Self-Help Group Leaders as Community Helpers: An Impact Assessment

Greg Meissen, Mary Warren, Tonja Nansel, & Samantha Goodman

Self-Help Network of Kansas    Wichita State University

ABSTRACT

The Self-Help Associate Leadership Project (SHAL), created roles for experienced self-help group leaders in Kansas in which these persons assisted rural communities in extending the use, awareness, and effectiveness of self-help groups. Volunteers were self-help group leaders willing to assist other groups in their area and to work to increase awareness of the use and efficacy of self-help in general. Following social exchange theory, this research assessed the leaders’ current self-help roles in terms of the costs and benefits of participation. This data was useful in tailoring SHAL roles to emphasize those tasks that are most rewarding and advantageous to both the volunteers and the groups that they serve, while being of low cost to the leaders personally. Ongoing data collected by the Self-Help Network of Kansas showed a significant increase in self-help group activity in counties with SHAL volunteers compared to matched counties without. This study supports the use of data-based applied research as a means to support natural helpers in rural communities.

SELF-HELP GROUP LEADERS AS COMMUNITY HELPERS: AN IMPACT ASSESSMENT

Self-help groups are being increasingly recognized as a viable and effective resource for meeting health and mental health needs. Recent years have seen increases in numbers of self-help groups and people attending them, greater legitimization of self-help groups, and more research documenting the benefits obtained by persons using these groups (Meissen & Warren, 1994; Kyrouz & Humphrey, 1997). Although such events have often been referred to as indicative of a growing self-help group movement, in reality, most group members are primarily aware of the problem for which their group was formed and do not see themselves as part of a broader and larger system of self-help groups. Because of this lack of awareness, many self-help group leaders, who have much valuable experience and knowledge to offer, are underutilized by the community at large and by other self-help groups. New, expanded roles for these leaders could be used to strengthen existing groups, assist newly-formed groups, increase public awareness of and accessibility to self-help groups, and further legitimize the usefulness of these groups. Primarily for these reasons, the Self-Help Network of Kansas, a statewide self-help group clearinghouse, developed the Self-Help Associate Leadership (SHAL) Project. This project involved the formation of a statewide network of experienced self-help group leaders designed to serve the needs of self-help groups in their community. The purpose of this action research study was to provide qualitative information about the activities of individuals volunteering for involvement in the SHAL Project, and the resulting impact on the communities they serve. This information was used to direct and refine the SHAL Project, to assist in understanding the qualities associated with self-help leaders who expanded their roles, and to assess the impact of these expanding roles on their communities.

Self-Help Groups

Self-help groups may be described as “member-governed voluntary associations of persons who share a common problem (or disease or human condition), who rely on experiential knowledge at least partly to mutually solve or cope with their common concerns” (Borkman, 1990, p. 323). Estimates of people attending self-help groups indicate that upwards of 6.25 million persons have been a member of a self-help group, and that 10 million were active in a group within a given year (Kessler, 1997). Lieberman & Snowden (1994), predict continued increases in membership. While self-help groups address many different issues (e.g., addiction, mental and physical illness, bereavement), and have a variety of goals and strategies, they all share a common purpose of providing mutual aid, advocacy, education, and emotional support. A growing body of research indicates that self-help groups are effective in assisting their members to achieve greater levels of wellness and recovery (see Kyrouz and Humphrey, 1997).

In response to the growing self-help movement, self-help clearinghouses have developed across the United States, providing information and referral to known self-help groups in their region. The Self-Help Network of Kansas is one such clearinghouse, operating on a statewide basis. Activities of the Self-Help Network include maintenance of a statewide database of self-help groups and toll-free information line, publication of a statewide directory and other literature helpful to self-help groups, promotion of public and professional awareness, and provision of technical assistance to groups.

The SHAL Project

One way that the Self-Help Network has attempted to extend statewide to the local communities it serves is through the Self-Help Associate Leadership Project (SHAL), which was designed to use the strengths of experienced self-help group leaders to expand the natural community support system (Meissen, Warren, and Sanders, 1992). This was done by creating a network of experienced leaders involved in self-help groups across the state who were willing to extend their commitment to self-help by functioning in their local areas as liaisons to the Self-Help Network and to area self-help groups, organizations in their area, and the public at large.

SHAL volunteers’ promoted awareness and use of self-help groups by lay persons, professionals, and organizations in an attempt to increase accessibility, visibility, and use of local groups. They also provided experientially based local support and technical assistance to existing self-help groups and to persons interested in starting new self-help groups.   

Applying Social Exchange Theory to the SHAL Project Development

It is not unusual for leaders of self-help groups to remain active for a number of years even though they are coping much better regarding their own circumstances that originally brought them to the group. Social exchange theory suggests that this occurs because benefits are being incurred that provide a balance with the costs involved in being a self-help group leader. At the same time, these talented and dedicated people are often not involved in the larger community outside the topic of the group. Social exchange theory would also suggest that they themselves do not perceive the benefits, but may appreciate the costs.

Relationships among people and organizations are made up of interactions or exchanges. Social exchange theories focus specifically on these exchanges, with the understanding that there is an interdependence of relationships between persons and an interdependence of social behavior between persons (Chadwick-Jones, 1976). Exchanges occur because they are mutually reinforced for both of the parties involved, and generally such that the exchanges are mutually advantageous (Blau, 1964). This reinforcement need not be economic. In fact, non-economic reinforcers such as social approval are often found to have the greater effect (Chadwick-Jones, 1976). The relationships that continue over time, then, are those in which benefits are maximized and costs are minimized.

Social exchange theory has been found to be useful in understanding participation and commitment in both voluntary and work organizations (Eisenberger, Fasolo, & Davis-LaMastro, 1990; Prestby, Wandersman, Florin, Rich & Chavis, 1990). Little research has been conducted, however, with regard to the social exchanges involved in the natural helping process or specifically, in the self-help context. One of the few such studies, conducted by Kendall and Kenkel (1989) examined the rewards and costs commonly experienced by natural helpers. People who were considered natural helpers were those who provided advice, referrals, time, material goods, and/or services within their community. They were often known in the community for their willingness to provide assistance, usually apart from any established group, and they did not charge a monetary fee for the aid provided. The study found that costs commonly incurred by natural helpers included use of time, feeling tired, and being emotionally drained. Common rewards from helping included social approval and a sense of accomplishment. It was noted that in situations where costs outweighed benefits, helpers ceased their activities. It was also found that natural helpers varied as to the types of help that they provided. Some were specialists, helpers to specific populations (e.g., children) in specific ways (e.g., truancy), while others were generalists, offering assistance to a wide variety of people (e.g., the needy, the elderly, or a friend). It was concluded that the helpers choose the type of helping that they find most rewarding, with this varying from person to person (Kendall & Kenkel, 1989).

Such research highlights the importance of taking social exchange into account when planning and implementing interventions involving natural helpers and others indigenous to the community setting. As self-help group leaders, the volunteers recruited for the SHAL project were already in a helping role in their community. These roles were assumed to be somewhat balanced in terms of costs and rewards, involving exchanges that were found to be mutually rewarding as they had a long history participating in their group. Information about the costs and rewards of their roles as self-help group leaders would thus be useful in collaboratively developing their roles as SHAL leaders, even though these new roles would be somewhat different.

Purpose of the Study

This research investigated the costs and benefits associated with the SHAL leaders’ roles in self-help groups, and the outcome of the SHAL leaders’ activities.  In terms of social exchange, specific research questions were: (a) what are the perceived benefits of the SHAL leaders’ current activities with self-help?, (b) what are the perceived costs of these activities?, and (c) do factors other than cost and benefits motivate the SHAL leaders’ behavior? These data were used in customizing the balanced role in terms of highly valued, low cost activities for each SHAL leader. In assessing the outcome of the SHAL leaders’ activities, it was hypothesized that counties with a SHAL leader would have a greater increase in referrals to self-help groups compared to counties without a SHAL leader.

METHOD

Participants

Participants included 20 female and 6 male experienced self-help group leaders who volunteered for the SHAL Project. The SHAL volunteers represented a variety of types of self-help groups in 16 counties, rural and urban, throughout the state of Kansas. SHAL volunteers represented groups for addiction, grief, chronic illness, parents of children with disabilities, developmental disabilities, heart disease, head injuries, parents of murdered children, families of inmates, women in abusive relationships, men’s and women’s issue groups, chronic fatigue syndrome, and emotional difficulties.

Instrument

Each SHAL volunteer was interviewed early in their involvement in the SHAL project through a telephone survey to conduct a social exchange analysis of self-help group related activities. A questionnaire explored the rewards and costs associated with SHAL volunteers’ current self-help group roles in their community. Open-ended questions were used to determine what activities leaders found most satisfying, and what rewards resulted from these activities. They were also asked about how their activities are beneficial to them as well as what keeps them involved with their self-help group. Leaders were asked which activities they found to be least satisfying, or “a chore”, and what costs resulted from these activities.  Leaders were asked to rate their satisfaction with their group leadership role on a 10-point scale, with 1 being completely dissatisfied and 10 being the most satisfied.  Finally, leaders were questioned about factors that could cause them to cease involvement with their self-help group.  

SHAL volunteers were informed of the upcoming survey during personal visits made to them by a representative of the Self-Help Network. The telephone interviews took place at pre-arranged times. All of the 26 SHAL volunteers were interviewed.

Referral Data

In addition to gathering data from SHAL volunteers, data collected routinely on a computerized database through incoming calls to the Self-Help Network of Kansas was used to assess the outcome of the SHAL project on the number of calls and referrals. These two “incident rates” of self-help group activity were used to compare counties which had SHAL volunteers with counties that did not have SHAL volunteers.  Referral rates (the average number of referrals per month made to self-help groups), and call rates (the average number of calls received per month) were recorded for the 18 months prior to the initial SHAL volunteer training conference (before SHAL) and the 18 months following the initial SHAL volunteer training conference (after SHAL).

RESULTS AND DISCUSSION

Analysis of the interviews provided data pertaining to the function of social exchange in the participants’ self-help group leadership role. Using an inductive approach, categories of responses to the open ended questions related to costs and benefits of self-help involvement were identified. A response was classified as a statement or group of statements which communicated one particular idea or theme.

Benefits of Involvement in Self-Help

Satisfaction in Helping. The most prevalent theme regarding the benefits of involvement in self-help was the enjoyment or satisfaction found in providing help to others (see Table 1).

Table 1

The Benefits of Involvement in Self-Help According to Group Leaders

Responses Regarding Benefits of Self-Help

Number of Times Response is Given

 

Number of Persons Giving Response

Satisfaction found in helping others

14

22 (85%)

Through involvement, personal growth occurs

  9

18 (69%)

Personal belief in the importance of self-help

  6

15 (58%)

Personal support

 

  4

14 (54%)

Observing others grow or be helped by group

49

10 (39%)

Opportunity for sharing self

 

37

10 (39%)

Sense of productivity and accomplishment

21

  7 (27%)

Enjoying specific group-related duties

31

  6 (23%)

Gaining knowledge

 

16

  4 (15%)

Twenty-two of the twenty-six SHAL volunteers (85%) described satisfaction obtained from helping others as an important reason for their involvement in self-help. Many respondents discussed a desire to help others as a benefit of their role.

Several people indicated experiencing satisfaction as a result of their help having an impact on another; on assisting another’s success or positive coping. Thus, these respondents indicated that a benefit of their involvement in self-help was the positive influence on others, primarily around the problem or issue that they share.

Others reported their work as satisfying because it met a need to help others, since they had themselves been helped at one time through a self-help group. They gained satisfaction from reciprocating the help that had previously been received (though not to the same persons who had helped them).

The prevalence of this theme of satisfaction gained from helping others suggests that the type of benefits obtained by these self-help group leaders may be more of an intangible nature and somewhat difficult to quantify. Some participants’ responses do suggest a social exchange type of reciprocity norm at work, as evidenced by statements indicating a desire to return the help that they had received from the group or an acknowledgment of personal fulfillment from the experience of helping others. A further understanding of many of the SHAL volunteer’s responses, however, may be provided by the concept of a more communal type of orientation toward their work in self-help.

The concept of communal relationships was first introduced by Clark and Mills (1979) as an explanation for the type of behavior characteristic of intimate relationships. In such relationships, persons experience a general obligation and desire to meet another’s needs, and act out of genuine concern for another’s welfare. Rather than the expectation of an immediate and tangible return for one’s efforts as outlined by social exchange theory, reciprocation may be delayed and a general sense of obligation to respond to needs is created (Clark and Mills, 1979). Communal relationships are also characterized by a responsiveness to emotional needs (e.g., responding to another’s sadness with increased helping) (Clark, Ouellette, and Milberg, 1984) and by nonequivalent exchange of resources (Clark, 1981). That is, the exchange of resources is based on need rather than on “equal” exchange. As a result of involvement in communal relationships, the person experiences positive consequences from the helping itself, including improved mood and self-evaluations (Williamson & Clark, 1989). Whether social exchange theory in its purest form can be used to explain what appears to be long-term provision of help without tangible return benefits, then, has to do with whether such intangible or intrinsic benefits as the satisfaction of helping can be considered an aspect of social exchange. If such behavior is reinforcing and rewarding independently of benefits given by others, then social exchange theory may not apply. That is, this type of reward appears to come from a concern for others, and it is this concern that makes helping intrinsically rewarding.

Personal Growth. The second most common theme with regard to benefits of involvement in self-help, expressed by 18 participants (69%), was that of the personal growth they experienced through their involvement. In these responses, the personal benefits were long-term self-improvements that resulted from the experience of being involved in the self-help group. Several participants described personal growth in which they had come to a greater appreciation of their own lives as a result of learning about other person’s experiences and circumstances. Recognizing that the problems one faces are also experienced by others and comparing oneself with persons in both worse and better situations serves as a method to cope with the stressful situation (Willis, 1981). Others described personal growth in which they gained valued coping skills through their association with others in the group who had developed positive and adaptive methods of coping with a stressful life situation.

Importance of Self-Help. Over half of the participants described a belief in the importance of self-help as an essential and needed form of assistance as a motivational factor in their personal involvement. Believing so powerfully in self-help as a vehicle for assistance may indicate that self-help group leaders attend to a larger set of issues of unmet community need that could be addressed through self-help groups.

Personal Support. Another frequently occurring theme, conveyed by a majority (54%) of participants, was that of finding benefit and support in the interaction with others experiencing the same problems. More specifically, several persons stated that they value the emotional support they receive from others in the group. Interaction with those who share a similar problem or situation provided benefits that were not found elsewhere. Participants also reported that their involvement in self-help provided them with friendships, a clear and powerful benefit.

Observing Growth in Others. Many respondents shared that they have found benefit from the process of seeing others grow or be helped by the group. This perceived benefit of observing growth in others may stem from the reality that the type of growth experienced by others in the group is likely to be similar to one’s own growth experienced within the self-help group.

Sharing of Self. Another common theme conveyed in respondents’ statements regarding benefits of involvement in self-help was an appreciation for the opportunity to share of themselves. For some participants, this occurred in the form of sharing personal life experiences, knowledge, or the opportunity to share personal ideas or values with regard to self-help that they found to be important. It is notable that being able to provide information was in and of itself found to be rewarding.

Sense of Productivity. Several participants related that one benefit of self-help involvement was the sense of productivity or personal accomplishment that it provided to them. This finding that a sense of productivity is perceived as a benefit of involvement in self-help appears related to findings in research on burnout. One of the subscales of the Maslach Burnout Inventory is entitled “Personal Accomplishment”, and assesses “feeling of competence and successful achievement in one’s work with people” (Maslach & Jackson, 1981, p.2). Research on burnout among self-help group leaders has found that this scale is an important indicator of decreased burnout among self-help group leaders (Meissen & Volk, 1994). Activity which one finds to enhance feelings of productivity or accomplishment is perceived to be a personal benefit, and could serve to motivate one to remain in the role which provides such feelings.

Costs of Involvement in Self-Help

Time Constraints. In response to questions about dissatisfactions or chores regarding their involvement in self-help, half of all SHAL volunteers cited time constraints as a problem (see Table 2). Participants described difficulty in managing the time involved in their work with their self-help group, along with the multiple commitments to family, job, etc

Table 2

The Costs of Involvement in Self-Help According to Group Leaders

Responses Regarding the Costs of Involvement

Number of Times Response is Given

 

Number of Persons Giving Response

Time constraints

 

  6

13 (50%)

Feeling overburdened

 

  6

12 (46%)

Some group-related tasks considered a chore

  5

11 (42%)

Difficulty in getting help with the work of the group

  4

  7 (27%)

Misunderstandings about group by those outside the group

  2

  6 (23%)

Misunderstandings regarding the group’s “theme” or goal

18

  4 (15%)

Misunderstandings regarding self-help in general

18

  2 ( 1%)

Frustration at people not utilizing group

16

  5 (19%)

Accomplishing fewer group goals than planned

13

  5 (19%)

Difficult group issues

 

  8

  4 (15%)

Inconsistent attendance of members

  5

  3 (12%)

Problems with recruitment

 

  3

  3 (12%)

Lack of funds

 

  7

  1 (  4%)

Overburdened. In addition, almost half of the respondents reported problems with feeling overburdened in their current self-help role. While some persons described taking on too much and thus feeling overwhelmed, others reported feeling overburdened due to an inability to find others to assist with the work. This phenomenon is likely related to self-help group leader burnout. One of the three burnout constructs developed by Maslach and Jackson (1981) is Emotional Exhaustion. When one person feels responsible for all the work of maintaining a self-help group, and is overwhelmed with this responsibility, a greater level of emotional exhaustion is likely to result (Meissen & Volk, 1994).

Tasks Perceived to be a Chore. Many SHAL volunteers reported dissatisfaction regarding specific group-related tasks that they find to be a chore. These included paperwork, organizing meetings, planning fund raisers, public speaking, and traveling. The wide perceptions of both time and administrative tasks as costs of involvement in self-help is supported by Revenson and Cassell’s findings (1991) that the most-liked aspect of self-help leadership were non-administrative activities involved in the “emotional support” role.

Difficulty Getting Others Involved. Another common theme was that of the difficulty of getting others involved in the work of the group. As a result, some leaders reported feeling overburdened, as discussed above, while others voiced discouragement over the apparent lack of commitment or desire to help the group on the part of other group members. This difficulty was also found by Meissen, Gleason, and Embree (1991) to be a commonly reported problem among self-help group leaders, voiced by 23% of respondents in response to an open-ended question regarding group problems. Meissen and Volk (1994) similarly found that 20% of self-help groups did not utilize shared leadership. For these groups, all administrative tasks fall upon the one leader. Since these tasks are the least enjoyed, it is likely that the leader would have difficulty recruiting others to assist them.

Misunderstandings by Others. Several participants discussed frustration they had experienced as a result of misunderstandings held by others regarding self-help groups. Some had experienced misunderstandings regarding the specific concern addressed by the group. Others had experienced misunderstandings regarding self-help in general. For example, some professionals may see groups as competition, while family or friends may trivialize the group as a crutch or just a place to complain.  By taking a leadership position in a self-help group, the participants are acting on a belief as to the value and efficacy of that group. When others voice opinions that are in conflict with this position, this in effect questions that leader’s position and value. As a result, this experience can be seen as a personal cost to the leader.

Seeing Others Not Utilize Self-Help. Another common frustration was that of dealing with people who do not use the help offered by the self-help group. SHAL volunteers shared these feelings in regard to their specific groups, expressing concern about people only coming to the group one or two times, or members not really using the group effectively to work on their issues. This frustration reported regarding dealing with people who do not utilize the help offered by the self-help group may be perceived to be a cost of involvement in self-help in part because it inhibits feelings of personal accomplishment

Inability to Accomplish as Much as Desired. Several participants discussed feelings of disappointment due to an inability to accomplish as much as they would like. Group leaders expressed the desire to see the group show more immediate results, while others felt pressured to be doing more with the group as a whole. An inability to accomplish as much as one would desire is also related to role conflict, which has been routinely found to be correlated to burnout (Maslach & Jackson, 1981). Role conflict is described as an inability to meet one’s role or goals, due to either lack of personal skills or the presence of unrealistic goals. McGee (1985) found that clear and obtainable goals resulted in decreased burnout in self-help group leaders. Likewise, Meissen and Volk (1994) found a strong positive correlation between role conflict and burnout.

Difficult Group Issues. Some of the volunteers voiced as a difficulty specific group issues that create problems. At times group members can be intolerant of others in the group. Group members sometimes become dependent on the leader and frequently call to discuss minor problems. At times people come to a group and fit in poorly. Previous research has found this area to be one of the more minor of group problems. Meissen, Gleason, and Embree (1991) asked self-help group leaders to rate ten group problems as to their importance. Problem members received the lowest mean ranking of the ten problems. It may be that, while such issues are perceived to be a cost, they are of less importance relative to other group problems.

Lack of Attendance and Problems with Recruitment. Other difficulties experienced by several group leaders were that of lack of regular attendance by current group members and problems with recruitment of new group members. Meissen, Gleason, and Embree (1991) also found lack of attendance and problems with recruitment to be commonly reported group problems. In fact, recruitment of new members was ranked as the most important problem facing self-help groups, and lack of attendance at meetings and group functions was ranked third. The ultimate outcome of not attracting new members is the disbanding of the group. Problems with attendance and recruitment may also inhibit feelings of personal accomplishment. If members do not attend or new members are not found, the leader may feel that their work is devalued or they have failed.

Impact on SHAL Roles

The broad array of feedback from this research was used by the Self-Help Network to further develop general SHAL roles that would be of high benefit and low cost. There was a focus on creating tasks that required less time, imposed less of a burden and produced obvious accomplishments. Since satisfaction in helping was the most frequently reported benefit, it was imperative that the SHAL role be one in which the volunteer perceives his/her work to be of assistance to other persons in a salient and meaningful way. The Self-Help Network achieved this by regularly sharing with the leaders ways in which their efforts were helpful and by engaging volunteers in the collaborative development of goals and activities in which they perceived their work to be of help. Recognizing that the major cost reported was time constraints, the SHAL role was designed to be time efficient. A cooperative relationship in which the volunteers receive ongoing support from the Self-Help Network is of great importance. These findings also suggest that selection of SHAL volunteers themselves is important for the success of the project. Group leaders who had moved beyond the specific concern of the group toward readiness for advocacy or education were more likely to perceive the SHAL role as rewarding, and thus more likely to be active and involved in that role. Individual needs were used to further customize and maximize benefit and reduce cost according to the specific interests and needs of the leader and the community they served.

Impact on SHAL Counties

To examine the SHAL Project’s impact on participating counties, the number of referrals provided by the Network to residents of SHAL counties was assessed. Individuals may receive referrals to specific self-help groups or organizations by calling the Self-Help Network at a toll-free number and inquiring about groups related to a specific issue or area of concern. One such inquiry may result in multiple referrals, depending on the number of relevant groups in the caller’s geographical area. The number of referrals provided to persons within a given county, then, may be impacted by a variety of factors--population of the county, number of known self-help groups in the county, awareness of and knowledge about self-help in general, and awareness of the Self-Help Network and its services. Except for county population, all of these factors may be influenced by the work of the SHAL volunteers. Therefore, intervention counties were matched with counties of similar size and type (ie: rural vs. Urban). Comparison of the matched intervention and non-intervention counties, as well as comparison of the intervention counties over time, both suggest increased self-help activity in counties with SHAL volunteers.

More specifically, in counties with a resident SHAL leader, a significant increase in referrals to self-help groups occurred at 18 months following the beginning of the intervention. There was also a significantly higher level of referrals to self-help groups in intervention counties compared to matched comparison counties at post testing but not at pre-testing (see Figures 1 and 2).

Figure 1

                              Call incidence rate (total number of calls received per month) 18 months preceding start of SHAL project and 18 months following SHAL. For SHAL, p.£.0001. Non SHAL is n.s.

 

Figure 2

             Referral incidence rate (total number of referrals per month made by The Self-Help Network to self-help groups) in counties with SHAL volunteers compared to counties without SHAL volunteers. For SHAL, p.£.0001. Non SHAL is n.s.

Using an epidemiological approach, the data indicate that these “hot spots” of self-help activities were most likely due to this collaborative intervention. The increase in self-help activity was due in part to greater public and professional awareness generated by the SHAL leaders in their home counties. For example, even though the Self-Help Network provides radio public service announcements to all stations in the state, those rural stations who were personally given a copy of the radio spots by a local resident received considerably more play. Greater levels of self-help activity may also have been influenced by the increased numbers of groups located in the SHAL counties. SHAL leaders were remarkably effective in finding new groups and helping to get the necessary information for inclusion in the statewide database. The Self-Help Network has the most comprehensive and representative database of any regional or statewide clearinghouse in the United States, in part, due to the help of the SHAL volunteers.

The impact of the SHAL Project on participating counties and the residents shows the ability of such an intervention to strengthen and extend the natural community support system of community-based self-help groups as a complement to existing resources throughout the state. These results further endorse this use of a community health approach in addition to the more traditional social science methods for assessing interventions.

Conclusions

In creating SHAL roles, the focus was on emphasizing those activities that took advantage of leaders’ self-help experience and knowledge of the local environment while minimizing their costs for participation. Already familiar with the unique needs of their own communities, as well as the organizations and activities present in their communities, SHAL volunteers continue to strengthen and extend the natural community support system of self-help groups by expanding their use, awareness, and effectiveness as a complement to existing community resources. SHAL volunteers are encouraged in their roles through a continuing examination of how best to extend their preexisting roles as self-help group leaders, taking advantage of the naturally occurring benefits of these roles.  Because these leaders expressed a strong belief in the efficacy of self-help and a desire for others who may benefit from self-help to have the opportunity to do so, it is likely they will continue to experience satisfaction from the SHAL role as it is tailored to provide personal and positive feedback regarding the results of their efforts.

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Author Note : Greg Meissen, Wichita State University; Mary Warren, Wichita State University; Tonja Nansel, Wichita State University now at Kansas State University Research and Extension Office of Community Health; Samantha Goodman, Wichita State University.

The Self-Help Associate Leadership Project is an ongoing program of The Self-Help Network of Kansas, a statewide clearinghouse for self-help groups located in the Psychology Department on the campus of Wichita State University. The SHAL project was created with support from the Kansas Health Foundation and the United Methodist Health Ministry Fund.

Correspondence concerning this article should be addressed to Greg Meissen or Mary Warren through the Department of Psychology at the Self-Help Network of Kansas at Wichita State University, 1845 N. Fairmount, Wichita, KS 67260. Electronic mail may be sent to: 

Greg Meissen: meissen@twsuvm.uc.twsu.edu or Mary Warren: warren@wsuhub.uc.twsu.edu.