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Frameworks and skills for keeping self-help groups on track

I Introduction

The Ontario Self-Help Network (OSHNET) Program of the Self-Help
Resource Centre (SHRC) provides support to self-help groups in their
development and, most importantly, with ongoing enhancement, change and
sustainability issues. This includes consultation services related to
specific challenges and training workshops on themes such as "Keeping
Your Group on Track" and "Facilitation Skills for Self-Help Support

Self-help/mutual aid support groups are informal networks of
individuals who share a common experience or issue. The primary focus
of self-help is emotional support, practical support and information
exchange. For more background about self-help groups and strategies,
see "Self-Help/Mutual Aid: Take Another Look" OHPE Bulletin 80.1
or visit

Since self-help groups depend on the leadership of peer volunteers,
challenges like maintaining momentum, ensuring regular evaluation, and
addressing change are accentuated even more than in professionally-led
programs. On the up side, the experience of working through these
community processes builds community members' personal skills,
empowerment and social support--all key ingredients of health.

The goals, structures, activities and procedures of
self-help/mutual aid groups vary as widely as the communities where
groups are present. And they should. Still, OSHNET (and similar
self-help capacity building programs across Canada, the US and the UK)
teaches common frameworks for how groups should approach discussing,
deciding and clarifying their activities. Beyond the realm of self-help
initiatives, many of our key messages point to good frameworks and
skills for any group working together towards health promotion goals.

This article will share the key messages covered in OSHNET's work
teaching frameworks and skills for keeping self-help groups on track:
* Understand the Stages of Group Development

* Share Leadership

* Clarify Guidelines for Group Activities

* Practice Skills for Dealing with Difficult Situations

* Maintain Momentum

For each, this article outlines why we teach it, what we use to
teach it and where readers can look for further resources on the topic
(some of which are also featured in OHPE 399.2).

II Understand the Stages of Group Development


Teaching group members about Tuckman's model on the stages of group
development gives important context to some of their experiences in
groups. Group members are often very concerned about the number of
meeting participants and the behaviours of newcomers to their group. By
learning a basic framework to interpret group dynamics and appreciate
the qualities of all stages of group development and participant
connection to groups, group leaders shift their perspectives and
develop more helpful insights on how to best meet their goals as a


We reference Tuckman's model of group development. We also use our
centre's own "popular" version, which employs the analogies of dating
instead of Tuckman's theoretical terms. The stages are thus first date
(forming) characterized by higher numbers, enthusiasm, interest,
anxiety; casual dating (storming/norming) characterized by questioning,
testing, conflict, decisionmaking); commitment (performing)
characterized by smaller numbers, clarity, trust, openness; and
separation (mourning/retiring) characterized by loss, reflection and
new opportunities--together or apart.


* Tuckman, B.W. & Jensen, M.A.C. (1977) Stages of small group
development revisited. Group and Organizational Studies, 2, 419-427

* Intro to Tuckman's stages of group development from the
Assessing Group Practice project website

* SHRC's "dating" version of the Stages of Group Development is on
page 8 of workshop handouts "Making It Work"

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III Share Leadership


On a most practical level, volunteer-run groups risk their
sustainability when they are led by only one person. Burnout is not
uncommon and in certain types of groups (e.g., cancer) disability or
death are realities that regularly affect group dynamics. More
fundamentally, the diverse grassroots community movements that
popularize self-help strategies question the common notion that
successful groups result from the influence of one or two good leaders.
Most successful self-help groups are those that share leadership roles
among many members--and leadership roles include any effort that
supports the positive momentum of the group (tasks as varied as
listening, cleaning up refreshments, welcoming new members, opening or
facilitating group discussions). When groups demystify leadership in
this way, members can affirm the real value of their unique
contributions; they will also perceive new responsibilities as more of
a development of their role and less of a risk.


We ask groups to seriously consider "what makes for good leadership
in groups?" In training workshops, we do this through a game where they
are asked to answer the question with words that begin with each letter
in the word "L-E-A-D-E-R-S-H-I-P." The results are most often words
like Listening, Empathy, Appreciation, Direction, Encouragement,
Respect, Sharing, Humour, Insight, Patience. When groups debrief these
results, it becomes clear that if only one group leader practiced these
actions/behaviours, the group would be awfully messy. A successful
group depends on the commitment of many to practice and model these
roles together through a variety of actions big and small.

Next we encourage groups to discuss how they can practice shared
leadership more effectively. To help groups clarify and structure
shared leadership roles, we invite them to break down leadership tasks
into their smallest components and divvy them up: e.g., What's involved
in preparing for a meeting? Setting up the room? Ensuring a welcoming
and safe space? Opening, facilitating, and closing a meeting? Cleaning
up and closing up? Ongoing outreach, evaluation, and planning? Once
each role is broken down, some members will commit to one task, some
might commit to several. Keeping the view that leadership is a
collection of supportive actions makes joining leadership less ominous,
and practicing leadership less of a burden.


* "From the Toolbox: The Leadership Matrix"

* OSHNET/SHRC Shared Leadership Workbook (

* Working Collectively handbook

* "Factsheet: Community Readiness for Economic Development:
Community Leadership", Ontario Ministry of Agriculture and Food, Chuck
Bokor, Community Leadership Specialist

* "Shared Leadership--developing theory and practice in groups and
organizations," Infed - Informal Education

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IV Clarify Guidelines for Group Activities


If only one or a select few leaders of a group are clear about why
the group meets and what norms guide its activities, the work of
maintaining these falls disproportionately on their shoulders.
Clarifying guidelines (and all agreements) puts the group vision out
front in a forum where all can participate in and support it.
Furthermore, guidelines for group discussions make the job of the
discussion facilitator easier by sharing responsibility (leadership)
among all participants to support good listening, avoid judgment and
offer appropriate responses during times of sharing or debate. This is
especially supportive when facing difficult situations. Clear
guidelines also help both members and outsiders better communicate what
the group does (goals and activities), and what it cannot do


We guide groups through the process of developing a group blueprint
(plan) that covers goals, activities, boundaries and guidelines.
Guidelines should include those related to confidentiality (a
cornerstone of mutual aid) and evaluation (how groups will receive and
integrate feedback from all members into their plans and practices). We
also encourage members to collectively develop guidelines specific to
their meeting procedures or group discussions (e.g., code of conduct).
A good question to ask is "what will make this group a supportive and
safe place for you?" Making a list of the answers forms the basis for
group guidelines.

During training, we guide participants through OSHNET's Shared
Leadership Workbook, which was designed as a tool to help groups
clarify guidelines and other decisions. Each page of the workbook
outlines key questions related to different aspects of a group
blueprint, with space to document decisions. Once agreed on and
documented, some of these decisions would be transferred to publicity
materials (e.g., group goals, activities and boundaries). Others, such
as confidentiality agreements and discussion guidelines, should be
incorporated into group welcoming materials, opening remarks, and/or
wall posters at meetings.


* Shared Leadership Workbook (see reference above in Share Leadership section)

* Ask existing groups in your community for sample guidelines or contact OSHNET

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V Practice Skills for Dealing with Difficult Situations


Conflict can happen at levels that are so small we hardly notice it
(e.g., I don't feel like eating fish for dinner) and on such heightened
scales it can become overwhelming or at times horrifying. Conflict in
groups is normal, yet it often seems mysterious and many people find
the task of addressing conflict ominous. To better address conflicts,
group members need to integrate two behaviours: 1) expect it--because
it's normal and 2) practice addressing it--because the more you address
it, the better you get (like learning to play an instrument).


The Self-Help Resource Association of BC outlines three skill areas
for effective facilitation (especially important to addressing
conflict). These are centering, listening, and assertive expression.
Practicing these skills makes dealing with difficult situations easier.
We help group members practice these skills through exercises that
address one specific skill (e.g., reflective listening exercises) and
through roleplays (roleplays offer the opportunity to practice
assertive expression in all its intimidating complexities). Foremost,
we encourage group members to support one another in bringing issues of
conflict to the table (preferably while they are still small) and
talking about them within the context of group guidelines.

More elaborate guidelines are available to assist groups in working
through conflict. OSHNET uses an adapted version from the Nova Scotia
Self-Help Connection. The steps in this process are check in with
yourself, use "I" statements to identify feelings of tension or
concern, create a space and time to "put the issue on the table",
clarify goals and ground rules, give everyone a chance to be heard, use
reflective listening skills, clarify the problem, brainstorming
solutions, identifying an action that is agreeable, pursuing the new
plan, committing to checking in later, congratulating yourselves (for
talking and trying) and checking out.


* "Working with the Hard Parts" workshop handouts, Ontario Self-Help Network (print)

* "Methods for Developing Skills," chapter 13, Psychological Self-Help, Clayton E. Tucker-Ladd

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VI Maintain Momentum


With volunteer-run groups, there are no paychecks to help maintain
momentum among leaders, so groups must be more conscious and creative
about recognizing their efforts, rewarding themselves, setting limits
and taking a break. Other important aspects of maintaining momentum are
the integration of new members and mentoring of new leaders.


Making a plan is paramount. Otherwise, this important aspect of
group sustainability can be neglected among other concerns. We
encourage group members to discuss amongst themselves how they like to
be acknowledged and thanked for both their day to day and special
contributions. This discussion focuses on the individual. For the group
as a whole, we advise them to incorporate activities of group
appreciation into regular meetings or at regular intervals (e.g.,
quarterly or annually). For example, reflect back over the past
meeting/year and share perspectives on how the group has helped members
over time. Enhancing group self-esteem helps keeps the energy flowing.


* Linda Kurtz, Self-Help and Support Groups: A Handbook for
Practitioners (Sage, London, 1997) has two chapters that discuss stages
of affiliation to groups, beginning participation and long-term
participation, with useful insights and tips for maintaining momentum

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VII Conclusion

Although member-led self-help groups achieve tremendous impacts in
diverse communities without outside funding, research has documented
how their impacts can be enhanced and broadened by capacity-building
support through professionals, non-profit organizations and government.
In Ontario, diverse local, regional and province-wide organizations
provide this support, among them the Ontario Self-Help Network. Ina
ddition to supporting groups directly, OSHNET's mandate includes
offering consultations and trainings to health promoters on strategies
for integrating and supporting self-help in their work.

Contact OSHENT for more details, or check out our online factsheets
"Tips for the Helping Professional"( and "Integrating
Self-Help Strategies in Your Health Promtion Work"