Accessibility and economy are appealing features of self-help groups. Since the groups are free, organizations such as AA and NA are very cost-effective. In addition, meetings are easy to locate through local newspaper announcements, hospitals, health care centers, churches, school counselors, and community agencies. For AA and sister organizations that encourage frequent attendance, hundreds of meetings may be held each week in large metropolitan areas. Furthermore, with the proliferation of online support communities and growth of connectivity to the Internet, self-help groups are becoming as accessible for individuals in rural areas as they are for those in large cities.
^ An important characteristic of 12-step groups is the a. preservation of anonymity by revealing first names only j= and by maintaining strict confidentiality of stories shared during meetings. Online self-help groups offer even more ^ anonymity since the exchanges are not face to face. The virtual anonymity of online experience helps to reduce social discomfort and discrimination, or stereotyping otherwise associated with real-life perceptions of age, disabilities, race, gender, or culture.
Self-help groups provide an intact community and a sense of belonging. The social support and mutual aid available in a group may be critical to recovery, rehabilitation, or healthy coping. This is especially true for socially isolated people or people from dysfunctional families, who may have little or no emotional support. Participating in a social network of peers reduces social and emotional isolation and supports healthy behavior. Group members can offer unconditional support and, collectively, are a repository of helpful experiential knowledge.
Self-help groups promote self-esteem or self-respect by encouraging reciprocal caring; the concept of self-efficacy, or the belief that one is capable, is promoted by reinforcing appropriate behavior and beliefs and by sharing relevant information regarding the disease or condition. For example, there may be an exchange of information regarding how to cope with failed or disrupted relationships, about what is reasonable to expect from health care professionals, about how to manage pain or public embarrassment, about where to go and to whom for a variety of needs. In groups such as AA, self-efficacy also is promoted by sponsors who act as mentors and role models, and by encouraging rotating leadership roles.
Introspection, or contemplation, is another fundamental feature of many self-help groups, particularly for groups that follow a 12-step program of recovery. For example, the fourth step of AA states that members make "a searching and fearless moral inventory" of themselves, and the tenth step states that members continue "to take personal inventory" and admit wrongdoing. Introspection is particularly beneficial to individuals who are not entirely aware of the moral repercussions of and motivation for their behavior. In a sense, working through some of the 12 steps resembles the cognitive restructuring learned in cognitive-behavioral therapy (CBT), as maladaptive ideas and behaviors are transformed.
The final step in a 12-step program recognizes that recovery entails a spiritual awakening; furthermore, recovering addicts are enjoined to spread the message to others suffering from addiction. Recovery depends on giving up both injurious self-will and denial of maladap-tive behavior, and turning to a higher power. Members are urged to seek guidance or inspiration from this higher power. For many addicts, the key to recovery is a spiritually guided movement away from self-centeredness or self-absorption, and a turning towards the "Power greater than ourselves" through prayer and meditation.
Some self-help groups meet to advocate or promote social and legislative remedies with respect to the issue of concern. For example, HIV/AIDS groups have lobbied for improved access to prescription drugs. Groups lobby for reforms by identifying key legislators and policy makers; they submit papers or suggestions for more equitable laws and policies to these key people. They also conduct public education programs (including programs meant to redress the harm of stigmatization). There are groups that advocate for more funds for research and for improved services for people who suffer from one of many diseases or mental disorders. The most important grass roots organization of families and consumers of psychiatric services (former or current patients) is the National Alliance for the Mentally Ill (NAMI). This organization was founded in 1979, and blends self-help with advocacy efforts for the improvement of research, services, and public awareness of major mental illnesses. Their advocacy efforts target both the federal and state levels.
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