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The Self-Help Way Mutual Aid and Health
Jean-Marie Romeder with contributions from
Hector Balthazar
Andrew Farquharson
Francine Lavoie

Canadian Council on Social Development Ottawa/Montreal

Foreword
Throughout my years as a medical practitioner, and through first-hand experience, I have come to appreciate the value of self-help and mutual aid for coping with health problems and crises. The sharing of common experiences through mutual help groups, particularly if there has been great hurt or suffering, unleashes something very special in the way of healing, as people who have known its effects will attest. Society in general, and human services personnel in particular, have much to learn about what can be accomplished through self-help/mutual aid. Today, the self-help movement is burgeoning and its growth gives promise for the day when the self-help way will be accorded the respect it deserves as one of many established helping methods. In the meantime, every effort must be made to support and nourish the development of a genuine partnership between the health, social services, and self-help communities. In the end, it will mean that all who seek help in society will be better served.

To self-helpers, there is still serious work to be done to get professional associations in the human services to recognize self-help as an important element in the range of helping methods. Many professionals still believe that self-help is nothing more than the blind leading the blind. To them, transformation, change, and healing are the prerogative of an elite who possess knowledge and techniques bestowed by specialized training institutions. It is difficult for these professionals to realize that the blind can indeed lead the blind. Not surprisingly, in a society that places so much emphasis on structured training, professionals all too often relegate the benefits of shared experience to a position of relative insignificance, without sufficiently recognizing the major role it plays in human behaviour and motivation.

But there is reason to be hopeful; many professionals have "crossed the Rubicon," as it were. Some have played key roles by helping to found major self-help groups. Others have learned that very special skill of being able to help groups who want help, while respecting the group's evolution and autonomy. Vanguard teaching professionals have introduced the study of self-help into professional training schools through behavioural science or other courses. There are also professional researchers and writers on the subject who genuinely understand self-help and whose activities have advanced the self-help movement.

There are also important economic reasons why self-helpers and professionals should coordinate their efforts to help people. Society is changing at a very rapid rate, creating havoc in the lives of many. There is an increasing demand for services, yet budgets and human resources are not expected to be able to meet all of these new demands. But with dialogue and mutual understanding about how people in need can best be served, those who need help will not fall by the wayside. Professionals who understand self-help can properly refer people to self-help groups, and self-helpers who understand when professional guidance is needed can suggest it to their group members, so that people get the help that is most appropriate for them. A partnership between traditional professional care and the self-help movement can provide a superior service.

For the general public, to whom this work is also addressed, this book can serve as a map, a primer introducing the many facets of self-help. Not enough has been written on this subject for general consumption. It is an excellent means of reaching those for whom the written word is the preferred medium.

This book touches on many issues of central importance to the promotion of self-help. Its appeal to the general public and to professionals makes it an important addition to the general fund of self-help resources. I am particularly pleased that a network be-tween Canadian and American self-help clearinghouses has been established. There are mutual benefits in such arrangements that are sure to strengthen the self-help communities in both countries. This may, in turn, lead to more formalized links with self-help organizations in other countries, a step that would add an international dimension to the whole field of self-help/mutual aid.
C. EVERETT KOOP, MD, ScD


Preface
This short book on self-help groups was written for the general public. It is intended primarily for people who are thinking of joining a self-help group because they are facing serious difficulties or because someone close to them is in that situation. The book is also for people who already belong to self-help groups, or who are close to someone who is a member.

The work is intended for a third audience as well- professionals in health and social services who know little about self-help groups but who want to increase their knowledge, if only to be able to refer some of their clients to appropriate groups. Most of these professionals (or students) work in disciplines such as social work, nursing, medicine, psychology, psychiatry and physiotherapy.

Readers will discover the general underlying principles on which mutual aid and self-help groups operate, the role of mutual aid in personal health, the diversity of groups, and the importance of the self-help movement in North America. At the same time, 'readers will be introduced to some more general or theoretical considerations in chapters 4, 5 and 7.

This book offers a summary of current knowledge in the field of self-help/mutual aid, expressed in the most straightforward manner possible and inspired by my own observations of self-help groups and the writings of numerous authors and researchers. To describe the nature of self-help groups, I have presented a minimum number of concepts and have tried to be clear and concise.

Thus, in Chapter 3, after focusing on three key characteristics of mutual aid, a new definition for self-help groups is proposed. Chapter 4 outlines a theory of motivation for mutual aid that gives readers a better understanding of the forces and dynamics at work in the mutual aid practised in self-help groups. In Chapter 5, my concern with establishing mutual aid as an option to which a person with health problems can turn led me to propose a model of personal health.

When health is discussed in this book, it is in no way limited to a notion of individual health focused purely on the physical aspects of health. In fact, self-help groups are generally more concerned with psychological distress than the physical pain associated with a crisis or chronic health disorder. Thus, personal health encompasses psychological and social elements, including our perception of ourselves and our relationships with others and with the society in which we live.

Chapter 6 examines the sources of reluctance many people have to self-help groups and the way one can overcome them.

Chapter 7, by Francine Lavoie, provides an informative overview of numerous studies on self-help groups. It focuses on three specific aspects of self-help groups -- activities, helping factors, and ideologies. It also provides a good summary of research findings on the five main helping factors.

In Chapter 8, Hector Balthazar provides an overview of the activities that have lent support to the self-help movement, a movement whose origins are in North America. As one of Canada's principal advocates in this field, he describes a number of activities undertaken by members of self-help groups and various professionals, activities which governments have now started to support. In particular, we find a good description of the different types of self-help clearinghouses that have been developed in the United States and, more recently, in Canada, as well as a description of the crucial role these clearinghouses play in sustaining the movement.

In Chapter 9, Andy Farquharson presents his observations on the similarities and differences between the activities of members of self-help groups and those of professionals. He offers suggestions to self-helpers for drawing maximum benefits from the full potential of their groups while recognizing when to call upon professional help.

The limitations and risks of self-help groups are dealt with briefly in the concluding chapter, which also includes some reflections on the future of self-help groups.

Readers familiar with mutual aid, whether through friends or relatives or through their own involvement in various groups or associations, may wonder why we are paying such detailed attention to an activity that is so widespread. Everyone is involved in some form or other of mutual aid. In fact, mutual aid, as practised in self-help groups, differs somewhat from other forms of mutual aid encountered in everyday life. This is why we refer to it as self-help/mutual aid.

Self-help can mean either helping oneself without the assistance of others or helping oneself with the assistance of others. In this book, we focus on the second meaning, as it occurs in self-help groups. This explains why some have characterized the benefits of self-help groups as follows: "In self-help, you get help, you give help, and you help yourself."
JEAN-MARIE ROMEDER
 

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