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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.

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 article uses Habermas’ model of the public sphere as an analytical tool with which to reconsider the literature on self-help groups in order to increase our knowledge of their civic functions. In doing this it also aims to illustrate the continuing relevance of Habermas’ work to our understanding of issues in health and social care. We consider, within the context of current health policies and practices, the extent to which self-help groups with a range of different forms and functions operate according to the principles of communicative rationality that Habermas deemed key to democratic legitimacy. We conclude that self-help groups’ civic role is more complex than is usually presumed and that various factors including groups’ leadership, organisational structure and links with public agencies can affect their efficacy within the public sphere.

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.

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.

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.

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.