Social Support Interventions

Social support refers to the exchange of a variety of helping behaviors that arise from people's interactions and relationships with members of their social network who have not received any formal mental health training. Natural support usually arises spontaneously when close network members such as family members and friends provide comfort, companionship, practical assistance, advice, and feedback about an individual's performance or worth. Moreover, a voluminous literature has amply documented the health-protective functions of perceived natural support under conditions of stress. What this means is that the belief that support is forthcoming—its anticipated delivery alone—seems to cushion the impact of stressors, perhaps by rendering them less daunting or by instilling greater confidence in the individual's own resources for resisting stress. High levels of perceived support are, at least in part, a consequence of past episodes when natural network members provided assistance. This entry reviews different types of interventions designed to increase, improve, or specialize social support and then concentrates on the design and processes occurring in support groups.

Recognizing the stress-buffering and health-protective effects of social support, and with an emphasis on actual rather than perceived support, a number of investigators and practitioners have formulated ideas about ways of harnessing this resource in programs for people exposed to a variety of adversities. Whole network initiatives teach people how to identify and capitalize on the support of their field of close associates, whereas dyadic interventions concentrate on ways of mobilizing, specializing, and optimizing the quality and durability of the support rendered by a single valued social tie or confidant. A complementary set of support interventions differs from these natural network strategies by introducing new social ties deemed capable of meeting people's supportive needs. Confidence in their capability as relevant sources of support stemmed from a growing literature on the benefits of mutual aid, self-help (MASH) groups, longstanding community programs such as Big Brothers/Sisters, and, not least of all, the legacy of Stanley Schachter's work on affiliation and Leon Festinger's theory of social comparison, which documented the need for affiliation and comparison under conditions of threat that evoke fear.

The resulting armamentarium of support interventions can be summarized in a 2 × 2 matrix that takes into account the level of intervention (namely, the dyad or the group) and the relationship status of the support provider (namely, a member of the natural network or a stranger who is grafted onto the network on a temporary or permanent basis). Of these four types, the most widely implemented and studied is the support group, the main focus of this entry. The other three types include: (1) grafted interventions at the dyadic level, such as a program that links volunteers who have recovered from cardiac surgery with patients about to undergo similar surgery; (2) natural network interventions at the group level, such as programs that assemble key network members to support an associate who is affected by a mental or physical disability; and (3) natural network interventions at the dyadic level, such as efforts to improve the frequency and quality of support that a romantic partner provides to a woman affected by breast cancer.

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