a camping trip due to a lack of resources and
funding. Camping received the most votes, followed by sewing, and then fitness programming.
Since camping received the most expressed interest, our program will focus on how to go about
planning an annual camping trip for the clubhouse. The barriers identified to completing this
desired camping trip were insufficient planning knowledge, limited access to transportation, lack
of necessary camping equipment/setup, and overall safety concerns. This program will teach
members how to effectively plan an annual camping trip and will address the current barriers
they face.

Program
The bulk of the Camping Planning Program will be provided to Alliance House in the
form of a physical binder in addition to an electronic file containing all relevant materials and
information. The purpose of the electronic file is to allow for reprinting and replacing camping
planning materials as needed. This program is not one that requires weekly maintenance.
Instead, if the clubhouse members and staff decide on a date that they would like to go camping
yearly, this material will need to be reviewed approximately three months prior to the trip. This
time frame gives the participants enough time to effectively work their way through the entirety
of the program and plan a successful camping trip. Eligibility for inclusion in the program will be
determined by the Alliance House staff to address safety and health related concerns.
Recruitment will be done through flyers posted within the clubhouse as well by word of mouth
from members and staff. The program is developed to be easily adjusted for any size of group
but most examples are created for the average number of estimated attendees based on
Alliance House feedback. Due to the member-driven format of Alliance House, program
materials are formatted to support member leadership opportunities in as many areas of the
program as possible. Members of Alliance House will lead the group sessions and implement all
aspects of programming materials. Alliance House staff members will be facilitators and
supervisors of the program as needed.
The program will break down the planning process into time increments relative to the
anticipated trip date, including three months, two months, one month, two weeks, one week,
and the day of. It also includes a follow-up section intended to be completed in the week after
the camping trip. Beginning at three months prior, participants will utilize the program
instructions and worksheets to make campsite reservations, create a budget and begin
purchasing needed materials, determine typical weather patterns, establish the number of
people attending, and fill out the participant pre-test survey. At two months prior, members will
Miranda Anderson, Jordan Fish, Tim Harker

need to complete an inventory follow-up, purchase missing or additional items if necessary,

confirm commitments, sign up for training, and confirm campground site. Trainings will occur at
one month prior to the trip date and will include hands-on practice and resources for the
following items: emergency situations including fire hazards, cuts and fractures, information on
cooking, clean up/disposal of waste, tent/camp setup and cleanup, map reading, and vehicle
maintenance. Specific schedules including trip departure times and daily itineraries will also be
determined at this point in the planning process. At two weeks out, members who have not
completed all of the trainings will need to do so at this time. A materials checklist will also be
provided for organizing group tools/equipment. For the week of the camping trip, members will
create an individual packing list, confirm commitments, and determine transportation seat
requirements. On the day of departure, time will be set aside to pack food and all camping
equipment into the vehicles. For the follow-up section of the program, members will practice
proper cleaning and storage of equipment as well as complete a post-test survey. This program
will be sustained through member interest, staff support to supervise the member
implementation of the program, and continued funding for program-related tools/materials.

Goals & Objectives

Goal 1: Adults with serious mental illness at Alliance House will have increased leisure
participation.
Process Objective: By the end of the camping program, 90% of all trainings will be led by
a different clubhouse member each time as measured by the training sign-up sheet.
Outcome Objective: By the end of the camping program, 90% of participants listed on
the camp sign-up sheet will attend a member planned camping trip.
Goal 2: To improve organizational/planning skills for adults with serious mental illness at
Alliance House in the Camping Planning Program.
Process Objective: By July 20, 2020 all planning sheets and instructional materials will
be provided to Alliance House members.
Outcome Objective: By the end of the camping program, 80% of participants will indicate
at least a 1-point increase in knowledge regarding organizational/planning skills, as
measured by pre-post surveys.

Potential Problems
There are many potential problems that could happen when going on a camping trip. In
order to reduce risk, contingency planning is crucial. All members will complete trainings on
potential safety concerns as well as crisis situations that could happen during the camping trip.
Throughout the process of the program, there could potentially be problems with loss of
member support during some of the planning sessions. In order to maintain progress, staff may
intervene to assist at any point. This will ensure that the program is being completed even if
there are a lack of members who are contributing.

Evaluation
The program evaluation will consist of a pre/post Likert scale consisting of four items.
Members will answer the four items on a five-point scale ranging from one meaning strongly
disagree and five meaning strongly agree. The items will measure areas such as confidence in
planning a camping trip, level of knowledge for planning a camping trip, level of comfort in being
in the wilderness, and ability in maintaining organization. Objectives will be not only measured
through the Likert scale but also per staff report. Sign-up sheets will be utilized in the evaluation
process to ensure group sessions are led by different members each time as well as keeping
track of any jobs/duties they have committed to.

Budget Justification
Miranda Anderson, Jordan Fish, Tim Harker

In order to keep the program running, member participation is crucial as well as staff
supervision for both the planning process and the camping trip. Lack of resources is an aspect
that has prevented a camping trip from happening in the past. For the anticipated costs, Alliance
House would need approximately $3,884 in order to buy the necessary tools/equipment to make
a 20-person camping trip possible. This money is needed due to the more expensive items such
as tents, sleeping bags, camping stove, and coolers. Other items that contribute to the overall
camping experience such as food, water, flashlights, wood, lighter fluid, cleaning materials,
tarps, portable sink, dishes/silverware, water purifier, etc., are all items needed for a successful
camping trip. The budget also includes campsite permit costs.

Sustained for the Future

Alliance House is confident in its ability to continue applying for and budgeting future
grant funding towards sustaining this program. Besides grant support, the program will be
supported by member efforts and sustained interest. The initial costs of planning an annual
camping trip like this will be costlier than future trips due to having to purchase more of the
expensive equipment that can then be stored away for future use. Camping is a leisure activity
that Alliance House members are motivated to participate in, especially because this type of
experience is something that many have never participated in previously. The binder and
electronic files containing the needed information on how to plan a camping trip is another way
this program can be sustained. All of the resources, to do lists, training, safety information,
planning procedures, etc., will help keep this program going every year. In order to make that
happen staff and members will need to set aside time to plan the camping trip accordingly.