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Social skills increase quality of life

Today strawberry yogurt is on Anna’s* grocery list. In front of the dairy section she notices that she cannot reach the yogurt sitting in a wheelchair. Many stressed people are rushing through the crowded store during rush hour and she does not dare to ask for help.

Daniel* is just about to put his wheelchair into the car when a colleague from work comes by and wants to help him to pack it in the trunk. Daniel is annoyed about the help he did not ask for and also shows it, until his colleague walks away shaking his head.

Nadine* is having a tough time. For having her pressure sore treated, she needs to go to the clinic. Her boss has noticed some mistakes she has done and she just had an argument with her boyfriend. She visits her sister and tells her how difficult everything is and how bad she feels. Her sister takes Nadine into her arms, comforts her and encourages her.

As the three examples show, the right kind of support from the people surrounding us is important, not only for wheelchair users. Literature shows that people who have a supporting social network are physically and mentally healthier and indicate a higher quality of life. First data evaluation of the Swiss Spinal Cord Injury Study (SwiSCI) show the role that social support plays and how social skills influence the life of people with spinal cord injury.

What are social skills?

“The way we interact with each other” would be a simplified description of social skills. Psychology defines social skills as the ability to interact appropriately but also efficiently with other people. This means striving to reach one’s own goals while respecting the norms and values of others. Social skills include simple communication tools such as verbal (e.g. volume or pitch of the voice) and non-verbal aspects (e.g. eye contact, body posture) but also more complex strategies such as self-assertion, goal orientation and problem solving. More explicitly, social skills include encoding (expressivity) and decoding of information as well as control in social situations.

Expressivity means to communicate understandably one’s emotions and needs to the listener but also to make contacts and to include others in a conversation. Sensitivity means being able to empathize with somebody else’s position and to sympathize with his/her emotions and thoughts (empathy). Self-control refers to being able to control one’s own emotions or anger, grief or enthusiasm, but it also refers to social “tactfulness”.

Research shows that deficits in social skills are related to numerous psychological conditions such as depression, anxiety disorders or alcohol and drug abuse. For the area of physical disabilities, there are only few studies so far and it is unclear which role social skills play for people with spinal cord injury.

What does social support mean?

Examples for social support would be help with shopping, good advices from friends or being comforted by one’s sister. Therefore it must be differentiated between diverse kinds of social support (instrumental, informational, emotional) from various sources (e.g. family, friends, neighbours) that can be considered from different perspectives (e.g. quantity and quality).

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Social support is like a “buffer" that protects people from negative influences and stress. Research in the field of spinal cord injury shows that social support is important to prevent pressure. People who are satisfied with the social support they receive, are physically and mentally healthier, report less pain, are coping better with burdening life situations and indicate a higher degree of life satisfaction.

Examining psychological topics within SwiSCI

SwiSCI is the so far largest survey from a comprehensive perspective of people with spinal cord injury among the Swiss population. In the below described study participants are asked to fill out various questionnaires. In order to measure social skills, the participants needed to judge how much certain statements apply to them. Examples are “Usually I take the initiative and introduce myself to people I have not met before", “I am absolutely able to give the impression that I am calm, even though I am upset" or “I always seem to know what others truly feel". In order to measure social support, the participants were asked to list people on which they can count when they need help or support when asked e.g. “Who does really take care of you, no matter what happens"? They were also asked how satisfied they were with the support they received in this context. Furthermore, with the help of the questionnaires, data about possible depressive disorders or limitations within various areas of life as well as the degree of quality of life were collected.


Data from 503 people with spinal cord injury has been analysed. Three quarters of the participants were male of an average age of 55 and have been living with spinal cord injury for a mean of around 20 years. The results show that social skills play an important role with respect to mental health and quality of life. However, they do not help to minimize limitations in everyday life.

In more detail the study shows that people with a high expressivity and control report more social support, less depressive disorders and a higher quality of life. That means that people who are able to communicate to the people surrounding them how they feel and what they need in an appropriate way, receive more support, are mentally healthier and report a higher quality of life.

Sensitivity, on the other hand, has a rather negative impact on the quality of life. People who are highly sensitive, through their empathy, also seem to perceive negative feelings and thoughts of others increasingly and this, again, has a negative effect on themselves. Social support, surprisingly, only seems to have a positive influence on limitations of everyday life, but does not contribute to quality of life and is not connected with depression.

Possible implementation of the results

A spinal cord injury has massive consequences on the life of the person affected, also when interacting with other people. This study shows that social skills are an important personal strength since more social support is connected with better mental health and a higher quality of life. Trainings to improve social skills during first rehabilitation may help the people affected to be better prepared for life in a wheelchair. Also outpatient psychotherapy clinics offer social competence trainings. Situations like the one described in the beginning of the text can be discussed in more detail during these trainings. The trainings mostly focus on learning how to be flexible and to avoid helplessness in different social situations that have changed through the dependency on the wheelchair. Social skills such as expressivity, sensitivity and control are being trained. Therefore it also increases the confidence in oneself to be able to handle the new situation while avoiding self-depreciation and withdrawal.


  • Saying how you are and feel, what you need, making friends and maintaining friendships and being socially active seems to be more important than the immediate support from other people.

* fictitious names


  • Paracontact 2/2013, Swiss Paraplegics Association

updated: December 2013

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