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When dealing with trauma victims, social support is commonly thought of in three areas: perceived support, enacted support, and social integration. Perceived support refers to an individual's judgment that services or providers will be available to offer effective help and support in times of need. Enacted support, also described as support received during a crisis or traumatic situation, refers to specific supportive services or actions provided by agencies, providers, or organizations in times of crisis or need. Social integration refers to the extent someone who receives supportive services is connected to or within a social network. These networks can take a number of different forms such as family relationships, church memberships, circles of friends, work environments, and organizations that allow the individual a sense of social integration. Each of these forms of social support has different strengths; for example, some research has shown that perceived support is consistently linked to better mental health, whereas social integration and enacted support are not. Social integration has been linked consistently to physical health outcomes, and enacted support has not been linked consistently to either physical or mental health. In one study, enacted support has been linked to worse mental health. This entry discusses five sources of social support for trauma victims: workplace or occupational, familial, counseling, peer, and community.

Sources of Social Support

Workplace/Occupational Support

When workers are placed at risk in traumatic situations, both organizational and employee support becomes essential in processing the information.

Employee interaction and even process-oriented conversation aid in support for coping with work-related stress, and this carries over when that stress is related to trauma. Peer groups at a workplace can be a significant factor in healing and support when trauma has occurred. In traumatic situations where occupational hazards include physical harm and death, the camaraderie within the organization of coworkers is often what allows emotional processing to occur. Examples of this include firefighters, police officers, emergency medical technicians (EMTs), and nurses. Within the structure of these organizations, supervisors are often supportive in the same way as peers are. This is particularly true when compared with reactions of people outside of an organization, who might not understand the nature of the traumatic event. Processing experiences with others who have had similar experiences can make the difference between developing a traumatic disorder and assimilating and integrating the experience and moving on. There is, however, controversy and mixed evidence regarding the efficacy of social support from peers. And “reverse buffering” (a strong relationship between stressors and strains under conditions of high social support rather than under conditions of low social support) has been found in some of the research findings. What may mitigate this is whether the peer group comes across as supportive or nonsupportive with the individual.

Familial Support

In society throughout the world, the closest social relationships and context for understanding is usually found in the immediate family. Our histories with one another, our formed memories with each other, and our deep connections with family often dictate our perceived support and are very important in the healing process. Although family communication is sometimes difficult, the level of intimacy opens the way for support to be perceived as benevolent and important. The family environment also buffers stress and stressful reactions to situations that are traumatic. The family structures that contribute to the best outcomes are those that are flexible, communicative, supportive, and cohesive. These families tend to be healthy, supportive, and functional, and they provide a supportive system for growth and healing. Families provide a mitigated factor that increases resiliency in the face of trauma. Research has shown that veterans who return from war zones integrate much better into society when they have stable and supportive family structures. This is in contrast to those individuals who were raised and return to a chaotic, dysfunctional family system. Families that are supportive allow a free expression of emotion, and the telling of stories allows the returning veteran the process of healing. Situations that stifle emotion and expression of experience often lead to an increase of adverse effects and a higher incidence of trauma-related disorders.

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