Mutual Aid Based Group Work

Andrew Cicchetti (Member, AASWG, NYC Chapter) presents in this entry a discussion of mutual aid based group work. A point derived from this discussion is that the social worker-led group that seeks to cultivate mutual aid is better designated as 'mutual aid based group work', rather than 'mutual aid group' as is often the case in the social work literature. The term 'mutual aid group' should be reserved for the mutual aid/self-help group. Furthermore, the term 'mutual aid based group work' more accurately reflects the dynamic that emerges from the presence of a worker invested in maximizing the group's capacity for mutual aid.

Mutual Aid in the Social Work Group
Mutual aid as group work technology can be understood as an exchange of help wherein the group member is both the provider as well as the recipient of help in service of achieving common group and individual goals (Borkman, 1999; Gitterman, 2006; Lieberman, 1983; Northen & Kurland, 2001; Schwartz, 1961; Shulman, 2006, Steinberg, 2004; Toseland & Siporin, 1986). The rationale for cultivating mutual aid in the group encounter is premised on mutual aid's resonance with humanistic values (Glassman, 2002) and the following propositions: 1) members have strengths, opinions, perspectives, information, and experiences that can be drawn upon to help others in the group; 2) helping others helps the helper, a concept known as the helper-therapy principle (Reissman, 1965) which has been empirically validated (Roberts et al, 1999); and 3) some types of help, such as confrontation, are better received when emanating from a peer rather than the worker (Shulman, 2006). Mutual aid transactions that occur amongst and between members stimulate cognitive and behavioral processes and yield therapeutic, supportive and empowering benefits for the members (Breton, 1990;Northen & Kurland, 2001; Shulman, 1986, 2006).

The role of mutual aid processes in the social work group is illuminated by Gitterman (2006), a contemporary expert on mutual aid based group work from the field of social work. Gitterman (2006) contends that “mutual aid is the major rationale for the provision of group services” (p.93). Gitterman (2006) elaborates on mutual aid in the social work group noting that, “as members become involved with one another, they develop helping relationships and become invested in each other and in participating in the group” (p.93). The mutual aid processes that unfold help group members “to experience their concerns and life issues as universal”, “to reduce isolation and stigma”, “to offer and receive help from each other”, and “to learn from each other’s views, suggestions and challenges” (Gitterman, 2006, p.93).

The Concept of Mutual Aid
The concept of mutual aid was first elaborated by Kropotkin (1903), one of the most important evolutionary theorists and socio-biologists of his time, as an evolutionary theory to expand upon that proposed by Darwin which underscored the role of struggle and competition encapsulated in the notion of ‘natural selection’ amongst species, an idea often understood as ‘the survival of the fittest’. Kropotkin (1903) argued that mutual aid as exemplified in efforts at cooperation in the face of common environmental threats was a significant factor in the survival of species. Upon being influenced by a lecture entitled “On the Law of Mutual Aid” delivered at the Russian Congress of Naturalists in January, 1880, by noted zoologist, Professor Kessler, and through his own observations of a number of species that placed communal needs before individual needs rather than engaging in competition for survival, Kropotkin formulated the theory of mutual aid (Kropotkin, 1903). Kropotkin underscored the role of mutual aid with this observation:

“…wherever I saw animal life in abundance…on the lakes…in the colonies of rodents…in the migrations of birds…
in a migration of fallow dear…I saw Mutual Aid and Mutual Support carried on to an extent which passed before my eyes, I saw in it a feature of greatest importance for the maintenance of life, the preservation of each species, and its further evolution” (p.ii).

The role of mutual aid in human society was observed by Kropotkin (1903) as well. Kropotkin (1903) observed:

“the mutual aid tendency in man has so remote an origin, and is so deeply interwoven with all the past evolution of the human race, that it has been maintained by mankind up to the present time, notwithstanding all vicissitudes of history" (p.145).

He noted the role of mutual aid in primitive societies as well as his then contemporary society. He found himself “struck with the immense part which mutual aid and mutual support principles play even now-a-days in human life” (Kropotkin, 1903, p.148). Principles of mutual aid are operating in spontaneous neighborliness; utopian cooperatives; trade unions; labor unions; and the settlement house movement (Katz and Bender, 1976; Lee and Swenson, 2005).

The concept of mutual aid bears resemblance to that of social support (Lee and Swenson, 2005). Social support is thought to buffer or cushion the individual from potentially harmful or physiological conditions (Caplan, 1974). Social support can include professional helping offered by an individual worker; this however, represents a departure from the concept of mutual aid as treatment technology. The bi-directional nature of mutual aid is more clearly illuminated when the concept of social support from peers is paired with the helper-therapy principle (Lee & Swenson, 2005; Reissman, 1965). This principle hypothesizes that helping others helps the helper (Reissman, 1965), a hypothesis supported by empirical findings (Roberts et al, 1999). This concept is resonant with the concept of altruism, identified by Yalom (1995) as a therapeutic factor available through group therapy.
Furthermore, Reissman (1965) suggests that the principle impacts the group as a whole:

“not only are individual group members aided in the group, but the group as a whole may be greatly strengthened in manifold ways as it continually offers assistance to individual group members” (p.32).

The Group as Mutual Aid System
While mutual aid has been inarguably a feature of social group work since the earliest of incarnations, William Schwartz in introducing the phrase brought greater primacy to the concept and the view of the group as an enterprise in mutual aid. The model originally proposed by Schwartz in 1961 is often referred to as the Mutual Aid Model.

The Mutual Aid Model of group work practice (Gitterman, 2004) has its roots in the practice theory proposed by Schwartz (1961) which was introduced in the article, “The Social Worker in the Group”. Schwartz (1961) envisioned the group as an “enterprise in mutual aid, an alliance of individuals who need each other in varying degrees, to work on certain common problems” (p.266). Schwartz elaborated:

“the fact is that this is a helping system in which clients need each other as well as the worker. This need to use each other, to create not one but many helping relationships, is a vital ingredient of the group process and constitutes a need over and above the specific tasks for which the group was formed” (1961, p. 266).

Schwartz (1976) regarded this approach as resonant with the demands of a variety of group types including, natural and formed; therapeutic and task; open and closed; and voluntary and mandatory. Both the Mutual Aid Model and the concept of mutual aid have endured and continue to inform social work practice with groups (Gitterman, 2004). While sometimes referred to as social group work, Schwartz (1977) preferred the designation 'social work with groups'.

Schwartz (1961) premised his approach to practice on ideas expressed by Kropotkin (1903), Dewey (1910), Mead (1934) and Simmel (1955) that illuminated the nature of the relationship between the individual and society. The model was premised on the proposition that there exists a reciprocal, symbiotic relationship between the individual and society, a dynamic encapsulated in the small group (Schwartz, 1961). This type of mutualistic symbiosis was expressed by Schwartz (1971) as the “need to use each other” to work on resolving common problems (p.7).

Schwartz (1977) contrasted this model with approaches that failed to collaboratively work with groups. More importantly he rejected the medical model wherein the worker “decides what is wrong”, “labels it” and prescribes the treatment (Schwartz, 1977, p.1331). This was not to say that the worker avoids using prior professionally obtained knowledge but rather the worker uses this knowledge to deepen “preliminary empathy” (Schwartz, 1977, p.1334). A similar perspective was advanced by Tropp (1977b) who suggested that the worker should employ a phenomenological approach and attend to “current group and individual behavior rather than on prior personality diagnosis” (p.96).

A concept common amongst social group work approaches has been the ‘two-client’ perspective which views both the individual and the group as the two clients engaged with the worker (Trecker, 1948; Schwartz, 1977; Steinberg, 2004). For Schwartz (1977) this dualism was resolved by observing that they both are inextricably linked, engaged in reciprocal relationship. Both the individual and the group “needs the other for its own life and growth” argued Schwartz (1961, p. 153). From this stance flowed Schwartz’ beliefs about the mediating role of the worker, a role he argued belonged to the social work profession at large (Schwarz, 1961, 1971, 1977). Schwartz (1961) viewed the group as an organic whole and identified “the group organism as a complex of moving, interdependent human beings” (p.18). Expanding on this perspective he identified four main features of the group: the group is a

“collective, in which people face and interact with each other; people need each other; the purpose of the group is oriented by needing to work on common problems or tasks; and the work of the group is embedded in the function of the agency” (Schwartz, 1976, p. 185).

Schwartz (1971) proposed that the tasks of the worker and the members of the group are interdependent but different, an idea he expressed as “parallel process” (Schwartz, 1971, p.10). The members of the group are charged with both helping themselves and each other (Schwartz, 1971, 1976). The nature of the help could be understood as deriving from the exchange of members’ personal views and experience as well as the expression of feeling (Schwartz, 1977).

Drawing upon ideas about the use of time as expressed by Rank, Taft and Robinson Schwartz (1961) conceptualized a preferred sequence of worker activity expressed as 'the phases of helping'. These phases occur over the course of the group’s life cycle and include: preparation, beginning, work and ending phases (Schwartz, 1961; Gitterman, 2004). This framework has relevance for conceptualizing the sequencing of worker activity in each group session as well (Birnbaum and Cicchetti, 2000; Birnbaum, Mason & Cicchetti, 2002; Shalinsky, 1983; Shulman, 2006).

The model proposed by Schwartz followed a historical, theoretical path along the mainstream of social group work (Papell and Rothman, 1980; Tropp, 1977a). According to Tropp (1977a):

“the mainstream was more deeply explored by William Schwartz, who further elaborated the concepts of group function and worker involvement, while adding the dimensions of the mutual aid phenomenon and the contractual relation between worker and group” (p.1322).

Noting the importance of this model, Papell and Rothman (1966) had identified the model’s primary contribution to social group work practice theory: “its outstanding contribution” is as “the construct of a mutual aid system with professional interventions” (p. 130). For Papell and Rothman, the conceptual strength of the model lay in the observation that

“what had been vaguely referred to in the past as ‘helping members help themselves’ has acquired a higher level of theoretical statement. It is now possible to consider the attributes and culture of a specialized system and to transmit the skills necessary to support its realization. This is probably the single most important contribution that group work method can make to the social work profession at large (italics mine, 1966, p. 130).

Sharpening Papell and Rothman’s observation, Schwartz (1976) would note that the worker invested in cultivating mutual aid had “the additional task of not only helping people help themselves, but to help each other as well” (p. 194).


Mutual aid would come to be regarded as a hallowed concept in the practice of social group work (Tropp, 1977b). Hartford (1976) noted that the cultivation of mutual aid had become central to generic group work practice. Echoing this observation, Papell and Rothman (1980) noted that “the conception of the group as a mutual aid system had become a universal one in all of group work practice” and had become a feature of the ‘mainstream’ of practice (1980, p. 9).


Mutual Aid is Central to Social Work with Groups
Social workers have elaborated upon mutual aid in the social work group. Schwartz (1961, 1971, 1976, 1977) had proposed that the social work group engage in problem solving; employ authentic, affect-laden communication; accommodate expressions of difference and conflict; and discuss ‘taboo’ topics. Shulman (1979, 1986, 1992, 1999, 2006) advanced a conceptual framework of mutual aid processes comprised of the following 10 types of processes: sharing data; the dialectic process; entering taboo areas; the ‘all in the same boat’ phenomenon; developing a universal perspective; mutual support; mutual demand; individual problem solving; rehearsal; and the strength in numbers phenomenon.

Papell and Rothman (1980) indicated mutual aid was central to the mainstream of social work practice with groups. Middleman and Wood (1990) echoed the perspective advanced by Papell and Rothman (1980). Glassman and Kates (1990) tethered mutual aid processes to humanistic values and democratic principles. Kurland and Salmon (1992) promoted mutual aid based problem solving as an antidote to casework in a group. Breton (1990, 1994, 2004) encouraged group workers to view mutual aid as integral to empowerment oriented practice. Northen and Kurland (2001) presented “the dynamic forces of mutual aid” that builds upon the contributions from group psychotherapy research as well as the conceptualization articulated by Shulman (p.26). Their elaboration includes the following processes/dynamics: mutual support; cohesiveness; quality of relationships; universality; a sense of hope; altruism; acquisition of knowledge and skills; catharsis; reality testing; and group control (Northen and Kurland, 2001, p.25/26).


The Worker and other Members Collaborate
Mutual aid based group work draws upon the strengths possessed by the group's membership. A social worker invested in potentiating the group's capacity for mutual aid views the group as an enterprise in mutual aid; helps group members identify common ground; views her role as a mediator of the individual/group connection; helps the group understand the benefit of mutual aid; helps the group work through conflict rather than avoiding it; and supports the group in identifying and removing obstacles to mutual aid (Schwartz, 1961; Shulman, 2006). A social worker invested in being the expert, having control over the group process, and engaging in casework in the group setting is likely to truncate the emergence and power of mutual aid (Kurland & Salmon, 1992; Steinberg, 1992, 1993). In structured groups wherein the worker is called to share her expertise, in order to qualify as social work with groups the worker seeks to integrate opportunties for mutual aid (Middleman & Wood, 1990).

Special skills are required to cultivate mutual aid in the social work group. The social work literature is replete with discussions of these special skills (Gitterman & Shulman, 2005; Glassman & Kates, 1990; Kurland & Salmon, 1998; Middleman & Wood, 1990; Steinberg, 2004). Of note, for the purpose of this brief discussion, is an approach to mutual aid based problem solving that allows the worker to engage the group in the work of solving individual problems thereby avoiding the pitfall of practicing casework in the group. This approach to problem solving highlights the interaction between worker skill and group member expertise in helping each other and themselves simultaneously.

Kurland and Salmon (1992) have articulated an approach to problem solving in the small group that draws upon mutual aid. Mutual aid based problem solving has been posed as an approach that considers the needs of the individual and the group simultaneously (Kurland & Salmon, 1992). Drawing upon the problem solving process proposed by progressive educator John Dewey, Kurland and Salmon (1992) have presented an eight step model for mutual aid based problem solving: 1) an individual member raises a problem or issue of concern; 2) the problem is clearly identified by the individual and the group; 3) the problem is explored as the group elicits more information, listens attentively, responds empathically, and communicates understanding; 4) the worker asks group members to recount situations similar or relevant to the concern under current discussion; 5) the group generates possible solutions to the individual's problems upon consideration of the experiences shared by other group members; 6) the worker and the group members help the individual decide on a course of action and think through an implementation plan; 7) the worker asks all the group members what they have gained from the discussion; and 8) in a future session the worker or other group members follow up with the individual about their concern (p.9). The effectiveness of problem solving when the solution calls for individual behavior change is likely to be enhanced when the worker utilizes as part of her conceptual framework the Transtheoretical Stages of Change Model (Prochaska, DiClemente and Norcross, 1992) and Motivational Interviewing (Miller & Rollnick, 1991). Furthermore, Motivational Interviewing, an individual counseling technique can be applied to the group setting and is highly resonant with mutual aid processes, especially the dialectic process (Cicchetti, 2007).

Mutual Aid Group vs. Mutual Aid Based Group Work
Mutual aid is the fuel that drives both mutual aid groups, such as Alcoholics' Anonymous, as well as mutual aid based group work. While the term 'mutual aid group' has often been used to designate a social worker-led group (i.e. Gitterman & Shulman, 2005), this term is better used to denote the mutual aid/self-help group, such as 12 Step Fellowships, so as to avoid confusion amongst social workers and the general public as well as conflation of these two very different groups. While similar processes occur amongst and between members in mutual aid/self help groups as those found in social work groups, the manner in which these processes occur is different, often occurring in dyadic exchanges or through sharing without an exchange amongst members. Evidence indicates that worker-led groups potentially yield a wider range of mutual aid processes due to the special skills utilized by the worker (Lieberman, 1983). Flowing from this, the term 'mutual aid based group work' serves as a more accurate descriptor of this type of group, as it reflects the activity of the group worker and the group members who are engaged in the exchange of mutual aid. For this reason it can be said that through mutual aid based group work, the skilled worker can potentiate the presence of mutual aid, maximizing the potential for therapeutic, supportive, and empowering benefits.

Summary
In sum, this entry sought to demonstrate that in social work groups mutual aid has been a central, if not defining, element. At the same time, special knowledge needs to be skillfully utilized by a group worker who acts in such as way as to encourage the group members to act. Through the parallel process of worker activity and member activity the group is transformed into a system of mutual aid. The designation mutual aid based group work, it was argued, accurately describes this type of group as it reflects both worker and member activity. The term 'mutual aid group' is better reserved to designate groups, such as Alcoholics' Anonymous, that do not include professional leadership.



Selected References:
(All Available Upon Request)

Breton, M. (1990). Learning from social group work tradition. Social Work with Groups, 13(3), 21-34.

Gitterman, A. and Shulman, L. (Editors) (2005). Mutual aid groups, vulnerable & resilient populations, and the life cycle (3rd edition). New York: Columbia University Press.

Kropotkin, P. (1903). Mutual aid: A factor of evolution. McLean, Virginia: IndyPublish.com.

Riessman, F. (1965). The Helper Therapy Principle. Social Work, 10, April, 27-32.

Schwartz, W. (1959/1994). Group work and the social scene. In T. Berman-Rossi (ed.). Social Work: The collected writings of William Schwartz (pp.202-220). Itasca, Ill: Peacock Publishers.

Schwartz, W. (1961). The social worker in the group. In B. Saunders (Ed.), New perspectives on services to groups: Theory, organization, practice (pp. 7-29), New York: National Association of Social Workers.

Schwartz, W. (1964/1994). Analysis of papers presented on working definitions of group work practice. In T. Berman-Rossi (ed.). Social Work: The collected writings of William Schwartz (pp.310-308). Itasca, Ill: Peacock Publishers.

Schwartz, W. (1971). On the use of groups in social work practice. In Schwartz, W. and Zalba, S. (Eds.). (1971). The practice of group work (pp. 3-24). New York: Columbia University Press.

Schwartz, W. (1976). Between client and system: The mediating function. In R.W. Roberts and H. Northen (Eds.), Theories of social work with groups (pp.171-197). New York: Columbia University Press.

Schwartz, W. (1977). Social group work: The interactionist approach. In J.B. Turner (ed.) Encyclopedia of Social Work (17th Edition), 2:1328-1338. Washington, DC: National Association of Social Workers.

Schwartz, W. (1986). The group work tradition and social work practice. In A. Gitterman and L. Shulman (Eds.), The legacy of William Schwartz: Group practice as shared interaction (pp. 7-27). New York: Haworth Press.

Schwartz, W. (1994). Social work with groups: The search for a method (1968-1972). In T. Berman-Rossi (ed.). Social Work: The collected writings of William Schwartz (pp.1-194). Itasca, Ill: Peacock Publishers.

Schwartz, W. and Zalba, S. (Eds.). (1971). The practice of group work. New York: Columbia University Press.

Shulman, L. (2006). The skills of helping individuals, families, groups, and communities (Fifth edition). Belmont. CA: Thompson.

Steinberg, D.M. (2004). The mutual–aid approach to working with groups: Helping people to help each other (second edition). New York: The Haworth Press.

Tropp, E. (1977b). A humanistic foundation for group work practice (second edition). Richmond, VA: Virginia Commonwealth University.


~~~~Andrew Cicchetti