Health and Social Care in the Community (2010) 18(4), 346–354 doi: 10.1111/j.1365-2524.2009.00899.

The lifespan and life-cycle of self-help groups: a retrospective study of groups in

Nottingham, UK
1 2
Sarah Chaudhary LLB (Hons) MA , Mark Avis BA (Hons) MSc RGN RMN RNT Cert Ed and Carol Munn-Giddings BA
3
MA PhD
1
School of Nursing, Midwifery and Physiotherapy, University of Nottingham, Nottingham, UK, 2School of Nursing,
Midwifery and Physiotherapy, University of Nottingham, Nottingham, UK and 3Faculty of Health and Social Care, Anglia
Ruskin University, Chelmsford, UK

Correspondence
Sarah Chaudhary
Room B49 (Research Office)
School of Nursing
Queen’s Medical Centre
University of Nottingham
Nottingham NG7 2HA, UK
E-mail: sarah.chaudhary@nottingham.
ac.uk
Abstract
This article is based on an analysis of a practice database held by Self
Help Nottingham, an organisation that supports local self-help groups.
The database contains details of 936 groups that closed between 1982
and 2007. The aim of the study is to provide qualitative and descriptive
quantitative information about the life-cycles of self-help groups, the
problems that they face throughout their existence and the likelihood of
different problems leading to their closure. The database was not
collated for research purposes and so we restrict our discussion of the
findings to identification of broad patterns regarding the birth and
closure rates of different types of group and questions for future
research. Comparisons were made between groups that addressed differ-
ent types of problem, groups with different memberships and groups
that had reached different stages in their existence. There was reasonable
consistency in the survival rates of different types of group with physical
health groups being the most likely to reach maturity followed by
mental health and lastly social issue groups. Survival rates for groups
that serve different membership populations were reasonably constant
although there were some anomalies. There were high levels of consis-
tency regarding the reasons for closure for groups closing at different
stages of maturity. The most commonly cited reasons among all groups
were the withdrawal of a ‘key’ member and a decline in membership.
The article suggests that some of the assumptions and prescriptions
within the existing literature need to be considered in light of more
detailed empirical evidence, and it raises questions about the theoretical
understanding of self-help groups.

Keywords: community settings, peer, self-help groups

Accepted for publication 04 October 2009

1999 at a rate of 9% per annum. However, these figures

Introduction
The number of self-help groups is believed to have
grown rapidly in recent years both in the UK and inter-
nationally (Borkman 1999, Munn-Giddings & McVicar
2006). Elsdon et al. (2000) estimated that there were more
than 23 000 groups in the UK, and, based on entries in
Self Help Nottingham’s (SHN) directory of self-help
groups, that the number had grown between 1982 and
require caution as Elsdon’s study was based solely in
Nottingham which may not be representative of the UK.
Since Elsdon’s work, there has been no large-scale study
of UK self-help groups.
The paucity of data about self-help groups reflects the
methodological challenges they present (Dadich 2003–
2004). First, there is a lack of clarity in defining self-help
groups, (Rootes & Aanes 1992, Adamsen & Rasmussen

346 ª 2010 Blackwell Publishing Ltd


2001), which are traditionally seen as distinct from sup-
port groups. The former being instigated and run by and
for members who generally share a medical condition or
social situation, while the latter are usually defined as
being controlled by professionals. Lack of an accepted
definition is compounded by a reliance on international
studies where different contexts and applications of self-
help complicate the picture (Steinke 2000). The definition
of self-help groups used in the current study draws on
that developed by SHN, which accepts varying levels of
professional contact provided that control and owner-
ship of the group resides with members (Munn-
Giddings 2003). In addition, self-help groups involve
meeting with other people, who share the same or simi-
lar circumstances or conditions, to discuss and to share
coping strategies. This is usually conducted through
face-to-face meetings, but as use of the internet increases,
some groups hold ‘virtual’ meetings on-line. Sometimes,
other terms are used to describe the relationships in
these groups, for example, mutual aid groups and
mutual helping groups.
Second, few local or national organisations systemati-
cally maintain records of self-help groups. Groups can
be hard to access and many have little or no contact with
public agencies, thereby remaining hidden from public
view. Research into self-help groups also tends to be par-
tial as usually only extant groups are included. It is diffi-
cult to contact groups that have closed or that have failed
to properly get started and consequently these groups
rarely attract research attention.
Although there is growing evidence regarding their
benefits (Kryouz & Humphreys 1997), little is known,
particularly in the UK, about groups’ life-cycles
(Borkman 1999, King et al. 2000) and their reasons for
closure. Understanding groups’ evolutionary processes
is based mainly on international, particularly American,
studies (Karlsson et al. 2002) that may have limited appli-
cation within the UK.
This study comes at a time when UK health policy,
especially in relation to the management of long-term ill-
ness, is beginning to incorporate lay and peer expertise
into service delivery (Taylor & Bury 2007). In addition,
there is an emphasis on the development of patient user
groups, which, although distinct, share similarities with
self-help groups (Godin et al. 2007). Although it is
observed that self-help groups emerge and evolve in
response to their social policy context (Munn-Giddings
2003) and national welfare systems (Steinke 2000), previ-
ous research also suggests that professionals misunder-
stand how self-help groups work (Wilson 1994, Elsdon
et al. 2000) and improving understanding of the ways in
which groups evolve is important in ensuring that pro-
fessional involvement is appropriate (King et al. 2000).
An understanding of self-help group processes is, there-
ª 2010 Blackwell Publishing Ltd
The lifespan and life-cycle of self-help groups
fore, essential to inform the sympathetic development of
health policies that encourage lay involvement in plan-
ning and delivery of services.
The study aims to add to the limited evidence regard-
ing UK self-help groups and to increase understanding
of group development and the reasons why groups
close.
Research context
The data on which this paper draws were provided by
SHN. SHN is an intermediary organisation that sup-
ports local self-help groups. It provides a contact point
for groups and for enquiries about self-help. It assists
groups at their inception and offers assistance, such as
training and small subsidies. It also supports groups
over less tangible matters, for example, their direction
and aims. The city of Nottingham is the only UK area
that has this type of support agency for all types of self-
help group.
SHN records data on all the groups with which it has
contact. It also produces a directory of current groups
that is distributed locally and available to the public. The
directory contains all those groups who consent to be
included and who have reached certain developmental
milestones.
Methods
The sample comes from a practice database that was
kept as a means of logging the development of and
maintaining contact with groups. It contains information
on 936 self-help groups that have closed down since
SHN commenced keeping records in 1982. Initially the
data were collected using a paper based record system,
and subsequently recorded and updated using a ‘Card-
box’ computer database.
The groups are classified into four types according to
their status at closure: (1)’enquiries’ are groups where
SHN received a request for information about starting a
group, but no further development occurred; (2) groups
at the ‘thinking’ stage had responded to the information
from SHN and a meeting had taken place between a
SHN worker and potential self-help group members; (3)
‘new’ groups had reached the stage of having some
internal organisation and had begun to hold meetings;
and (4) ‘established’ groups had been operating for over
a year, had held regular meetings and had a method for
being contacted by the public.
After losing contact with groups, SHN sends out a
final letter asking the group to contact them if they are
still active. If they receive no response, the group will be
logged as ‘closed’. It is possible that some of these groups
may still be running without the knowledge of SHN.
347
S. Chaudhary et al.

The majority of information is recorded within prede- words in the free text. Again there was some overlap
termined categories including the group name, first and with some groups citing more than one reason for their
last contact dates, contacts with professionals and closure. In these cases, the groups were included in all
whether groups undertook certain forms of publicity. In cited categories as it was generally not possible to rank
addition, the database includes some free text providing the various reasons.
more information about some of the groups, such as To increase the validity of the study, the findings
their reasons for closure. were referred back to staff at SHN for comment.
Ethical approval was not deemed necessary as the
study, relying solely on existing, routinely collected data,
Results
falls within the definition of service evaluation (National
Patient Safety Agency 2008) and was undertaken for the
Types of group
purposes of SHN’s own internal evaluation. The data-
base was anonymous and contained no confidential Of the 936 groups, 419 were physical health groups.
information. These included groups for transient, long-term, common
and rare conditions. The mental health category com-
prised of 185 groups. These included diagnosed condi-
Analysis
tions such as schizophrenia and more general conditions
The data record fields were not designed for research such as stress or addiction. ‘Social issues’ comprised 349
purposes and the validity of the information contained groups including bereavement and unemployment as
in the database had not been tested. Consequently, a well as broader situations such as ‘isolation’. Some
broadly qualitative approach coupled with descriptive groups from this category were social groups that did
analysis was deemed most appropriate. The descrip- not address a specific problem.
tive statistics were obtained using ‘Cardbox’ indexing Within these broad categories were a number of fre-
software. Basic content analysis was used (Graham quently occurring subgroups as shown in Table 1 below.
2005) for counting key words and themes contained
in the database. This is an appropriate analytic
Characteristics of members
method for building a picture of a phenomenon rather
than explaining the reasons for its occurrence (Adams Some groups were exclusive to specific memberships
et al. 2009), and thereby consistent with the paper’s including parents, black people and women, as can be
aim of contributing to evidence about UK self-help seen in Table 2. These membership categories were not
groups and to develop further questions for future mutually exclusive. Four hundred and ninety-nine
research. groups did not have specific membership require-
Groups were categorised according to the type of ments.
condition they addressed. The three main categories
were physical health, mental health and social issues.
These categories were subdivided according to the most
frequently occurring subgroups. Additional groupings Table 1 Most frequently occurring subgroups
were made according to membership characteristics such
as gender and ethnicity. The allocation to these catego- Number of groups
ries was done through the group’s name and explana-
Cancer 34
tory notes in the text. There was some overlap among
Disability 39
the categorisations. Where it was possible to discern a Gynaecology 21
main purpose or main type of membership, it was allot- Parents of sick children 84
ted to that category. Where groups appeared to have a General mental health 67
dual purpose or membership, they were allotted to both Addiction 45
Bereavement 49
categories.
Parenting 85
The data were also categorised according to the Domestic violence and rape 22
group’s status at closure. Groups at the ‘enquiry’ or Social group 39
‘thinking’ stage were categorised as having closed while Sexual abuse 24
‘in development.’ Those at the ‘new’ or ‘established’ General carers’ groups 24
Other 420
stage were classified as closing after becoming ‘estab-
lished.’ The column total is greater than the number of groups as the
Reasons for closure were given for approximately categories were not exclusive.
one-third of groups. Categories were derived from key *Total number of groups is 936.

348 ª 2010 Blackwell Publishing Ltd

 The lifespan and life-cycle of self-help groups

Table 2 Breakdown of type of group by status

Longevity of groups
Established In development Total
To provide more insight into groups’ life-cycles, the data
Health 205 (49%) 214 (51%) 419 were summarised according to the length of time for
Mental health 81 (44%) 104 (56%) 185 which the groups existed, as shown in Table 2 below.
Social 136 (39%0 213 (61%) 349 Of the 936 groups, 515 (55%) had closed while ‘in
Cancer 16 (47%) 18 (53%) 34 development’. These groups’ lifespan ranged from a sin-
Disability 18 (46%) 21 (54%) 39
gle contact with SHN to over 30 months.
Parents of sick children 45 (54%) 39 (46%) 84
General mental health 30 (45%) 37 (55%) 67 The remaining 421 (45%) groups had closed after
Addiction 24 (53%0 21 (47%) 45 becoming ‘established.’ These groups had lasted
Bereavement 26 (53%) 23 (47%) 49 between 1 and 27 years.
Social group 19 (49%) 20 (51%) 39 There was reasonable consistency regarding the pro-
Domestic violence and rape 7 (32%) 15 (68%) 22
portion of groups reaching ‘established’ status prior to
Criminal justice 2 (17%) 10 (83%) 12
Sexual abuse 9 (37%) 15 (63%) 24 closure. However, as Table 2 indicates, some categories
Parenting 35 (41%) 50 (59%) 85 showed exceptionally high or low proportions of ‘estab-
Black 21 (60%) 14 (40%) 35 lished’ groups.
Asian 15 (48%) 16 (52%) 31
Men 10 (36%) 18 (64%) 28
Women 78 (45%) 96 (55%) 174 Reasons for groups’ closure
Reasons were given for 319 groups, although for 42
groups, these reasons merely stated that SHN had ‘lost
Professional contacts
contact’ with the group and so we cannot be certain that
This information was recorded for 688 groups of which they were not still running. Of the 42 groups where ‘lost
384 had been in contact with professionals. The database contact’ was stated, 27 (64%) were ‘in development’ and
showed 304 groups as not having had contact with pro- 15 (36%) were established. The subsequent analysis con-
fessionals; however, it may be that some of these had cerns the remaining 277 groups for which reasons for
contacts of which SNH was unaware. The type of profes- closure were given.
sional was logged in most cases. These included health
and social workers, clergy, teachers and charity workers.
Reasons for closure: groups ‘in development’
The nature of the relationship was not recorded.
Similar proportions (41% and 42% respectively) of Of these 277 groups, 85 had closed while ‘in develop-
groups that closed while ‘in development’ and when ment’. The most common reason, given by 25 groups,
‘established’ were recorded as having had contact with was due to the key member’s withdrawal. The most fre-
professionals. quent reasons for this withdrawal were ill-health, a
Of the 49 groups that had lasted for at least 10 years, change of focus or a change in their circumstances.
only 11 had links with professionals, whereas 25 had ‘Dwindling numbers’ was cited by 23 groups as a cause
not. The remainder of these cases was unknown. of closure and 23 groups also stated that they had failed
to properly ‘get going.’ This was often for similar reasons
as for key members’ withdrawal, such as the initiator’s
Publicity
ill-health.
The database logged which groups had appeared in Six groups reported practical problems, such as find-
SHN’s directory and their listings page in the local news- ing suitable venues, as either the reason for the group’s
paper. To be eligible for inclusion in either medium, closure or leading to a decline in numbers and its conse-
groups had to have reached ‘established’ stage and been quent closure.
fulfilling certain requirements such as holding meetings. A further 11 groups closed for reasons connected to
One hundred and thirty-one groups had appeared in the external organisations. In four cases, the group believed
newspaper, while 194 had not. Two hundred and one that the national organisation better addressed their
groups had been entered in the directory while 64 had needs than a local group. The remaining seven groups
not. It was unclear from the database how many of these were reliant on public sector workers and when these
groups had chosen not to be included and how many workers withdrew the groups were unable to continue.
were omitted due to not meeting SHN’s entry require- Additional reasons for closure were; the group hav-
ments. However, staff at SHN stated that a ‘significant ing achieved its purpose (two), the group no longer
proportion’ had elected not to be entered in either med- being self-help (five) and problems among members
ium. Only nine groups had had their own website. (one).

ª 2010 Blackwell Publishing Ltd 349

S. Chaudhary et al.

Table 3 Reasons for groups’ closure at different stages of

Reasons for closure: ‘established’ groups maturity
Of the 277 groups with reasons for closure, 192 were
Age of group 1–3 4–6 7–9 10 or
‘established’. Again the two most common reasons were at closure (total years years years more
key member withdrawal (74 groups), followed by declin- number of groups) (74) (43) (26) years (49)
ing membership (72). The reasons for key members leav-
ing were similar to those given by groups ‘in Key member 24 18 10 22
development’; however, ‘established’ groups also cited withdrawal
Dwindling numbers 37 11 9 15
the ‘unwilling[ness]’ of other members to contribute to Practical problems 4 3 1 6
the group’s organisation or to assume leadership. External 9 9 6 9
A change in focus was cited by 23 groups. Five of these organisations
became professionally organised while others became Change of focus 5 11 2 5
campaigning groups. A few groups changed from meet- Never got going 7 0 0 0
Achieved aims 2 3 4 0
ing as a group to meeting simply as friends. In some Problems 4 2 0 1
cases, a change of direction was related to declining among members
membership, group leaders therefore deciding to offer Merger 3 1 0 2
telephone help-lines instead. Lack of support 0 0 2 1
The reasons given by ‘established’ groups were similar
*Columns add up to more than total of groups as categories are
in proportion to those for groups ‘in development’,
not exclusive.
although some, such as a failure to ‘get going,’ were, as
perhaps expected, less common in ‘established’ groups,
with only seven groups citing this. Conversely, some Number of group closures
problems were more likely to become apparent after the Table 4 indicates the number of groups that closed
group had been operating for some time, for example, within 5-year bands for the time period under consider-
problems between members were reported by seven ation. The years in which groups actually closed were
groups and merger was the reason why six groups closed. given for 585 groups. For 350 groups, no closed date was
Reasons connected to external agencies accounted for recorded and so the table uses the date of their final con-
the closure of 33 groups, with 14 of these closing due to tact with SHN. One group had no contact dates
the influence of national self-help organisations. As with recorded.
groups ‘in development’, closure was sometimes at the
members’ instigation; however, there were also ‘compli-
cations’ and ‘problems’ with national bodies and in five Discussion
cases, the national group was cited as having closed The data provide a number of points of interest that will
down the local branch. A change in relationship with add to the limited knowledge base about UK self-help
professionals was stated by 19 ‘established’ groups. groups’ life-cycle processes. They suggest important
Again, this was usually due to reliance on a worker who questions, both for future research and regarding the the-
could no longer support the group. In addition, some oretical understanding of self-help groups.
groups closed due to changes in local services, which It is important, however, to note the limitations of the
made them unviable or superfluous. study. First, the data held by SHN were not collected for
Further reasons included practical problems, usually research purposes. Second, Nottingham is the only area
with venues (14 groups), or the group having achieved with a dedicated organisation that supports all types of
its purpose (nine groups). A lack of ‘support’ was cited self-help group. This may have a significant effect on
by three groups, although it was unclear to whom this groups’ survival rates. Furthermore, not all self-help
lack of support referred. groups in the Nottingham area choose to be in contact

Further analysis of ‘established’ groups according

Table 4 Number of group closures over time
to lifespan
The reasons for closure were further analysed for groups 1982– 1985– 1990– 1995– 2000– 2005– Total
that had existed at different lengths of time to provide 1984 1989 1994 1999 2004 2007
more detail about the types of problem that occur during
Number of 10 142 157 313 213 100 935
a group’s evolution. In fact, as Table 3 indicates, the rea- groups
sons for closure were fairly consistent irrespective of the
group’s age. *No contact dates were recorded for one group.

350 ª 2010 Blackwell Publishing Ltd


with SHN and those that do not may behave differently
than those that do.
Consequently, the findings would strictly be
regarded as specific to Nottingham. However, the dearth
of knowledge about UK self-help groups means that at
present they may represent the best available informa-
tion of this type and a means through which future ques-
tions about self-help groups in all areas of the UK can be
defined.
Groups’ practices, such as their ways of attracting
new members, are believed to affect survival rates (Wi-
tuk et al. 2002). However as Medvene (1985) stated, due
to their small-scale, non-bureaucratic and collectivist nat-
ure, standard organisational theories may not be applica-
ble to self-help groups and this may still be the case
today. Similarly standard organisational practices such
as the need for publicity or the desire to maximise mem-
bership will not necessarily be desirable for self-help
groups. Some of these groups, including many that had
existed for several years, appear to have preferred to
remain ‘hidden’ and to limit their membership, as shown
by their reluctance to publicise themselves. It may be that
for some groups to maintain their particular philosophy,
it is desirable that prospective members proactively seek
them out rather than being reached through standard
routes such as advertising. Self-help groups are extre-
mely varied in their aims and ways of working and so it
should be expected that a wide range of practices will
suit different groups. Therefore, guidance and advice for
groups should not be overly prescriptive or necessarily
based on presumptions that underlie mainstream organi-
sations.
Literature suggests that growing numbers of groups
have links with health and social care professionals
(Medvene et al. 1999–2000, Ben-Ari 2002, Wituk et al.
2002), but there is disagreement as to how this relates to
groups’ lifespans (Maton et al. 1989, King et al. 2000,
Wituk et al. 2002). Maton et al. suggest a complex rela-
tionship, whereby there is an optimal level of profes-
sional support, beyond which it actually lowers survival
rates. They also state that when professional support is
coupled with assistance from a national umbrella organi-
sation, it can negatively affect longevity. The findings do
not allow for firm inferences, but appear to support the
view that the effects of professional involvement are not
straightforward. Over half of the groups that closed after
10 years or more did not have any links with profession-
als suggesting that professional contact is not vital to
group survival.
Although these findings do not allow for predictions
about the expected lifespan of different types of group,
some of the data stood out as being of particular interest.
The difficulties in establishing ex-prisoners’ groups sug-
gest that the demographic characteristics of group mem-
ª 2010 Blackwell Publishing Ltd
The lifespan and life-cycle of self-help groups
bers may affect survival rates. International studies
(Lieberman & Snowden 1999, Barnett et al. 2006) state
that self-help groups are more widely used by people
with higher levels of education and socioeconomic sta-
tus. Elsdon’s study (2000) found that UK groups are
rarely accessed by social classes that include unskilled
labour and the unemployed. It may be that the typically
low socioeconomic status, low levels of education and
often chaotic lives of prisoners would make the establish-
ment of groups more difficult. Domestic violence, rape
and sexual abuse groups also showed high rates of early
closure, which may indicate a negative relationship
between social stigma and group survival. These issues
also have greater scope for political and ideological dis-
agreements between group members than do health con-
ditions, potentially leading to difficulties in becoming
established. Such factors could also possibly account for
the difference in proportions of early closure between
groups for parents of sick children, of which 54% became
‘established’ and for parenting of which only 41%
became ‘established. Williams (2004) describes how
members of parenting groups have an acute sense of
stigmatisation, whereas such feelings are unlikely to be
held by parents of sick children, and parenting problems,
at least those reaching the attention of statutory services,
tend to be associated with lower socioeconomic groups
(Katz et al. 2007). However, the numbers in the data set
are too small to allow further testing of this hypothesis.
In all cases, further research would be needed to allow
firm conclusions about why groups for certain popula-
tions have difficulty in becoming established. It would
be useful, for example, to explore whether these groups
require additional support, whether they are more feasi-
ble when operating under a national organisation or
whether indeed there are some problems for which self-
help may not generally be appropriate.
Black groups were the most likely to become ‘estab-
lished’. Again this raises questions for future research. If
the reasons relate to particular features within black com-
munities, then this may not be transferable to non-black
groups. However, if it is due to the nature of the support
or assistance that black groups receive, lessons might be
learned that are relevant more broadly. Obaze (1999) has
suggested that black people are more likely to be
involved in community mutual aid than in traditional
voluntary organisations, and it may be that this also
applies to single issue self-help groups. This type of
information can be useful at the level of policy planning,
for example, when trying to recruit ethnic minorities into
volunteering too narrow a focus on the traditional volun-
tary sector may be less effective than policies that facili-
tate the organisation of self-help groups.
The closure of 55% of the groups before becoming
‘established’ supports the work of Maton et al. (1989) that
351
S. Chaudhary et al.
found a ‘steady turnover’ of self-help groups and the
view that self-help groups tend to have a natural life-
span. This life-cycle may be a consequence of the way in
which groups are usually instigated and led by individ-
ual founder members. It may also be due to patterns in
membership renewal, which slow down after groups’
initial impetus to attract members. A common response
(King et al. 2000, Wituk et al. 2002) is to regard these
issues as ‘problems’ and to look for ways to resolve them
to increase survival chances. However, the risk in this
approach is that extending groups’ lives may come to
take priority over allowing them to evolve in their own
unique and spontaneous ways. Interventions designed
to improve longevity could thus undermine groups’
effectiveness. Furthermore, to focus too closely on the
‘problem’ of key member withdrawal, or to place too
much emphasis on groups developing pre-emptive strat-
egies against it could lead to the creation of the very
problems such interventions were intended to resolve,
ensuring that groups who may otherwise have coped
with this situation come to see it as inevitably leading to
crisis. The ‘problem’ of group closure due to key mem-
ber withdrawal or declining membership may be an
intrinsic by-product of how groups work and thus inter-
ference in these processes could fundamentally alter the
group’s nature.
Similarly, attempts to ‘improve’ the survival chances
of self-help groups could affect the environmental equi-
librium that gives rise to new groups. Maton et al. (1989)
explain how groups arise in response to their environ-
ment, particularly in relation to existing groups. If this
environment is altered by prolonging groups’ lives, the
spontaneous dynamic of groups’ birth rates and turn-
over could be altered and consequently their unique
responsiveness to changing problems could be affected.
This does not mean that groups should not be given
assistance or that advice and guidance would always be
inappropriate, but rather that care is needed to ensure
that this advice works sympathetically with self-help
groups’ natural processes and patterns.
Although the data cannot support detailed conclu-
sions about why groups close, they suggest that a crucial
role is played by key members. It is therefore important
that future research begins to ask more in-depth ques-
tions about the nature of this role, the characteristics of
its holders and the reasons why groups may become so
reliant upon them.
The reliance by some groups on professionals, as
illustrated by these groups’ demise upon their with-
drawal, is also an important area for future research. The
findings here raise questions about the different roles
that professionals have within groups and the ways in
which different types of professionals may view their
relationship with self-help groups. Borkman (1999) high-
352
lights these issues in response to her work with Ameri-
can groups and the extent to which her typology of
professional relationships with self-help groups is appli-
cable in the UK is open to further enquiry. Research
should also begin to ask how groups that are begun by,
or initially rely heavily on, professionals can successfully
pass control to group members.
Increased understanding of professionals’ different
roles may also allow for more accurate definitions of
self-help groups in relation to support groups.
The data do not indicate any distinct pattern in the
rate of group closure over the last 30 years and do not
allow us to infer the effects of changing social attitudes,
policy changes or technological advances, most particu-
larly the growth of the internet. However, the mainte-
nance of this type of information is important if future
research is to address such questions and it would be
valuable to discover how the growth of on-line self-help
might be related to the survival chances of face-to-face
groups.
The findings also raise theoretical questions about
self-help groups. Self-help groups are believed to be
grounded in the principle of serial reciprocity whereby
benefit to oneself is derived through helping others and
contributing to the group (Medvene & Teal 1997, Munn-
Giddings & McVicar 2006). That so many groups close
when key members leave suggests that this is not always
occurring. The withdrawal of the key member would
seem unlikely to have such effects if the members were
all contributing to the group. However, it may be that
reciprocity applies only to the substantive work of
groups, for example with regard to giving and receiving
support, and not to its organisational functions.
The findings also indicate the need to begin to
broaden the theoretical contextualisation of self-help
groups. It has been claimed that self-help groups play a
civic role within the community and can contribute
towards democratic regeneration (Giddens 1992, 1998,
Van Hove et al. 2000). However, while groups have been
analysed in relation to civil society and the voluntary or
third sector (Karlsson et al. 2002), they have not as yet
been considered within Habermasian type frameworks
of the public sphere. Within these models the public
sphere is broadly defined as a space in society, indepen-
dent of the state, in which groups of citizens associate
freely and communicate about issues pertaining to the
common good (Calhoun 1992). These associations must
be inclusive and non-hierarchical in structure, and they
should be conducive to the dissemination of ‘political
learning’, which includes, for example, organisational
skills (Marcello & Perrucci 2000).
The apparent control of groups by key members and
the inability or unwillingness of other members to take
organisational responsibility, as well as some groups’
ª 2010 Blackwell Publishing Ltd

reliance on the leadership of professionals, suggests that
groups may not be functioning as ‘perfect democracies’
or structured in the egalitarian way that is frequently
presumed (Rootes & Aanes 1992, Brown et al. 2000) and
that gives rise to their being seen as contributing within
the public sphere.
This inability of members to take control of groups
also implies that they are not necessarily as effective as
sites for the development of political learning as is some-
times suggested (Gidron & Chesler 1994, Elsdon et al.
2000).
The reliance on and frequency of links with profes-
sionals also raises questions about the extent to which
groups can be seen as operating independently of the
state, and hence how far they should be seen as being
able to contribute validly to communication within the
public sphere.
Conclusions
The article draws together information held about 936
self-help groups that closed between 1982 and 2007. The
findings provide a broad-brush, picture of the life-cycle
of self-help groups which until now has been absent
from UK literature.
The majority of groups in the sample closed before
becoming ‘established’, that is, before having started to
function properly as a group by, for example, holding
regular meetings. This seemingly high figure is in line
with USA studies that similarly suggest a high turnover
rate.
Groups that supported people who were involved in
the criminal justice system and for rape and domestic
violence victims had the lowest rates of survival. Black
groups had the highest rates. And physical health
groups were more likely than social issue or mental
health groups to become ‘established’. The findings did
not provide enough information to allow us to explain
the reasons for groups’ differential survival rates; how-
ever, they do provoke questions for future research to
address.
The database held information about the reasons for
the closure of 277 groups. By far the most commonly
cited of which were the group leader’s withdrawal and
declining group membership. There was a notable con-
sistency in the reasons for closure with groups of all dif-
ferent ages.
The database does not allow for accurate predic-
tions about the expected lifespan of different types of
group but does allow us to begin to build a picture of
the ways in which UK groups evolve and develop
and the problems they face at different stages of their
existence. And it raises questions for future research
particularly regarding the leadership and organisation
ª 2010 Blackwell Publishing Ltd
The lifespan and life-cycle of self-help groups
of groups and the reasons why different types of
group appear to have a different likelihood of reaching
maturity.
Acknowledgements
The authors would like to thank the staff at Self
Help Nottingham, particularly Caroline Bell and
David Thornton, for their assistance at all stages of
the research.
References
Adams J., Khan H., Raeside R. & White D. (2009) Research
Methods for Graduate Business and Social Science Students.
Sage, London.
Adamsen L. & Rasmussen M. (2001) Sociological perspec-
tives on self help groups: reflections on conceptualisation
and social processes. Journal of Advanced Nursing 35 (6),
909–917.
Barnett R., Barnett P., Pearce J. & Howes P. (2006)
Reconsidering the role of a local Diabetes Society: pat-
terns of membership in Christchurch, New Zealand.
Australian and New Zealand Journal of Public Health 30
(3), 275–279.
Ben-Ari A. (2002) Dimensions and predictions of profes-
sional involvement in self help groups: a view from
within. Health and Social Work 27 (2), 95–103.
Borkman T. (1999) Understanding Self Help ⁄ Mutual Aid:
Experiential Learning in the Commons. Rutgers, New
Jersey.
Brown K., Kenny S., Turner B. & Prince J. (2000) Rhetorics
of Welfare: Uncertainty, Choice and Voluntary Associations.
Palgrave Macmillan, Gordonsville.
Calhoun C. (1992) Habermas and the Public Sphere. MIT
Press, Cambridge, Mass.
Dadich A. (2003–2004) Self Help Groups and Issues in
Research. International Journal of Self Help and Self Care 2
(1), 41–55.
Elsdon K., Reynolds J. & Stewart S. (2000) Sharing Experi-
ence, Living and Learning: A Study of Self Help Groups.
Community Matters, London.
Giddens A. (1992) The Transformation of Intimacy: Sexuality,
Love and Eroticism in Modern Society. Polity Press, Cam-
bridge.
Giddens A. (1998) The Third Way: The Renewal of Social
Democracy. Polity Press, Cambridge.
Gidron B. & Chesler M. (1994) Universal and particular
attributes of self help: a framework for international and
intranational analysis. In: F. Lavoie, T. Borkman and B.
Gidron (Eds) Self Help and Mutual Aid Groups: Interna-
tional and Multicultural Perspectives, 1–44. Haworth Press,
New York.
Godin P., Davies J., Heyman B., Reynolds L., Simpson A.
& Floyd M. (2007) Opening communicative space: a
Habermasian understanding of a user-led participatory
research project. The Journal of Forensic Psychiatry and
Psychology 18 (4), 452–469.
Graham B. (2005) Resaerch Interviewing: The Range of Tech-
niques. Open University Press, Milton Keynes.
Karlsson M., Jeppsson Grassman E. & Hansson J. (2002)
Self help groups in the welfare state: treatment program
353
S. Chaudhary et al.
or voluntary action? Non-Profit Management and Leadership
13 (2), 155–167.
Katz I., Corlyon J., La Placa V. & Hunter S. (2007) Poverty
and Parenting. Joseph Rowntree Foundation, York.
King G., Stewart D., King S. & Law M. (2000) Organiza-
tional characteristics and issues affecting the longevity of
self help groups for parents of children with special
needs. Qualitative Health Research 10 (2), 225–241.
Kryouz E. & Humphreys K.(1997) A review of research on
the effectiveness of self help mutual aid groups [WWW
document]. URL http://www.telosnet.com (accessed on
12 January 2009).
Lieberman M. & Snowden L. (1999) Problems in assessing
prevalence and membership characteristics of self help
group participants. Journal of Applied Behavioural Science
29, 166–180.
Marcello M. & Perrucci R. (2000) Small groups and civic
engagement [WWW document]. URL www.rwu.edu/
~ccps/rcq/rcq-smallgroups.html (accessed on 19 Novem-
ber 2009).
Maton K., Leventhal G., Madara E. & Julien M. (1989) Fac-
tors affecting the birth and death of mutual-help groups:
the role of national affiliation, professional involvement,
and member focal problem. American Journal of Commu-
nity Psychology 17 (5), 643–671.
Medvene L. (1985) An organizational theory of self help
groups. Social Policy 15 (3), 35–37.
Medvene L. & Teal C. (1997) Leaders’ ambivalence about
reciprocity obligations in self help groups. Small Group
Research 28 (2), 302–322.
Medvene l., Wituk S. & Luke D. (1999–2000) Characteristics
of self help group leaders: the significance of professional
and founder statuses. International Journal of Self Help and
Self Care 1 (1), 91–105.
354
Munn-Giddings C. (2003) Mutuality and Movement: An
Exploration of the Relationship of Self-Help ⁄ Mutual Aid to
Social Policy. Loughborough University, Loughborough,
UK.
Munn-Giddings C. & McVicar A. (2006) Self help groups
as mutual support: what do carers value? Health and
Social Care in the Community 15 (1), 26–34.
National Patient Safety Agency (2008) Defining Research.
NHS, London.
Obaze D. (1999) Black people and volunteering. In: R. Hedley
and J. Davis Smith (Eds) Volunteering and Society, 132–
144. NCVO, London.
Rootes L. & Aanes D. (1992) A conceptual framework for
understanding self help groups. Hospital and Community
Psychiatry 43 (4), 379–381.
Steinke B. (2000) Rehabilitation initiatives by disability self
help groups: a comparative study. International Social
Security Review 53, 83–107.
Taylor D. & Bury M. (2007) Chronic illness, expert patients
and care transition. Sociology of Health and Illness 29 (1),
27–45.
Van Hove E., Damen S. & Mortelmans D. (2000) Self help
groups in Belgium: their place in the care network. Soci-
ology of Health and Illness 22 (3), 331–348.
Williams F. (2004) Care, values and support in local self
help groups. Social Policy and Society 3 (4), 431–438.
Wilson J. (1994) Self Help Groups and Professionals. Social
Care Research 60. Joseph Rowntree Foundation, York, UK.
Wituk S., Shepherd M., Warren M. & Meissen G. (2002)
Factors contributing to the survival of self help
groups. American Journal of Community Psychology 30 (3),
349–366.
ª 2010 Blackwell Publishing Ltd