Self-help groups

Self-help and seniors

There are volunteer and self-help access centres in most regions of Canada. The Self-Help Resource Centre of Greater Toronto has documented self-help groups for seniors, put potential members in touch with them, and helped groups get started. Randi Fine, who was the Centre's director for many years, notes that seniors' self-help is often the same as what's offered by other groups. She says that age seems less important than the issue that brings self-helpers together; indeed, goal-specific groups appear more effective than age-specific groups covering a range of concerns.

The range of self-help groups seems limitless. The motto appears to be, "No issue too large or too small." The Self-Help Resource Centre data base lists at least 100 senior-specific groups, including Alzheimer-related support groups, the Older Women's Network, GRAND (Grandparents Requesting Access and Dignity), and groups dealing with addictions, elder abuse, isolation, depression, chronic diseases and many more issues.⁸

And lest anyone think that it's all doom and gloom, there are also groups like the Ulyssean Society, a cultural/social group, and SPRINT (Senior People in North Toronto). Even when groups are dealing with serious issues, they show that humour can be an effective antidote. Take "Totally Hip," an online group for people preparing for hip replacement. Indeed, humour and shared laughter are an essential part of healing for many self-helpers.

Seniors' groups also vary in their structure and method of operation. A survey of one Canadian city found six types of groups operating:

• traditional self-help groups (as defined earlier)
• groups run with the support of professionals or formal service organizations
• groups making the transition from "supported" to traditional self-help groups
• telephone networks
• groups offering peer leadership and counselling by seniors specially trained to provide them
• mutual aid networks.

There are also Internet groups enabling people to converse, gather information and provide mutual aid through electronic conversation. These may be especially helpful for people who feel uncomfortable or pressured in groups, who live far away from where a group meets, or who find it difficult to get out of the house.⁹ Many seniors could benefit if they have the necessary computer access and skills.

Peers or professionals?

Many seniors' support groups include professional involvement. This seems to be for several reasons:

• The issues being dealt with may be medically and socially complex, requiring a variety of resources to be brought to bear.

• Professionals may be in a better position to form a group because they are more likely to encounter the requisite number of patients or clients with similar needs.

• Professionals can help overcome barriers to a group getting started – lack of awareness, the isolation of potential members, some of whom may have mobility difficulties, the need for meeting space and other facilities.

But can a support group organized and/or led by a professional (a doctor or nurse, a social worker) meet the test of being a "true" self-help group? Many self-helpers argue that disillusionment with traditional health and social services is what led them to a group in the first place. Some groups actually make change or reform in these systems part of their raison d'être.

Self-helpers are also concerned that "professionalization" of a group reduces the opportunities for "real" self-help by shifting the emphasis away from emotional support, experience-based advice, and consideration of alternatives to "traditional" types of treatment or care. Some professionally led groups charge a fee and are offered over a limited period of weeks or months. This, too, critics say, is contrary to the "self-help way."

These concerns are no doubt behind a growing literature of advice for professionals on how to work with groups. The Self-Help Resource Centre, for instance, has a pamphlet outlining 10 steps for professionals thinking about developing a group.

If the general tenor of the advice can be summed up in a single phrase, it is "Professionals – on tap, not on top." The phrase was coined by Andrew Farquhason, a professional who has worked with the self-help community for many years and who believes peers and professionals have distinct kinds of knowledge and expertise to contribute.

The bottom line? There is room for both "traditional" self-help groups and those with professional involvement – and many variations in between. Their benefits for health alone – improved health status, healthier behaviour, less use of health services – are enough to support the idea of partnership between self-helpers and professionals. These groups could be important ingredients of reform and renewal in Canada's health system.³