Social support interventions for rheumatoid arthritis patients: the cart before the horse?

Enthusiasm about the potential of social support to promote successful adaptation to chronic illness has already led to support interventions for arthritis patients designed to increase coping ability, reduce the need for professional mental health services, and limit periods of disability. But have we put the cart before the horse? Do these interventions achieve these goals? Existing interventions are reviewed, and a number of research issues are addressed from within an ecological framework, including the content of support interventions, the source of support, the type of support provided, support as an intervention variable versus outcome, and the need to target interventions not only to patients but to their family members and health professionals. It is suggested that future interventions be more theoretically grounded.