Self-help groups

SHGs can form an important part of recovery for people who experience substance use issues. Through the provision of noncommodified peer support, they can facilitate personal, social, and structural change. Furthermore, given their relative accessibility, SHGs can help to sustain such change. More specifically, they are economically accessible, as no fees are required. Typically, they are geographically accessible, given the number of established groups and chapters. They are also cognitively accessible, as group participants can self-determine their degree of involvement. Caution is warranted before becoming overly optimistic about the preponderance of positive findings. There are inherent methodological issues in many studies to date, these include the reliance on self-reports from group participants, the use of retrospective data, the lack of comparison groups, and the use of cross-sectional designs. Notwithstanding some methodological exceptions, a systematic review of 12-step fellowships for alcohol dependence identified a need for more efficacy studies (Ferri et al., 2006). Although SHGs may not be the panacea for everyone with substance use issues, several factors appear to increase their perceived value. These include best fit between the group and the participant, a structure that guides group processes, the sharing of personal narratives, the reciprocity of support, as well as active and prolonged group involvement. Some of these factors appear to reflect those associated with successful treatments. Given the complex and chronic nature of substance use issues, SHGs may be best perceived as a supplement to a suite of strategies toward recovery. This is because SHGs can offer a unique type of support (be it psychological or practical) and can be accessed if, and when deemed appropriate by the individual.