KAPITTEL 4 «Midt i smørøyet» – samarbeid og ambivalens i grenseflater mellom profesjons- og erfaringskunnskap

The chapter discusses collaborations and «borderwork» between self-help/mutual aid activists and professionals by the example of the project Utviklingsprosjekt LINK Vestfold. The project was initiated and run by three patient education resource centres (LMS) in Vestfold county in 2009–2010, financially supported by the Directorate of Health and in close collaboration with the National Competence Centre Self-Help Norway. Essentially, the project was very successful, resulting in a broad and active network of professionals and volunteers and the formation of new self-help groups. The project paved the way for a new district office of the National Competence Centre. At the same time, the collaboration revealed certain tensions and ambiguities on both sides, originating in close similarities as well as important differences regarding the use and practice of experiential knowledge – as opposed to professional knowledge – by actors operating in between and on the fringe of established fields. The project highlights how processes of standardization of the self-help model (by Self-Help Norway) is met by kind of resistance and how self-help as a «boundary object» needs to be kept flexible to adjust to different local contexts. This may be an act of balance in a context where the self-help movement is the weaker part regarding institutional strength, in need of guarding the autonomy of self-help groups.

KAPITTEL 2 Selvhjelpsgrupper og behandlingsgruppers tilnærming til personlig endring – hva er likt og ulikt?

In this chapter, the author discusses how, and to which extent, self-help groups differ from treatment groups in their approach to personal transformation. The focus is on the self-help group’s work, exploring what kind of community a self-help group is and what is happening there. The chapter compares two main models for self-organized self-help groups and points out some common “therapeutic mechanisms” that are also shared by therapy groups. At the same time there are interesting differences, not only between professional group therapy and self-help groups, but also between a 12-step group (e.g. Anonymous Alcoholics) and a typical “Self-help Norway group”. Self-help Norway is more psychologically oriented and emphasizes personal autonomy and self-control, while AA groups build up under a strong collective identity and view self-control as an illusory target for an addict. The author argues that the primary objective of self-help groups is not making new intimate friends. The therapeutic effectiveness of self-help groups seems to depend on that the intimacy and confidentiality within the group does not transform it into a “new family”. It is the quality of becoming “confidential strangers” that is the clue here.

KAPITTEL 1 Den nye selvhjelpsbevegelsen

In order to provide a background for subsequent discussions, the chapter introduces the notion of the “new self-help movement” in Norway. The 1980s and 90s saw the establishment of self-help groups that differed from more traditional approaches, such as Alcoholics Anonymous and other 12-step groups. The new self-help movement, we argue, cannot be understood independently of broader social developments. The chapter, therefore, discusses the self-help movement in light of recent welfare reforms and processes of individualization more generally. Developments in the new Norwegian self-help movement is part of a larger, international trend. Internationally, as well as in Norway, new self-help groups increasingly have a psychological and therapeutic orientation. Our aim, however, is not to contribute to the growing literature on causes and effects of the “therapeutic” or “self-help culture”. Rather, our interest lies in collective, group-based forms of self-help. We argue that the context for group-based self-help activities has changed, and that this, in turn, changes the content and form of contemporary self-help groups and movements. We then proceed to introduce the theoretical framework on which the various contributions draw, and, finally, to introduce the various contributions.

KAPITTEL 7 Fra felt til verktøy: Om Selvhjelp Norge som koordinerende enhet

Since 2004, Norway has a National plan for self-help. The plan results from the collaboration of the Directorate for Health and the Norwegian Self-Help Forum, a civil society organization. The chapter asks whether and how the plan coordinates the efforts and activities of self-help organizations and other civil society actors. It compares two cooperative efforts between civil society actors in the self-help field: the self-help seminars of the 1990s and the establishment of LINK Trondheim in 2014. The analysis shows that the national plan for self-help has transformed the field, but not as envisaged in the 2004 plan. The chapter suggests that the diagnosis informing the plan was flawed. That rather than being a sign of fragmentation, diversity is an indication of a well-functioning self-help field. It argues, therefore, that it is problematic that the plan, rather than representing diversity, promotes a particular understanding and approach to self-help. Whereas a central idea in the 2004 plan was to build stronger ties and networks between civil society actors, interviews with actors involved in the establishment of LINK Trondheim, as well as other civil society organizations, indicate that there is less interaction between the organizations today than 20 years ago. Instead, Self-Help Norway seems to have turned to other actors, such as welfare producers, welfare professionals, and public authorities. The question, then, is whether we are witnessing the contours of a new self-help field, organized around other actors, interests and resources.

KAPITTEL 3 Fra frivillig arbeid til folkehelsearbeid – om politisering av selvhjelpssaken

This chapter analyzes the politicisation of self-help groups as a public concern in Norway for the last three decades. The empirical data are three policy-documents, white papers on voluntary work (1992), mental health (1996) and public health (2002) and two national plans on self-help (2004, 2014). Besides, documents published from the self-help activists are analyzed together with interviews with central agents. The research question asks what has been the significance of the different politicisation stages that self-help activities were passing. The article concludes that self-help has undergone a political redefinition from voluntary work to mental and public health work. The dominant actors defining self-help have shifted from social work to a combined enterprise between the health authorities and the Norwegian self-help forum in the planning and regulating of self-help activities at the national level.

KAPITTEL 5 Nasjonal selvhjelpssatsing møter lokalsamfunnet

The chapter studies how a national self-help actor cooperates with a local Norwegian community about self-help work. It analyses this cooperation as a type of boundary work passing several challenges: The initiating work by the self-help actor moves from one-sided information work to negotiations with the local authorities, where the primary objective is to create a common understanding of self-help. Later, expanded networking and a type of translation of the understanding of self-help to new actors and situations are taking place. The main project for the self-help actor was to create a common understanding of self-help, meeting places for self-help groups and networks. The chapter concludes that the most challenging stage was the networking activities including the translation of the common understanding of self-help.

KAPITTEL 6 Rom for selvhjelp. Sosialt entreprenørskap og offentlig–frivillig samarbeid

This chapter describes and analyses how self-help in groups was introduced in a rural municipality in Northern Norway. The location has drawn national attention because local forces managed to establish a clearinghouse for self-help groups (LINK) based on Self-help Norway’s principles at an early moment in the organization’s history. The case of “Selvhjelpshuset LINK” is analyzed with theories of social entrepreneurship and social innovation and field-theory. The legacy of Selvhjelpshuset LINK may give us some lessons on the social entrepreneur’s central role when it comes to introduce and implement social innovations, the potential for resource allocation – in terms of economic, social, cultural and symbolic capital. It also draws attention to the dynamics of collaboration between civil society actors and municipal and state government agents. A dimension that has been the focus for studies of new forms of governance.

KAPITTEL 8 Selvhjelp i grenseland – en ny type helsebevegelse?

In this chapter, we study the Norwegian self-help activism in light of the idea of boundary work. We focus our attention on the Norwegian self-help forum (NSF) and Self-Help Norway (SN) as representatives of a specific direction within the diversity of self-help organizations that grew up towards the end of the 20th century. NSF/SN stands out for their strategic cooperation with the authorities, while at the same time having adopted ideological positions when it comes to defining the phenomenon of self-help. We argue that the state-oriented self-help activism has been a unique Norwegian phenomenon, and probably also in an international context. The chapter is organized in several parts: After a short introduction, we describe empirically how the national self-help actors were met by quite different local communities. Secondly, we discuss whether this self-help activity represents civil society or a type of boundary work between civil society and the welfare state. As our third theme, we ask whether this new self-help activism in Norway, can be characterized as part of a social movement or more specifically a new type of health movement. Finally, we summarize how the development in self-help activism over the past 20 years has contributed to actualizing tensions and hybridity in the borderland between the national and local and between civil and state agency.