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While it is well-established that mutual aid groups are effective in the psychological rehabilitation of vulnerable individuals, few studies have thoroughly investigated the dynamic mechanism of how psychological well-being improves through mutual aid groups of young patients with chronic health conditions. In connection with several existing theories (i.e., the helper therapy principle, equity theory, the norm of reciprocity, and the concept of communal relationships), this study aims to: (1) evaluate whether emotional support exchanges (i.e., emotional support reception and provision) mediate the relationship between group interaction and psychological well-being; and (2) compare three potential underlying mechanisms—the mediating role of emotional support provision, equitable reciprocity (i.e., a balance of receiving and providing emotional support, where no party over-benefits or under-benefits), and sequential reciprocity (i.e., repaying the helper or a third party in the future after receiving help)—through a path analysis model. A stratified random sampling procedure with chronic health conditions as the stratifying criterion was used to recruit 391 individuals aged 12–45 years from mutual aid groups in Hong Kong, who completed both the baseline and follow-up surveys over a 12-month interval. The results of the path model revealed significant mediating roles of emotional support provision and sequential reciprocity, not equitable reciprocity. The present study offers theoretical and practical implications for promoting the psychological well-being of young patients with chronic health conditions. Full article