The contribution of social support to the successful functioning of men with epilepsy

One hundred men with epilepsy were interviewed about the history of their illness, employment history and personal support network. Included as sources of support were: household members, close friends and relatives, more distant relationships and general forms of social participation such as church membership. Four potentially supportive aspects of these relationships were assessed: structural features of the pattern of relationships; characteristics of the individual ties; exchanges of helping resources and subjective assessments of the supportiveness of ties. The social support networks of the men who were satisfied with their lives were large, diverse, active and generally helpful. Church membership was also a strong predictor of satisfaction. Indicators of social support were not as predictive of employment success although close knit ties between friends and kin and general social participation were associated with successful employment. Efforts of professional service providers, friends and family members to provide help specifically directed toward helping the person deal with epilepsy were negatively associated with successful employment outcomes when the individual perceived himself as unable to control his symptoms and limited by his condition. The implications of these findings for research are that a fine-grained approach to the study of the effects of support, in terms of sources, types and effects yields a richer, and in some cases, less optimistic picture of the role of informal support in helping a person cope with a chronic disability. The implications for policy are that support from family and friends is limited, strains these relationships and may reinforce patterns of dependence on the part of the recipient that are counterproductive to successful employment and independent living. Help from professionals may produce many of the same results. Programs that are attempting to help such people become successfully employed might do better to focus on changing the self-perceptions of clients in the direction of greater autonomy and focus their social activities towards a more normal pattern of general sociability and equal exchange rather than dependence on a few, close ties