重返社區之路：會所模式中的過渡性就業

The Road Back to the Community: Transitional Employment under the Clubhouse Model

曹寶玉(Pao-Yu Tsao)；余漢儀(Annie Hon-Yei Yu)

社區 ； 就業服務 ； 會所模式 ； 過渡性就業 ； 精神障礙者 ； Clubhouse model ； community ； employment services ； people with mental illness ； transitional employment

臺灣社會工作學刊

15期（2015 / 01 / 01）

1+3 - 49

繁體中文

「過渡性就業」是會所獨有的就業服務形式，以臺灣的樂奇會所為田野，研究者就此服務方案有三個提問：（1）過渡性就業的實質內涵為何？（2）會員的使用經驗如何？（3）過渡性就業對會所的意涵？並採取質性研究典範中的參與觀察與深度訪談蒐集資料，研究者從2012 年開始參與會所的工作日、就業晚餐以及醫院傳送過渡性就業職場，前後達15 個月；訪談之有效樣本包含2 位主管、1 位外聘督導、5 位工作人員、及8 位曾在過渡性就業正式上線的會員。最後則以「過渡性就業的實質內涵：彈性擺盪」、「會員的使用經驗：嘗試就是成功」、「過渡性就業對會所的意涵：建立精障社群」分別回應研究提問。研究結果發現，過渡性就業的確能為會員帶來正向的經驗，但受限於外部資源不利於會所模式發展，過渡性就業亦未能得到充分支持，因此建立精障社群的意涵目前並未充分發揮。文末進一步討論就業服務能否回到精障者的主體需要，避免僅成為再製合格公民的工具，這也是會所運動需要持續反思的議題。

Transitional Employment (TE) is a unique form of employment services. With Lerchi Clubhouse in Taiwan as the study field, three questions were proposed by the researcher: First, what was TE? Second, what was the user experience of the clubhouse members in TE? Third, what was the implication of TE to the clubhouse community? With the qualitative research paradigm, participant observation and in-depth interviews were used to collect data. The researcher had participated in Lerchi Clubhouse's work-ordered days, employment dinners, and the TE workplace in the hospital for 15 months since 2012. Two mangers, one external supervisor, and five staff from the service, as well as eight online members who obtained employment through the TE service were interviewed as effective samples. Three research findings emerged as follows. The essence of TE was flexible entrance and exit. Experience of the members was characterized by ＂to try is to succeed.＂ The implication of TE to the clubhouse was establishing community for people with mental illness. It was found that although TE provided its members with positive experiences, due to the fact that external resources disfavored the Clubhouse model, TE also had not been adequately supported. Therefore, the community for people with mental illness had not been fully realized. In order not to become just a tool to reproduce functional citizens, employment services must constantly reconsider the principle need of people with mental illness, which the Clubhouse as a social movement must continue to reflect on.

1. 余漢儀(2009)。從社區復健到社區就業：以台北地區醫院的支持性就業為例。東吳社會工作學報，20，33-62。
   連結：
2. 內政部統計處（2013）。內政統計月報－身心障礙者人數。取自http://sowf.moi.gov.tw/stat/month/m3-05.xls
3. Clubhouse International. (2012). International standards for clubhouse program. Retrieved from http://www.iccd.org/images/2012edition-intl_standards_english.pdf_New%20Logo.pdf
4. International Center for Clubhouse Development (2010). International standards for clubhouse program. Retrieved from http://www.iccd.org/quality.html
5. Anderson, S. B.(1998).We are not alone: Fountain House and the development of clubhouse culture.New York:Fountain House.
6. Bilby, R.(1992).A response to the criticisms of transitional employment.Psychosocial Rehabilitation Journal,16(2),69-82.
7. Chambré, Susan M.(Ed.),Goldner, Melinda(Ed.)(2008).Patients, Consumers and Civil Society.Warrington, UK:Emerald.
8. Cook, J. A.,Razzano, L.(1995).Discriminant function analysis of competitive employment outcomes in a transitional employment program for persons with severe mental illness.Journal of Vocational Rehabilitation,5(2),127-139.
9. Crowther, R.,Marshall, M.,Bond, G. R.,Huxley, P.(2001).Vocational rehabilitation for people with severe mental illness.Cochrane Database of Systematic Reviews,2,CD003080.
10. Decker, P. T.,Thornton, C. V.(1995).The long-term effects of Transitional Employment services.Social Security Bulletin,58(4),71-81.
11. Evans, J.,Repper, J.(2000).Employment, social inclusion and mental health.Journal of Psychiatric and Mental Health Nursing,7,15-24.
12. Greig, T.,Zito, W.,Bell, M. D.(2004).Rehab Rounds: A hybrid transitional and supported employment program.Psychiatric Services,55(3),240-242.
13. International Center for Clubhouse Development(2004).Clubhouse employment manual.:The New York Work Exchange, Coalition of Voluntary Mental Health Agencies, Inc.
14. Jackson, R. L.(2001).The clubhouse model: Empowering applications of theory to generalist practice.Toronto, Canada:Nelson Thomson Learning.
15. King, R.,Waghorn, G.,Lloyd, C.,McLeod, P.,McMah, T.,Leong, C.(2006).Enhancing employment services for people with severe mental illness: The challenge of the Australian service environment.Australian and New Zealand Journal of Psychiatry,40(5),471-477.
16. Lodin, S.(1992).The meaning of transitional employment.Psychosocial Rehabilitation Journal,16(2),85-86.
17. McKay, C. E.,Johnsen, M.,Banks, S.,Stein, R.(2006).Employment transitions for clubhouse members.Work,26(1),67-74.
18. Persson, M.(1992).Transitional employment: The Swedish experience.Psychosocial Rehabilitation Journal,16(2),83-84.
19. Pirttimaa, R.,Saloviita, T.(2009).Transitional employment and its effects in Finland.Psychiatric Rehabilitation Journal,32(3),231-234.
20. Provencher, H. L.,Gregg, R.,Crawford, S. M.,Mueser, K. T.(2002).The role of work in the recovery of persons with psychiatric disabilities.Psychiatric Rehabilitation Journal,26(2),132-144.
21. Schur, L.(2002).The difference a job makes: The effects of employment among people with disabilities.Journal of Economic Issues,36(2),339-347.
22. Tsang, A. W. K.,Ng, R. M. K.,Yip, K. C.(2010).A six-month prospective case-controlled study of the effects of the clubhouse rehabilitation model on Chinese patients with chronic schizophrenia.East Asian Archives of Psychiatry,20(1),23-30.
23. Wang, F. T. Y.,Lu, Y. H.(2008).Clubhouse as a site of social inclusion for mentally ill persons: The experience of Easy House in Taiwan.5th East Asian Social Policy International Conference, Welfare Reform in East Asia: Meeting the Needs of Social Change, Economic Competitiveness and Social Justice,Taipei, Taiwan:
24. 方永泉譯、Freire, P.(2004)。受壓迫者教育學。台北市:巨流。
25. 江明志(2004)。碩士論文(碩士論文)。南投縣，國立暨南國際大學。
26. 陳向明(2002)。社會科學質的硏究。臺北市:五南。
27. 黃佳琦(2009)。碩士論文(碩士論文)。台北市，國立政治大學。

1. 梁瓊宜、呂又慧(2016)。從病人到人─專業關係再建構？精障會所工作者之主體生成歷程。臺大社會工作學刊，33，129-170。
2. 余漢儀(2015)。精神科初診的醫病相遇：醫師會說些什麼？。東吳社會工作學報，29，1-23。