As its base, this model has an intentionally-created working community to which members belong. There, members are needed, and they have the opportunity to build their self-efficacy, motivation and relationships. In short, Fountain House is a place where, at their own pace, members can build confidence and acquire the interpersonal and work skills necessary to find a sense of purpose and fulfillment in the general community.
Yet no course on the Fountain House model or its practices exists in any university or department teaching prospective social workers or psychiatric rehabilitation counselors or, for that matter, ANY prospective helping professional. Why?
To help discover an answer to this conundrum, I posit the notion that the creation of the Fountain House model by John Henderson Beard was the result of his ability to think "outside of the box." Thinking "outside of the box" in developing programs for people with mental illness, I believe, means a focus on satisfying their real needs by incorporating new professional skills in the program plan or utilizing old professional skills, practiced in a new way.
Based on my forty-five years in the field, programs that most planners create to help at-risk client groups - including people with serious mental illness - are usually the result of "in the box" thinking which utilizes professional skills that are consistent with graduate school training courses. I have further observed that these programs have the effect of creating a comfortable working environment for staff but do not always meet the comprehensive needs of the people they are intended to serve.
On the other hand, an "out of the box” program has problems, too. Since it requires new ways of doing things, some professionals exposed to these practices experience discomfort and even question the program’s professionalism. I'm speculating that, as a way to handle this discomfort, they label the new "out of the box" program, as adjunctive. An adjunctive status label quiets their concerns, because it implies that there are other programs in existence, consistent with university training, that represent the major thrust in the effort to assist the seriously mentally ill in the community. A program labeled as adjunctive is a semi-professional supportive element of that effort.
The “adjunctive” program may be mentioned in graduate schools, but its underlying theories are not taught in university departments. The new skill set that this new program requires is not taught, not only because the program’s status, but also because no professors are adequately trained in its methodology. As a result of this somewhat negative circularity, the “out of the box” program must develop extensive, expensive, and time-consuming in-service training programs for new staff, and it must depend on the word of mouth praise by clients and their families for support, growth and development.
Even when, as in the case of Fountain House, an “out of the box” program is successful in meeting the needs of an at-risk group of people, is praised by clients and family members, and is replicated in the US and around the world, professional schools are still incapable of overcoming the erroneously assigned adjunctive status label. It’s doubly galling to me that these academics somehow feel that they then have the right to criticize a program about which they know little.
So far, I have come to the conclusion that the Fountain House social practice has been excluded from academia because its methods and practices are not widely understood. Professionals trivialize it as a treatment modality, categorizing it is as adjunctive to the “real” treatment of seriously mentally ill adults.
However, there must be another reason for Fountain House’s exclusion. I’ve been thinking long and hard on this question, and I’ve come to the conclusion that, regardless of effectiveness, any program that does not have an office-based, one-on-one or group counseling process of some sort at the core of its design, will be forever considered adjunctive. That’s what is taught, that’s what is considered professional, and that’s what makes traditional workers comfortable.
Consultant, Education and Wellness, Fountain House