SELF-MANAGEMENT IN ONLINE SELF-HELP GROUPS FOR BREAST CANCER PATIENTS: FINDING THE RIGHT GROUP, A SPECULATIVE HYPOTHESIS

Abstract

A common strategy to maximize the effectiveness of psychotherapy is patient placement to a particular form or type of psychotherapy. Six online selfdirected breast cancer groups (N = 114) were studied to explore the speculative hypothesis that participants select the particular group that best fits their needs. All the groups encouraged “lurking,” reading the postings before joining. Seventy-four percent lurked, half of them for about a week, the other half from two to eight weeks. Forty-eight percent shopped for “the right fit” by trying out other Internet BC groups. We found that: 1) pre-post measures (six months) show substantial improvement; 2) analysis of between groups differences in outcomes was not significant; and 3) analysis of processes linked to positive outcomes (Helpful Group Experiences and negative emotional expression) differed among the groups. The findings may be explained by the prospective members’ ability to sample a variety of groups and to select the one that they believe will be the most comfortable and helpful to them. A common strategy used to maximize the effectiveness of professionally provided psycho-social intervention is matching a patient to a particular form or type of psychotherapy. For nearly 50 years clinicians have written about and studied criteria for such placement. An organized matching strategy is not an option for both traditional and online self-help groups. The goal of this study is to examine a speculative hypothesis: in online SHG groups, matching to a specific group occurs through the active choices made by participants. Specifically, the study explores the common practice of “lurking,” reading the group members messages but not