Chapter 71 Self-help groups
No doctor or health professional can afford to ignore the rise of the self-help movement in the management of illness, disability and social problems. Self-help ranges from the large national organizations, to small, unique, local groups. All have arisen from people wanting to take more control of their lives and responsibility for the management of their illness/disability. Probably the largest and most famous self-help organization is Alcoholics Anonymous (AA) (see pp. 82–83) with its 12-step programme (Box 1). This is a model followed by others, e.g. Gamblers Anonymous, Narcotics Anonymous and Overeaters Anonymous. The concepts behind the 12-step programme have been incorporated into some professionally run services.
Box 1 Twelve steps of Alcoholics Anonymous
Types of self-help groups
Self-help groups divide into two broad categories – those whose aim is to help members and those with a primarily campaigning role, aiming to change public attitudes and policy, although many include both aims.
In the health field, self-help groups exist for practically every condition, whether defined as illness or some ‘deviation from the norm’. There are groups for people with lifelong conditions (e.g. Association of Cystic Fibrosis Adults), chronic medical conditions (e.g. Ileostomy Association), mental health problems (e.g. MIND), and people who define themselves as survivors, whether of the system (e.g. Survivors Speak Out) or of abuse (e.g. Incest Survivors Group). Groups exist for relatives (e.g. National Schizophrenia Fellowship, renamed Rethink in 2002). Other groups exist for those experiencing traumatic life events, including bereavement (e.g. Compassionate Friends).
Functions of self-help groups
Support
The emotional support, acceptance and understanding that come from others in a similar position cannot be overestimated and the importance of social support has been discussed elsewhere (see pp. 136–137). For particularly stigmatized or disadvantaged groups their main source of social contact and friendship may come through such groups. However some people may feel more stigmatized by being expected to socialize with such people, or see it as a sign of weakness. Members of the British Council of Organizations of Disabled People (BCODP), which organizes the Rights not Charity demonstrations, are more likely to view themselves as political than those organizations which do not join.
Role models
Those who have overcome or learned to live with the problem provide a powerful model for others in the same position and can offer a hopeful and optimistic view of the future.
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