Group work is always subject to a certain set of dynamics. Difficulties can arise in every phase.

While people with similar problems and concerns meet each other in self help groups, they can be very different in their personalities. Differing opinions, interests and needs come together in every group of people. That is quite normal and not problematic, when taken by itself. It is not the differing opinions and points of view which are a problem, but rather the way people deal with these.

The following difficulties can arise:

• Members do not know how they can play a part in the group or tell others something about themselves.
• The help anticipated outweighs the individual’s willingness to become active; that is, the people affected by the common problem generally take it for granted that they will primarily be helped by the others (consumer mentality)
• Responsibility for what happens in the group is delegated to the ‘group leader’ or contact person.
• It is always the same people who do all the work which arises.
• The group is too large or too small.
• Expectations and the state of being affected are very different.
• It is not possible to reach any agreement on objectives and approach.
• Minimal organisational prerequisites cannot be fulfilled (e.g. room, times).
• Integration of new members is difficult because there is already a core group. The opposite is likewise possible: it is hard to take on new members because the existent does not yet have sufficient inner stability. The resulting fluctuation can endanger the group.

Every self help group develops its own styles and structures. These constitute the strength of the group and determine its inner life. This has its difficulties:

• There are few active members but many passive members. The passive members expect the active members to keep the group alive, but they feel this is asking too much of them.
• Special tasks and duties are taken on in a self help group by dominating and especially active persons. The group becomes oriented to certain individual members who are thus regarded (in)officially as leaders.
• Members react to conflicts in the group by staying away. This can endanger the existence of a small group.
• In difficult situations the group might also grow together. The decision on whether to admit new members can be of great importance. Large fluctuation (market character) endangers continual group development and stabilization.
• Mutual affection can be an important factor for cohesion in a self help group. This is made possible by an open, honest and pleasing group atmosphere. When antipathies between members are not addressed, they have a significant negative effect on the atmosphere of the group.
• Excessively large differences between expectations of a self help group and the possibilities for realizing these lead to resignation and/or dissolution of the group.
• Referrals of persons (e.g. by physicians or therapists) to a self help group can be very problematic. Quite frequently, these persons have not been properly informed of the self help character of the group and expect immediate help for their problem without having to be become active themselves (consumer mentality).

The members of a self help group which has been in existence for quite some time can, due to their intensive dealings with the group topic, become experts in their own matter. They have accepted their problem, are able to cope with it better or have even overcome it. This frequently leads to their desire to use their acquired abilities (e.g. in the form of counselling) for the benefit of others who are struggling to overcome the same problem.

In this way the focus and objectives of their work, which was at first directed to themselves, becomes redirected to the outside world. Frequently this leads to a core group of members who inform and counsel persons not in the group on a volunteer basis. The boundaries between self help and outside help vanish.

In this phase, strains and conflicts can arise which affect the self help group and, most especially, can lead to roll conflicts for the persons giving counselling (overload and dominance of individuals, extension of the volunteer activity for others, etc.). At this time of change, or upheaval, openness among the group members and mutual reassurance of joint objectives and methods are a prerequisite for the self help group to continue. Advice from experienced project workers or timely help through supervision can ward off disappointment.