Self-Help Groups

Self-help groups consist of individuals who share the same problem or concern. Group members provide emotional support to one another, learn ways to cope, discover strategies for improving their condition, and help others while helping themselves. Self-help groups, also referred to as support groups or mutual help groups, are cost-free, voluntary groups that have no limit as to how long a person can attend. Self-help groups rely on the experiential knowledge of members, as everyone has valuable contributions based on their unique experiences. Self-help groups encourage personal responsibility and self-care, with most self-help groups having one or more of the following three basic functions: (1) providing social support for members so that they can overcome life-disrupting problems through mutual support and assistance; (2) providing education about the problem or concern the group addresses, often through presentations from health and mental health professionals and materials obtained at group meetings; (3) providing advocacy for bringing about social and/or personal change to improve conditions for those who face the same issue or problem.

While the most widely recognized self-help group is Alcoholics Anonymous, there are groups available for nearly every concern and problem. Self-help groups are available for addictions; physical illness and health; parenting, family, and youth; disability; grief and bereavement; mental illness and health; emotional, physical, and sexual abuse; widowhood; divorce; and pregnancy, childbirth, and fertility concerns.

Research estimates that more than 25 million Americans have been involved in self-help groups at some point during their lives and as many as 10 million have attended a group in the previous year. As self-help groups have gained popularity, they have increasingly come to be recognized as an emerging social movement. Over the past half century, self-help groups have become a prominent component of healthcare systems across the world. Yet, because of their grassroots nature, the growth of self-help groups has primarily been through word of mouth. The growth of self-help groups can likely be attributed to a number of reasons, including greater recognition of the unique benefits self-help groups, growing acceptance and use of alternative therapies and approaches across the United States, and limited access to health and mental health professional services.

A growing body of research and literature suggests that self-help groups are an effective and efficient complement to traditional health and human services. The benefits of self-help groups are well documented in these studies. The benefits include improved patient/client outcome, greater social and emotional support, and higher levels of personal satisfaction. Additional benefits include a better understanding of the disease or concern leading to better decision making; lower unnecessary dependence on the healthcare system; and improved access to health care.

A number of reasons have been offered suggesting why self-help groups work for those who attend. These reasons include:

Instant identity. Recognizing that there are others who face the same situation or problem
Empowerment. Being able to meet the challenges and concerns using their own strengths and abilities
Mutual self-disclosure. Sharing with one another about their experiences
Helper-therapy principle. Growing stronger through the process of helping others
Social role models. Noticing that others who have experienced the same situation, issue, or problem are in a better position and able to cope
Shared ideology. Creating a new understanding of the situation, issue, or problem based on shared experiences

Self-help groups have increasingly come to be viewed as dynamic and complex social groups. While the 12 steps of Alcoholics Anonymous continue to be the most widely recognized model, self-help groups are growing in their diversity, with differences in their structure, mission, and focus. Many self-help groups meet in churches, hospitals, or individual members’ homes, with little external support or prescribed structure. Other groups have developed into nationally recognized nonprofits with sophisticated structures and political power (e.g., National Alliance for the Mentally Ill). Similar to other community-based programs and services, most self-help groups do not simply exist without outside factors contributing to their development. Previous research has found that many self-help groups have some type of formal relationship with either national self-help organizations, local agencies, and/or professionals in their community.

Professional Involvement in Self-Help Groups

Health and human service professionals are increasingly aware of and involved in assisting self-help groups. The extent of professional involvement in self-help groups ranges from groups with no involvement to those that have a professional actively involved in group meetings. Many professionals, particularly counselors, have supported the self-help group movement. The ideas and principals of self-help groups are consistent with those of counseling, including a strength-based approach, recognition of participants’ experiences, and empowering others. At the same time, the dilemma faced by counselors is the extent to which they should be involved in self-help groups, and in particular how they can support people starting self-help groups. Professional therapists, counselors, and health and human service professionals can support self-help groups in a number of ways as described below.

Referrals to Self-Help Groups

Self-help groups’ primary needs are public awareness and new members. Health and human service professionals are “gatekeepers” to many individuals who could benefit from participation in a self-help group.

Forming a Core Group of Leaders

One of the most important roles a counselor can play is to encourage the development of shared leadership in new self-help groups. When someone expresses interest in starting a group, counselors might suggest finding others who would be interested in helping. Several people contributing to the development of a group creates shared responsibility for the group and clarifies its purpose. One of the tenets of self-help groups is shared leadership, which has also been found to predict successful groups. Perhaps most importantly, the organizational tasks of the group are no longer the responsibility of one individual, thus decreasing the potential of the leader’s experiencing frustration and burnout.

Setting Realistic Expectations

Group founders are motivated to start groups because they want to help others and believe that self-help groups provide the type of help that is needed. Yet, starting a group also involves a number of organizational tasks. Potentially, there is incongruence between founders’ expectations for starting a group and the reality. Counselors are in a position to help founders recognize that starting a group involves both help giving and receiving, as well as organizational aspects. In many cases, it takes up to 6 months for a group to form and have regular group meetings. Counselors can help founders to have more realistic expectations as the group develops.

Assisting With Organizational Tasks

Several discussions prior to group meetings can be useful to clarify hopes, purpose, and format.

Counselors’ skills match nicely with helping facilitate these meetings without becoming the group leader. Regular discussions regarding the direction of the group can also be useful, as members have an opportunity to express their opinions about group topics, speakers, and structure.

A second organizational task identified by self-help group founders was finding adequate meeting locations. Counselors often are knowledgeable about accessible, cost-free meeting locations. With a limited amount of effort, counselors can suggest to founders a number of meeting locations, allowing them to decide which would fit their needs.

Connecting With Groups and the Local Community

Counselors are very knowledgeable about community resources. Self-help groups represent another resource for counselors’ clients and patients. By maintaining information about self-help groups, counselors can help new groups by referring clients and patients.

Strong relationships with community organizations and professional gatekeepers can help newly developing groups receive much-needed referrals from other sources. Counselors are particularly well suited for helping group founders make these connections due to their knowledge of local social services, organizations, and professionals.

Self-help groups are a useful complement to the services of health and mental health professionals, providing participants with opportunities to learn, grow, and help others. These groups are effective in improving the outcomes of participants, especially considering that they are free.

References:

Kessler, R. C., Mickelson, K. D., & Zhao, S. (1997). Patterns and correlates of self-help group membership in the United States. Social Policy, 27(3), 27—46.
Kyrouz, E. M., Humphreys, K., & Loomis, C. (2002). A review of research on the effectiveness of self-help mutual aid groups. In B. J. White & E. J. Madara (Eds.), American self-help clearinghouse self-help group sourcebook (7th ed., pp. 71-85). Cedar Knolls, NJ: American Self-Help Group Clearinghouse.
Powell, T. J. (1990). Differences between national self-help organizations and local self-help groups: Implication for members and professionals. In T. J. Powell (Ed.), Working with self-help. Silver Springs, MD: NASW Press.
Schubert, M. A., & Borkman, T. J. (1991). An organizational typology for self-help groups. American Journal of Community Psychology, 19, 769-787.
Shepherd, M., Shoenberg, M., Slavich, S., Wituk, S., Warren, M., & Meissen, G. (1999). The continuum of professional involvement in self-help groups. Journal of Community Psychology, 27, 39-53.
White, B. J., & Madara, E. J. (1998). The self-help sourcebook. Denville, NJ: Northwest Covenant Medical Center.
Wituk, S., Shepherd, M., Warren, M., & Meissen, G. (2002). Key ingredients contributing to the survival of self-help groups. American Journal of Community Psychology, 30, 349-366.