Alston Yan

Social work theory · Volume C: Ecological & Contextual

Social support theory

Social support theory explains how the help, care and resources that people receive from their relationships protect health and wellbeing.

1. What it is

Social support theory explains how the help, care and resources that people receive from their relationships protect health and wellbeing. Social support refers to the functions that social relationships serve, especially the provision of emotional, informational, practical and evaluative help (House, 1981). The theory proposes two main pathways: support can benefit wellbeing directly, and it can protect people from the harmful effects of stress (Cohen & Wills, 1985). Decades of research link social relationships to mental health, physical health and survival (House et al., 1988; Holt-Lunstad et al., 2010). For social work, social support theory explains why isolation is a risk and why strengthening informal networks is a core practice goal.

Structural and functional support. Researchers distinguish the structure of a person’s relationships (the number, type and frequency of ties, often called social integration) from their functions (what relationships actually provide). Social network theory addresses structure (see Social network theory). Social support theory focuses mainly on function, although the two are related (Barrera, 1986).

Perceived and received support. Perceived support is a person’s belief that help would be available if needed. Received support is help actually given. Perceived support is more consistently associated with wellbeing than received support, which can sometimes signal crisis or create feelings of dependence (Barrera, 1986; Uchino, 2004).

Emotional support. Emotional support involves expressions of care, empathy, love and trust. It helps people feel valued and understood, and it is the form most consistently linked to wellbeing (House, 1981).

Informational support. Informational support involves advice, suggestions and information that help a person understand and address a problem. Examples include explaining how a service system works or sharing knowledge about a health condition.

Instrumental or practical support. Instrumental support is tangible help, such as money, transport, childcare, meals or help with tasks. It directly reduces demands on the person and is often decisive in crises.

Appraisal support. Appraisal support provides information useful for self-evaluation, such as feedback, affirmation and social comparison (House, 1981). It helps people judge their situation and their own capacities.

James House. House (1981) proposed the four-part typology of emotional, instrumental, informational and appraisal support in a study of work stress. With colleagues he later reviewed prospective studies showing that socially isolated people had higher mortality, and argued that social relationships should be treated as a major risk factor for health (House et al., 1988).

Cohen and Wills’s buffering hypothesis. Cohen and Wills (1985) reviewed the evidence and distinguished two models. The main effect model holds that support benefits wellbeing regardless of stress levels, mainly through social integration. The buffering model holds that support protects people mainly when they are under stress, by changing how stressors are appraised or by assisting coping (see Stress and coping theory). They found evidence for both: buffering effects appeared when measures assessed perceived availability of functional support, while main effects appeared for measures of social integration. They also proposed that support buffers stress best when the type of support matches the needs created by the stressor.

2. Historical development

Period Development
1897 Durkheim links low social integration to higher suicide rates
1974 Caplan describes support systems as a resource in community mental health
1976 Cassel and Cobb propose that social support protects against the health effects of stress
1979 Berkman and Syme’s Alameda County study links social ties to mortality
1981 House’s typology of four support functions
1983–1990 Social work develops network-based practice and the social network map (Whittaker & Garbarino, 1983; Tracy & Whittaker, 1990)
1985 Cohen and Wills distinguish main effect and buffering models
1988–2010 Reviews and meta-analyses confirm associations between relationships and mortality

Social support theory grew from sociology, social epidemiology and community psychiatry. Durkheim’s (1897/1951) work on social integration and Caplan’s (1974) account of support systems were early influences. The modern theory emerged in the 1970s when Cassel (1976) and Cobb (1976) argued that social relationships altered vulnerability to disease. Berkman and Syme (1979) found that people with fewer social ties had higher mortality over nine years, independent of baseline health and health behaviours. These findings established support as a distinct field of research.

The theory became independent of general social network analysis through its focus on function, its typologies of support, and its link to stress research. Social workers had always worked with families and informal helpers, and in the 1980s writers such as Whittaker and Garbarino (1983) argued that strengthening informal support networks should be a deliberate part of practice. Tracy and Whittaker’s (1990) social network map gave practitioners a structured assessment tool. Thoits (2011) later summarised the mechanisms that link ties to health, including social influence, a sense of mattering, and stress buffering.

3. Practical guidance

Social support theory guides assessment of relationships and interventions that strengthen them.

4. Critical evaluation

Strengths. Social support theory has one of the strongest evidence bases in the social sciences. Meta-analysis shows that stronger social relationships are associated with greater likelihood of survival, with effects comparable to established health risk factors (Holt-Lunstad et al., 2010). The typology of support is clear and practical. The theory provides a rationale for work with informal networks that is central to social work.

Limitations. Support is difficult to measure, and different measures produce different findings (Barrera, 1986). Much of the research is correlational, and people in better health may find it easier to maintain relationships. The theory can underplay the negative side of relationships and the burden placed on carers, who are often women (Rook, 1984). An emphasis on informal support can also be used to justify reducing formal services, shifting responsibility onto families and communities.

Overall importance. Social support theory explains why relationships protect wellbeing and how they buffer the effects of stress. It underpins network-based practice, peer support, carer support and group work. It works closely with stress and coping theory (C5), social capital theory (C3) and social network theory (B6), and it gives social workers a clear way to assess and strengthen the resources that relationships provide.

5. References

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