Self-help groups in the United Kingdom continue to grow in number and address virtually every conceivable health condition, but they remain the subject of very little theoretical analysis. The literature to date has predominantly focused on their therapeutic effects on individual members. And yet they are widely presumed to fulfil a broader civic role and to encourage democratic citizenship. The thesis uses qualitative data derived from individual and group interviews with 33 groups in order to provide an outline of the ethos, aims, activities and structural arrangements of a broad range of self-help groups in Nottinghamshire, UK. It then uses these findings as the foundation on which to construct a model of self-help groups’ democratising effects in the public sphere and as a means of differentiating them from other types of ‘health citizenship’ organisation such as new social movements. In order to do this it broadly follows the work of Jurgen Habermas, making use of his concepts of communicative action; system-lifeworld integration; lifeworld autonomy and collective identity as an appropriate framework against which to account for these groups in civic terms. It was found that in their pursuit of personal and collective identities the groups were augmenting individual autonomy through increasing mutual recognition and understanding in the lifeworld. Although at first sight the groups appeared to be structured hierarchically, leaders tended to use their influence to foster a type of communicative equality that sustained the democratic negotiation of these identities. In addition, through their two-way communicative links with the system the groups were adding to the complexity and quality of discourse in the public sphere and increasing the possibility of attaining social consensus. Unlike new social movements who are believed to operate at the protest end of civil society, the self-help groups were oriented to its enabling sector.

Text in Afrikaans / Egskeidings en daaropvolgende hersaamgestelde gesinne neem toe. Die literatuur sowel as praktykervaring van die navorser het bewys dat die aanpassing in 'n hersaamgestelde gesin veral vir die adolessent traumaties is. Uit 'n literatuurstudie is bepaal watter probleme/behoeftes adolessente in hersaamgestelde gesinne ervaar. Die nominale groepstegniek is gebruik ten einde probleme/behoeftes te verfyn. Dit het uitgewys dat probleme in hersaamgestelde gesinne voortspruitend is uit kommunikasieprobleme. Die groepwerkproram met stiefadolessente is dus daarvolgen opgestel. Psigodrama word beskou as die mees ideale benadering in groepwerk met adolessente. Twee meetskale is gebruik, te wete 'n kommunikasievraelys en die Hudson-indeks wat gewysig is vanaf ouerlike verhoudings na stiefouerlike verhoudings. 'n Voorondersoek groep is met vyf stiefadolessente oor vyf byeenkomste en 'n eksperimentele groep met tien stiefadolessente oor tien byeenkomste aangebied. Voor- en nameting is gedoen. Op beide meetskale is groei in vaardighede gemeet en is die navorser se doelstelling bereik / Divorces and remarriages are increasing. The literature study and practical experience of the researcher, has shown that the adaption to remarriage is the most traumatic for adolescents. A literature study was done to determine the problems/needs of adolescents in remarried families. The nominal group technique was then used to refine the problems/needs. The results showed clearly that problems in remarried families are a result of communication problems. The group work programme with stepadolescents was therefore composed. Psychodrama is the most ideal method in working with adolescents. Two measuring instruments were used, namely the communication questionnaire and the Hudson-index which was modified from parentchild relationships to step-parental relationships. A pilot study group with five step-adolescents over five meetings and an experimental group was then held with ten step-adolescents over a period of ten meetings were held. Measurement was done before and after the group meetings. Both measuring instruments recorded growth in skills and the researcher's objective was reached / Social Work / M.A. (Sosiale Wetenskappe)

Text in Afrikaans / Egskeidings en daaropvolgende hersaamgestelde gesinne neem toe. Die literatuur sowel as praktykervaring van die navorser het bewys dat die aanpassing in 'n hersaamgestelde gesin veral vir die adolessent traumaties is. Uit 'n literatuurstudie is bepaal watter probleme/behoeftes adolessente in hersaamgestelde gesinne ervaar. Die nominale groepstegniek is gebruik ten einde probleme/behoeftes te verfyn. Dit het uitgewys dat probleme in hersaamgestelde gesinne voortspruitend is uit kommunikasieprobleme. Die groepwerkproram met stiefadolessente is dus daarvolgen opgestel. Psigodrama word beskou as die mees ideale benadering in groepwerk met adolessente. Twee meetskale is gebruik, te wete 'n kommunikasievraelys en die Hudson-indeks wat gewysig is vanaf ouerlike verhoudings na stiefouerlike verhoudings. 'n Voorondersoek groep is met vyf stiefadolessente oor vyf byeenkomste en 'n eksperimentele groep met tien stiefadolessente oor tien byeenkomste aangebied. Voor- en nameting is gedoen. Op beide meetskale is groei in vaardighede gemeet en is die navorser se doelstelling bereik / Divorces and remarriages are increasing. The literature study and practical experience of the researcher, has shown that the adaption to remarriage is the most traumatic for adolescents. A literature study was done to determine the problems/needs of adolescents in remarried families. The nominal group technique was then used to refine the problems/needs. The results showed clearly that problems in remarried families are a result of communication problems. The group work programme with stepadolescents was therefore composed. Psychodrama is the most ideal method in working with adolescents. Two measuring instruments were used, namely the communication questionnaire and the Hudson-index which was modified from parentchild relationships to step-parental relationships. A pilot study group with five step-adolescents over five meetings and an experimental group was then held with ten step-adolescents over a period of ten meetings were held. Measurement was done before and after the group meetings. Both measuring instruments recorded growth in skills and the researcher's objective was reached / Social Work / M.A. (Sosiale Wetenskappe)