Self-Help within A Medical Institution: Its Potentials and Limits

The current health self-help movement has its roots in the social movements of the 1960's. Frustrated with the practices and priorities of established medicine, many groups organized to meet their health needs outside the medical care system. Now self-help is becoming more attractive to health care providers. Hospitals, physicians and funding agencies are putting new emphasis on teaching self-help skills to a variety of patients.This report describes one such program established for asthmatic children and their parents in a medical center in New York City. By analyzing the different perspectives of parents, children, educators, physicians, hospital administrators and the funding agency, it shows how self-help programs within a hospital setting are shaped by an interaction of forces. The potential and limits of self-help as an instrument for social and institutional change are described. The article concludes with recommendations on how health workers can contribute to the self-help process.