As discussed earlier, as long as the members perceive one another as similar peers, social comparison will be an ongoing covert process throughout the course of the group. Ideally, in composing the group, some thought should go into ways of exploiting this psychological process to the best advantage of the participants. For example, in most self-help groups there is a "veteran sufferer'' who serves as a model of effective coping and thereby instills hope and motivation to
Support Groups comply with the group's behavioral prescriptions. Social comparison theory also postulates that, to accomplish its stress-reducing effect, the companions must be perceived to be reacting relatively calmly to their situation, suggesting that support groups are not appropriate during periods when people are feeling emotionally overwhelmed. It is therefore advisable to recruit participants only after they have recovered from the initial shock of a crisis, and are ready to commence a structured and paced social support program.
Once it is conceded that experiential similarity serves as a stronger basis for mutual identification and empathic understanding than structural similarity based on age or marital status, for example, questions arise concerning how similar the common experience must be in order for the participants to attend and compare themselves to one another, and to develop bonds of affection and belonging. For example, for a group of recent widows, their bereavement is probably not sufficient to level differences based on the cause and age of their partner's death. It is unlikely that widows whose husbands had died of heart attacks would perceive themselves to be "in the same boat'' as widows whose husbands had been murdered or killed in a traffic accident or who had died in the line of wartime fire or by taking their own lives. The same careful consideration of the bases of similarity is warranted in planning the composition of virtually every group for people who have undergone stressful life events and transitions, such as parental death or divorce, retirement, new parenthood, job loss, serious accidents, and illness diagnoses. Three factors in particular warrant consideration: (1) the contextual or situational parameters that are likely to be most salient to the participants; (2) factors that are known to affect people's risk status; and (3) the probable trajectory the participants will experience. For example, in composing support groups for the family caregivers of elderly relatives, program planners should recognize that caring for a relative afflicted with dementia poses greater risk to the mental health of the caregiver than caring for a frail but cognitively intact relative, and that the future course of dementia is distinctly different from other disabilities and conditions. Hence, it would not be advisable to compose a group that combines caregivers in these contrasting situations. Of course, if the prospective participants are children or youth, it is necessary to ensure that the group content and composition is developmentally appropriate.
Finally, the similarity of the participants not only bears on their ability to relate and compare themselves to one another, but it also affects the substantive content of the educational component and ultimately, the impact of the intervention. As noted earlier, reviews of the support group literature have been consistent in their criticism of the heterogeneity of groups, arguing that interventions will impact differently on various subgroups of participants and suggesting that null results may mask differential effectiveness for such subgroups. In addition to structural and experiential differences among participants, they may also differ on the basis of the stage of the condition or problem they face, their use of both informal and formal supports in the community, and a number of personality and coping factors that affect their receptiveness to and benefit from this type of intervention.
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