Mutual Help Groups for Mental Health Problems are Effective
A mutual help group is defined as a group of people sharing a similar problem, who meet regularly to exchange information and to give and receive psychological support, like Alcohol Anonymous. Traditionally, groups meet face to face, but internetbased groups have expanded rapidly in recent years.
In a recently published review of 12 studies meeting strict inclusion criteria mutual help groups provide limited but promising evidence that mutual help groups benefit people with three types of problems: chronic mental illness, depression/anxiety, and bereavement.
Seven of the 12 studies reported some positive changes in mental health for group members. The strongest findings come from two randomized studies showing that the outcomes of mutual help groups were equivalent to those of established, more costly, professionally provided psychological interventions. Five of the 12 studies found no differences in mental health outcomes between mutual help group members and non-members; no studies showed any evidence of negative effects. There was no indication that mutual help groups were beneficial for certain types of problems but not others.
Strenghts of mutual help groups:
- they utilize support from people who have gone through similar difficulties and participants therefore can easily empathize with each other
- This may compensate for deficiencies in people’s natural support networks
- group members possess ‘‘experiential knowledge’’, in contrast to the professional knowledge of service providers
Mutual Self Help groups and Depression
One excellent trial compared group behavioral therapy (CBT) and mutual help groups for depression, both professionally and non-professionally (peer) led. Self-report measures as well as ratings by an independent clinician were used to assess the change between before and after treatment. Participants improved on all measures, the outcomes of the mutual help groups being equivalent to those of the CBT groups, and peer leaders were as effective as professional therapists. Peer led groups are far more inexpensive than professional led groups.
In this group the only Internet based study of internet support groups was included. They used a longitudinal design to assess depressive symptoms over time. One-third of members showed a resolution of depressive symptoms with more frequent users more likely to improve (after adjusting for a number of other variables). Control group was lacking.
The third study included in the depression group studied self-help groups for adults hospitalized for unipolar or bipolar depression. Alas due to methodological flaws no conclusion can be drawn from this trial.
So for depression, mutual self help groups might be of benefit.
Evidence for efficacy of mutual self help groups is still in it’s infancy, what do you think?
The studies varied in terms of design quality and reporting of results. More high-quality outcome research is needed to evaluate the effectiveness of mutual help groups across the spectrum of mental health problems
Nancy Pistrang, Chris Barker, Keith Humphreys (2008). Mutual Help Groups for Mental Health Problems: A Review of Effectiveness Studies American Journal of Community Psychology, 42 (1-2), 110-121 DOI: 10.1007/s10464-008-9181-0
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February 13, 2009 @ 9:02 am
Participants improved on all measures, the outcomes of the mutual help groups being equivalent to those of the CBT groups,
It has been know for quite some time now that complete amateurs can deliver psychotherapy as successfully as highly trained professional therapists, and that CBT is no more effective overall than other forms of psychotherapy. Something the professionals, and CBT advocates, do not like to mention.
(Not saying there is no place for professionals, or CBT, but just saying.)
February 13, 2009 @ 11:12 am
Nonspecific factors in psychotherapy are very relevant. Is your comment based on evidence, would surely like to read it. Kind regards Dr Shock
February 14, 2009 @ 12:20 am
As a former facilitator of a local chapter of DBSA (Depression Bipolar Support Alliance) here in the U.S. for a number of years I can only share my anecdotal observations and the comments shared by those participants suffering from MDD (Major Depressive Disorder) and Bipolar disorders.
For some of the depression participants the meetings were not only the highlight of their week but were the only encouragement for them to force themselves to get out of bed and for the hour and a half or two hours they often stated they felt better. For some it was also their only human contact for the week and an opportunity to be hugged and to share their tears and stories with others of understanding without any judgment.
These meetings often led to friendships and the outside telephone networking of participants for both friendship and emergencies.
There were suicides within the group and although I cannot share statistically the number of aborted suicide attempts there is no doubt in my mind that the number was substantial and many were saved by way of these group meetings and the telephone support lent to one another.
In my opinion, support groups are an invaluable and no or little expense resource to aid in patient recovery.
Warmly,
Herb
VNSdepression.com
February 14, 2009 @ 12:36 am
Hi,
I have been enjoying your updates on twitter, certainly varied and have provided some interesting links.
I first came across your blog from Aqua :o)
February 14, 2009 @ 10:49 am
@life Your very welcome, noticed you just started a blog with very nice pictures, enjoyed them very much. As you might have noticed I like photography. Kind regards Dr Shock
Points of Interest, vol. 2 #4 « Mind, Soul, and Body
February 14, 2009 @ 8:04 pm
[…] Shock reports on a study that shows peer mutual support groups are as effective as the standard of care, cognitive behavioral therapy for chronic mental illness, bereavement, and depression/anxiety, and ponders if the cost savings […]
March 18, 2009 @ 2:37 am
For a review of earlier, rigorous studies which reflected the value of mutual aid self-help groups across a broad spectrum of health and bereavement, see:
http://www.chce.research.va.gov/docs/pdfs/KyrouzHumphreysLoomis2002.pdf
If you are interested in a better understanding of what mutual aid self-help groups are, look over the first chapter of the “Self-Help Group Sourcebook” at:
http://www.medhelp.org/njgroups/SB-Understanding%20SH.pdf
March 18, 2009 @ 12:13 pm
Thank you for the links, very interesting and helpful, kind regards Dr Shock
Self-Help Treatment for Depressive symptoms, which is the best? | Dr Shock MD PhD
March 21, 2009 @ 11:32 am
[…] self help groups, cognitive behavioral therapy and problem solving therapy are the most important Mutual help groups provide limited but promising evidence that mutual help groups benefit people with three types of […]
June 8, 2009 @ 12:15 am
Interesting and helpful, thank you. I am the manager of an anxiety support organisation that offer contracted services and support groups to people with a range of anxieties. It can be a fine balance in support groups between assisting people’s recovery whilst trying to avoid fostering long term dependence. We find it to be very constructive to encourage people to become involved in the workings of the group, including at times acting as ‘buddies’ for new members. This can assist people to realise what they’ve gained and learned from having a mental illness, giving something back helps to make it meaningful. I note that the preamble to the study material talked about three types of problems, one of which is noted as anxiety/depression. Both conditions are so prevalent that I believe they each deserve study in their own right. Yes, anxiety is very often comorbid with depression but not necessarily the other way around. Were the studies concerned conducted only with people where comorbidity was present?
October 20, 2009 @ 7:17 pm
According to the Samsha report that was just publushed on October 19, 2009, Self help groups and support groups are playing and ever increasing role in the recovery for people. As funding for traditional services is being cut groups are becoming more and more needed. Peer facilitators who are properly trained can lead a group more effectively than a professional who probably “has not been there” or walked in the steps of those in the group. That’s what makes groups work is the peer to peer connection people find.
Points of Interest, vol. 2 #4 | Mormon Bloggers
December 12, 2009 @ 11:51 am
[…] Shock reports on a study that shows peer mutual support groups are as effective as the standard of care, cognitive behavioral therapy for chronic mental illness, bereavement, and depression/anxiety, and ponders if the cost savings […]