The social support. Social dissupport continuum

A person's network embodies "the good, the bad, and the ugly" of all social relationships. The nature of these relationships may be conceptualized as a continuum between social support and social dissupport. Social support, as a product of relationships that facilitate growth, generates self-esteem and assists in assuming appropriate societal roles. Social dissupport represents those relationships that hinder growth and/or promote disintegration. Clinically, nurses either formally or informally assess the degree of social support, but neglect the overall social support/dissupport ratio. The MSNI profiles the person's perception of social support/dissupport on four levels of social relationships and is an efficient instrument in assessing who is in the social network, what is provided, perceived helpfulness, and expectations. Preliminary use of the instrument with parents of the long-term mentally ill, acutely and long-term mentally ill clients, students, and a variety of clients of graduate students enrolled in a crisis intervention course are promising. Thus, nurses must be prepared to confront their clients' perceptions of the professional's role and to modify and adapt those interactions to facilitate goal achievement.