The Social Prescription: Counseling Clients Toward Connection

by Dr. Carrie Caudill, Ed.S., Ph.D., LPC, NCC

If you could make just one choice today to boost both your health and your happiness for years to come, what would it be? Surprisingly, it’s not cold plunging, eating more kale or adding a TikTok-influenced supplement. The strongest predictor of a longer, healthier, and more flourishing life is far more human: invest in relationships. In the longest study of people’s entire lives, Waldinger and Schulz (2023) confirm that across diverse individuals tracked over their adult lifetime, relationship quality is the strongest predictor for a longer and happier life.

However, in our digital age the current loneliness epidemic is spreading (Office of the Surgeon General, 2023). There are many potential barriers for clients in building positive support networks. Depression often locks clients into a negative feedback loop, inhibiting socialization. Current cultural beliefs may keep a client inordinately busy or exhausted. Those who struggle with anxiety or past trauma may find it harder to trust others. At the same time, counselors often encourage self-care and healthy boundaries. To a client who is already guarded or withdrawn, these messages may sound like permission to detach—leaving them more isolated, often while immersed in the pseudo-social world of devices. The most vulnerable to chronic loneliness, a known health risk, are younger people, adults who live alone, and adults struggling financially (Proctor, A.S. et.al, J. 2023).

Three interventions that support clients in building healthy social lives are social prescription, supporting social breadth, and normalizing relational effort. Social prescription begins at the first

Dr. Carrie Caudill, Ed.S., Ph.D., LPC, NCC

intake session. Throughout the counseling process, make it a practice to ask about a client’s social connections and relationship patterns. Emphasize that cultivating meaningful social connections is a vital therapeutic priority for overall well-being. Mental health and social health are interdependent.

Social breadth means that, despite the human tendency to prefer scrolling to conversing, human beings need social interaction at a range of intimacy levels from casual acquaintance to trusted companion. Even more surprisingly, chit-chat is psychologically good for us! I know it may be shocking, especially to us counseling folks, drawn to the deep inner worlds. But having a conversation with a stranger while waiting in line or sincerely complimenting a stranger on an elevator may leave you both feeling happier than you would think (Kumar & Epley, 2020). Clients also need close, intimate friends, the kind of friend who will answer middle of the night call. This kind of friend in particular is linked with the experience of social support and belonging.

 Normalizing relational effort is also ongoing and varied. For example, reaching out for coffee with a new acquaintance or showing up to an adult kickball group for the first time can feel awkward. That discomfort doesn’t mean a client is doing it wrong—it’s simply part of building relationships. Normalizing expectations can be powerful for clients, especially since many don’t realize how much time it truly takes to form meaningful connections. Research suggests it takes about 50 hours together to develop a casual friendship, and more than 200 hours to grow a close, trusted one (Hall, 2018).

Since counselors can advocate for their clients’ health and happiness by prescribing social connection and normalizing the effort it takes to build relationships, here’s a gentle reminder: don’t neglect your own social life either. After all, you can’t exactly encourage clients to get out there and connect if you’re “peopled-out” with your treatment notes and Netflix. Go take that walk with a friend after work, join the book club, or text a friend—you’ll be modeling what you preach …without popping another supplement! 

References

Hall, J. A. (2018). How many hours does it take to make a friend? Journal of Social and Personal Relationships, 36(4), 1278-1296. https://doi.org/10.1177/0265407518761225 (Original work published 2019)

Kumar, A., & Epley, N. (2020). Type less, talk more. Harvard Business Review.

Office of the Surgeon General. (2023). Our epidemic of loneliness and isolation: The US Surgeon General’s Advisory on the healing effects of social connection and community [Internet].

Proctor, A. S., Barth, A., & Holt‐Lunstad, J. (2023). A healthy lifestyle is a social lifestyle: The vital link between social connection and health outcomes. Lifestyle Medicine. https://doi.org/10.1002/lim2.91

Waldinger, R., & Schulz, M. (2023). The good life: Lessons from the world's longest scientific study of happiness. Simon and Schuster.