A group therapist perspective on self-help groups

The author provides an overview of self-help groups in terms of their origins, growth, scope, and effectiveness, and then compares these groups with professionally conducted psychotherapy groups. A framework for evaluating group helping systems is proposed which includes five principal dimensions: the helping group as a social microcosm; technological complexity/simplicity; psychological distance/closeness between helper and helpee; specificity/generality of help methods; and differentiation versus nondifferentiation among participants. The author concludes his article by recommending four strategies for how group therapists can contribute to self-help groups.     

Meta-analysis of medical self-help groups

Self-help groups (SHGs) may rival all other forms of treatment sometime within the next century (see Goodman & Jacobs article in "The Handbook of Group Psychotherapy," Wiley, 1994), though the "purist" model of SHGs seems inaccurate because many professionals are actually involved. Although traditional forms of group treatment have kept pace with empirical research (Fuhriman & Burlingame, "The Handbook of Group Psychotherapy," 1994), SHGs have not. In particular, medical SHGs, often promoted by hospitals as viable treatment alternatives, have no systemized database from which to draw conclusions about overall effectiveness compared to traditional group therapies. A preliminary assessment of this area is presented using a meta-analysis of articles culled from a comprehensive review of the literature from 1970 to 1997. Results indicate that although the posttreatment analysis produced no significant differences between active and control conditions, pre to posttreatment scores indicated that SHGs produced higher patient improvement when compared to the control condition. Future implications for research and use of medical SHGs are explored.     

An organizational typology for self-help groups

Conclusion Several continuing obstacles have hindered the compilation of a research-based body of literature on self-help groups. Among them are the diversity of the groups and the need for appropriate research methodology. The validated typology described above was designed to address some of these problems. It provides a means of recognizing the diversity of the groups and sorting them into broad types without stating that one is better or more productive than another. It supplies a framework for examining the organizational features of a group in order to facilitate comparison with other groups. It recognizes the potential effects of time, change, and leadership on the small local units of self-help organizations. It has implications for making research more compatible with self-help groups. The use of this typology might eliminate some of the ambiguity and conflicts currently found in the literature and thereby help people — professionals and self-helpers — to more clearly understand the nature and functioning of self-help groups.     

Leadership skills and helpful factors in self-help groups

The effects of training on leadership skills and group processes in cancer and anorexic self-help groups are investigated. Three components of the study are reported. Firstly, an observational case-study of each type, of group was conducted to investigate the nature of the leadership input. Secondly, a Self-Help Questionnaire based on Lieberman's classification of leadership skills was administered to members of eight self-help groups to compare the experiences of groups with trained and untrained leaders. Thirdly, group members completed a Helpful Factors Questionnaire based on Yalom's analysis of group processes. The observational case-study revealed significant differences between the trained and untrained leaders in that, unlike the trained leader, the untrained leader clearly dominated the group. Results from the Self-Help Questionnaire showed that trained leaders scored higher on Caring and Emotional Stimulation but lower on Attribution of Meaning. Member satisfaction, however, was similar in the two types of group. Results from the Helpful Factors Questionnaire showed that most of the helpful factors were seen similarly by the two types of group, though differences were found concerning the relative rankings of both Guidance and Altruism. It is concluded that some degree of training of group leaders could be usefully incorporated into the self-help movement.     

Alcohol recovery in self-help groups: Surrender and narcissism

This study was designed to determine if subjects participating more actively in Alcoholics Anonymous (AA) were higher on surrender and lower on pathological narcissism than those less involved in AA or participating in Rational Recovery. Male subject groups scored as predicted on surrender. As hypothesized, surrender also correlated negatively with pathological narcissism and was not associated with nonpathological narcissism. Results failed to support the predicted relationship between levels of participation in AA and pathological narcissism. A sex difference was found both on pathological narcissism and on surrender. Females scored lower on narcissism and higher on surrender than males.     

Factors contributing to the survival of self-help groups

Despite the growing utilization of self-help groups, there have been only a handful of studies that have examined the factors that contribute to their survival. The purpose of this study was to explore the factors that contribute to self-help group survival by examining their relationship with external sources (i.e., national and local self-help organizations, professionals) and group organizational characteristics (i.e., leadership diversification, recruitment, attendance at group meetings). Representatives from 245 active and 94 recently disbanded self-help groups were included in the analysis. Results indicated that the primary factors that discriminated between active and disbanded groups were the number of new people to attend a meeting, average group meeting attendance, length of existence, leadership diversification, outreach to potential group members, and support from national and local organizations. Results are discussed in terms of what national self-help organizations, self-help clearinghouses, and others who interact with self-help groups can do to empower and support them.     

Group psychotherapy with alcoholics: Interface with self-help groups

This paper addresses recovering alcoholics' concurrent involvement in psychotherapy groups and self-help groups. A developmental model of alcoholism group psychotherapy is presented, differentiating between early and advanced sobriety. Psychotherapy and self-help groups are compared and contrasted. Multiple group membership entails various areas of compatibility. Divergence and conflict result from differences in underlying conceptual framework and approach. Clinical implications of members' involvement in partially discrepant group settings are explored with an emphasis on transference and countertransference reactions. Multiple group membership is identified as a salient factor in alcoholism group psychotherapy at all levels of recovery.She is also in private practice.This paper was presented at the American Group Psychotherapy Association Annual Conference, Boston, February 1990.     

Surveying the drug service users' perspective through self-help groups

Survey data is presented from a questionnaire designed and distributed through Victorian drug self-help groups. This survey yielded 203 returns representative of Melbourne metropolitan admissions to drug treatment services on the variables of sex and region. The survey is examined both from the perspective of its methodological potential for providing entry to this hard-to-access population and also on the basis of its findings. Questioning of this sample concerning the difficulties they had encountered when seeking help revealed that the most frequently listed difficulties were waiting periods for access to services. Respondents that had previously used particular services were asked how beneficial they had found these services: Respondents most frequently listed self-help groups, residential and methadone services as beneficial and least frequently listed medical (hospital casualty) and doctor services as beneficial. Stepwise logistical regression revealed six variables significantly predicting selfhelp treatment. Those reporting having sought self-help groups were predicted by more frequently listed problems with alcohol and ‘over the counter’ drugs, reports of having sought counselling services and more frequently reported difficulties due to a lack of information and admission restrictions when seeking services. Despite a number of methodological weaknesses identifiable in the survey, experience with this project suggested collaboration between researchers and those active in self-help networks as a useful model for future research into the drug service users perspective. Such collaboration should, however, begin at an earlier phase than occurred in the present study.     

Alternative professional roles in health care delivery: leadership patterns in self-help groups.

The increasing professionalization of health care delivery systems, improved client awareness, funding cutbacks, and an emphasis on voluntarism have led recipients of health services to turn increasingly to self-help groups. This article examines the leadership and organizational pattern of such groups, using a study of 43 self-help groups from around the U.S. whose members are parents of children with cancer. Three leadership patterns emerged: groups were independent and parent-led, were led by professionals, or had a shared leadership of parents and professionals. Data indicate that the professionally led groups were the smallest, least formal, and had the narrowest range of activities. The groups with shared leadership had the greatest longevity, tended most often to retain as members parents of deceased children. The authors conclude that such coalitions of clients and professionals are vital for ensuring proper service delivery at a time when health care systems will likely remain bureaucratic and public resources for professional care are being reduced.     

Effectiveness of self-help and support groups for cancer patients: A Review

Abstract

Following the recognition of the psychological difficulties faced by cancer sufferers, there has been a rapid growth in forms of group help. There is a wide variety of types, and nomenclature is far from consistent. Evaluation studies are reviewed, and issues of potential harmfulness are considered.     

Professional involvement in self-help groups for parents of high-risk newborns

Patterns of professional involvement and control in self-help groups were studied through a questionnaire completed by representatives of 63 self-help groups for parents of high-risk newborns located throughout the United States. Results indicated that when professionals began a group, they were likely to continue to maintain control over it. Groups controlled by professionals were more likely to utilize professional counseling as a form of support and less likely to provide outreach services to parents following hospital discharge of their infants. Group stability, growth, and innovation were associated with more consultation between parents and professionals in the planning process.     

The Future of Social‐Health Psychology: Prospects and Predictions

Social‐health psychology has made substantial contributions to health psychology and is poised to make many more in the future. Some new developments will come from empirical progress in theoretical and empirical social psychology that can elucidate the psychological mechanisms whereby social variables affect health. Others will come from technological advances, such as functional magnetic resonance imaging, that will uncover mechanisms that underlie effects of stress, coping, persuasive communications, and other factors on health. Progress will also come from social psychologists’ increasing comfort with biological processes and measures, including genetics and neuroendocrine mechanisms. As such, social‐health psychology will not only continue to enrich both health psychology and social psychology, but increasingly be able to speak to intervention possibilities. Moreover, by virtue of its emphasis on psychobiological mechanisms, social‐health psychology leads the way for an expanding role of social psychology in the integrative science of the future.     

Group properties and outcomes: a study of group norms in self-help groups for widows and widowers

Despite the nearly universally shared agreement among group therapists about the importance of group norms, empirical studies have rarely demonstrated a positive relationship between specific norms in psychotherapy groups and patient benefit. The study explored this relationship by examining the linkages between norms, a specific therapeutic process, and patient outcome. Examined were seventy-two spousal bereavement groups. Subjects' responses to a thirty-one item behavioral inventory were used to define norms; outcomes were based upon Time 1/Time 2 differences on a series of eleven measures indexing depression, anxiety, somatic symptoms, abuse of psychotropic medication, coping mastery, well-being, self-esteem, target problem rating, several measures of role stress and strain, and stigma. The findings suggest that normative characteristics were linked to a process, reciprocal social exchange, that influences positive outcomes. The results are preliminary, since they only serve to demonstrate such a relationship can exist.     

Professional support of self-help groups: a support group project for Chronic Fatigue Syndrome patients

Professionals are involved in self-help groups in a variety of roles as advising experts, facilitators and even as group leaders. A few studies focus on attitudes toward professional involvement, but very little is known about the nature of this collaboration. The study follows a collaborative support group project between a team of health professionals at a regional hospital in Norway and a Chronic Fatigue Syndrome patients' group. It is arguably an advantage for professionals to decide upon the aim of a joint intervention in dialogue with the participants, but simply asking the participants what their aims are does not guarantee actual agreement. As this case study demonstrates, participants may have reason to conceal their objectives.     

Researching self-help/mutual aid groups and organizations: Many roads, one journey

Self-help and mutual help groups are defined and the status of the literature described and reviewed. Self-help groups are different from peer and nonprofessional services under the supervision of professionals. Controlled studies of mutual help groups may be neither possible nor desirable as the method of choice by which to understand the phenomena of interest. Other approaches to research, including worldly evaluations, and ways of construing self-help organizations, that is, as normative communities and political action organizations rather than as psychological treatments, are discussed, and suggestions for future research are presented.