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In France, Therapeutic Patient Education (TPE) developed in community groups, mainly through professional training and research activities that were supported by the voluntary and academic sectors. This social and historical study of one of the oldest associations in France (Afdet) combines theoretical frameworks from health sociology and political sciences. The analysis focuses on the specialized magazines published since 1990 by this association, and on a collection of qualitative data featuring twenty-two interviews with key actors. The association’s reformist stance is a constant presence in its history, and has given rise to tensions between the different actors and paved the way toward two major reorganizations. Afdet aims to spread a new concept of the health and caring process, and can be considered as a “laboratory for engineering ideas” and as a developer of public policy away from an institutional setting.