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. 2023 Jun 2:1–9. Online ahead of print. doi: 10.1007/s42843-023-00085-w

How to Help Clients Make Friends

Sophia Thompson 1,✉, Kaitlyn Deaner 1,✉, Marisa G Franco 1,✉
PMCID: PMC10237073  PMID: 37360221

Abstract

Friendships have been declining for the past 30 years, resulting in severe mental and physical health consequences. However, multiple barriers prevent individuals from initiating and maintaining connections. This paper highlights the individual and societal-level challenges that limit social connection including fear of rejection, insecure attachment style, structural racism, and increased use of technology. To help clients make friends, we recommend clinicians assess loneliness, social competency, and attachment style; administer cognitive behavioral or behavioral activation therapies; and guide clients to assume others like them and be self-compassionate.

Keywords: Friendship, Social Support, Loneliness

Clinical Vignette

Regina is a 19-year-old White, cisgender female college student. She struggles to make new friends, rarely initiating friendships. She often declines social events from existing friendships due to social anxiety, using academics as “an acceptable excuse when I’m not feeling social.” She describes her current friends as “thrust upon her” through chance. She feels lonely.

When feeling lonely, Regina withdraws, thinking “no one wants to be around me.” Thus, she struggles to connect with others, even current friends. She states, “I don’t go out of my way to hang out with my friends, it usually just happens by chance.” She usually initiates plans only if her friends are going through struggles. Instead of spending time with friends, Regina spends her time with technology. She averages 9–10 h of screen time during weekdays. Alone in her room, she watches shows, plays video games, or scrolls through social media.

Regina is rarely vulnerable with friends. Thus, even when around friends, she often feels disconnected. She tends to not be vulnerable because she is “always thinking about how people perceive me,” and she “wants nothing to do with an awkward conversation.”

Regina’s loneliness stems from not initiating new friendships or outings with current friends and avoiding vulnerability, which makes her friendships unsatisfying. While she does have some strong relationships, she wishes to deepen them and make new friends.

Background

The Health Impact of Friendship

Friendship networks have been dwindling for decades—an issue that has only worsened with the social isolation onset of the COVID-19 pandemic. According to the American Survey Center, the number of individuals who report having ten or more close friends, excluding relatives, has decreased from 1990 to 2021 (Cox, 2021). For men, this decline was from 40% in 1990 to 15% in 2021 and for women, the decline was from 28 to 11%. Having 3–4 friends improves life satisfaction, and additional friends confer a smaller but still significant increase (Degges-White & Kepic, 2020). However, the number of individuals who report having no close friends at all has increased. In 1990, only 3% of men and 2% of women reported having no close friends. In 2021, this increased to 15% and 10%, respectively (Cox, 2021). This concern is even more severe among people of color who endure the effects of structural and interpersonal racism daily. A 2021 study found that 75% of Hispanic adults and 68% of Black/African American adults experience loneliness, compared to 58% of the general population (Cigna, 2021).

These trends are concerning, given that an individual's social connections greatly influence their mental and physical health (Richard et al., 2017). Loneliness is linked to multiple mental health conditions, including anxiety and depression (Hutten et al., 2021). Social support, however, reduces the risk of poor mental health. For example, having a confidant is linked to mitigated symptoms of depression (Wang et al., 2021).

Social connection may protect mental health because those with strong social ties experience stressful events as less stressful. A study found that individuals partnered with a friend were likelier to report a hill as less steep than those alone, suggesting that friendship makes challenges appear less challenging (Schnall et al., 2008). This finding might occur because, at a physiological level, having social support decreases hypothalamic–pituitary–adrenal (HPA) stress response to threats (Hostinar et al., 2014). For example, one study found that people with the highest levels of social support have lower rates of cortisol (Rosal et al., 2004). Furthermore, a meta-analysis found that social support buffers the impact of stress induced in the laboratory on blood pressure, heart rate, and skin conductance level (Thorsteinsson & James, 1999). Therefore, social support may lessen stress responses and thus improve mental health.

On the other hand, when connection is compromised, mental health is severely impacted. The interpersonal theory of suicide states that both a "thwarted belongingness" and "perceived burdensomeness" predict suicidal ideation (Van Orden et al., 2010). For example, a study of participants ages 20–64, found both these factors to be strong indicators for suicidal ideation (Christensen et al., 2013).

Overall, this research suggests that social connection can improve mental health and indirectly trigger a more positive appraisal of threats. Therefore, prioritizing forming and maintaining friendships is vital in improving and maintaining mental health.

Individual and Societal Barriers to Connection

Loneliness has increased due to both individual and systemic factors. For example, at the individual level, people may be more likely to experience loneliness when they anticipate rejection and have an insecure attachment style. At the societal level, people may be more likely to experience loneliness due to systemic discrimination and the rampant use of technology to replace in-person interaction. Each of these individual and societal constraints will be further explored.

Clinical and Ethical Challenges

Individual Factors

Loneliness is a Self-Fulfilling Prophecy

Individuals tend to perpetuate their loneliness by isolating themselves. Some of the primary emotions that arise from loneliness include anger and anxiousness (Cacioppo et al., 2006). These emotions limit individuals from initiating conversation and socializing, perpetuating their loneliness. For Regina, isolating herself has become routine as she spends copious amounts of time on social media instead of initiating connection with her friends.

Like Regina, those experiencing loneliness may be hyper-aware and fearful of rejection and tend to withdraw to avoid social rejection (Jones et al., 1981). For example, people underestimate the extent to which those around them like them (Boothby et al., 2018). People assume rejection when presented with an opportunity to socialize with strangers, prompting them to avoid unnecessary interactions (Epley and Schroeder, 2014). This internalized fear of rejection hinders connection. These trends are exacerbated for individuals experiencing persistent loneliness (Qualter et al., 2013). This fear of rejection becomes a self-fulfilling prophecy; people fearing rejection act less warmly towards new acquaintances, further inhibiting contact and maintaining their initial internal beliefs (Stinson et al., 2011).

Those experiencing loneliness tend to develop more cynical and pessimistic views of others, manifesting as hostility and anger (Jones et al., 1981). A study gave lonely and non-lonely men a chance to use a buzzer at someone who critiqued them while they completed a task (Check et al., 1985). The lonely men blared the buzzer more loudly than the non-lonely. This hostility further distances lonely people from their peers and perpetuates their actual and perceived disconnection.

People experiencing loneliness can develop self-centered behaviors as their loneliness progresses. Specifically, individuals who experience loneliness tend to engage in more egotistical behavior the following year. Inversely, individuals who engage in self-centered behavior find themselves lonelier in the subsequent year (Cacioppo et al., 2017). Thus, fear of rejection—which coincides with loneliness—may become a self-fulfilling prophecy by triggering avoidance of others, egotistical behavior, and hostility.

Insecure Attachment Styles

Attachment style manifests from an individual's past relationships, upbringing, family dynamics, and close relationships and, therefore, can affect future friendships. It consists of assumptions regarding how one will be treated in close relationships (e.g., people will accept or reject me). Attachment style affects friendships and social networks by influencing the ability to initiate and the tendency to terminate friendships (Gillath et al., 2017). Therefore, attachment style may explain struggles in connecting.

Secure people display more behaviors that allow them to cultivate and sustain friendships. They quickly build intimacy because of their inherent trust in others, which allows them to be vulnerable and leads them to report more intimacy in friendships (Grabill & Kerns, 2000). Securely attached individuals are also more likely to forgive others and less likely to avoid them following a conflict (Lawler-Row et al., 2006). The securely attached report higher levels of compassion and empathy after witnessing someone undergo a distressing event (Mikulincer et al., 2005). They are likelier to value and exhibit honesty and trust others more (Gillath et al., 2010).

Individuals who display insecure attachment are either avoidant or anxious. Avoidantly attached individuals fear intimacy and withdraw from a friendship to avoid getting hurt. Regina displays an avoidant attachment style, characterized by taking less initiative in forming and maintaining friendships (Gillath et al., 2017). Due to a fear of developing intimacy, an avoidantly attached individual like Regina is more likely to report negative feelings towards another individual disclosing information (Mikulincer & Nachshon, 1991) and is more likely to end friendships out of fear of vulnerability (Gillath et al., 2017). Considering Regina as avoidantly attached can aid the clinician in better understanding the unique challenges Regina has in making connections, such as expressing vulnerability.

Individuals who are anxiously attached fear abandonment. Unlike securely attached people, they do not modulate their interactions based on reciprocity from the other person. For example, like securely attached individuals, anxiously attached people are more likely to enjoy interacting with a high-disclosing individual and to self-disclose themselves. However, anxiously attached individuals are less likely than secure people to adjust their self-disclosure based on the degree to which a partner reciprocates (Mikulincer & Nachshon, 1991). While those who are anxiously attached form and maintain friendships, these relationships are more fragile (Gillath et al., 2017). Understanding attachment style can help clinicians apprehend and address each client's unique barriers to friendship.

Systemic Barriers to Connection

Racism Perpetuates Loneliness

It is crucial to recognize the impact of structural and interpersonal racism on disconnection and loneliness in society. The design of American slavery intended to dismantle any form of social capital among enslaved people and between enslaved people and others. Following the end of slavery, Jim Crow laws took effect for the following century. Still today, the lowest levels of community engagement are in the South, where slavery and Jim Crow Laws were most prominent (Putnam, 2000). This structuralized prohibition of social and community engagement has lasting effects today.

Historic redlining in the 1930s created geographical boundaries that prevented Black people from purchasing homes in "White" and "more favorable" neighborhoods (Woods, 2012). This segregation has had lasting impacts and continues to prevent multiracial communities and subsequent connections. Propinquity theory describes that individuals form friendships usually through proximity and frequent contact (Nahemow & Lawton, 1975). Disconnection implemented through segregated housing legislation, therefore, impedes interracial connections.

Experiencing racism itself can also influence an individual's sense of loneliness. For example, Black students facing adversity report a lower sense of belonging (Walton & Cohen, 2011) and for students of color at predominantly White institutions, experiencing microaggressions is associated with a lower sense of belonging (Lewis et al., 2021). Alternatively, White students who face adversity do not indicate depleted belonging (Walton & Cohen, 2011). Sense of belonging has been indicated as a protective factor against loneliness (Arslan, 2021). Therefore, people of color are at a greater risk of feeling lonely due to the reduced sense of belonging resulting from the racism they face (Priest et al., 2014).

Sense of belonging can be challenging for people of color as they often experience tension between finding connection and remaining authentic to their identity. For example, a study found that people may perceive Black men as more intelligent, trustworthy, and warm when wearing formal attire, unlike "swagger" (i.e., sweatpants, sweatshirts; Gurung et al., 2021). Similarly, Asian Americans may be falsely labeled as lower status, less intelligent, and insecure due to the perception of a so-called ‘Asian’ accent (Bauman, 2013). Thus, people of color may be penalized when acting authentically, and feel the need to sacrifice authenticity to be accepted by White people.

Regina, who is White, does not experience loneliness or a depleted sense of belonging due to racism. Clinicians should keep in mind that clients of marginalized identities may face additional difficulties in forming and maintaining connections, especially if their identity is underrepresented in their environment.

Technology and Loneliness

The growing use of technology and social media can induce loneliness. Displacement theory indicates that individuals who use technology to create in-person social connections report higher rates of social interaction. Conversely, those who use it in place of in-person connection report lower interaction (Twenge et al., 2019). These findings indicate that technology can impede social connection unless used to support in-person connections. Similarly, Regina tends to use technology and social media to withdraw socially, further contributing to her loneliness.

Excessive use of technology can restrict in-person interactions. In recent decades there have been increases in connections via social media and decreases in face-to-face interaction. In 2019, an average of 3.1 h, or 20% of individuals' waking hours, were spent on mobile devices. During the pandemic, this increased to 4.3 h, or 27% of waking hours, with 2.4 h spent on social media. Increased technology use coincides with decreased face-to-face communication. From 1995 to 2020, there has been a decrease of 1.2 h of face-to-face socialization per week (Hall & Liu, 2022).

Interaction via technology can impair social skills. Social presence theory indicates that the better individuals notice social cues and body language, the better social connection will be. Therefore, many technological methods for interaction may prevent users from accessing body language, which may hinder connection. For example, one study found that face-to-face communication led to the highest levels of social connection compared to instant messaging, which had the lowest levels (Sherman et al., 2013).

Another reason face-to-face communication may improve connectedness more than technologically mediated communication is because technology limits eye contact between conversation partners. The development of empathy requires eye contact (Murphy, 2014). Thus, the increasing use of social media for connection may pose unique challenges to developing empathy in relationships, which is crucial for connection.

Evidence-Based Assessment

UCLA Loneliness Scale

The UCLA Loneliness Scale assesses a client's loneliness and sense of belonging. The third edition of the UCLA Loneliness scale includes 20 questions graded on a four-point Likert scale of frequency (always, sometimes, rarely, and never). Questions include: "How often do you feel that you are 'in tune' with the people around you?" and "How often do you feel isolated from others?". Responses are summed, with a total score range from 20–80, with a higher score indicating a higher state of loneliness (Russell, 1996).

The UCLA Loneliness Scale is effective in assessing loneliness across various populations, including college students (Russell et al., 1987a, b), nurses (Constable & Russell, 1986), teachers (Russell et al., 1987a, b), and older populations (Russell & Cutrona, 1991). The UCLA Loneliness Scale has also been successfully cross-culturally adapted among Japanese mothers, Brazilians, and in Farsi (Arimoto & Tadaka, 2019; Barroso et al., 2016; Zarei et al., 2016). The UCLA Loneliness Scale's application across various ages, populations, and cultures signifies its utilization in assisting clinicians in understanding clients’ loneliness. However, one major limitation is that it fails to differentiate between social (i.e., lacking a social network) and emotional (i.e., lacking feelings of intimacy) loneliness (Gordy et al., 2022).

The clinician assesses Regina with the UCLA Loneliness Scale at the onset of Regina’s indications of feeling lonely. Regina’s score is 55, which indicates that she is experiencing loneliness. The clinician should then further explore barriers to Regina’s ability to connect.

Interpersonal Competence Questionnaire

Practitioners should also utilize the Interpersonal Competence Questionnaire (ICQ) to evaluate individuals' social competence, the ability to establish and maintain relationships. Interpersonal competence has five domains: initiation, negative assertion, disclosure, emotional support, and conflict management. A total of 40 statements address these five domains, and the ICQ utilizes a five-point Likert scale of an individual's likelihood of engaging in a behavior. Example statements include: "Introducing yourself to someone you'd like to get to know (or date)" (initiation); "Telling a companion you don't like a certain way he or she has been treating you" (negative assertion); "Confiding in a new friend/date and letting him or her see your softer, more sensitive side," (disclosure); "Being a good and sensitive listener for a companion who is upset," (emotional support); and "Being able to admit that you might be wrong when a disagreement with a close companion begins to build into a serious fight," (conflict management; Buhrmester et al., 1988).

A limitation of the ICQ is that although it has been validated among several populations and cross-culturally adapted, it has only been used in Western cultures and, therefore, clients from non-Western cultures may obtain a biased score (Giromini et al., 2016; Górska, 2011).

The clinician provides Regina with the ICQ and her lowest scores are for disclosure, initiation, and negative assertion. Ultimately, the clinician determines Regina’s discomfort with initiation and disclosure as her most significant barriers to connection.

Experiences in Close Relationships Questionnaire

An insecure attachment style can hinder the ability to form and maintain friendships. Therefore, clinicians should administer the Experiences in Close Relationships Questionnaire (ECR) to clients struggling with friendships. The ECR offers statements with responses on a five-point Likert scale. The questionnaire categorizes attachment style as avoidant or anxious. Statements include: “I’m afraid this person may abandon me,” which suggests anxious attachment, and “I don’t fully trust this person,” which suggests avoidant attachment (Fraley et al., 2011). The ECR has been validated in young adults (Wei et al., 2007) and across cultures (Tsagarakis et al., 2007). After administering the ECR to Regina, her score indicates that she is avoidantly attached. This lets the clinician know that encouraging Regina to be more vulnerable with others may be the first step in becoming more securely attached and aiding her in making friends. If ECR results indicate anxious attachment, the clinician should focus on practices that reduce the client’s fear of rejection.

Practice Considerations

Cognitive Behavioral Therapy

Clinicians should consider cognitive behavioral therapy (CBT) for clients who score high on the UCLA Loneliness Scale or low on the ICQ. CBT is a valuable tool to help individuals make friends, and a meta-analysis found that CBT successfully reduces loneliness (Hickin et al., 2021). A primary goal of CBT is for a client to dismantle negative self-attribution and beliefs that potentially interfere with their ability to connect with others (McWhirter, 1990; Schultz & Moore, 1986). In combination with social skills training, CBT can successfully assist a client in forming friendships (Glass et al., 1976; Peplau & Perlman, 1982). Furthermore, CBT has been found to promote opposite-gender friendships among adolescents (Dharsana et al., 2020).

Like Regina's experience, social anxiety may be a significant barrier to making friends, contributing to loneliness (Lim et al., 2016). CBT can benefit individuals suffering from social anxiety. The protocol includes exposure, cognitive restructuring, and critical examination techniques. With exposure techniques, clients are encouraged to face situations that provoke fear (either in reality or through role-play) and stay present to allow natural fear-reduction processes to proceed. Role-playing conversations with strangers or encouraging a weekly conversation with a new stranger may be helpful methods for an individual struggling to make connections. In cognitive restructuring techniques, clients critically examine their negative thoughts for accuracy and construct more helpful and accurate thoughts in an anxiety-provoking situation (Heimberg, 2002). Specifically, it may be helpful to examine negative thoughts during social interactions and replace them with more positive ones likely to reflect the situation better. Social skills training with a clinician through role-play and corrective feedback can also help individuals struggling with making connections (Heimberg, 2002).

Avoidantly attached individuals like Regina may have distorted thinking about social connection that hinders their ability to connect. Distorted beliefs can include having distrust in others’ kindness or believing that being vulnerable is a display of weakness (Franco, 2022). Cognitive behavioral therapy sessions that help Regina analyze her distorted views of social interaction may be helpful in encouraging her to become vulnerable. For example, the clinician should encourage Regina to recall times when she felt scrutinized for being vulnerable. By challenging Regina's thoughts on vulnerability in friendships, she can realize that expressing vulnerability will not always result in rejection.

The clinician should also use exposure techniques to build Regina's comfort in social situations. Exposure techniques can begin with in-session role-play activities where Regina can build her social confidence and lead to activities that encourage Regina to initiate connections with current friends or people she sees regularly.

Behavioral Activation Therapy

Low scores on the ICQ, like Regina’s, signify difficulties initiating interactions. Behavioral activation may help. The primary goal of behavioral activation is for an individual to increase behaviors that will promote positive outcomes and reduce behaviors that impair well-being (Uphoff et al., 2019). Studies have found that behavioral activation reduces loneliness among older adults (Pepin et al., 2021) and is also effective when administered virtually (Käll et al., 2020).

As these studies suggest, clients experiencing loneliness and difficulties forming connections should be encouraged to put substantial effort into making friends. A common misconception is that friendship is an "organic" process, even though forming friendships requires effort and initiation. In a five-year longitudinal study, those who believed friendship relies on chance were lonelier five years later, whereas those who thought friendship requires effort were less lonely (Newall et al., 2009). While many factors may be out of an individual's control, making an effort to initiate social interactions can lead to new friendships.

Clinicians delivering behavioral activation therapy to clients should first suggest reconnection with clients’ previous ties. Reconnection often ensures a shared sense of understanding and trust with one another, and thus, clients may find reconnection easier than initiating new connections (Walter et al., 2011).

Clients should be encouraged to engage in consistent contact with others. The mere exposure effect suggests that people like what is familiar. In a study, four different strangers posed as students in a college classroom and did not interact with the class. At the end of the semester, students liked the strangers who showed up to class frequently more than those who did not (Moreland & Beach, 1992). Therefore, familiarity is an essential component of building sustainable connections. Clinicians should consider suggesting signing up for repeating events or activities for clients to gain familiarity with others.

Given Regina’s tendency to use technology passively, which exacerbates her loneliness, the clinician could recommend Regina to actively use social media or other forms of technology to reconnect with friends. After Regina feels comfortable reconnecting, the clinician should encourage Regina to build familiarity with new connections. Given that Regina is a college student, the clinician should suggest that Regina joins a club or organization on campus that meets frequently. For clients who may not have access to social organizations, clinicians should suggest initiating connections with coworkers, neighbors, or other individuals they see frequently.

Assume People Like You

The acceptance prophecy indicates that as individuals believe people will like and accept them, they will act more warmly and witness their expected results. Indeed, individuals who act more warmly in the presence of acquaintances or strangers find themselves more accepted (Stinson et al., 2009). Clinicians should remind clients that going into social situations expecting acceptance will only help their chance of developing a connection.

Incorporating the acceptance prophecy into daily interactions does require effort. For Regina, the clinician may recommend reaching out to a classmate or someone with the same major, assuming they will be open to connection as a first step in assuming people will like her.

Clinicians should be aware that experiences of racism may inhibit people of color from assuming others like them. These experiences should be explored, and clinicians may probe if clients of color are more comfortable practicing assuming people like them with their ingroup rather than the White majority.

Self-Compassion

Self-compassion is a crucial component of building friendships because it can contribute to one's ability to express vulnerability (Bruk et al., 2022), and vulnerability is a vital component required for deepening connections. Self-compassion also can help to build confidence for anxiously attached individuals who commonly assume rejection. A meta-analysis found that those with high self-compassion tend to have secure attachment styles and more conflict-resolution skills (Lathren et al., 2021). These findings suggest that self-compassion could aid in initiating and maintaining friendships via increased vulnerability and secure attachment.

Primary components of self-compassion meditations include self-kindness, common humanity, and mindfulness, all negatively associated with loneliness (Akin, 2010). Encouraging Regina to practice self-compassion meditation a few times per week may build her self-compassion and thus improve her confidence to become more vulnerable with others.

For individuals like Regina who use the internet and technology as a way to escape negative emotions, self-compassion may mitigate this internet addiction, thus opening up available time for socializing. A study found that self-kindness, common humanity, and mindfulness were all negatively associated with internet addiction (Iskender & Akin, 2011). Those with “problematic” usage of social media, such as uncontrolled use, were found to have lower levels of anxiety and depression if they reported higher levels of self-compassion (Phillips & Wisniewski, 2021). This indicates that building self-compassion may not only improve relationships but also mental health.

Conclusion

Regina is not an isolated case of loneliness. Over decades, the number of friends individuals have has declined for many reasons. First, past relationships shape attachment style, possibly leading to an insecure attachment style and fears of rejection, which can inhibit social connection. For Regina and others with insecure attachments, the fear of rejection notably causes withdrawal and perpetuates loneliness. In the modern age, these trends may be exacerbated given the increased use of technology to replace social interaction. For people of color, these trends may be further amplified as experiencing structural and interpersonal racism can deplete one's sense of belonging and thus induce loneliness. Loneliness has devastating effects on both mental and physical health, demonstrating the importance of meaningful connection.

Clinicians should focus on educating clients on how loneliness affects their mental health and ability to connect. The UCLA Scale of Loneliness assesses levels of loneliness. The ICQ measures important social skills. The ECR assesses attachment style. These questionnaires can provide clinicians with a baseline understanding of their client's loneliness and ability to move forward. An item-level analysis of questionnaires can help clinicians be aware of how loneliness manifests differently for each client.

Clinicians should consider cognitive behavioral therapy and behavioral activation to diminish negative thoughts and actions perpetuating loneliness. Clinicians should also suggest that clients assume people like them and practice self-compassion meditation. These resources can aid clients in forming connections and mitigate feelings of loneliness. After being presented with her options, Regina felt cognitive behavioral therapy would be her best route to make new friendships and deepen current ones by increasing her ability to express vulnerability.

Forming new friendships can be challenging. The self-fulfilling prophecy of loneliness can exacerbate this challenge. We hope these resources may assist clinicians in helping mitigate loneliness in clients, thus improving client mental health.

Key Clinical Considerations

  • Both societal and individual-level barriers to initiating and maintaining connections should be considered. Clinicians should recognize that structural and interpersonal racism, segregation, and increased use of technology have furthered disconnection among the entire population. However, clinicians should also consider that individual limitations such as insecure attachment style and fear of rejection can also prevent social connection.

  • Clinicians should administer the UCLA Loneliness Scale, Interpersonal Competence Questionnaire, and Experiences in Close Relationships Questionnaire to clients expressing loneliness and difficulties making friends. The UCLA Loneliness Scale will provide clinicians with an understanding of clients' loneliness. The Interpersonal Competence Questionnaire can aid in understanding the social skills of clients. The Experiences in Close Relationships Questionnaire can provide clinicians insight into clients' past or current friendships and personal challenges to forming and maintaining friendships. Together, all are useful in determining the best paths for treatment.

  • Clinicians should customize their support based on the client's attachment styles. Clinicians should recognize how insecure attachment can affect initiating and forming friendships. For avoidantly attached individuals, clinicians should tailor treatment to concentrate on expressing vulnerability. For anxiously attached individuals, clinicians should tailor treatment to improve self-compassion to reduce the fear of rejection.

  • Clinicians should encourage self-compassion. Self-compassion is helpful for clients struggling with making connections. Self-compassion can be incorporated into either formal behavioral therapy or through meditation and personal practices.

  • Recognize the intersection of marginalized identities and loneliness. Clinicians should consider the effect that being a part of a minoritized group may have on forming connections and make adjustments to assessments and interventions as necessary.

Biographies

Sophia Thompson

is a Public Health Science student at the University of Maryland, College Park. She is in the University Honors Program where she took the course, The Loneliness Crisis: Origins and Solutions with Dr. Marisa G. Franco, and became interested in the science of connection and friendship.

Kaitlyn Deaner

is a Nutrition and Food Science student at the University of Maryland, College Park. As a member of the University Honors Program, she became more interested in psychology through a course taught by Dr. Marisa G. Franco.

Marisa G. Franco

, PhD—a psychologist, TED speaker, and New York Times bestselling author—works as an assistant clinical professor at The University of Maryland. She writes for Psychology Today and authored the book Platonic: How the Science of Attachment Can Help You Make–and Keep–Friends.

Contributor Information

Sophia Thompson, Email: sthomp@umd.edu.

Kaitlyn Deaner, Email: kdeaner@umd.edu.

Marisa G. Franco, Email: mgf269@umd.edu

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