As the belief that social support and coping can moderate the impact of stress becomes part of the common wisdom in the mental health field, the demand for support-oriented interventions has increased. However, a review of the stress-buffering research indicates that the effect of support is more modest and more complex than most researchers suggest. Interesting stress-support relationships at the significant level have led many to pay less attention to the implications of the large numbers of nonsignificant and problematic findings. Some inconsistencies may be due to methodological issues both in hypothesis development and statistical design. A more enriched understanding of the role of social support requires a paradigm shift that will expand the questions being asked. Research should focus on an ecological perspective examining the determinants of stress, coping, and support patterns; the costs and consequences associated with helping behavior; systematic consequences of support patterns; and the social and personal context of support. Such an approach goes beyond the stress-buffering hypothesis, toward providing a richer understanding of the role of support in the process of adaptation. (BL)