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SchizophreniaNCT07006935

REACH Study (Recovery Environments: Assessing Cognitive & Brain Health in Community Mental Health)

A study testing Clubhouse Model of Psychosocial Rehabilitation for Serious Mental Illness and Usual Community-Based Mental Health Care in people with Schizophrenia and Schizo Affective Disorder, run by Case Western Reserve University at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The purpose of this study is to understand how different types of community-based mental health care affect thinking abilities, daily functioning, and brain activity in adults with schizophrenia and related conditions. Read more about this study

Who is it for?
Ages 18 to 50 years
What is being tested?
Clubhouse Model of Psychosocial Rehabilitation for Serious Mental Illness and Usual Community-Based Mental Health Care
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
1 siteUnited States
Study dates
30 Aug 2026to 30 Jan 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 50 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • (1) have a DSM-V diagnosis of schizophrenia, schizoaffective disorder, or schizophreniform confirmed by diagnostic assessment and medical record review
  • (2) between the ages of 18-50
  • (3) stabilized on psychotropic medication as indicated by no changes to the primary psychiatric medication in the last month
  • (4) able to read and speak fluent English at a sixth grade level or higher for purposes of informed consent and cognitive testing
  • For Clubhouse members, they must be a first-time, newly enrolled member

Who cannot join

  • (1) had previous membership at a Clubhouse (Magnolia or elsewhere)
  • (2) have a current severe substance use disorder
  • (3) have persistent suicidal or homicidal behavior
  • (4) a co-occurring diagnosis of an intellectual or learning disability or neurodevelopment condition (e.g., Autism; based on chart review)
  • (5) had recent psychiatric instability requiring hospitalization in the past month;
  • (6) history of a traumatic brain injury (TBI; based on record review)
  • (7) contraindicators for MRI (e.g., pacemaker, claustrophobia)
  • Participants in the usual care will be excluded if they are a current Clubhouse member or join a Clubhouse during participation in this research

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Jessica A Wojtalik, PhD contact

216-368-1329

reach-study@case.edu

United States1 site, 1 recruiting
  • Case Western Reserve University

    Cleveland, Ohio, 44106

    Jessica A Wojtalik, PhD, 216-368-1329, reach-study@case.edu

    Recruiting

Other trials in United States

About this study

Official title: Pilot Study of the Cognitive and Neurobiological Effects of the Clubhouse Model of Psychosocial Rehabilitation for Schizophrenia and Related Conditions

The purpose of this study is to understand how different types of community-based mental health care affect thinking abilities, daily functioning, and brain activity in adults with schizophrenia and related conditions. The investigators are especially interested in learning whether the Clubhouse Model-a structured, supportive community for individuals with mental illness-has unique benefits compared to standard outpatient mental health services. If participants decide to join, they will be asked to complete a total of six study visits with the research team over the course of your participation. Three of these study visits are at the beginning (baseline) and the remaining three are six months later. Two of the three visits will includes interviews, questionnaires, and thinking and memory tasks (cognitive testing) and one session will be an MRI brain scan, which is a safe and non-invasive imaging procedure. The total time required for each visit will be approximately 90 minutes to two hours. Participants may take breaks as needed.

Being tested
Clubhouse Model of Psychosocial Rehabilitation for Serious Mental Illness, Usual Community-Based Mental Health Care
Keywords
Clubhouse Model of Psychosocial Rehabilitation, Community mental health interventions, Cognition, Brain functioning
Medical subject headings
Schizophrenia, Psychotic Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Clubhouse Model of Psychosocial Rehabilitation for Serious Mental IllnessBehavioural

    The Clubhouse Model (CM) is a strengths-focused, evidence-based, and comprehensive approach to psychosocial rehabilitation for serious mental illness. The CM uses an intentional community of support to create a safe and holistic setting to practice real-world functioning. The core of the CM is the 'work-ordered day,' a concept where members, as opposed to patients, are integral to and needed for the successful daily operation of the Clubhouse. Members choose a 'work unit' each day of attendance. Most clubhouses have four work units, such as (1) Administration (e.g., database management); (2) Hospitality (e.g., Clubhouse cafe); (3) Membership (e.g., employment programs); and (4) Communications (e.g., newsletter). Other unique aspects include its voluntary and humanistic nature, prioritization of member choice, unrestricted and flexible membership, and the elimination of provider-patient hierarchy. The CM has a sophisticated accreditation process based on 37 international standards.

  • Usual Community-Based Mental Health CareBehavioural

    Usual care includes services typically available in the community at mental health agencies, including case management, Assertive Community Treatment, counseling, peer support services, psychoeducational support groups, family support groups, supported education/employment, permanent supportive housing, and medication management.

Study groups in NCT07006935
Study groupRoleWhat they receive
Clubhouse Model of Psychosocial Rehabilitation for Serious Mental IllnessExperimentalThe Clubhouse Model (CM) is a strengths-focused, evidence-based, and comprehensive approach to psychosocial rehabilitation for serious mental illness. The CM uses an intentional community of support to create a safe and holistic setting to practice real-world functioning. The core of the CM is the 'work-ordered day,' a concept where members, as opposed to patients, are integral to and needed for the successful daily operation of the Clubhouse. Members choose a 'work unit' each day of attendance. Most clubhouses have four work units, such as (1) Administration (e.g., database management); (2) Hospitality (e.g., Clubhouse cafe); (3) Membership (e.g., employment programs); and (4) Communications (e.g., newsletter). Other unique aspects include its voluntary and humanistic nature, prioritization of member choice, unrestricted and flexible membership, and the elimination of provider-patient hierarchy. The CM has a sophisticated accreditation process based on 37 international standards.
Receives: Behavioral: Clubhouse Model of Psychosocial Rehabilitation for Serious Mental Illness
Usual Community-Based Mental Health CareActive comparatorUsual care includes services typically available in the community at mental health agencies, including case management, Assertive Community Treatment, counseling, peer support services, psychoeducational support groups, family support groups, supported education/employment, permanent supportive housing, and medication management.
Receives: Behavioral: Usual Community-Based Mental Health Care

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in overall cognitive performance as measured by MATRICS Consensus Cognitive Battery (MCCB)

    The MATRICS Consensus Cognitive Battery (MCCB), which was developed by NIMH as a standardized assessment tool as an outcome measure of cognitive change in intervention trials. This performance-based battery contains 10 field standard, individually administered computer and paper-and-pencil tests of neurocognition (processing speed, attention, working memory, verbal learning, visual learning, and problem solving) and social cognition. The MCCB takes approximately 60-90 minutes to administer. The overall composite score (M = 50, SD = 10) with higher scores indicated better cognitive performance.

    Measured: Baseline and 6 months

  2. Change in functional outcome as measured by Specific Levels of Functioning Scale (SLOF)

    The SLOF is a 30-item self-and/or informant-report measure of interpersonal relationships, social acceptability, community activities, and living and work skills rated on a 5-point scale, with higher scores reflecting better functional outcome.

    Measured: Baseline and 6 months

  3. Change in quality of life as measured by World Health Organization Quality of Life Brief Assessment (WHOQOL-BREF)

    The WHOQOL-BREF is a 26-item quality of life (QoL) measure developed by the World Health Organization of physical health, psychological, social relationships, and environment QoL. Items are rated on a 5-point scale, with higher scores reflecting better QoL.

    Measured: Baseline and 6 months

  4. Change in disability as measured by the 12-item WHO Disability Assessment Schedule 2.0 (WHODAS 2.0

    A brief (12-item), universal interviewer/self-report measure of functional disability that assesses 6 areas (mobility, life activities, cognition, participation, self-care, getting along with others) rated on level of difficulty in the past 30 days with higher scores indicating more disability.

    Measured: Baseline and 6 months

  5. Change in task-based brain activation during functional MRI (fMRI) as measured by the AX-Continuous Performance Task (AX-CPT)

    An NIMH validated fMRI task of goal maintenance (attention) in schizophrenia. This task implements the "A-then-X rule" where participants are instructed to make an index finger button press only when "A" precedes "X" (target trial, 72%) and a middle finger press for all other "non-target" trials (AY: 11%; BX: 11%; BY: 6%) for a total of 4 blocks of 36 trials (144 total). Trials are presented for 500ms followed by a cue (+) presentation for 1000ms (target or non-target response expected) with an interstimulus interval of 2000ms. Instructions and practice trials are embedded. The main contrast of interest for group-level analyses is the high vs. low cognitive load trials (cue A > cue B), with greater fronto-limbic brain activation during high cognitive load indicating strong attention-related brain activation.

    Measured: Baseline and 6 months

  6. Change in task-based brain activation during functional MRI (fMRI) as measured by the Emotional Faces N-Based Task (EFNBACK)

    A modified version of the standard working memory n-back task. This task includes 8 blocks (4 are 0-back and 4 are 2-back) of 12 trials. Each block starts with instructions indicating the condition (0-back or 2-back) presented for 3500ms, which is followed by the target stimulus (letters) flanked by emotional valence distractor conditions (happy, fearful, neutral, or no face) for 500ms, with an interstimulus interval jittered at an average of 3500ms. Blocks with emotional vs. no distractors are randomly interspersed throughout. The main contrasts of interest for group-level analyses are working memory load (2-back > 0-back) and emotion distractor conditions (happy > neutral; fearful > neutral), with greater activation during the 2-back and emotional distractor conditions indicating better working memory and emotion regulation brain functioning.

    Measured: Baseline and 6 months

Secondary outcomes (5)
  1. Change in social cognition (emotion recognition) as measured by Penn Emotion Recognition Task (ER-40)

    Measures the ability to accurately identify different emotions (i.e., happy, sad, anger, and fear) in 40 colored images of human faces with a computer-administered, performance-based, and forced-choice format. Generates a total score of correctly identified emotions, with higher scores indicative of better emotional recognition ability.

    Measured: Baseline and 6 months

  2. Change in social cognition (social inference) as measured by The Awareness of Social Inference Test, part III (TASIT)

    The TASIT is a performance-based assessment that includes 16 short video vignettes (15 to 60 seconds) of social exchanges between actors. After watching a vignette, participants are asked four questions regarding their perceptions of lies or sarcasm in the social exchange. A total score is generated of correct responses, with higher scores indicative of better social inference ability.

    Measured: Baseline and 6 months

  3. Change in social cognition (theory of mind) as measured by the Hinting Task

    Requires theory of mind to infer the genuine intentions of a character's indirect speech to a second character across 10 short stories read by the test administrator. Created as a performance-based measure of theory of mind ability in people with schizophrenia. A total score of correct responses is yielded, with higher scores reflecting stronger ability to correctly perceive the hint of the character's true intention.

    Measured: Baseline and 6 months

  4. Change in functional capacity as measured by he UCSD Performance-Based Skills Assessment, Brief version (UPSA-B)

    The UCSD Performance-Based Skills Assessment is a brief performance-based measure of functional capacity of financial and communication skills. Scores range from 0 to 100, with higher scores indicating better functional capacity.

    Measured: Baseline and 6 months

  5. Change in Self-Efficacy as measured by the New General Self-Efficacy Scale (NGSE)

    The New General Self-Efficacy Scale (NGSE) is an 8-item self-report questionnaire designed to assess an individual's overall belief in their ability to perform well across a variety of situations. Respondents rate their agreement with each statement on a 5-point Likert scale, ranging from 0 (strongly disagree) to 4 (strongly agree). The total score range is from 0-32 with higher scores indicating greater self-efficacy.

    Measured: Baseline and 6 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Jun 2025
  2. Study start30 Aug 2026 (estimated)
  3. Primary completion30 Jan 2028 (estimated)
  4. Study completion30 Jan 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
30 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07006935
Sponsor's protocol ID
STUDY20250623
Status last verified
Apr 2026
First submitted
28 May 2025
Last updated
17 Aug 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Clubhouse Model of Psychosocial Rehabilitation for Serious Mental Illness and Usual Community-Based Mental Health Care in people with Schizophrenia and Schizo Affective Disorder, run by Case Western Reserve University at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 17 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Jessica A Wojtalik, PhD (216-368-1329, reach-study@case.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in overall cognitive performance as measured by MATRICS Consensus Cognitive Battery (MCCB) (time frame: Baseline and 6 months). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Aug 2026.

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