It has been suggested from previous studies (for example, Coyne & DeLongis 1986) that therapeutic and preventive efforts will be most successful when they proceed from a specific understanding of target populations, environmental settings, target behaviours and the nature of the optimal congruence between them. Presently, the social support literature is limited in what it can offer to such efforts. This study suggests that it is more likely to make contributions if theory and research do not become prematurely focused on decontextualized cognitive processes, with the exclusion of the circumstance in which these processes purportedly occur. Taken together, the type of illness (CHD) and time phase (chronic) provide a context to integrate aspects of a comprehensive understanding and assessment for a specific model of family stress, perceived social support, and coping. These findings support of the scheme for the resiliency model of family stress, adjustment and adaptation and can be used for both preventive screening of high-risk families for health care professionals and family centred care and as part of the overall evaluation and intervention for families who have a child with chronic illness.