Self-help groups Health Article

Introduction

Self-help groups—also called mutual help or mutual aid groups—are composed of peers who share a similar mental, emotional, or physical problem, or who are interested in a focal issue, such as education or parenting. Historically, people banded together to improve their chances for survival by pooling their social and economic resources; however, contemporary groups are more likely to organize around a theme or problem.

Most self-help groups are voluntary, non-profit associations open to anyone with a similar need or interest; however, spin-off groups also exist to meet the needs of particular types of people; for example, the elderly, women, or Hispanics. Usually, groups are led by peers, have an informal structure, and are free (except for small donations to cover meeting expenses). However, professionals of various kinds lead some self-help groups.

In the past thirty years, the number of self-help organizations and groups operating in communities throughout the U.S. has dramatically risen; some organizations operate in several countries, primarily in the developed world. One of the reasons for the rapid proliferation of groups focusing on health problems may be the advent of managed health care. For individuals with insurance plans offering limited mental health coverage, self-help groups are an economical way to find emotional and social support.

Self-help groups and therapy

Because of the peer-led, informal, and democratic (as opposed to hierarchical and medical) structure, health professionals consider self-help groups for mental or emotional problems to be an adjunct to therapy. While there are therapeutic aspects associated with participation—principally, intimacy as a result of self-disclosure, personal growth in response to others' role modeling, and erosion of denial as a result of social confrontation—the primary value of contemporary groups is in the mutual aid offered by members to one another. Though the nature of self-help groups is outside of the medical realm, doctors and therapists see participation as a way to improve the outcome related to either ongoing or future formal treatment.

Another issue arguing against considering self-help groups as a type of therapy is that the variety of groups is extensive; groups available may include advocacy groups with a focus on legal or social remedies, groups organized around housing or employment needs, and groups focusing on racial or gender issues. Additionally, the self-help movement shares some characteristics with volunteerism and consumerism. In general, members who persevere have experience with other voluntary organizations and believe in the value of donating time and service; also, members may be thought of as consumers who participate in their own care and who have experience and knowledge of relevant goods and services.

Twelve-step groups

The most popular type of self-help group is based on the Twelve Steps and Twelve Traditions of Alcoholics Anonymous (AA), founded in 1935. The Twelve Steps are a guide to recovery from alcoholism or addiction, whereas the Twelve Traditions are a code of ethics. AA and other 12-step programs are based on the spiritual premise that turning one's life and will over to a personally meaningful "higher power," such as God or Spirit, is the key to recovery. Another essential idea is that sobriety or recovery (not cure) depends on the admission of powerlessness with respect to alcohol or the substances(s) stance(s) abused. This idea is offensive to critics of 12-step groups, but others believe that this admission accurately reflects the contemporary view of addiction as a disease. Furthermore, people with a familial, genetic vulnerability to addiction are particularly at risk. While some studies suggest that 20% of people suffering from alcoholism will experience remission without benefit of therapy or a 12-step group, most will suffer deteriorating health and dysfunctional, if not ruined, social relationships. In other words, most alcoholics need formal therapy or an informal self-help program to recover. While the dropout rate for AA groups during the first three months is high, alcoholics who persevere have a good chance of attaining and maintaining sobriety or abstinence. This is especially true if the person regularly attends a home group (90 meetings in the first 90 days, slowly diminishing to two or three times per week for years thereafter) and finds an experienced and sympathetic sponsor who also is in recovery.

In addition to AA and its sister organizations, Narcotics Anonymous (NA) and Cocaine Anonymous (CA), a number of 12-step organizations exist for a variety of disorders, such as Gambler's Anonymous (GA), Schizophrenics Anonymous (SA), Emotions Anonymous (EA), and Overeaters Anonymous (OA).