Chronister, Johnson and Berven (2006) report that researchers from various disciplines have established a positive relationship between social support and an array of outcomes generally associated with coping, health and well-being. From this work they also report that social support has been established to be negatively correlated to stress, emotional distress and even mortality. There is rising empirical support that social bonds and support appear to be key in post-traumatic growth, recovery and better adjustment (Cook & Bickman, 1990; Flannery, 1990; MacRitchie, 2006; Mirzamani, 2006; Wilson & Boden, 2008). There is substantiation that it offers health protection and that recovery from illness is positively influenced by social support (Sarason et al., 1987). It has long been accepted that social support undoubtedly lessens the effects and severity of secondary traumatic stress symptoms (Basedau, 2004; Hyman, 2004; Figley, 2002a). In a systematic review of literature spanning more than a decade, Michie and Williams (2003) found social support to be one of the key work factors related to poor psychological health and sickness- related absenteeism in a diversity of workers.
As with empathy, social support is innate and biologically programmed (Flannery, 1990). One of many definitions for social support entails the help, comfort and/or information a person receives, verbally or non-verbally, through formal or informal contact with others (Flannery, 1990). It also refers to the existence or availability of people on whom a person can rely and who makes the person feel cared for, loved and valued (Sarason, Levine, Basham & Sarason, 1983). Cohen,
Underwood and Gottlieb (2002) further elaborate that social support also includes social resources that are provided in reality by non-professionals, within the framework of informal helping relationships as well as formal support groups. However, these contacts need to be perceived as both available and helpful to qualify as social supports (Flannery, 1990). Social support available early in life allows a child to develop into a self-reliant person who then also acts as a support to others, and it bolsters one’s ability to withstand difficulties and challenges (Sarason et al., 1983). The psychopathologies that may emerge later in life are diminished significantly where social support is present from early on (Sarason et al., 1983).
Defining the term social support is no easy feat as there are numerous definitions and conceptualisations of the term, each with their own meaning and implications (Basedau, 2004). To begin with, the concept of social support is viewed to be a complex, multidimensional construct (Cook & Bickman, 1990; Flannery, 1990; Hyman, 2004). In addition, there is a clear lack of consensus that further complicates how social support should be conceptualised (Elklit et al., 2001). To measure a construct as broad, vague and undecided as social support is an even more difficult task. This has been misguiding, complicating and hampering many research efforts, as the term is too vague and too unspecific for research purposes (Chronister et al., 2006). Basedau (2004) further suggests that subscribing to any one definition of social support could result in oversimplification of a complex meta-construct.
From the research of Cohen et al. (2002) it is reported that there are numerous comprehensive and complex theories and schools of thought that guide and influence the way in which social support is studied. To illustrate, whilst reviewing social support research studies, it was indeed a difficult task to navigate through the literature in search of commonalities and points of agreement. The more studies looked at, the more diversified viewpoints became and the more varied elements and definitions were. Instead of homing in on the accepted fundamentals and nature of social support, it led to an ever-widening body of literature with very few points of intersection. A best effort had to be made, within the limited scope of the present study, to extricate the most outstanding ideas, or simply those that were encountered more often.
Firstly, the way in which social support affects psychological outcomes is one scope of research (Demirtepe-Saygili & Bozo, 2011). Although advancement has been made in accepting and comprehending the potential benefits of social support, research has not yet uncovered the specific processes and mechanisms that underlie these benefits (Chronister et al., 2006). This debate
continues and is far from resolved (Basedau, 2004; Demirtepe-Saygili & Bozo, 2011; MacRitchie, 2006). According to Chronister et al. (2006) the two most widely accepted models of social support are the main-effect and the stress-buffering models.
Even though the study did not approach social support from any of the following theoretical standpoints, these are nonetheless discussed briefly to highlight some of the developments in social support literature. In the first place, the stress-buffering model proposes that social support moderates the outcomes of stresses on health and adaptability. Hence, stress is viewed to have more negative effects in the absence of social support (Chronister et al., 2006). Low levels of social support in themselves are not necessarily stressful, but under circumstances involving trauma or stress, those with higher levels of support will experience less negative outcomes (MacRitchie, 2006).
Conversely, the main-effect model posits that, regardless of stress levels, high levels of support will always bolster health and well-being. Whether a person is under pressure or not, social support is believed to have a generally beneficial effect on wellness as well as emotional and social development (MacRitchie, 2006). It is believed that social support directly promotes health and healthy behaviours, consequently shielding the person from negative effects. In other words, social support has a direct effect on psychological outcome variables, regardless of the person’s stress levels (Demirtepe-Saygili & Bozo, 2011).
Chronister et al. (2006) conclude that research supports both these models, but that they merely reflect two different, distinct dimensions of social support. They explain that support for the stress- buffering model emerges where subjective evaluation of social support is measured, whereas the main-effect model receives supported where the structural dimensions of social support are measured. The latter entails exploring, for instance, people’s connection to their personal networks, the size and frequency of such contacts as well as the characteristics of their social ties (Chronister
et al., 2006).
Two further models that have emerged are the support mobilisation and the support deterioration models (Chronister et al., 2006). These authors explain that the first proposes that stress is a trigger that initiates the development of a social support system. From this view, individuals are believed to have a tendency to connect with others when they are faced with adversity. The second view, in contrast, emphasises that individuals who are experiencing stress are unlikely to seek out
affiliations, and this in turn generates more negative outcomes (Chronister et al., 2006). Upon pondering this point, one could logically and intuitively conclude that these two different courses of action might also be a product of individual differences in personality traits. More extroverted individuals might reach out to others, or mobilise social support more readily. On the other hand, an introverted person might withdraw and become even more introverted during trying times, resulting in social support deterioration. Some researchers do, in fact, propose that the extent of social support mobilisation may very well be related to an individual characteristic; however, they refer to the person’s psychological resources (Chronister et al., 2006). Basedau (2004) also cited literature that views social support to be regulated by the individual characteristics of willingness to access support.
In conjunction to stress being viewed as a moderator, another viewpoint is that social support interacts with the stressors, and should be seen as a mediator in the stressor-strain relationship (Demirtepe-Saygili & Bozo, 2011). However, another source of confusion is the imprecise use of the terms mediator and moderator as though they are interchangeable (e.g. Murphy, 1988). The pedagogy of the article by Baron and Kenny (1986) emphasised the importance of respecting the distinction between the two terms and to highlight the theoretical implications of the moderator- mediator distinction.
They argue that both terms are firmly based in statistics, each having very specific definitions and equally specific statistics that best represent each. Again, both the moderator and mediator hypotheses are clearly supported by research. There is ample research evidence in favour of the view that social support is a moderator (e.g. Kirmeyer & Dougherty, 1988; Cook & Bickman, 1990). Others offer support in terms of social support being a mediator (e.g. Andrews, Brewin, & Rose, 2003; Joseph et al., 1993). Olstad, Sexton and Søgaard (2001) concluded that empirical research on which of the two approaches is most correct has been inconclusive. Clarification is again hampered by the lack of conformity on how to define and measure the various concepts concerned.
It is important to mention here that the purpose of the present study is not to further develop any of the debates outlined here or to attempt to resolve any of the highlighted issues. These different approaches and perspectives were merely flagged as ongoing points of controversy and the most salient debates in social support research. As stated before, social support was not approached from any of the standpoints outlined here and the study merely sought to establish whether social support
is important to claims workers in relation to vicarious trauma.
Finally, on top of the various debates outlined here, it is also important to differentiate between received and perceived social support (Chronister et al., 2006). Sarason et al. (1987) suggest that it is in general more useful to measure perceived social support as this term has been found to be more related to psychological health than actual support. Demirtepe-Saygili and Bozo (2011) add that the appraisal of the support is actually more critical than the enacted support itself. Dalgleish, Joseph, Thrasher, Tranah and Yule (1996) differ on this point and propose that it is more helpful to study received support following trauma.
Measures of perceived and received support have been found to correlate weakly, signifying that received and perceived support are actually separate and dissimilar constructs (Basedau, 2004). Basedau concluded, after an extensive literature review, that the majority of research studies suggest that the perception of being supported is more important in psychological well-being than the magnitude of actual support received. In line with this finding, the present study opted for measuring perceived social support, therefore an instrument was selected that also offers some insight into the structural composition and size of support networks.
Despite the conceptual confusion about social support, the study nonetheless demarcated this variable to form part of the study. The persisting uncertainty and indecision surrounding social support studies clearly indicate a need for continued research in this area. When it comes to preventing and treating secondary traumatic stress, assessing and enhancing social support are important exercises (Figley, 2002a). Figley also strongly urges that it is imperative to enlarge the helping person's support system – not only in numbers but also in diversity of relationships to draw support from. On the other hand, Figley (2002a) warns that some relationships may be a source of tension and distress, thus it would also be necessary for the helping person to regularly re-evaluate and winnow out any toxic relationships.
In conclusion, the claims workers investigated by the present study are inadvertently in a helping role as they continuously assist clients in crisis and emergency situations. As stated before, it was assumed, though circumspectly, that the trauma counsellor participants might be better equipped to deal with vicarious traumatisation compared to the claims workers. Trauma counsellors have extensive training, superior insight into the hazards of trauma work and usually have supervision, work-based support and other helpful resources. It is believed that they might be in a less
compromised position at intrapersonal, interpersonal and social levels compared to claims workers. However, claims workers might appear to be coping well at a given moment, as with any other group serving traumatised clients, but might be teetering on the brink of becoming overwhelmed, in the face of additional pressures or a diminution in their support systems (Jordan 2001). The next section will look at a more positive construct associated with vicarious traumatisation, being compassion satisfaction.