Self-Help and Mutual Aid Groups

International and Multicultural Perspectives

Francine Lavoie, Benjamin Gidron

• Publisher: Routledge
• Year: 2014
• eBook ISBN: 9781317764472
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Here is new information on the development of international and intercultural research on self-help groups. This book reflects the many developments which have occurred in the field over the past decade, emphasizing empirical research. Self-Help and Mutual Aid Groups provides specific research findings and honed concepts to help health professionals learn more about self-help groups and work effectively with such groups. More countries and ethnic groups are now involved in the self-help movement, and this volume increases knowledge of how different cultures react to and participate in self-help mutual aid and how self-help groups can be adapted to fit different racial or ethnic populations. Self-Help and Mutual Aid Groups explores the definition of self-help, the centrality of culture as a major factor explaining variability in self-help, the development of appropriate methodological tools, and the role and involvement of professionals. It brings together different traditions of research for the study of cross- and intercultural and inter- and intraorganizational aspects of self-help groups. Contributors who represent various disciplines, including psychology, sociology, social work, and nursing, discuss:

• a paradigm for research in self-help
• the development of self-help groups in Japan, Hong Kong, and the former East Germany
• the participation of blacks in Alcoholics Anonymous
• the participation of Mexican Americans in groups for parents of the mentally ill
• relationships between self-help groups and health professionals
• predictors of burnout in self-help group leaders
• characteristics of effective groups
• ways individuals change their world view through self-help participationSelf-Help and Mutual Aid Groups is an informative and helpful resource for self-help researchers and teachers, students, and professionals who want to be more effective in their work with self-help groups across cultural and national lines.

Chapter 1

Universal and Particular Attributes of Self-Help:

A Framework for International and Intranational Analysis

Benjamin Gidron

Ben Gurion University of the Negev

Mark Chesler

University of Michigan

SUMMARY. The growth in self-help activity in many countries in the past two decades, brings into focus the international nature of this social phenomenon. The paper deals with both the universal and particular aspects of self-help, and proposes a framework within which to analyze and conduct research on it. In analyzing the universal attributes of self-help, the concept “Community” is used. The use of this concept directs our attention to three internal processes, common to traditional communities and modern self-help frameworks: (1) the development of distinct cultures which shape individuals’ identity; (2) the provision of social support to members, especially during times of crisis; and (3) the empowerment of members.

The paper then turns to discuss the particularistic attributes of self-help. The analysis of the differences among self-help groups focuses on their structural properties. Our analysis divides the self-help phenomenon into three key dimensions along which one can detail its wide variety: (1) the nation, its legal and administrative structure, which defines social relationships and the relationship between individuals and the state, (2) within nations, the different ethnic/racial cultures, which define norms of behavior with kith and kin and the place of individuals within communities and (3) the issues around which groups and organizations are formed.

As the issue at hand was hardly dealt with in the literature, the paper uses as its data base a review of indirect studies on the subject, as well as findings from the authors’ own comparative study of self-help groups in Israel and the U.S.

Introduction

The 1970s and 1980s saw a major expansion in the scientific attention paid to the self-help phenomenon globally, and apparently a significant rise in the occurrence of self-help throughout the world. Several international conferences have included major sections dealing with self-help, and the recent International Conference on Self-Help/Mutual Aid (1992) included sessions with authors from Asia, Africa and South America, as well as Europe and North America. The presentations reflected a varied background of political and social traditions, but they all dealt with aspects of the same “newly discovered” phenomenon. In fact, an international review of self-help published in 1983 already was titled Rediscovering Self-Help (Pancoast, Parker & Froland, 1983). While social historians may speculate on the timing of this development, it is clear that we are dealing with a rediscovery rather than a discovery. This should not be surprising. One of the main theses of this paper is that self-help is based on natural modes of affiliation and bonding between human beings, a form of communal relationship that is both timeless and universal.

Because of the often informal nature of self-help, data about its expansion, and its particular forms, are difficult to obtain. However, many nations now are formulating social policies vis-à-vis self-help, are building coordinating structures to link self-help groups with other support and service systems, and are establishing clearing houses to further facilitate the use of this mode of mutual aid (Katz & Bender, 1990; Leventhal, Maton & Madara, 1988; Madara, 1985; Pancoast et al., 1983; Reynolds, 1982).

The focus of this paper is the international nature of self-help. We deal with both the universal and particular aspects of self-help, and propose a framework with which to analyze and potentially conduct research on this growing phenomenon. Next, we describe the methods used in constructing this analysis and this paper.

We also examine the universal attributes of self-help, some of which have been discussed widely. The recruitment and mobilization of peers in an informal and non-hierarchical setting, and the sharing of their common experiences, are the basic building blocks for almost all forms of self-help, in all nations and cultures. Under these conditions, all members have an opportunity to see their personal problems in a new light, to collectivize and legitimize their understandings and reactions, and to adopt active and empowered roles in coping with life dilemmas. The opportunity not only to receive help from others, but to provide it to others, also is empowering. Thus, self-help reemphasizes the importance and even the indispensability of the human bond among peers as a mechanism of communication around difficult issues, and as a mechanism with healing power. While different groups, and even different forms of self-help, emphasize different aspects of this process, in different ways and degrees, they almost all share this basic paradigm. We conceptualize all these self-help characteristics within the universal social framework of community.

Finally we explore the particularistic aspects of self-help. Our analysis divides the self-help phenomenon along three key dimensions which detail its wide variety: (1) the nation, its politico-economic and administrative structure, and the resultant social relationships and relationships between individuals and the state; (2) the different demographic statuses and ethnic/racial cultures within nations, which define norms of behavior with kith and kin and the place of individuals within communities; and (3) the issues or problems around which groups and organizations are formed.

Different nations have different visions of the proper relationship between individuals and the state, and organize these visions into different legal and politico-economic frameworks. These frameworks, which reflect the dominant culture in a society, help both to give meaning to human experience and to define the ways in which people should act on their experiences. Some societies promote notions of self sufficiency that cause people to rely solely on their own resources in times of crisis. Others promote a view of the general welfare that suggests citizens should look to and rely on the state–on public and formal resource systems–for assistance when they are in trouble. Still others promote a view of reliance upon small groups of kith and kin in such circumstances, and emphasize the importance of families, neighborhood units and other voluntary or informal associations for assistance to people in crisis.

Given the existence of demographic and ethnic or cultural variations within any nation, and the powerful effects of economic and ethnic stratification, within any nation there are various modes of self-help group organization, depending on the specific ethnic/racial culture, and where discriminatory practices exist, different degrees of access to all resources, including self-help groups.

The issues around which groups organize and define their members are: their economic and social location, kith and kin connections, their physical and mental situation, often their age and gender, the chronicity of their situation. The scope of this paper does not permit us to list and examine all the issues around which people organize to form self-help associations; such a list would be several pages long (however, see examples in Katz & Bender, 1990a; Katz & Bender, 1976; Killilea, 1976; Neighbors, Elliott & Gant, 1990; Powell, 1987; Trojan, Halves & Wetendorf, 1986). Suffice it to say, in many nations one can find self-help groups and/or organizations dealing with practically every social, personal or medical problem. Although groups often focus on common problems of economic deprivation or immigration, they also can focus on rare events and diseases, where the incidence in the population is very small or scattered through a wide geographic area. It is under these conditions that the normal economic apparatus or the formal medical or social service network, as well as family connections, are most likely to be inadequate. It also is not uncommon to find several groups focusing on the same (economic, social or personal) problem, either for somewhat different populations (e.g., people with sub-standard housing as well as homeless people, or family members of patients as well as patients), or with somewhat different ideological and programmatic preferences (e.g., economic cooperatives vs. unemployment support groups).

These three major differentiating factors (nation, demographic or cultural group, issue or problem) provide the contexts in which self-help operates, and therefore have major impact on it. The impact is on both: (a) the overall self-help sector in a nation, namely its size, the issues around which groups organize (and others around which they don’t), and their relationships with human service professionals and formal service organizations; and (b) individual groups, in terms of their goals, resources, leadership patterns, organizational structures and activities or programs. The self-help sector in a nation can be large or small, with groups and organizations existing for many or a few issues, with close, loose or no contacts with formal helping agencies and professionals. Individual groups can focus primarily on goals of personal change of their members, or on social change, or on some combination thereof. Leadership patterns vary between groups which are led externally–mostly by professionals, or internally–by one or more members, or by some combination or shared pattern (Mellor, Rzetelny & Hudis, 1984; Borkman, 1990; Yoak & Chesler, 1985). The organizational structures of groups can be formal or informal, with or without elected officers, regular committees, budgetary procedures and rules of operation. Finally, different groups can engage in a variety of programs or activities, including emotional support, education (of members and of the public), advocacy, fund-raising, counselling, etc.

Methods of Inquiry

In preparing this analysis two data bases and methods were used: (a) a synthetic review of the literature, a secondary analysis of prior work, much of which is only indirectly related to the issues at hand; and (b) an analysis of original empirical data from a recent study we conducted.

We conducted a review of the literature on self-help in different nations, with a special focus on those reports that were deliberately comparative. Part of the problem encountered in this review is that there are no studies that examine the same issues, in groups dealing with the same “problems” or “life conditions” in different nations. What we do find are: (1) theoretical, and often quite general and abstract, discussions of the probable impact of different national polities/economies and cultures on self-help processes and groups; (2) case study reports of self-help groups and processes in various nations and cultures, where the reader may extrapolate to internationally comparative conclusions; (3) a few instances of comparative studies of self-help groups and processes dealing with the same problem or condition within a single nation, but across cultural or demographic characteristics. In the absence of truly international comparative studies that are sufficiently well-designed and controlled we do the best we can with the above reports.

We also report here some findings from our own comparative study of self-help groups and processes in Israel and the United States (see Chesler, Chesney & Gidron, 1990; Gidron, Chesler & Chesney, 1991 for details). This study gathered data from self-help groups of parents of children with cancer (U.S.), parents of murdered children (U.S.), parents of persons with mental illness (Israel) and parents in families of new immigrants (Israel). Informants included people actively participating in these groups, as well as some persons experiencing these life crises who had not elected to join a self-help group.

In both countries nationwide convenience samples of groups were used. In the U.S., data were gathered from 111 parents in 8 groups dealing with childhood cancer, and from 104 parents in 5 groups dealing with murdered children. In Israel, data were gathered from 50 parents in 5 groups dealing with mental illness, and from 69 parents in 2 groups dealing with immigration. As a result of our prior study and knowledge of the variety and distribution of these groups (Gidron & Bargal, 1986; Yoak & Chesler, 1985), we are fairly confident that the group population is roughly similar to the national population of groups dealing with these issues.

The major research tool was a self-report questionnaire with structured and open-ended questions about various aspects of informants’ lives and group experiences. The inquiry focus included social background characteristics, access to various types and sources of social support, coping strategies, perceived life-changes over the course of the illness, activities or programs of the self-help group, and benefits derived from self-help group membership. Each of these major areas of concern were assessed via several items and indices, all answered on 3, 4, or 5-point Likert type formats. Most items were selected from prior studies of families in crisis, as well as from self-help group inquiries, and were adapted to the relevant national culture and life condition, as well as language (Hebrew and English). Additional data on groups were gathered via in-depth interviews with a sub-sample of informants, field notes based on visits to local groups and perusals of their meeting minutes, published documents and records.

While we would have preferred to focus this research on similar types of family crises in both nations, problems of access made that impossible. Thus, unfortunately, these data also do not contain international comparisons of groups dealing with the same problem or condition, although they do utilize similar questions and variables with varying groups in the two nations. Thus, although these data, like some of the above literature, may at times approach a comparative perspective, they too fail to provide a well-controlled comparative framework. Because problems of access required the use of somewhat different procedures in the study of these four different types of groups, the data reported in most tables do not represent a single universe. Thus while we provide illustrative comparative data, we cannot provide tests of statistical significance of data drawn from different universes. Once again, we do the best we can. On the other hand, such a design enabled us to highlight the common elements of self-help, regardless of problem-areas and culture.

Universal Attributes of Self-Help: The Community Concept

One of the earliest social frameworks in the history of humanity is the geographic community (the “community of propinquity”). Some researchers relate it to similar frameworks that exist among animals and even plants. The way in which members of a common species cling together, and create a social unit, is prevalent in all cult...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• Preface
• Chapter 1. Universal and Particular Attributes of Self-Help: A Framework for International and Intranational Analysis
• Chapter 2. Participatory Action Research as a Strategy for Studying Self-Help Groups Internationally
• Chapter 3. Self-Help Groups in Japan: Trends and Traditions
• Chapter 4. The Development of Self-Help in Germany’s New Provinces (Former East Germany): The Case of Schwerin
• Chapter 5. Advocacy on Self-Help for Patients with Chronic Illness: The Hong Kong Experience
• Chapter 6. Mexican American and Anglo American Parents of the Mentally Ill: Attitudes and Participation in Family Support Groups
• Chapter 7. Are Twelve Step Programs Appropriate for Disenfranchised Groups? Evidence from a Study of Posttreatment Mutual Help Involvement
• Chapter 8. Understanding Worldview Transformation in Members of Mutual Help Groups
• Chapter 9. Partnerships Between Health Professionals and Self-Help Groups: Meanings and Mechanisms
• Chapter 10. Predictors of Burnout Among Self-Help Group Leaders
• Chapter 11. Social Climate Correlates of Effectiveness in Alliance for the Mentally Ill Groups
• Chapter 12. The Involvement of Self-Help Groups with Mental Health and Medical Professionals: The Self-Helpers’ Perspective
• Chapter 13. Workshop on “Good Practice” in the Collaboration Between Professionals and Mutual Aid Groups
• Chapter 14. Self-Help Group Participation Among People with Severe Mental Illness
• Conclusion
• Index