Self-help groups for mental health

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Self-help groups for mental health are voluntary associations of people who share a common desire to overcome mental illness or otherwise increase their level of cognitive or emotional wellbeing. [1] [lower-alpha 1] Despite the different approaches, many of the psychosocial processes in the groups are the same. Self-help groups have had varying relationships with mental health professionals. Due to the nature of these groups, self-help groups can help defray the costs of mental health treatment and implementation into the existing mental health system could help provide treatment to a greater number of the mentally ill population. [2]

Contents

Types

Mutual support and self-help

Mutual support or peer support is a process by which people voluntarily come together to help each other address common problems. Mutual support is social, emotional or instrumental support that is mutually offered or provided by persons with similar mental health conditions where there is some mutual agreement on what is helpful. [3] [4]

Mutual support may include many other mental health consumer non-profits and social groups. Such groups are further distinguished as either Individual Therapy (inner-focused) or Social Reform (outer-focused) groups. The former is where members seek to improve themselves, where as the latter set encompasses advocacy organizations such as the National Alliance on Mental Illness and Psychiatric Rehabilitation Association. [5]

Self-help groups are subsets of mutual support and peer support groups, and have a specific purpose for mutual aid in satisfying a common need, overcoming a shared handicap or life-disrupting problem. Self-help groups are less bureaucratic and work on a more grassroots level. [3] [6] [7] Self-help Organizations are national affiliates of local self-help groups or mental health consumer groups that finance research, maintain public relations or lobby for legislation in favor of those affected. [6]

Behavior Control or Stress Coping groups

Of individual therapy groups, researchers distinguish between Behavior Control groups (such as Alcoholics Anonymous and TOPS) and Stress Coping groups (such as mental health support groups, cancer patient support groups, and groups of single parents). [8] German researchers refer to Stress Coping groups as Conversation Circles. [6]

Significant differences exist between Behavioral Control groups and Stress Coping groups. Meetings of Behavior Control groups tend to be significantly larger than Stress Coping counterparts (by more than a factor of two). Behavior Control group members have a longer average group tenure than members of Stress Coping groups (45 months compared to 11 months) and are less likely to consider their membership as temporary. While very few members of either set saw professionals concurrently while being active in their group, Stress Coping members were more likely to have previously seen professionals than Behavior Control group members. Similarly, Stress Coping groups worked closer with mental health professionals. [8] [9]

Member vs professional leadership

Member leadership. In Germany, a specific subset of Conversation Circles are categorized as Talking Groups (Gesprächsselbsthilfegruppen). In Talking Groups all members of the group have the same rights, each member is responsible only for themselves (group members do not make decisions for other group members), each group is autonomous, everyone attends the group on account of their own problems, whatever is discussed in the group remains confidential, and participation is free of charge. [6]

Professionally led group psychotherapy. Self-help groups are not intended to provide "deep" psychotherapy. Nevertheless, their emphasis on psychosocial processes and the understanding shared by those with the same or similar mental illnesses does achieve constructive treatment goals. [10]

Interpersonal learning, which is done through processes such as feedback and confrontation, is generally deemphasized in self-help groups. This is largely because it can be threatening, and requires training and understanding of small group processes. Similarly, reality testing is also deemphasized. Reality testing relies on consensual validation, offering feedback, seeking feedback and confrontation. These processes seldom occur in self-help groups, though they frequently occur in professionally directed groups. [4] [9]

Professional affiliation and group lifespan

If self-help groups are not affiliated with a national organization, professional involvement increases their life expectancy. Conversely, if particular groups are affiliated with a national organization professional involvement decreases their life expectancy. [11] Rules enforcing self-regulation in Talking Groups are essential for the group's effectiveness. [6]

Typology of self-help groups

In 1991 researchers Marsha A. Schubert and Thomasina Borkman created five conceptual categorizations for self-help groups. [12]

Unaffiliated groups

Unaffiliated groups are defined as self-help groups that function independently from any control at state or national levels, and from any other group or professionals. These groups accept all potential members, and everyone has an equal opportunity to volunteer or be elected. Leaders serve to help the groups function by collecting donations not through controlling the members. Experiential knowledge is mostly found, and there is a high emphasis on sharing. An example of an unaffiliated group includes Wildflowers' Movement in Los Angeles. [12]

Federated groups

Federated groups have superordinate levels of their own self-help organization at state or national levels which makes publicity and literature available. The local unit of the federated self-help group retains full control of its decisions. These groups tend to rely on experiential knowledge, and professionals rarely directly interact. The leaders of these groups would be any members comfortable with the format and willing to accept responsibilities. Leaders do not need to have formal training to gain their title. Examples of a federated self-help group would be Depression and Bipolar Support Alliance (DBSA) and Recovery International. [12]

Affiliated groups

Affiliated groups are subordinate to another group, a regional or national level of their own organization. Local groups conform to the guidelines of the regional/national groups. Leaders are self-helpers not professional caregivers, and meetings included educational activities and sharing, supplemented by research and professionals. Examples of an affiliated self-help group would be the National Alliance on Mental Illness (NAMI). [12]

Managed groups

Managed groups are based on a combination of self-help and professional techniques. These groups are populated generally through referrals and group activities are led by group members. Managed groups do not meet all the criteria for self-help groups, and so should be designated professionally controlled support groups. Examples of managed groups are common with support groups in hospitals, such as those with breast cancer survivors and patients that may be managed by a nurse or therapist in some professional fashion. [12]

Hybrid groups

The hybrid group has characteristics of the affiliated and managed groups. Like affiliated groups, hybrid groups are organized by another level of their own organization. To participate in specialized roles, training is developed by a higher level and enforced through trained leaders or facilitators. Like a managed group, a hybrid group cooperates and interacts with professionals, and that knowledge is highly valued alongside experiential knowledge. [12]

Group processes

No two self-help group are exactly alike, the make-up and attitudes are influenced by the group ideology and environment. [4] In most cases, the group becomes a miniature society that can function like a buffer between the members and the rest of the world. [10] The most essential processes are those that meet personal and social needs in an environment of safety and simplicity. Elegant theoretical formulations, systematic behavioral techniques, and complicated cognitive-restructuring methods are not necessary. [9]

Despite the differences, researchers have identified many psychosocial processes occurring in self-help groups related to their effectiveness. This list includes, but is not limited to: acceptance, behavioral rehearsal, changing member's perspectives of themselves, changing member's perspectives of the world, catharsis, extinction, role modeling, learning new coping strategies, mutual affirmation, personal goal setting, instilling hope, justification, normalization, positive reinforcement, reducing social isolation, reducing stigma, self-disclosure, sharing (or "opening up"), and showing empathy. [3] [4] [6] [9] [10] [13] [14]

Five theoretical frameworks have been used in attempts to explain the effectiveness of self-help groups. [3]

  1. Social support: Having a community of people to give physical and emotional comfort, people who love and care, is a moderating factor in the development of psychological and physical disease.
  2. Experiential knowledge: Members obtain specialized information and perspectives that other members have obtained through living with severe mental illness. Validation of their approaches to problems increases their confidence.
  3. Social learning theory: Members with experience become credible role models.
  4. Social comparison theory: Individuals with similar mental illness are attracted to each other in order to establish a sense of normalcy for themselves. Comparing one another to each other is considered to provide other peers with an incentive to change for the better either through upward comparison (looking up to someone as a role model) or downward comparison (seeing an example of how debilitating mental illness can be).
  5. Helper theory: Those helping each other feel greater interpersonal competence from changing other's lives for the better. The helpers feel they have gained as much as they have given to others. The helpers receive "personalized learning" from working with helpees. The helpers' self-esteem improves with the social approval received from those they have helped, putting them in a more advantageous position to help others.

A framework derived from common themes in empirical data describes recovery as a contextual nonlinear process, a trend of general improvement with unavoidable paroxysms while negotiating environmental, socioeconomic and internal forces, motivated by a drive to move forward in one's life. The framework identified several negotiation strategies, some designed to accommodate illnesses and others designed to change thinking and behavior. The former category includes strategies such as acceptance and balancing activities. The latter includes positive thinking, increasing one's own personal agency/control and activism within the mental health system. [15]

Relationship with mental health professionals

A 1978 survey of mental health professionals in the United States found they had a relatively favorable opinion of self-help groups and there was a hospitable climate for integration and cooperation with self-help groups in the mental health delivery system. [7] The role of self-help groups in instilling hope, facilitating coping, and improving the quality of life of their members is now widely accepted in many areas both inside and outside of the general medical community. [4]

The 1987 Surgeon's General Workshop marked a publicized call for egalitarian relationships with self-help groups. Surgeon General C. Everett Koop presented at this workshop, advocating for relationships that are not superordinate-subordinate, but rather emphasizing respectful, equal relations. [16]

A survey of psychotherapists in Germany found that 50% of the respondents reported a high or very high acceptance of self-help groups and 43.2% rated their acceptance of self-help groups as moderate. Only 6.8% of respondents rated their acceptance of self-help groups as low or very low. [17]

Surveys of self-help groups have shown very little evidence of antagonism towards mental health professionals. [18] The maxim of self-help groups in the United States is "Doctors know better than we do how sickness can be treated. We know better than doctors how sick people can be treated as humans." [6]

Referrals

A large majority of self-help users use professional services as a gateway to self-help services, or concurrently with professional service or the aftercare following professional service. Professional referrals to self-help groups thus can be a cost-effective method of continuing mental health services and the two can co-exist within their own fields. While twelve-step groups, such as Alcoholics Anonymous, make an indispensable contribution to the mental and/or substance use (M/SU) professional services system, a vast number of non-twelve-step groups remain underutilized within that system. [2]

Professional referrals to self-help groups for mental health are less effective than arranging for prospective self-help members to meet with veterans of the self-help group. This is true even when compared to referrals from professionals familiar with the self-help group when referring clients to it. [13] Referrals mostly come from informal sources (e.g. family, friends, word of mouth, self). Those attending groups as a result of professional referrals account for only one fifth to one-third of the population. [4] One survey found 54% of members learned about their self-help group from the media, 40% learned about their group from friends and relatives, and relatively few learned about them from professional referrals. [8]

Effectiveness

Self-help groups are effective for helping people cope with, and recover from, a wide variety of problems. [3] [19] German Talking Groups have been shown to be as effective as psychoanalytically oriented group therapy. [6] [20] Participation in self-help groups for mental health is correlated with reductions in psychiatric hospitalizations, and shorter hospitalizations if they occur. Members demonstrate improved coping skills, greater acceptance of their illness, improved medication adherence, decreased levels of worry, higher satisfaction with their health, improved daily functioning and improved illness management. Participation in self-help groups for mental health encourages more appropriate use of professional services, making the time spent in care more efficient. The amount of time spent in the programs, and how proactive the members are in them, has also been correlated with increased benefits. [3] [13] Decreased hospitalization and shorter durations of hospitalization indicate that self-help groups result in financial savings for the health care system, as hospitalization is one of the most expensive mental health services. Similarly, reduced utilization of other mental health services may translate into additional savings for the system. [3]

While self-help groups for mental health increase self-esteem, reduce stigma, accelerate rehabilitation, improve decision-making, decrease tendency to decompensate under stress, and improve social functioning, they are not always shown to reduce psychiatric symptomatology. [4] [10] [21] The therapeutic effects are attributed to the increased social support, sense of community, education and personal empowerment. [22] [23] [24]

Members of self-help groups for mental health rated their perception of the group's effectiveness on average at 4.3 on a 5-point Likert scale. [8]

Social support, in general, can lead to added benefits in managing stress, a factor that can exacerbate mental illness. [25]

List

Adult Children of Alcoholics & Dysfunctional Families

Adult Children of Alcoholics (ACA)/Dysfunctional Families is a Twelve Step, Twelve Tradition program for people who grew up in dysfunctional homes [26] .

Emotions Anonymous

Emotions Anonymous (EA) is a derivative program of Neurotics Anonymous [27] and open to anyone who wants to achieve emotional well-being. [18] Following the Twelve Traditions, EA groups cannot accept outside contributions. [18] A similar 12-step program is known as "Emotional Health Anonymous".

GROW

GROW was founded in Sydney, Australia, in 1957 by a Roman Catholic priest, Father Cornelius Keogh, and people who had sought help with their mental illness at Alcoholics Anonymous (AA) meetings. After its inception, GROW members learned of Recovery, Inc. (the organization now known as Recovery International) and integrated its processes into their program. GROW's original literature includes the Twelve Stages of Decline, which state that emotional illness begins with self-centeredness, and the Twelve Steps of Recovery and Personal Growth, a blend of AA's Twelve Steps and will-training methods from Recovery International. GROW groups are open to anyone who would like to join, though they specifically recruit people who have been in psychiatric hospitals or are socioeconomically disadvantaged. GROW does not operate with funding restrictions and have received state and outside funding in the past. [18]

Neurotics Anonymous

Neurotics Anonymous is a twelve-step program open to anyone with a desire to become emotionally well. [28] According to the Twelve Traditions followed in the program, Neurotics Anonymous is unable to accept outside contributions. [18] The term "neurotics" or "neuroses" has since fallen out of favor with mental health professionals, with the movement away from the psychoanalytic principles of a DSM-II. [29] Branches of Neurotics Anonymous have since changed their name to Emotions Anonymous, which is currently the name in favor with the Minnesota Groups. [30] Groups in Mexico, however, called Neuróticos Anónimos, still are referred to by the same name, due to the term "neuroticos" having a less pejorative connotation in Spanish. This branch continues to flourish in Mexico City as well as largely Spanish-speaking cities in the United States, such as Los Angeles.

Recovery International

Recovery, Inc. was founded in Chicago, Illinois, in 1937 by psychiatrist Abraham Low using principles in contrast to those popularized by psychoanalysis. [31] During the organization's annual meeting in June 2007 it was announced that Recovery, Inc. would thereafter be known as Recovery International. [32] Recovery International is open to anyone identifying as "nervous" (a compromise between the loaded term neurotic and the colloquial phrase "nervous breakdown"); [31] strictly encourages members to follow their physician's, social worker's, psychologist's or psychiatrist's orders; and does not operate with funding restrictions. [18]

Fundamentally, Low believes "Adult life is not driven by instincts but guided by Will," using a definition of will opposite of Arthur Schopenhauer's. Low's program is based on increasing determination to act, self-control, and self-confidence. Edward Sagarin compared it to a modern, reasonable, and rational implementation of Émile Coué's psychotherapy. [31] Recovery International is "twelve-step friendly." Members of any twelve-step group are encouraged to attend Recovery International meetings in addition to their twelve-step group participation. [33]


Criticism

There are several limitations of self-help groups for mental health, including but not limited to their inability to keep detailed records, lack of formal procedures to follow up with members, absence of formal screening procedures for new members, lack formal leadership training, and likely inability of members to recognize a "newcomer" presenting with a serious illness requiring immediate treatment. Additionally, there is a lack of professional or legal regulatory constraints determining how such groups can operate, there is a danger that members may disregard the advice of mental health professionals, and there can be an anti-therapeutic suppression of ambivalence and hostility. [10] [18] Researchers have also elaborated specific criticisms regarding self-help groups' formulaic approach, attrition rates, over-generalization, and "panacea complex". [4] [10]

Formulaic approach

Researchers have questioned whether formulaic approaches to self-help group therapy, like the Twelve Steps, could stifle creativity or if adherence to them may prevent the group from making useful or necessary changes. [10] [34] Similarly others have criticized self-help group structure as being too rigid. [18]

High attrition rates

There is not a universal appeal of self-help groups; as few as 17% of people invited to attend a self-help group will do so. Of those, only one third will stay for longer than four months. Those who continue are people who value the meetings and the self-help group experience. [4] [10] [18]

Overgeneralization

Since these groups are not specifically diagnosis-related, but rather for anyone seeking mental and emotional health, they may not provide the necessary sense of community to evoke feelings of oneness required for recovery in self-help groups. [13] Referent power is only one factor contributing to group effectiveness. A study of Schizophrenics Anonymous found expert power to be more influential in measurements of perceived group helpfulness. [35]

Panacea complex

There is a risk that self-help group members may come to believe that group participation is a panacea—that the group's processes can remedy any problem. [4] [10]

Sexual predation and opportunism

Often membership of non-associated self-help groups is run by volunteers. Monitoring of relationships and standards of conduct are seldom formalized within a group and are done on a self-regulating basis. This can mean undesirable and unethical initiation of sexual and intimate encounters are facilitated in these settings. Predatory and opportunistic behavior in these environments which by association involve divulging volatile mental states, medication changes and life circumstances mean opportunities by those willing to leverage information that is often normally guarded and deeply personal, is a risk more-so than in other social meetup settings or professionally governed bodies. [36] [ additional citation(s) needed ]

See also

Notes

  1. ↑ This article focuses on groups for which members do not need to share a common diagnosis or etiology of their mental illness. Improving mental health and wellbeing is also a desired outcome of groups like Alcoholics Anonymous and Survivors Network of those Abused by Priests. In those cases, for example, members share the trait of alcoholism or traumatic experiences of abuse by priests and those groups focus on improving the mental health and wellbeing of members while acknowledging their shared circumstances.

Related Research Articles

A mental disorder, also referred to as a mental illness, a mental health condition, or a psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. A mental disorder is also characterized by a clinically significant disturbance in an individual's cognition, emotional regulation, or behavior, often in a social context. Such disturbances may occur as single episodes, may be persistent, or may be relapsing–remitting. There are many different types of mental disorders, with signs and symptoms that vary widely between specific disorders. A mental disorder is one aspect of mental health.

Twelve-step programs are international mutual aid programs supporting recovery from substance addictions, behavioral addictions and compulsions. Developed in the 1930s, the first twelve-step program, Alcoholics Anonymous (AA), founded by Bill Wilson and Bob Smith, aided its membership to overcome alcoholism. Since that time dozens of other organizations have been derived from AA's approach to address problems as varied as drug addiction, compulsive gambling, sex, and overeating. All twelve-step programs utilize a version of AA's suggested twelve steps first published in the 1939 book Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism.

<span class="mw-page-title-main">Mental health</span> Level of human psychological well-being

Mental health encompasses emotional, psychological, and social well-being, influencing cognition, perception, and behavior. According to World Health Organization (WHO), it is a "state of well-being in which the individual realizes his or her abilities, can cope with the normal stresses of life, can work productively and fruitfully, and can contribute to his or her community". It likewise determines how an individual handles stress, interpersonal relationships, and decision-making. Mental health includes subjective well-being, perceived self-efficacy, autonomy, competence, intergenerational dependence, and self-actualization of one's intellectual and emotional potential, among others. From the perspectives of positive psychology or holism, mental health may include an individual's ability to enjoy life and to create a balance between life activities and efforts to achieve psychological resilience. Cultural differences, personal philosophy, subjective assessments, and competing professional theories all affect how one defines "mental health". Some early signs related to mental health difficulties are sleep irritation, lack of energy, lack of appetite, thinking of harming oneself or others, self-isolating, and frequently zoning out.

Coping refers to conscious strategies used to reduce unpleasant emotions. Coping strategies can be cognitions or behaviors and can be individual or social. To cope is to deal with and overcome struggles and difficulties in life. It is a way for people to maintain their mental and emotional well-being. Everybody has ways of handling difficult events that occur in life, and that is what it means to cope. Coping can be healthy and productive, or destructive and unhealthy. It is recommended that an individual cope in ways that will be beneficial and healthy. "Managing your stress well can help you feel better physically and psychologically and it can impact your ability to perform your best."

<span class="mw-page-title-main">Social support</span> Support systems for individuals

Social support is the perception and actuality that one is cared for, has assistance available from other people, and most popularly, that one is part of a supportive social network. These supportive resources can be emotional, informational, or companionship ; tangible or intangible. Social support can be measured as the perception that one has assistance available, the actual received assistance, or the degree to which a person is integrated in a social network. Support can come from many sources, such as family, friends, pets, neighbors, coworkers, organizations, etc.

Recovery International is a mental health self-help organization founded in 1937 by neuropsychiatrist Abraham Low in Chicago, Illinois. Recovery's program is based on self-control, self-confidence, and increasing one's determination to act. Recovery deals with a range of people, all of whom have difficulty coping with everyday problems, whether or not they have a history of psychiatric hospitalization. It is non-profit, secular, and although it uses methods devised by Low, most groups are currently led by experienced non-professionals.

Peer support occurs when people provide knowledge, experience, emotional, social or practical help to each other. It commonly refers to an initiative consisting of trained supporters, and can take a number of forms such as peer mentoring, reflective listening, or counseling. Peer support is also used to refer to initiatives where colleagues, members of self-help organizations and others meet, in person or online, as equals to give each other connection and support on a reciprocal basis.

Compassion fatigue is an evolving concept in the field of traumatology. The term has been used interchangeably with secondary traumatic stress (STS), which is sometimes simply described as the negative cost of caring. Secondary traumatic stress is the term commonly employed in academic literature, although recent assessments have identified certain distinctions between compassion fatigue and secondary traumatic stress (STS).

<span class="mw-page-title-main">Emotions Anonymous</span> Twelve-step program

Emotions Anonymous (EA) is a twelve-step program for recovery from mental and emotional illness. As of 2017 there were approximately 300 Emotions Anonymous groups active in the United States and another 300 around the world.

The recovery model, recovery approach or psychological recovery is an approach to mental disorder or substance dependence that emphasizes and supports a person's potential for recovery. Recovery is generally seen in this model as a personal journey rather than a set outcome, and one that may involve developing hope, a secure base and sense of self, supportive relationships, empowerment, social inclusion, coping skills, and meaning. Recovery sees symptoms as a continuum of the norm rather than an aberration and rejects sane-insane dichotomy.

<span class="mw-page-title-main">Neurotics Anonymous</span> Twelve-step program

Neurotics Anonymous (N/A), founded in 1964, is a twelve-step program for recovery from mental and emotional illness. To avoid confusion with Narcotics Anonymous (NA), Neurotics Anonymous is abbreviated N/A or NAIL.

Grow is a peer support and mutual-aid organization for recovery from, and prevention of, mental illness.

Psychoeducation is an evidence-based therapeutic intervention for patients and their loved ones that provides information and support to better understand and cope with illness. Psychoeducation is most often associated with serious mental illness, including dementia, schizophrenia, clinical depression, anxiety disorders, eating disorders, bipolar and personality disorders. The term has also been used for programs that address physical illnesses, such as cancer.

Drug addiction recovery groups are voluntary associations of people who share a common desire to overcome their drug addiction. Different groups use different methods, ranging from completely secular to explicitly spiritual. Some programs may advocate a reduction in the use of drugs rather than outright abstention. One survey of members found active involvement in any addiction recovery group correlates with higher chances of maintaining sobriety. Although there is not a difference in whether group or individual therapy is better for the patient, studies show that any therapy increases positive outcomes for patients with substance use disorder. The survey found group participation increased when the individual members' beliefs matched those of their primary support group. Analysis of the survey results found a significant positive correlation between the religiosity of members and their participation in twelve-step programs and to a lesser level in non-religious SMART Recovery groups, the correlation factor being three times smaller for SMART Recovery than for twelve-step addiction recovery groups. Religiosity was inversely related to participation in Secular Organizations for Sobriety.

Helper theory or the helper therapy principle was first described by Frank Riessman (1965) in an article published in the journal Social Work. The principle suggests that when an individual provides assistance to another person, the helper may benefit. Riessman's model has inspired subsequent research and practice by scholars, clinicians, and indigenous populations to address a variety of social and health-related issues plaguing individuals and communities around the world.

In psychology, posttraumatic growth (PTG) is positive psychological change experienced as a result of struggling with highly challenging, highly stressful life circumstances. These circumstances represent significant challenges to the adaptive resources of the individual, and pose significant challenges to the individual's way of understanding the world and their place in it. Posttraumatic growth involves "life-changing" psychological shifts in thinking and relating to the world and the self, that contribute to a personal process of change, that is deeply meaningful.

Psychological hardiness, alternatively referred to as personality hardiness or cognitive hardiness in the literature, is a personality style first introduced by Suzanne C. Kobasa in 1979. Kobasa described a pattern of personality characteristics that distinguished managers and executives who remained healthy under life stress, as compared to those who developed health problems. In the following years, the concept of hardiness was further elaborated in a book and a series of research reports by Salvatore Maddi, Kobasa and their graduate students at the University of Chicago.

<span class="mw-page-title-main">Psychological stress</span> Feeling of strain and pressure

In psychology, stress is a feeling of emotional strain and pressure. Stress is a type of psychological pain. Small amounts of stress may be beneficial, as it can improve athletic performance, motivation and reaction to the environment. Excessive amounts of stress, however, can increase the risk of strokes, heart attacks, ulcers, and mental illnesses such as depression and also aggravation of a pre-existing condition.

Positive criminology is based on the perspective that integration and positive life influences that help individuals develop personally and socially will lead to a reduced risk of criminal behavior and better recovery of offenders. Integration works in three levels: inter-personal, intra-personal and spiritual. Positive influences include participation in recovery programs, such as those for substance use disorders. Factors that can make growth difficult include a long-standing pattern of criminal activity, serious adverse life events, and chronic mental health illness.

The mental health of Filipino Americans is emotional and cognitive status of Americans of Filipino descent. Filipino-Americans utilize mental health services less than some Asian-American groups.

References

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  16. ↑ Borkman, Thomasina (April 1990). "Self-help groups at the turning point: Emerging egalitarian alliances with the formal health care system?". American Journal of Community Psychology. 18 (2): 321–332. doi:10.1007/bf00931307. ISSN   0091-0562. PMID   2198799. S2CID   45454212.
  17. ↑ Friedhelm, Meyer; Matzat, Jürgen; Höflich, Anke; Scholz, Sigrid; Beutel, Manfred E. (December 2004). "Self-help groups for psychiatric and psychosomatic disorders in Germany—themes, frequency and support by self-help advice centres". Journal of Public Health. 12 (6): 359–364. doi:10.1007/s10389-004-0071-0. ISSN   0943-1853. S2CID   24298468.
  18. 1 2 3 4 5 6 7 8 9 Kurtz, Linda F.; Chambon, Adrienne (1987). "Comparison of self-help groups for mental health". Health & Social Work. 12 (4): 275–283. doi:10.1093/hsw/12.4.275. ISSN   0360-7283. PMID   3679015.
  19. ↑ Kyrouz, Elaina M.; Humphreys, Keith; Loomis, Colleen (October 2002). "Chapter 4: A Review of Research on the Effectiveness of Self-help Mutual Aid Groups" (PDF). In White, Barbara J.; Madara, Edward J. (eds.). American Self-Help Group Clearinghouse Self-Help Group Sourcebook (7th ed.). American Self-Help Group Clearinghouse. pp.  71–86. ISBN   978-1-930683-00-6 . Retrieved 2008-01-06.
  20. ↑ Daum, K.W.; Matzat, J.; Moeller, M.L. (1984). "Psychologisch-therapeutische Selbsthilfegruppen: Ein Forschungsbericht". Schriftenreihe des Bundesministers für Jugend, Familie und Gesundheit. (in German) (Stuttgart: Kohlhammer).
  21. ↑ Kaufman, C. L. (1996). "The lion's den: Social identities and self help groups". The Community Psychologist. 29: 11–13. OCLC   14089992.
  22. ↑ Hatzidimitriadou, E. (2002). "Political ideology, helping mechanisms and empowerment of mental health self-help/mutual aid groups" (PDF). Journal of Community and Applied Social Psychology. 12 (4): 271–285. doi:10.1002/casp.681. ISSN   1099-1298. OCLC   43956503.
  23. ↑ Kurtz, Linda (1990). "The self-help movement: review of the past decade of research". Social Work with Groups. 13 (3): 101–115. doi:10.1300/J009v13n03_11. ISSN   0160-9513.
  24. ↑ Maton, Kenneth I. (February 1988). "Social support, organizational characteristics, psychological wellbeing and group appraisal in three self-help populations". American Journal of Community Psychology. 16 (1): 53–77. doi:10.1007/BF00906072. ISSN   0091-0562. PMID   3369383. S2CID   40655711.
  25. ↑ Cobb, Sidney (September 1976). "Social Support as a Moderator of Life Stress". Psychosomatic Medicine. 38 (5): 300–314. doi:10.1097/00006842-197609000-00003. ISSN   0033-3174. PMID   981490. S2CID   6537305.
  26. ↑ "Welcome". Adult Children of Alcoholics & Dysfunctional Families. Retrieved 2024-03-16.
  27. ↑ Chestnut, Glenn F. (2015-07-17). "Notes". Father Ed Dowling: Bill Wilson's Sponsor. iUniverse. ISBN   978-1491770870. OCLC   914573796.
  28. ↑ Boydston, Grover (1974). "Part I. Introduction". A history and status report of Neurotics Anonymous, an organization offering self-help for the mentally and emotionally disturbed (Thesis). Miami, Florida: Barry University. pp. 1–5. OCLC   14126024.
  29. ↑ Bayer, Ronald (1985-02-01). "Neurosis, Psychodynamics, and DSM-III". Archives of General Psychiatry. 42 (2): 187–96. doi:10.1001/archpsyc.1985.01790250081011. ISSN   0003-990X. PMID   3883941.
  30. ↑ It works if you work it. Emotions Anonymous International. Saint Paul, Minn.: Emotions Anonymous. 2003. ISBN   978-0960735693. OCLC   54625984.{{cite book}}: CS1 maint: others (link)
  31. 1 2 3 Sagarin, Edward (1969). "Chapter 9. Mental patients: are they their brothers' therapists?". Odd Man In: Societies of Deviants in America. Chicago, Illinois: Quadrangle Books. pp. 210–232. ISBN   978-0-531-06344-6. OCLC   34435.
  32. ↑ "Annual Meeting". Recovery Reporter. Chicago, Illinois: Recovery, Inc. 70 (2). 2007. OCLC   22518904.
  33. ↑ Dey, Bob (2006-10-14). "How Recovery Inc. has Helped Me Stay Sober (page 1)". Archived from the original on 2009-02-21. Retrieved 2007-06-02.
    Dey, Bob (2006-10-14). "How Recovery Inc. has Helped Me Stay Sober (page 2)". Archived from the original on 2009-02-21. Retrieved 2009-02-20.
  34. ↑ Sagarin, Edward (1969). "Chapter 3. Gamblers, addicts, illegitimates, and others: imitators and emulators". Odd man in; societies of deviants in America. Chicago, Illinois: Quadrangle Books. pp. 56–77. ISBN   978-0-531-06344-6. OCLC   34435.
  35. ↑ Salem, Deborah; Reischl, Thomas M.; Gallacher, Fiona; Randall, Katie Weaver (June 2000). "Referent and Expert Power in Mutual Help". American Journal of Community Psychology. 28 (3): 303–324. doi: 10.1023/A:1005101320639 . ISSN   1573-2770. PMID   10945119. S2CID   38699737.
  36. ↑ Samenow, Stanton. "The Thinking Processes of Sexual Predators". Psychology Today. Retrieved 15 December 2017.
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