Social Support DTW

Key Points of Social Support

• The importance of social support:
• Social support is repeatedly cited as an important factor promoting resilience among children, adolescents, and adults (e.g. Werner, 2000).
• Important individuals both within and outside the family can nurture children and support their parents.
• Social support's effects on parenting:
• Attachment: Experimental research suggests that the provision of informational support to new mothers (in this case, through a local 'coaching' program) has a positive impact on mother-infant attachment (Jacobson, S.W. 1991) .
• Improved parenting: Observational research suggests that mothers who report more optimal social support evidence more positive maternal behavior (e.g. increased praise and warmth, more optimal control) than mothers who report less social support (e.g. Crnic, Greenberg, Ragozin, Robinson, & Basham, 1983; Jennings, Stagg & Connors, 1991).
• Better able to meet emotional needs: Findings like these lend support to the notion that mothers with satisfactory social networks likely "have more of their emotional needs met and thus are better able to meet the emotional needs of their children" (Jennings et al., p. 976).
• Social support for children and adolescents: The importance of responsive, warm care has been repeatedly documented as a critical element in child development, particularly for children at risk.
• "Research on resilient children has shown that they had at least one person in their lives who accepted them unconditionally, regardless of temperamental idiosyncrasies, physical attractiveness, or intelligence level" (Werner, 2000, p. 129).
• Peers can also be an important source of support for children and adolescents (Hartup, 1996).
• Social support via mentoring programs for children and adolescents: A variety of mentoring programs are available for children and adolescents. Big Brothers/Big Sisters, perhaps the most widely known mentoring program, has demonstrated effectiveness in the following (Tierney, J.P. 1995) :
• reducing the risk of youth behavior problems and substance use
• increasing children's peer success
• increasing children's sense of academic self-esteem
• increasing the likelihood of school attendance and success
• Social support for children and adolescents with health concerns: LaGreca, Bearman, & Moore (2002) review the literature on peers as a source of social support for children with health concerns.
• Buffer for stress: Social support may serve as a buffer between sick children and the stressors they face.
• Better health: LaGreca and colleagues even highlight studies suggesting that disclosure of health problems to friends is associated with improved health, for example in the case of children with HIV.
• Treatment adherence: Peers may also support treatment adherence for children and adolescents, and may encourage health-promoting, as opposed to health-risk, behaviors.
• External support for high-risk families: For families at high risk, home visiting programs and other institutional support can be helpful. They have shown benefits in:
• Prevention of child abuse and neglect (Olds, D.L. 1986) ,
• Improvement of developmental outcomes for children (Olds, D.L. 2004a)
• Reduction of antisocial behavior in children (Olds, D. 1998)
• General positive effects on home environments, parenting interactions, and maternal wellbeing (Kitzman, H. 2000) (Olds, D.L. 2004a)

Management of Social Support

• Initial assessment should focus not solely on risks for the child and family, but on sources of support (Werner, E.E. 2000) .
• Encourage parents to work on developing support networks, offering advice such as the following (Adapted from Barnard):
• Develop friendships where a balance of give and take can be set up, e.g. in terms of material support, childcare support, etc.
• Suggest that parents begin by offering support to a friend or neighbor with children, for example, offering to care for their children at a time they may need it.
• Encourage parents to join religious or other organizations to meet people who share similar interests/values
• Encourage babysitting co-ops for convenience, financial savings, and social benefits
• Suggest that parents use child-centered events (Gymboree, preschool, etc.) as opportunities to meet other parents
• For cases in which severe support deficits exist (e.g. families in poverty, adolescent parents), consider referral to appropriate home visiting support services.
• Consider supports such as "grandparents, older siblings, child-care providers, or nursery school teachers" as potential alternatives or additions to therapeutic services for families (Werner, 2000, p. 129).
• Mentoring programs may be useful for children and adolescents at risk. Sipe (2002) reviewed the literature on mentoring programs for adolescents, highlighting characteristics of effective programs:
• Provision of training and support for mentors' development of relationships with mentees
• Standardized methods for "screening, orientation and training, and support and supervision" (p. 255)
• Mentor/mentee matches based on the preferences and interests of both
• Facilitate social support for children and adolescents with health concerns. LaGreca and colleagues (2002) suggest the following:
• Talk to youth regarding whom to tell about their illness, and what information to give about both the illness and its treatment.
• In cases of conditions associated with stigma, consider encouraging the patient's teacher(s) to facilitate integration by pairing the child with a peer in the classroom.
• Encourage contact with close friends during hospital stays. Encourage return to normal school and peer routines as soon as safely possible after medical treatments.
• Assess areas where peer groups may have negative influences on treatment adherence, and help patients develop strategies to resist these influences. Conversely, consider ways that peers may become involved in facilitating treatment adherence.

Tools

Multidimensional Scale of Perceived Social Support (MSPSS)

The MSPSS (Zimet, G.D. 1988) is a 12-item screening assessing the respondent's perceived social support from family, friends, and significant other. A total score is also derived. All of the items are phrased in positive terms, with 7-point Likert-type response options. The reliability and validity of the MSPSS have been assessed in a sample of 275 university students (Zimet, G.D. 1988) . Subscales were derived through factor analysis. Internal reliability ranged from .85 to .91. Test-retest reliability ranged from .72 for the Significant Other subscale to .85 for the Family subscale. The test-retest reliability of the total score was .85. The MSPSS demonstrated adequate construct validity in comparison with measures of depression and anxiety. Reliability and validity have been further assessed in other samples, including a diverse sample of pregnant women, adolescents, and pediatric residents (Zimet, G.D. 1990) and a sample of urban adolescents (Canty-Mitchell, J. 2000) . The three subscales determined by Zimet and his colleagues (1988) were supported by confirmatory factor analysis. Good internal reliability and construct validity were again demonstrated.

In CHADIS, the MSPSS is scored based on interpretation guidelines provided by the author (Zimet, G.D. 1998) . Average scores are derived for each of the subscales, as well as for the total score. For any of these, average scores greater than 4 are highlighted for clinical attention.

References

1. Barnard, K. (). Parent-Child Communication Coaching, Children's Home Society of Washington, University of Washington, Seattle-King County Department of Public Health..
2. Canty-Mitchell, J., Zimet, G.D. (2000). Psychometric properties of the Multidimensional Scale of Perceived Social Support in urban adolescents. .
3. Crnic, K.A., Greenberg, M.T., Ragozin, A.S., Robinson, N.M., Basham, R.B (1983). Effects of stress and social support on mothers and premature and full-term infants. .
4. Hartup, W.W. (1996). The company they keep: Friendships and their developmental significance. .
5. Jacobson, S.W., Frye, K.F. (1991). Effect of maternal social support on attachment: Experimental evidence. .
6. Jennings, K.D., Stagg, V., Connors, R.E. (1991). Social networks and mothers? interactions with their preschool children. .
7. Kitzman, H., Olds, D.L., Sidora, K., Henderson, C.R., Hanks, C., Cole, R., et al. (2000). Enduring effects of nurse home visitation on maternal life course: A 3-year follow-up of a randomized trial. .
8. LaGreca, A.M., Bearman, K.J., Moore, H. (2002). Peer relations of youth with pediatric conditions and health risks: Promoting social support and healthy lifestyles. .
9. Olds, D.L., Henderson, C.R., Chamberlin, R., Tatelbaum, R. (1986). Preventing child abuse and neglect: A randomized trial of nurse home visitation. .
10. Olds, D., Henderson, C.R., Cole, R., Eckenrode, J., Kitzman, H., Luckey, D., et al. (1998). Long-term effects of nurse home visitation on children's criminal and antisocial behavior: 15-year follow-up of a randomized controlled trial. .
11. Olds, D.L., Kitzman, H., Cole, R., Robinson, J., Sidora, K., Luckey, D.W., et al. (2004a). Effects of nurse home-visiting on maternal life course and child development: Age 6 follow-up results of a randomized trial. .
12. Olds, D.L., Robinson, J., Pettitt, L., Luckey, D.W., Holmberg, J., Ng, R.K., et al. (2004b). Effects of home visits by paraprofessionals and by nurses: Age 4 follow-up results of a randomized trial. .
13. Sipe, C.L. (2002). Mentoring programs for adolescents: A research summary. .
14. Tierney, J.P., Grossman, J.B., Resch, N.L. (1995). Making a difference: An impact study of Big Brothers/Big Sisters.
15. Werner, E.E. (2000). Handbook of Early Childhood Intervention, Second Edition.
16. Zimet, G.D. (1998). Evaluating Stress: A Book of Resources, Volume 2.
17. Zimet, G.D., Dahlem, N.W., Zimet, S.G., Farley, G.K. (1988). The Multidimensional Scale of Perceived Social Support. .
18. Zimet, G.D., Powell, S.S., Farley, G.K., Werkman, S., Berkoff, K.A. (1990). Psychometric characteristics of the Multidimensional Scale of Perceived Social Support. .