Resolution on Self-Help Support Groups

Resolution on Self-help Support Groups

Approved by the Society for Community Research and Action (APA Division 27) Executive Committee and supported by APA Divisions 17 (Society of Counseling Psychology) and 48 (Society for the Study of Peace, Conflict, and Violence: Peace Psychology)

A self-help support group is defined as:

A voluntary, self-determining, and non-profit gathering of people who share a condition or status; members share mutual support and experiential knowledge to improve persons’ experiences of the common situation.

Whereas 18 percent of Americans have used self-help support groups sometime in their lifetime (1,2);

Whereas self-help support groups have been shown to substantially improve symptoms, increase health-promoting behaviors, complement other treatments, and reduce distress among people with a variety of chronic conditions, including asthma / COPD / emphysema (3) , sickle cell (4,5), heart disease (6,7), mental illness (8-11) , scoliosis (12), diabetes (13, 14), and HIV (15);

Whereas self-help groups are effective for people of diverse ages, genders, backgrounds, and life situations, although they do not benefit all people in all circumstances equally (12, 16-21);

Whereas self-help support groups are used and effective across a wide range of racial, ethnic, and cultural groups and settings, both within the US and internationally (4, 13, 22-29);

Whereas psychologists have documented the effectiveness of self-help support groups in reducing the costs of medical and psychological treatment (9, 30-33);

Whereas individuals utilizing self-help and peer-support services experience significantly reduced rates of re-hospitalization compared with non-users (10, 34-38);

Whereas doctors and other clinicians report that patients in self-help support groups better utilize their time in clinical appointments (30, 39), are better able to collaborate effectively with their treatment providers (40, 41), and are more likely to be adherent to prescribed medications (42);

Whereas people taking part in self-help support groups report enhanced satisfaction with the professionally delivered behavioral and mental health services they also receive (43-45);

Whereas self-help support groups for parents have been shown to increase social support (46-49), reduce parenting stress (46, 48, 50), reduce child maltreatment (48, 51,52), increase parents’ self-esteem (46, 48), improve caretaking abilities (48, 53), and increase parents’ positive affect (47, 48);

Whereas self-help support groups provide tangible social support, peer validation, and valuable coping and other skills to people with serious mental health problems (54-58) and can make an important difference between a person being disabled by a mental illness or living with it successfully (42, 45, 59, 60);

Whereas self-help support groups for depression can be as effective as more costly treatments such as cognitive-behavioral therapy (61);

Whereas self-help support groups for smoking cessation have increased rates of tobacco abstinence (62);

Whereas self-help support groups for bereavement have been shown to reduce stress, depression, and anxiety, while helping participants make new friends and begin new activities (63-66);

Whereas self-help support groups have been shown to be effective substance abuse recovery methods (16, 67-79), even reducing criminal behavior associated with substance abuse (72, 80);

Whereas self-help support groups increase caregivers’ resources and reduce caregiver stress (81-85);

Whereas self-help support groups provide opportunities and benefits that improve outcomes for those providing support as well as those receiving it (9, 60, 86-89);   

Whereas self-help support groups help erode stigma attached to physical and mental health conditions by changing the attitudes of families, communities, and health workers (90, 91) and by helping the people affected better cope with and respond to stigma (92); and

Whereas self-help support groups increase people’s sense of empowerment (9, 21, 29, 43, 87);

Therefore, be it resolved that the American Psychological Association will:

1) Include information about the effectiveness of self-help support groups and how to find them on its website and via other venues to get this information to the public;

2) Advocate that self-help support groups be included as a health promoting intervention in the American Psychological Association’s healthcare reform priorities;

3) Ensure that self-help support groups be included as a health promoting intervention in other American Psychological Association policy work with federal, state, and local governments;

4) Recommend that psychologists provide information about self-help support groups, assist clients in locating these services, and support clients in joining with others to start new support groups where and when needed;

5) Promote the inclusion of information about self-help and its evidence base in psychology training programs;

6) Actively support research establishing evidence-based practices regarding self-help support groups;

7) Advocate that self-help support group centers be widely established to promote the awareness, utilization, development, and understanding of self-help support groups in the areas they serve and to provide them with meeting space and organizational assistance. 


1.  Kessler, R.C., Mickelson, K.D., & Zhao, S. (1997). Patterns and correlates of self-help group membership in the United States. Social Policy, 27, 27-46.

2.  Goldstrom, I.D., Campbell, J., Rogers, J.A., Lambert, D.B., Blacklow, B., Henderson, M.J., &  Manderscheid, R.W. (2006). National estimates for mental health mutual support groups, self-help organizations, and consumer-operated services.  Administration and Policy in Mental Health and Mental Health Services Research, 33(1), 92-103. doi: s10488-005-0019-x

3. Jensen, P.S. (1983). Risk, protective factors, and supportive interventions in chronic airway obstruction. Archives of General Psychiatry, 40, 1203-1207.

4.  Nash, K.B., & Kramer, K.D. (1993). Self-help for sickle cell disease in African American communities. Journal of Applied Behavioral Science, 29, 202-215.

5.  Nash, K.B. (1989). Self-help groups: An empowerment vehicle for sickle cell disease patients and their families.   Social Work with Groups: A Journal of Community and Clinical Practice, 12, 81-97. doi: 10.1300/J009v12n04_06

6.   Ornish, D., Scherwitz, L.W., Billings, J.H., Gould, K.L., Merritt, T.A., Sparler, S., Armstrong, W.T., Ports, T.A., Kirkeeide, R.L., Hogeboom, C., & Brand, R.J. (1998). Intensive lifestyle changes for reversal of coronary heart disease. JAMA, 280, 2001-2007.

7.  Schulz, U., Pischke, C.R., Weidner, G., Daubenmier, J., Elliot-Eller, M., Scherwitz, L.,  Bullinger, M., & Ornish. D. (2008). Social support group attendance is related to blood pressure, health behaviours, and quality of life in the multicenter lifestyle demonstration project.  Psychology, Health & Medicine, 13, 423-437. doi: 10.1080/13548500701660442

8. Galanter, M. (1988). Zealous self-help groups as adjuncts to psychiatric treatment: A study of Recovery, Inc. American Journal of Psychiatry, 145, 1248-1253.

9. Raiff, N.D. (1984). Some health related outcomes of self-help participation: Recovery, Inc. as a case example of a self-help organization in mental health.  In A. Gartner & F. Riessman (Eds.), The self-help revolution (pp. 183-193). New York: Human Sciences Press.

10. Pistrang, N., Barker, C., & Humphreys, K. (2008). Mutual help groups for mental health problems: A review of effectiveness studies. American Journal of Community Psychology, 42, 110-121. doi: 10.1007/s10464-008-9181-0  

11.  Christo, G., & Sutton, S. (1994). Anxiety and self-esteem as a function of abstinence time among recovering addicts attending Narcotics Anonymous. British Journal of Clinical Psychology, 33, 198-200.

12.  Hinrichsen, G A., Revenson, T.A., & Shinn, M. (1985). Does self-help help? An empirical investigation of scoliosis peer support groups. Journal of Social Issues, 41, 65-87.

13. Simmons, D. (1992). Diabetes self help facilitated by local diabetes research: The Coventry Asian Diabetes Support Group. Diabetic Medicine, 9, 866-869.

14.  Gilden, J.L., Hendryx, M.S., Clar, S., Casia, C., et al. (1992). Diabetes support groups improve health care of older diabetic patients. Journal of the American Geriatrics Society, 40, 147-150.

15. Sibthorpe, B., Fleming, D., & Gould, J. (1994). Self-help groups: A key to HIV risk reduction for high-risk injection drug users? Journal of Acquired Immune Deficiency Syndromes, 7, 592-598.  

16. Atkins, R.G., & Hawdon, J.E. (2007). Religiosity and participation in mutual-aid support groups for addiction. Journal of Substance Abuse Treatment, 33, 321-331.

17. Caserta, M.S., & Lund, D.A. (1993). Intrapersonal resources and the effectiveness of self-help groups for bereaved older adults.  The Gerontologist, 33, 619-629.

18.  Ullman, S.E., Najdowski, C.J., & Adams, E.B. (2012). Women, Alcoholics Anonymous, and related mutual aid groups: Review and recommendations for research. Alcoholism Treatment Quarterly30, 443-486.

19. Hughes, J.M. (1977). Adolescent children of alcoholic parents and the relationship of Alateen to these Children. Journal of Consulting and Clinical Psychology, 45, 946-947.

20.  Lieberman, M.A., & Bliwise, N.G. (1985). Comparisons among peer and professionally directed groups for the elderly: Implications for the development of self-help groups. International Journal of Group Psychotherapy, 35, 155-175.  

21. Lieberman, M.A., Solow, N., Bond, G.R., & Reibstein, J. (1979). The psychotherapeutic impact of women's consciousness-raising groups. Archives of General Psychiatry, 36, 161-168.  

22. Mok, E., & Martinson, I. (2000). Empowerment of Chinese patients with cancer through self-help groups in Hong Kong. Cancer & Nursing, 18, 206-213.

23. Chien, W., Chan, S.W.C., & Thompson, D.R. (2006). Effects of a mutual support group for families of Chinese people with schizophrenia: 18-month follow-up. The British Journal of Psychiatry, 189, 41-49.

24.  Chenhall, R.D., & Oka, T. (2006). An initial view of self-help groups for Japanese alcoholics: Danshukai in its historical, social, and cultural contexts.  International Journal of Self Help and Self Care, 5, 111-152.

25.  Oka, T., & Chenhall, R.D. (2006). Research on self-help organizations in Japan: Working with a sense of duty (“giri”). International Journal of Self Help and Self Care, 5, 371-392.

26.  Guitierrez, L., Ortega, R.M., & Suarez, Z.E. (1990).  Self-help and the Latino community. In T. J. Powell (Ed.), Working with self help (pp. 218-236).  Silver Spring, MD: National  Association of Social Work. 

27.  Medvene, L.J., Lin, K.M., Wu, A., Mendoza, R., Harris, N., & Miller, M. (1994). Mexican American and Anglo American parents of the mentally ill: Attitudes and participation in family support groups. Prevention in Human Services, 11, 141-163.

28.   Humphreys, K., & Woods, M.D. (1994). Researching mutual-help group participation in a segregated society. In T.J. Powell (Ed.), Understanding the self-help organization: Frameworks and findings (pp. 62-87).  Thousand Oaks, CA: Sage.

29.  Mok, B-H. (2004). Self-help group participation and empowerment in Hong Kong.  Journal of Sociology and Social Welfare, 31, 153-168. 

30. Humphreys, K., & Moos, R. (2001). Can encouraging substance abuse patients to participate in self-help groups reduce demand for health care? A quasi-experimental study. Alcoholism: Clinical and Experimental Research, 25, 711-716.

31. Subramaniam, V., Stewart, M.W., & Smith, J.F. (1999). The development and impact of a chronic pain support group: A qualitative and quantitative study. Journal of Pain and Symptom Management, 17, 376-383. doi: 10.1016/s0885-3924(99)00012-3

32.  Humphreys, K., & Moos, R.H. (1996). Reduced substance-abuse-related health care costs among voluntary participants in Alcoholics Anonymous. Psychiatric Services, 47, 709-713.  

33. Walsh, D.C., Hingson, R.W., Merrigan, D.M., Levenson, S.M., Cupples, L.A., Heeren, T.C., & Kelly, C.A. (1991). A randomized trial of treatment options for alcohol-abusing workers. The New England Journal of Medicine, 325, 775-782.

34. Humphreys, K., & Moos, R. (2007). Encouraging post-treatment self-help group involvement to reduce demand for continuing care services: Two-year clinical and utilization outcomes.  Focus, 5, 193-198.

35. Gordon, R.E., Edmunson, E., Bedell, J., & Goldstein, N. (1979). Reducing rehospitalization of state mental patients: Peer management and support.  The Journal of the Florida Medical Association, 65, 927-933.

36. Klein, A.R., Cnaan, R.A., & Whitecraft, J. (1998). Significance of peer social support with dually diagnosed clients: Findings from a pilot study.  Research on Social Work Practice, 8, 529-551.

37. Min, S-Y., Whitecraft, J., Rothbard, A.B., & Salzer, M.S. (2007). Peer support for persons with co-occurring disorders and community tenure: A survival analysis.  Psychiatric Rehabilitation Journal, 30, 207-213.

38. Lander, G.M., & Zhou, M. (2009). An analysis of relationships among peer support, psychiatric hospitalization, and crisis stabilization. Community Mental Health Journal, 106-112.

39.  National Depressive and Manic-Depressive Association. (1999). National DMDA Support Group Survey: Does participation in a support group increase treatment compliance?  Chicago: DMDA.

40. Ellis, T.E. (2004). Collaboration and a self-help orientation in therapy with suicidal clients. Journal of Contemporary Psychotherapy, 34, 41-57.

41. Corrigan, P.W., Liberman, R.P., & Engel, J.D. (1990). From noncompliance to collaboration in the treatment of schizophrenia. Hospital and Community Psychiatry, 41, 1203-1211.

42. Magura, S., Laudel, A.D., Mahmood, D., Rosenbaum, A., & Knight, E. (2002). Adherence to medication regimens and participation in dual-focus self-help groups. Psychiatric Services, 53, 310-316.

43. van Uden-Kraan, C. F., Drossaert, C.H.C., Taal, E., Shaw, B.K., Sergdel, E.R., & van de Laar, M.A.F.J. (2008). Empowering processes and outcomes of participation in online support groups for patients with breast cancer, arthritis, or fibromyalgia, Qualitative Health Research, 18, 405-407.

44. Hodges, J.Q., Markward, M., Keele, C., & Evans, C.J. (2003). Use of self-help services and consumer satisfaction with professional mental health services. Psychiatric Services, 54, 1161-1163.

45. Brown, L.D., &  Lucksted, A. (2010). Theoretical foundations of mental health self-help.  In L.D. Brown & S. Wituk (Eds.), Mental health self-help (pp. 19-38). New York: Springer.

46. Cameron, G. (2002). Motivation to join and benefits from participation in parent mutual aid organizations. Child Welfare, 81, 33-57.

47. Henninger, C., & Nelson, G. (1984). Evaluation of a social support program for young unwed mothers. Journal of Primary Prevention, 5, 3-16.

48. Polinsky, M.L., Pion-Berlin, L., Williams, S., & Long, T. (2010). Preventing child abuse and neglect: A national evaluation of Parents Anonymous groups. Child Welfare, 89, 43-62.

49.  Solomon, M., Pistrang, N., & Barker, C. (2001). The benefits of mutual support groups for parents of children with disabilities. American Journal of Community Psychology, 29, 113-132.

50.  Telleen, S., Herzog, A., & Kilbane, T.L. (1989). Impact of a family support program on mothers' social support and parenting stress. American Journal of Orthopsychiatry, 59, 410-419.

51.  Cohn, A.H. (1979). Essential elements of successful child abuse and neglect treatment. Child Abuse & Neglect, 3, 491-496.

52. Lieber, L.L., & Baker, J.M. (1977). Parents Anonymous - Self-help treatment for child abusing parents: A review and an evaluation. Child Abuse & Neglect, 1, 133-148.

53.  Minde, K., Shosenberg, N., Marton, P., Thompson, J., Ripley, J., & Burns, S. (1980). Self-help groups in a premature nursery: A controlled evaluation. Behavioral Pediatrics, 96, 933-940.

54.   Rummell-Kluge, C., & Kissling, W. (2008). Psychoeducation in schizophrenia: New developments and approaches in the field. Current Opinion in Psychiatry, 21, 168-172.

55. Chien, W.T., & Lee, I.Y.M. (2010). The schizophrenia care management program for family caregivers of Chinese patients with schizophrenia. Psychiatric Services, 61, 317-320.

56. Jones, S., Deville, M., Mayes, D., & Lobban, F. (2011). Self-management in bipolar disorder: The story so far. Journal of Mental Health, 20, 583-592.

57.  Finn, L.D., Bishop, B.J., & Sparrow, N. (2009). Capturing dynamic processes of change in GROW mutual help groups for mental health.  American Journal of Psychology, 44, 302-315. doi 10.1007/s10464-009-9265-5

58.  Humphreys, K., & Noke, J. M. (1997). The influence of post-treatment mutual help group participation on the friendship networks of substance abuse patients. American Journal of Community Psychology, 25, 1-16.

59.   Castelein, S., Bruggeman, R., van Brussebach, J.T., van der Gaag, M., Stant, A.D., Knegtering, H., & Wiersma, D. (2008). The effectiveness of peer support groups in psychosis: A randomized controlled trial. Acta Psychiatria Scandinavia, 118, 64-72.

60. Goldberg, R.W., Rollins, A.W., & Leman, A.F. (2003). Social network correlates among people with psychiatric disabilities. Psychiatric Rehabilitation Journal, 26, 393-402.

61. Bright, J. I., Baker, K.D., & Neimeyer, R.A. (1999). Professional and paraprofessional group treatments for depression: A comparison of cognitive-behavioral and mutual support interventions. Journal of Consulting and Clinical Psychology, 67, 491-501. doi: 10.1037/0022-006x.67.4.491

62. Jason, L.A., Gruder, C.L., Martino, S., Flay, B.R., Warnecke, R., & Thomas, N. (1987). Work site group meetings and the effectiveness of a televised smoking cessation intervention. American Journal of Community Psychology, 15, 57-72.

63.   Marmar, C.R., Horowitz, M.J., Weiss, D.S., Wilner, N.R., & Kaltreider, N.B. (1988). A controlled trial of brief psychotherapy and mutual-help group treatment of conjugal bereavement. American Journal of Psychiatry, 145, 203-209.

64.   Vachon, M.L.S., Lyall, W.A.L., Rogers, J., Freedman-Latofsky, K., & Freeman, S.J. (1980). A controlled study of self-help intervention for widows. American Journal of Psychiatry, 137, 1380-1384.

65.   Videka-Sherman, L. & Lieberman, M. (1985). The effects of self-help and psychotherapy intervention on child loss: The limits of recovery. American Journal of Orthopsychiatry, 55, 70-82.

66.  Lieberman, M.A., & Videka-Sherman, L. (1986). The impact of self-help groups on the mental health of widows and widowers. American Journal of Orthopsychiatry, 56, 435-449.

 67. Hser, Y., Huang, D., Terriya, C., & Anglin, M.D. (2006). Diversity of drug abuse treatment utilization patterns and outcomes. Evaluation and Program Planning, 27, 309-319.

68. Sullivan, C.J., McKendrick, K., Sacks, S., & Banks, S. (2007). Modified therapeutic community treatment for offenders with MICA disorders: Substance use outcomes. The American Journal of Drug and Alcohol Abuse, 33, 823-832.

69. Moos, R., Schaefer, J., Andrassy, J., & Moos, B. (2001). Outpatient mental health care, self-help groups, and patients’ one-year treatment outcomes. Journal of Clinical Psychology, 57, 273-287.

70. Emrick, C.D., Tonigan, J.S., Montgomery, H., & Little, L. (1993). Alcoholics Anonymous: What is currently known? In B.S. McCrady & W.R. Miller (Eds.), Research on Alcoholics Anonymous: Opportunities and alternatives (pp. 41-76). New Brunswick, NJ: Rutgers Center of Alcohol Studies.

71. Kingree, J.B., & Thompson, M. (2000). Mutual health groups, perceived status benefits, and well-being: A test with adult children of alcoholics with personal substance abuse problems. American Journal of Community Psychology, 28, 325-342.

72. McAuliffe, M.E. (1990). A randomized controlled trial of recovery and self-help for opioid addicts in New England and Hong Kong, Journal of Psychoactive Drugs, 22, 197-209.

73. Timko, C., DeBenedetti, A., & Billow, R. (2006). Intensive referral to 12-Step self-help groups and 6-month substance use disorder outcomes. Addiction, 101, 678-688.

74. Timko, C., & Debenedetti, A. (2007). A randomized controlled trial of intensive referral to 12-step self-help groups: One-year outcomes. Drug and Alcohol Dependence, 90, 270-279. doi: 10.1016/j.drugalcdep.2007.04.007

75.  Watson, C.G., Hancock, M., Gearhart, L.P., Mendez, C.M., Malovrh, P., & Raden, M. (1997). A comparative outcome study of frequent, moderate, occasional, and non-attenders of Alcoholics Anonymous. Journal of Clinical Psychology, 53, 209-214.

76.  Kaskutas, L.A., (2009). Alcoholics Anonymous effectiveness:  Faith meets science.  Journal of Addictive Diseases, 28, 145-157. 

77.  Ye, Y., & Kaskutas, L.A. (2009). Using propensity scores to adjust for selection bias when assessing the effectiveness of Alcoholics Anonymous in observational studies. Drug and Alcohol Dependence, 104, 56-64.

78. McKay, J. R., Alterman, A.I., McLellan, A.T., & Snider, E.C. (1994). Treatment goals, continuity of care, and outcome in a day hospital substance abuse rehabilitation program. American Journal of Psychiatry, 151, 254-259.

79.  Pisani, V. D., Fawcett, J., Clark, D.C., & McGuire, M. (1993). The relative contributions of medication adherence and AA meeting attendance to abstinent outcome for chronic alcoholics. Journal of Studies on Alcohol, 54, 115-119.

80.  Sacks, S., Sacks, J. Y., McKendrick, K., Banks, S., & Stommel, J. (2004). Modified TC for MICA offenders: Crime outcomes.  Behavioral Sciences & the Law, 22, 477-501.

81. Fung, W., & Chien, W. (2002). The effectiveness of a mutual support group for family caregivers of a relative with dementia. Archives of Psychiatric Nursing, 16, 134-144.

82. Cook, J.A., Heller, T., & Pickett-Schenk, S.A. (1999). The effect of support group participation on caregiver burden among parents of adult offspring with severe mental illness. Family Relations, 48, 405-410.

83. Dixon, L.B., Lucksted, A., Medoff, D., Burland, J., Stewart, B., Lehman, A., Fang, L.J., Sturm, V., Brown, C., & Murray-Swank, A. (2011). Outcomes of a randomized study of a peer-taught family-to-family education program for mental illness. Psychiatric Services, 62, 591-597.

84. Lucksted, A., Medoff, D., Burland, J., Stewart, B., Fang, L.J., Brown, C., Jones, A., Lehman, A., & Dixon, L.B. (2012). Sustained outcomes of a peer-taught family education program on mental illness. Acta Psychiatrica Scandanavica (electronic publication).  doi: 10.1111/j.1600-0447.2012.01901.x

85.  Toseland, R.W., Rossiter, C.M., & Labrecque, M.S. (1989). The effectiveness of peer-led and professionally led groups to support family caregivers. The Gerontologist, 29, 465-471.

86. van Mierlo, L.D., Merland, FJ.M., van der Roest, H..G., & Drois, R.M. (2012). Personalized caregiver support: Effectiveness of psycho-social interventions in subgroups of caregivers of people with dementia. International Journal of Geriatric Psychiatry, 27, 1-14.

87. Roberts, L.J., Salem, D., Rappaport, J., Toro, P.A., Luke, D.A., & Seidman, E. (1999). Giving and receiving help: Interpersonal transactions in mutual-help meetings and psychosocial adjustment of members. American Journal of Community Psychology, 27, 841-868.

88. Schutt, R. K., & Rogers, E. S. (2009).  Empowerment and peer support: Structure and a process of self-help in a consumer-run center for individuals with mental illness.  Journal of Community Psychology, 37, 697-710. 

89. Magura, S. (2008). Effectiveness of dual focus mutual aid for co-occurring substance use and mental health disorders: A review and synthesis of the ‘Double Trouble’ in recovery evaluation.  Substance Use & Misuse, 43, 1904-1926. 

90.  Demissie, M., Getahun, H., & Lindtjorn, B. (2003). Community tuberculosis care through “TB clubs” in rural North Ethiopia. Social Sciences & Medicine, 56, 2009-2018.

91. Nguyen, T.A., Oosterhoof, P., Ngoc, Y.P., Wright, P., & Hardon, A. (2009). Self-help groups can improve utilization of postnatal care by HIV-infected mothers. Journal of the Association of Nurses in AIDS Care, 20, 141-152.

92. Crabtree, J.W., Haslam, S.A., Postmes, T., & Haslam, C. (2010). Mental health support groups, stigma, and self-esteem: Positive and negative implications of group identification. Journal of Social Issues, 66, 553-569.