In this study the question is raised how family support should be organized so that it is as efficient and effective as can be. Exchange theory can provide an answer to this question while taking into account that the needs of individuals will differ. In the study that is presented here, generalized reciprocity is the key concept that is derived from exchange theory. All support systems, in the seven countries under study, have benefited somehow from generalized reciprocity. However, what is effective and efficient support in the perception of one individual will differ from someone else's, and also, support systems that are effective and efficient in country X will not be so in country Y. Even though benefiting from generalized reciprocity, in the end the support system has to be matched to the support arrangement, arriving at different solutions in different countries.