1
It has been shown that sometimes the people closest to us cannot or do not provide support to those in
distress (Sullivan & Reardon, 1985; Wortman & Lehman, 1985). According to Cline (1999), “Industrialization and
growth of technology radically changed the geographic landscape and yielded parallel losses in familial and
community social support” (p. 517). People in need of support often turn to nonintimate relations (Tardy, 1992).
Adelman, Parks, and Albrecht (1987) contend that weaker social relationships help us to compensate during times of
stress when our close relationships are disrupted. Support groups have emerged to provide an alternative sense of
community (Wuthnow, 1994). According to Wasserman and Danforth (1988), "It would appear that the support
group modality, with its ability to foster connectedness and mutuality amidst isolation, stigma and despair, provides
a building block in countering the faltering sense of community. Support groups offer a reparative potential by
tapping a universal human resource--the need for and the strength of interconnection" (p. 72).
More than 25 million Americans are estimated to have participated in a support group at some time in their
lives, with approximately 10 million presently participating (Kessler, Mickelson, & Zhao, 1997). Numerous
researchers have reported the health benefits of support and support group participation (see Cohen & Syme, 1985;
DiMatteo & Hays, 1981; Sarason, Sarason, & Gurung, 1997). These benefits have included favorable symptom
change, enhanced recovery, and adaptive responses to the diagnosis of illness (Berger, 1985; Spiegel, Bloom &
Yalom, 1981; Spiegel et al., 1989; Taylor, Falke, Mazel, & Hilsberg, 1988). Others have pointed out the potentially
negative health consequences of support (Albrecht & Adelman, 1987; Albrecht, Burleson, & Goldsmith, 1987) such
as caregiver burnout, and the promotion of dependence. Research findings on face-to-face cancer support groups
suggest that they can enhance coping, reduce adverse emotional responses to cancer, and help participants resume
previous life activities (Taylor et al., 1988; Youssef, 1984).
Cline (1999) distinguishes between internal and external oriented support groups. Internally orientated
groups function to enhance members’ sense of personal control by consensual validation of experiences and
meaning. The communication climate of an externally orientated group is “subtly strategic and evaluative,” (Cline,
1999) more characteristic of a defensive climate (Gibb, 1961). These external oriented groups tend to be highly
structured and rule-governed. It is remains to be seen whether online groups, based in textual cues, hold up to these
two distinct ideologies. Recently, people have been turning to the Internet to fulfill support needs.
The number of online support groups has increased dramatically over the past several years. These online
groups are providing new opportunities for patients to communicate with health care professionals and other
Convention