Working with self-help.

Koonin, Renee ; Napier, Lindsey

Introduction

As we edged our way through the inner city traffic, we were distracted by the weekly announcement on the blackboard of a twenty four-hour gym. 'Development of character consists solely in moving towards self sufficiency'. In the nineties there was little escape from this new, or is it old, version of self-help. For example, in an interview conducted by James Woodford with Senator Herron, the Federal Minister for Aboriginal Affairs, in relation to Aboriginal Affairs policy of the liberal coalition government (Sydney Morning Herald, 2 November 1996) the policy direction was clear. The Minister strongly advocated a new emphasis on 'self-help', captured in the new catchphrase 'self-empowerment through economic independence'. The forthcoming occasion of the Lyons Lecture at the Australian National University was to provide him with the opportunity to propose the philosophy of individualism--'pulling yourself up by your bootstraps'.

The history of self-help in social welfare does not reflect this individualistic tradition (Adams 1990, 1996). The assumption rather is that relying totally on oneself may not always be possible or helpful. The term 'mutual aid' is often used interchangeably by social work and welfare workers when thinking of self-help. Total self reliance may not necessarily always help people even to cope, far less 'move on'. Self-help groups encourage people to reach out for and offer the understanding, information and ideas for personal support and policy improvement, which comes from being 'in the same boat'.

It is opportune to review social work's relation to self-help. Boehm has exhorted us to '... discern significant societal changes and to utilise the opportunity to develop their implications for better social work' (Boehm 1976). Ideas about selfhelp have become enmeshed in the new languages of 'mutual obligation', empowerment, consumer rights and customer choice. In social welfare we are impelled to 'build social capital' and to rediscover official versions of community development. The meanings of these words and the place and purpose of self-help groups in relation to them warrants examination.

This article examines the changing meanings and purposes of self-help, both within social policy and within social welfare work. We start with a brief review of the arguments for a return to greater individual personal responsibility. We contrast those meanings with some of the meanings conferred by social work on self-help in the light of our personal and professional involvement in self-help groups. (Our review is limited, limited to a review of the literature, which speaks directly to the situation, needs and rights of the groups with whom we worked and were members. So too therefore is the learning: it is not our intention to suggest universal meanings for self-help). We describe the current reliance on the market and on notions of self-help and mutual obligation to produce social welfare and social cohesion. We produce evidence about how accompanying notions of diversity, customer choice and consumer empowerment provide the conditions for some groups to 'help themselves' and further exclude the most vulnerable from being able to.

We conclude by simply reiterating that current expectations for self-help, with its emphasis on obligation, must take account of people's differential capacity to compete in the marketplace.

A revival of self-help

Throughout the nineties, the arguments for greater self-sufficiency were defended on both economic and moral grounds. Both arguments assume a continuing need to reduce the size of the public sector, a change introduced in Australia from the mid 1980s (Saunders 1994). The arguments have been espoused forcefully in many countries, notably the United Kingdom under Thatcher, the United States under Reagan, New Zealand under Bolger and Shipley and Australia under Howard. They are by now well known.

Fiscally, it has been argued, it is not sustainable for citizens to continue relying on a welfare state for the provision of basic services and resources, like education and shelter, and for protection from the ordinary hazards of life, like illness. Better to achieve economic growth and let the benefits trickle down. The greater efficiency of the market will free individuals to define their own interests and their wants.

By OECD standards, Australia is a low-tax country (Saunders 1994), despite high personal income tax rates. Nevertheless, it has been argued that from the seventies, as unemployment rose, Australians became more unwilling to fund welfare. Australia voted overwhelmingly for tax cuts. The consistency of successive governments' persistence in containing the costs of publicly funded health care can be used to bolster such an argument. While there may be strong resistance to public sector cutbacks, one can point to the fact that no government has as yet risked raising the Medicare levy to levels that can realistically maintain a standard of universal provision of health care (see, for instance, Gittins 1999).

The moral argument runs as follows. Reliance on a welfare state has undermined a traditional pride in self-reliance and reduced a sense of moral obligation to each other.

[It has] destroyed the charitable impulse, the moral obligation of the materially fortunate to help those who are 'down on their luck'. People who have grown to resent paying taxes for 'welfare' have also forgotten their responsibility to their community that used to result in philanthropy. (Mills 1996)

Corporations are now exhorted to commit themselves to corporate philanthropy. Pointing to the long tradition of successful 'mutual associations', it is claimed that people have learned to take from the state but not give to one another. Acts of private mercy and charitable kindness, both those undertaken by individuals and those by community organisations have been made redundant. Further, the state is incapable of differentiating the deserving from the undeserving, those who cannot help themselves from those who are can. It breeds dependency. Market forces will produce inequalities as should be expected; but opportunity is provided for people to rise up to their level of capacity, to make their own way in the world. Equality of opportunity is flaunted, without reference to the uneven playing field.

Giddens has pointed out that this dismissal of the state in preference to the market is associated in the minds of neoliberal thinkers with 'a distinctive view of civil society as a self-generating mechanism of social solidarity' (Giddens 1998, 11). The purpose of self-help then is for people to reach their potential, including their moral potential. This, in turn, will lead to 'natural networks' of support flourishing spontaneously.

Nothing new under the sun

For Patricia Beer (1990, 94), these arguments are familiar. The beliefs instilled and the practices arising, are not new.

 I was brought up on notions of self-help,
 Not that it was so called and none of us
 Had read or heard of Samuel Smiles; perhaps
 Fortunately, as his pioneers,
 Artists and inventors were all men.
 Women could be useful or obstructive,
 Hungry, in tears, or steadfast like the wife
 Of Flaxman, but they had to play the game
 Of Help the Genius till their dying day.

 I looked down on ne'er do-wells and wastrels,
 Did homework all the evening, winter and summer,
 Took the Scholarship, School Cert and Higher.
 It was the only way to rise above
 Being a maid or serving in a shop.
 All this went with religion very well,
 The Christian message seeming to be that if
 You didn't help yourself in worldly matters
 Nobody else was at all likely to.

The arguments are familiar to us too. Each of us can recall childhood experience of listening to parents say respectfully: 'There was a man who made something of himself'. 'My, she's done well. It all goes to show you can pull yourself up by your bootstraps if you've got the will'.

Growing up in the fifties and sixties self-help was a moral pursuit. Men were expected to rely on their innate personal resources to provide for themselves, their wives and children and to 'get on and get ahead'. Regardless of the weather, seasonal variation in employment, differential access to training and education or poor health status, a man without a job was guilty of being 'workshy' or 'unemployable'.

It meant that personal wellbeing was the responsibility of each individual, with no one else to blame when things went wrong save, perhaps, one's spouse, one's genes or one's fecklessness. 'What can you expect?' 'They were born that way' were statements of resignation. Disaster could be avoided. For women, selfcontrol, particularly in relation to sexuality and fertility, could be exercised. Regardless of one's income, self discipline could be practised--being thrifty, living within one's means, 'making ends meet'. Self respect could be maintained by expecting help from no one, but showing deference and gratitude if help came one's way. 'Putting up' with things showed evidence of stoicism and kept dignity intact. The expectation was 'Once you've made your bed you've got to lie in it'. This was true for women, who lived in violent relationships: drinking to shield themselves from grief or despair invoked criticism. There was no mutual aid, even to help cope.

Generations before had heard the argument put by Samuel Smiles. 'Self-help with illustrations of conduct and perseverance' was the embodiment of Victorian middle class values (Smiles 1913). In it he described individual self-help as the means to the achievement of prosperity and status. Earnestness, respectable comportment and behaviour, character, duty, hard work and thrift: these were the attributes to be acquired. Smiles considered outside assistance as 'enfeebling' and state assistance 'negative and restrictive' (Smiles 1913, 1-2). The route to selfadvancement was clear. 'The healthy spirit of self-help created amongst working people would more than any other measure serve to raise them as a class ...' (Smiles 1913, 346). 'To secure independence, the practice of simple economy is all that is needed' (Smiles 1913, 347). His response to poverty was quite simple: people should 'resolve not to be poor and to spend less' (Smiles 1913, 351).

Self-help and social work

The assumptions on which self-help are based in social welfare work are quite different. Reciprocity and mutual aid are key; so too is the permission granted to name and share personal pain, experience of injustice, wishes and ideas about how to make things better. Self-help as protest and activism is explicit in moving between the personal and the political.

The primary impetus for starting up a group often comes from the determination of one or a few people, directly affected by an issue or a problem, to reach out and speak out to others 'in the same boat'. There is often a wish to prevent others experiencing the isolation and loneliness of their own experience. McLeod (1998 1999) writing of the initiative to start self-help groups for women with secondary breast cancer, for instance, affirms the motivation of women wanting to 'break through the isolation accompanying their condition'. The desperate wish to connect with others is often accompanied by frustration and anger at not being heard, not being understood, or at being actively blamed and silenced, and by terror of losing one's sanity, of losing one's capacity to survive alone.

Self-help groups provide identification for people with each other's plight and they provide reciprocal support on the basis of first hand experience, the solidarity of which Butler and Wintram speak (Butler and Wintram 1991). This solidarity may assist members resist being stigmatised. Lay professional alliances can be helpful. Self-help groups tend to accept rather than reject relationships with professionals whilst at the same time their members may be profoundly critical of professional activities (Adams 1990; 1996).

Some people avoid joining groups at any cost (as reconfirmed by many conversations). At the same time, there is a persuasive case for the view that ...those in the same boat have a natural desire to compare notes' (Bayley 1998, 60). In his eloquent biographical memoir of Iris Murdoch, for instance, Bayley describes a surprising sense of comradeship with a fellow carer. In some situations, people will flaunt official advice against sharing personal stories. For example, in a study of adults attending a cancer centre for radiotherapy treatment, sharing personal stories and details of treatment was 'the expressed norm', although they were given printed material at the start of treatment advising them not to share such information (Schou and Hewison 1999).

To be helpful, the nature of reciprocal support must be specific. For instance, one of the motivations for establishing groups by and for women with secondary breast cancer (McLeod 1998, 1999) was their feeling of a pressure to stay silent in 'general' breast cancer support groups. The deeper understanding and sense of solidarity made possible by moving from a focus on recovery to the possibility of dying, enables women to grow in resilience to face their intensified fears of dying and death as well as in assertiveness to open up and negotiate treatment options. In other studies of people with cancer, the particular function of support has been shown to be modelling. People looked to friends facing similar illness issues to reappraise their own personal resources and the range of alternative ways of coping (Rose 1990).

Of course as in all groups, destructive norms can develop. Groups are not always able or willing to be inclusive. Where people do find a place, however, friendships often form and outlast the life of the group. Members find renewed strength and resilience. There is often gradual involvement by some members in the broader political and policy issues involved. A few move to a primary focus on activism. This often involves, as a first step, insisting on a different language, which marks an active rather than a passive stance. 'Resisting stigmatisation', suggests Frank (1991, 96) reflecting on illness, 'requires more than individual will. Ill persons who cannot brush off stigmatisation as someone else's problem need to organise themselves. The prospect of hanging tough against stigma may not be comforting to one who must do it alone, but as a group people can hang tough'. This may take diverse forms, depending on context, focus and scope: we are reluctant to paint a universal picture.

Self-help then can foster a sense of agency in the face of an alienating context. This sense of power and agency coming both from within and from the links created with like situated others can lead to resistance (including resistance to professional interests) and to 're-creation'.

Our work in self-help

Our experience in self-help groups has been both personal and professional. In our personal lives and independently of each other, we have been involved in the establishment and growth of several self-help groups. Here we limit our reflection to four examples of our work. The people with whom we worked at different times to form groups were with women and men labelled 'ill' (sufferers of Crohn's disease), 'infertile' (women and men with prolonged fertility problems), 'disordered' (women and men with 'eating disorders') and 'victims' (women survivors of incest).

Our beliefs and our experience were that for many the distress of individual experience was exacerbated by its isolating nature and could be alleviated by the understanding of people who were 'in the same boat'. Solidarity can spring from shared experience. We held the view that people are entitled to information, to the tools of understanding about their situation and to sharing ideas about moving forward. In each case an important goal was the turning of personal troubles into public issues through the collective action of group members. We believed in 'strength in numbers', the belief that collective action is a strategic way to lobby for changes--for involvement in policy processes, for desirable policies, for resources to implement policies, for basic services, for more appropriate services.

Our beliefs were in part borne out. It was clear that for some, finding other people in the same boat can be enormously important, and can stop people feeling crazy, abnormal, alone, misunderstood. For some, friendships, which formed in the course of sharing experience, were an unanticipated spin off and outlasted membership of the group. We found that some people developed skills, which stood them in good stead elsewhere. They learned to laugh and cry at the same time (yes, really!), speak up for themselves, defend themselves. They found strength to make difficult decisions, confront 'demons', forgive themselves and others. They learned to address meetings, appear on television, write letters, present evidence at official inquiries. They learned that they could be helpful to another by 'just' listening.

For each of us, there were many tensions.

Language

Both of us were keenly aware of the significance of language, of the power of labelling, how it carries definitions of problems and people. Many people with fertility problems did not mind labelling themselves 'infertile women', 'infertile couples' (rather than women, men and couples with fertility problems), so agreeing to an identity wholly defined by reproductive capacity or for women by their couple status. For them, agreeing to such a label was a small price to pay for the relief of having a 'respectable' medical complaint; of gaining a sense of validation and belonging; of being offered the hope of successful treatment; of taking home 'their' baby. While that caused one of us concern, it was important to remember that when identity and self definition become prescribed by one characteristic--reproductive capacity, for instance--this may simply reflect the felt experience.

Agreeing to be called a 'victim' of incest for some women brought with it the profound relief of being safe enough to disclose a long harboured secret. But for some women in this group, a much greater sense of power and liberation occurred when they chose to reframe experience, by choosing to call themselves survivors rather than victims. Part of the strengthening nature of self-help in the Crohn's disease group was when a member was free to name the experience of medical treatment in words describing the subjective experience, not as it had been presented to them. Procedures described as routine could be called 'invasive', 'unspeakable acts'. They might have been accepted as necessary, but this was the meaning. Distress could be acknowledged and 'informed consent'--nderstood within the context of power relations.

Inclusion and Exclusion

As in all groups, inclusion was conditional. Diversity characterised the women and men who sought membership in each group. This included diversity of meaning--what it meant to have borne the violence and shame of incest, for instance. For us, working with the difficulties of keeping groups open and inclusive was the hardest issue.

Resources

We both thought that some members of these groups were in danger of being expected to carry too much responsibility for helping others to cope, grieve or face things. Professionals often referred a person to a self-help group when in our view they 'needed' professional counselling help. Far from official services ignoring the strengths of people's existing support networks, it seemed to us that often the capacity or will of existing informal support networks was inadequate or non existent. They lacked knowledge, imagination, will, trust, or time, to see it from the affected person's point of view. There was often no 'natural community of interest'. Sometimes the informal network was a source of danger, fear, violence or horror. For women who had survived incest, for instance, the self-help group provided the only place that was safe and 'containing'. Sometimes there was interest but competing need. Friends might be too overwhelmed themselves by the impact of a woman's distress and revelations to be available to her. Grandparents might be preoccupied by their own frustrated wishes for grandchildren, to be able to reach out to their daughter.

At times we felt caught in a bind over this, and argued with 'professionals' about the skills needed to 'hold' and 'help' members move on. We also knew that there was often no other place or service for people to go. In 'agreeing' to such practices we recognised our respective tendencies to play 'organiser' or 'big sister'! At that point, we both remember being alert to a different set of dangers. For some members being referred for 'professional help' was perceived as alienating and disempowering. Fears that reactions of distress to, say, another ongoing expression of grief or rage or another failed pregnancy might be labelled immature, atypical or excessive were not without foundation. Women, in particular, related stories substantiating fear that resorting to professional help was regarded as a sign of weakness and evidence of lack of fortitude to continue with treatment or to get over childhood problems. Paradoxically, the risk was that some became stuck in a limited self-identity.

Co-option

We also found that groups could be co-opted, for instance by pharmaceutical companies who supported publications and information networking. Sometimes members felt there was too much to lose by being independent of the professionals on whom they relied. Fears of retribution from health professionals, who could withhold a discretionary treatment or 'one more chance', were by no means always imagined.

Reflection

Neither of us can make simple statements about how effective overall were these groups. Like most people who become members of self-help groups, we too have 'moved on'. New languages for self-help have been invoked: the languages of user empowerment, of consumer choice, of customer focus, of rights and citizens' charters in the welfare market place. We know that such language can be empowering. We also share Lorenz' reservations, however:

The attraction of this regime is the use of imagery and of language which sounds as if it had been borrowed from the vocabulary of the social professions and particularly their more radical sections: it speaks of a move towards the community, of consumer choice being extended to clients who now become, to be politically correct, users of services, entitled to be participants in the services, protected by citizens' charters. They are recast as empowered members of civil society which, it is claimed, looks after its own affairs and needs so much better than the distant state, recast as autonomous citizens who through voluntary self-help activities empower themselves to put limits to the autocratic rule of privileged professionals. (Lorenz 1997, 7-8)

We are concerned about which group interests may be excluded by this shift. One of us works closely with such a group. Before examining our reservations, we identify the official meanings endorsed for self-help now and the surrounding debate.

The New Individualism

'Self-help' is now enmeshed in a new language of mutual and reciprocal obligation. There are clear indications in official policy of what this language means. At Federal government level, community capacity for self-help is a designated goal. So is an end to 'welfare dependency'. In a speech to the National Press Club, the Federal Minister for Family and Community Services, Senator Newman recently identified welfare dependency as the next reform priority of the Howard Government. She followed this, in a 'Speech to the Regional Australia Summit' (27 October 1999) with a rationale:

I believe there is some truth in the idea that the old one-size-fits-all Government program approach has undermined personal responsibility and the older ethos of community spirit. Worse, some say it has harmed our communities' ability to develop solutions, to prosper in the face of change, and be independent. And, as people look to external authorities for solutions, rather than using their own strengths and skills, we see the growth in welfare dependency. (Newman 1999, 1)

For Newman (1999, 3), 'Strong communities are those that have the 'capacity' to help themselves. Strong communities are good at grasping opportunities because they have the capacity to do so'. The guarantee of a strong and sustainable social safety net is to go hand in hand with the fostering of families' and communities' resilience, independence, choice and self-reliance through partnerships between Government, Business and Community.

The strategic plan of the Commonwealth Department of Family and Community Services espouses these goals in terms of desired policy outcomes: stronger families; stronger communities; and economic and social participation. A 'culture of self-reliance' is to be fostered alongside the provision of a safety net, implying tougher attitudes and an expansion of mutual obligation principles. Now, of course, it can be argued that the espousal of individual responsibility and self reliance in social policy may reflect, as much as lead, popular views. They may go hand in hand with the value placed on right to individual expression. In postmodernity, with its accompanying individualism, it can be argued that diversity is to be celebrated. Lifestyle can be chosen; people can define themselves in terms of their uniqueness, do life 'their way', centre on inner experience and replace public rituals with individually authored ones. Self-help groups can provide the opportunity and can release people's capacity to be 'themselves'.

Indeed there is evidence that interest in small group membership increases at times like this. Fukuyama (1999, 71) claims that in North America and Europe, there is evidence of increasing affiliation with groups and group membership; people now join groups on the basis of shared individually chosen values. They become linked with 'smaller communities of like-minded folk' rather than ceding individuality to the authority of large institutions and organisations like the Church. For Fukuyama this is a problem: 'the radius of trust is diminishing, not just in the United States but across the developed world' (Fukuyama 1999, 71). He claims that contemporary Americans and Europeans seek contradictory goals. They are increasingly distrustful of any authority, political or moral, that would constrain freedom of choice, but 'they also want a sense of community and the good things that flow from community, such as mutual recognition, participation belonging and identity' (Fukuyama 1999, 71).

Walter (1994) too remains circumspect and questions whether, in the context of individualism, self-help groups are but a poor substitute. In his discussion of how death is managed in postmodernity, he observes the phenomenon of a 'growing army of counsellors and self-help bereavement groups'. He acknowledges what they offer:

This creation of a small space for the intimate ritual of counselling may be all that can be attempted, for perhaps public rituals are gone for good. The sharing of loneliness may not be a cure for individualism but it can be very effective first aid. We may not be able to reconstruct community, but we can construct self-help groups and pairs of lonely individuals having heart-to-hearts (Walter 1994, 35).

However he questions the worth of 'little huddles of bereaved individuals being encouraged to share their sorrow with one another rather than be subject to rules of mourning'. May it be that they exacerbate the very isolation they seek to redress?

Giddens (1998) would probably dismiss such a view. His reading of the rise of the small group movement in the US is that it reveals a different phenomenon: renewed evidence of 'a rich civic life' (Giddens 1998, 81). While acknowledging that therapeutic models have influenced the orientation of these groups and that self-help groups are particularly prominent, his view is that responsibility and mutual obligation, always flourishing in old-style democracy, had become 'submerged within the concept of collective provision' (Giddens 1998, 37). For him the new individualism, described as associated with 'the retreat of tradition and custom from our lives, a phenomenon involved with the impact of globalisation widely conceived rather than just the influence of markets' (Giddens 1998, 36), restores opportunity to find a new balance between individual and collective responsibility.

Self-help, Disability and Community Care

We have difficulty with this interpretation of self-help, assuming as it does a level playing field, one which assumes capacity for autonomy and for access to resources that will enable autonomy to be embraced. So we place this contemporary debate about self-help groups in a specific context--the context of one small 'supported' self-help group, with whom one of us works. The group comprises the parents and family members of adults who are severely intellectually and sometimes multiply disabled. It started as an advocacy group, lobbying for the provision of basic services for their children. It is now constituted as an incorporated association, employs between twenty and thirty people, and provides supported accommodation for around thirty women and men.

What is the will and capacity of the group for responsibility and self-reliance?

The facts are stark enough. The people whom this agency serves, its clients, are not fully autonomous people. They do not have, and will never have, the personal resources to improve their situation single-handedly. This does not mean that they are not able to be strong and self reliant within their limited intellectual and social resources. Their families have always created a community of interest: self-help has always been necessary, a matter of survival. They have always had to show self-reliance and to practise self-advocacy. 'Welfare dependency' has not been an option. Now, in the new marketplace of welfare, providers do not jostle with each other to secure the market opportunity. To be blunt, it is an undesirable market; and as yet, we would argue, the market has been unable to deliver the level of commitment shown by parents.

The group's self-help efforts started by 'trying to cope'. Through their efforts, they have achieved a rights based policy platform in legislation, with standards that have to be adhered to. Government commitment to closing down large institutions and to developing community care has certainly led to more community based services and advocacy services. In New South Wales, a Community Services Commission is charged with monitoring the legislation.

Clients and their families now do have an inkling of being able to 'be themselves', to claim identity. This inkling is called 'quality of life', a goal worth striving for. Aspirations have changed: aspirations for education, employment, adult relationships have some hope of being realised. With consistent and intensive support, tailored to meet specific needs, some clients and their families are very slowly learning that they can 'speak up'. As some of the clients have achieved greater autonomy, pride has developed in capacities to cook dinners, win jobs, perform dance. Participating in employment decisions of the professionals who work for the group is highly valued. Refusing to call themselves consumers, customers or users, they continue to prefer to be called clients and contributors.

Mutual obligation

One can argue that obligation is now mutual, that choice has been opened up by governments supporting the demand for options of groups like this one. The picture, however, is not so clear. Consider what has eventuated on the broader policy stage. 'The shift to community care in the disability field has been characterised by a large growth in the numbers of people with ongoing support needs living with relatives' (Madden 1999). While there have been increases in the numbers of people aged under 65 years with 'severe handicap', or any disability, in all types of community living arrangement since 1981, including 'a small but growing number living alone' (Madden 1999, 20), the majority (87% in 1993) of people with a severe handicap aged under 65 years were living with relatives (Madden 1999, 15). Madden comments 'The trends show clearly the importance of programs to support carers and the stability of community living and caring arrangements' (Madden 1999, 17).

When the chips are down, the families of this group of people are still expected to manage, to absorb the great range of needs thrown up by community care. As 'mutual obligation' is increasingly imposed by government, as a principle to be applied to the goal of stemming 'welfare dependency', they express intense fear that communities of interest such as theirs may be perceived as avoiding their obligations. The truth is that the people with disabilities whom the agency serves are able to meet their obligation only to the extent of the resources offered them--and the resources may still not be adequate. Self-sufficiency is not possible and should not be expected. The result of current policy is continuing inequality and further exclusion.

Where to from here?

It would be all too easy to draw the strands of this writing together by sounding a renewed clarion call for us in social welfare to foster both the sort of self-help activities we discuss here and the kinds of broader 'radical', anti-professionalist self-help movements, of which many women in social welfare were part in the 60s and 70s. The latter led to the identification of new social issues--domestic violence, homosexual relations, indigenous land rights, for example. Many social welfare workers are involved in these movements now. With respect to the context of current welfare practice, it needs to be acknowledged how difficult it is to foster any sort of group work in a pervasive context of case management. Speaking out against unfair expectations for self reliance is essential however, both by harnessing the energy of the widespread depression threatening to engulf many and the clarity of thought and potential coherence of ensuing collective action. Such coherence flows from examinations of the meanings of self-help within social welfare and their relation, if there are any, to the current rhetoric of mutual obligation, This article is a contribution to that analysis.

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Renee Koonin [1] and Lindsey Napier [2]

[1] Renee Koonin is a Consultant to disabilities services.

[2] Lindsey Napier is Senior Lecturer in the Department of Social Work, Social Policy and Sociology at the University of Sydney.