Social Skills Therapy: How Treatment Can Help Young Adults Build Lifelong Connection

We are all born social beings – connection is an integral part of our human experience. But just as we all have different talents and skills, not all of us find social interaction easy. We forget that social skills are just that, a skillset like any other that needs to be developed and cultivated with time. At The Dorm, social skill treatment is key focal point. Together, our clinical teams help clients develop, practice and fine tune new skills in a safe and supported environment, so they can better build friendships, social rapport and community.

We don’t come into this world knowing how to ride a bicycle or how to swim a lap in a pool. It’s the same with holding a conversation or developing a new friendship.

Key Article Takeaways

At The Dorm, many clients struggle with social skills across a broad spectrum. Some clients come to us with a diagnosed Autism Spectrum Disorder (ASD) that makes communication and social interaction a daily challenge. Other clients come to us because they are concerned about feelings of isolation and social anxiety. They describe themselves as shy, anti-social, painfully introverted or “socially awkward”. It is not surprising that we are seeing this trend.

Pew Research polls indicate a rise in general anxiety and depression among U.S. teens with 28% of youth respondents indicating that their anxiety stems from a need to ‘fit in socially’. According to the American and Anxiety Association of America (ADAA), Social Anxiety Disorder (SAD) affects 15M Americans and commonly develops around age 13 when the transitions of puberty begin. One 2023 study highlights that reduced social skills can actually predict an increase of anxiety in children. The unfortunate reality is that 36% of people with social anxiety disorder symptoms take 10 or more years before seeking out treatment. 

What the Research Tells Us About the Importance of Social Support and Connection

Research has long shown the link between strong social support and mental health/recovery outcomes but why is it so significant?

Part of it may be how social connections change the way we think and perceive our world. One fascinating study conducted by researchers Schnall, Harber, Stefanucci & Profitt, found that individuals perceive things differently, like a geographical hill in front of them, based on whether they are facing it alone, or with social support. “Participants accompanied by a friend, when standing in front of a hill, estimated the hill to be 10 to 20% less steep than participants who were alone.”

Why is this important? Mental health recovery (and life!) is difficult with its fair share of challenges and “hills” to overcome. But when faced with others, rather than alone, the tough days and the hard moments feel less difficult. With others, life’s hills feel surmountable.

Image 1:: Schnall S, Harber KD, Stefanucci JK, Proffitt DR. Social Support and the Perception of Geographical Slant. J Exp Soc Psychol. 2008 Sep 1;44(5):1246-1255. 
Image 2:  Pete Berridge, 2017

Navigating Labels And a Diagnosis Like Autism Spectrum Disorder (ASD)

Regardless of whether a young person is diagnosed with an Autism Spectrum Disorder (ASD), Social Anxiety Disorder (SAD), or they simply need help with improving social skills , our team at The Dorm prioritizes proper diagnoses, psycho-education, affirming and validating language and terminology and works to dispel myths around what “healthy” social interaction looks and sounds like.

Importantly, there is a difference between a client lacking social skills and the lack of social skills or awareness of social cues that come with a diagnosed ASD.

Clients diagnosed with ASD can experience a wide range of symptoms from mild to severe. This can cover social-emotional reciprocity (anything from a failure to hold typical back-and-forth conversations to a failure to respond to social interactions in general), deficits in nonverbal communicative behaviors (including eye contact, body language, facial expressions) and deficits in developing, maintaining and understanding relationships. Regardless of where a client falls on this spectrum, it is important to respect and understand these distinctions and the ‘why’ behind a diagnosis so that they can move forward with confidence and clarity.

 It is important to respect that the needs for someone experiencing ASD will differ from someone with SAD or a case of underdeveloped social skills. The Dorm’s individualized treatment approach enables providers to deliver that level of care.

As it relates to other common terminology, our team at The Dorm always works to unpack misconceptions such as around terms like shyness and social anxiety. Many people who are shy, for example, are comfortable with being shy and do not feel that it impacts their choices or quality of life. A person with social anxiety, on the other hand, may become frustrated, upset or fearful due to the impacts of social situations. Similarly, there is a key distinction between isolation and solitude – terms we hear often in this space. Both imply being alone, but that is where the similarities end. Solitude is usually sought after and is a personal choice that comes from an inner yearning. Isolation, on the other hand, occurs when clients are actively avoiding some unpleasant situation that is often fear-based. The isolation may offer immediate gratification and a sense of personal ‘protection’ but create long term complications and a disruption to daily life functioning.

By properly distinguishing what clients need, feel and experience, we empower them to find personal solutions.

What Are Social Skills?

There are many therapeutic models for understanding social skills, but some common examples of social skills include:

• Listening
• Communication
• Nonverbal communication
• Peer group interaction

Why are Social Skills Important for Young Adults?  

It may seem like common sense that social skills ‘matter’, but it is helpful to understand why improving social skills is important for young adults in general, and our clients at The Dorm in particular.

First, learning social skill development helps with identity processing. The majority of our young adult clients are between the ages of 18 and 30 and are still in an active phase of building their identity and/or processing how to become comfortable with their identity. This time can be marked by confusion, denial, anxiety and a whole host of other emotions. Part of social skill-building at The Dorm involves creating a safe space for clients to focus on socializing and learning about themselves through healthy, respectful encounters with others. This applies to all clients whether they have a diagnosis of ASD, SAD, or not.

Second, developing social skills helps build layered relationships that are essential to mental health and human connection. Almost every aspect of modern life is built around social interaction, networking and connection. Social relationships are also a critical contributor to human health and longevity.

When clients establish basic social skills, they have the building blocks for establishing a peer group and a professional network, as well as the tools for pursuing vocational opportunities and the confidence to engage themselves in educational environments.

Third and finally, learning social skills in the digital age is more important than ever. Recent statistics indicate that 46% of teens report being online constantly, and this is more than double the rates from 2015. 54% of teens report it would be somewhat hard to give up social media. Helping young adults figure out how to be their authentic selves interpersonally (where there is more exposure and vulnerability than behind a screen) is an important step towards sustainable social interactivity.

Social Skills Therapy: How The Dorm Helps Young Adults Improve Social Skills

1:1 Individual DBT Therapy

One evidenced-based therapeutic treatment modality we offer at The Dorm which has proven to be effective for clients working on their social skills is Dialectical Behavioral Therapy (DBT). With an entire module dedicated to interpersonal effectiveness, DBT skills can help clients communicate more effectively, build and maintain better life relationships. 

1:1 Social Skills Therapy Coaching

Individualized social skills coaching helps identify clients’ individual anxiety triggers that surround social settings, as well as to identify specific coping skills for these situations. Special emphasis is placed on developing tailored social skills therapy for clients with a diagnosed Autism Spectrum Disorder (ASD). 

Clinical Example:  

A client at The Dorm had a very mild case of ASD, got along well with others and did so enthusiastically, often suggesting activities and giving supportive feedback. But almost everyone reported the same experience with this individual: liking them and also feeling afraid of being trapped in a conversation for too long since this individual was not picking up the social cues indicating a conversation was coming to an end.

Through individualized coaching work we were able to focus on helping this individual better recognize social cues, including:

• A person looking away for more than a few seconds
• Someone talking out their phone and looking at it
• Someone stopping the reciprocation of asking questions
• An individual standing up and or/pointing their body away from the conversation 

By being able to work with this client and approach this issue with real specificity, the way one might teach someone to juggle or do a Rubik’s Cube, the situation got much better.

Practicing Social Skills Safely: The Dorm Community Clubhouse 

The Dorm Clubhouse is a unique community environment that offers a casual, supported space where peer group interactions can take place during downtime or as part of structured activities. This is a prime location for organic social skills practice to take place day-to-day. 

Clinical Example: 

• When our clinicians hear that two clients are both into a common hobby or interest, say anime, writing or chess, it will often pain them to see those individuals sitting in the same area of our Dorm Clubhouse on their phones not talking to each other, both acting so engaged in something far away and not wanting to be the one to initiate a conversation. 
• This is where we (as Dorm clinicians) can practice the “bridging-then-leaving strategy”, as we call it. This involves sitting next to the clients for a few minutes and casually talking to one of them and then bringing the other in. Once the conversation has turned to an area of shared interest, our team excuses themselves and leaves the clients to navigate the course of a conversation together. 
• Some clients who have never really had a friend have benefitted from this approach. It is deeply gratifying to see these individuals go out and make plans together and later cite the other person, now a friend, as a positive influence in their life and well-being!

Social Skills Group Therapy

Our dedicated social skills groups are designed to promote healthy peer-based socialization and exposure to social engagements. Through these social events our clients are encouraged to put into practice the skills they are learning to manage social anxiety and form interpersonal relationships.

• Social skills group supports healthy peer group exposures where clients can practice skills in a structured, safe environment. The social skills group is co-educational and facilitated by two licensed clinicians. Clients are given a monthly budget and can pick social activities on a weekly basis that fall within the budget. They are challenged to practice and utilize social skills they have been learning in therapy groups and receive feedback from group facilitators and peer groups.
• Artful communication group: A psycho-educational and process-oriented communication group where clients are challenged to explore communication dynamics at home, at work and socially. Social anxiety, as well as communication skill-building, is stressed as a focal point of group discussions. Role play and homework assignments are done regularly.
• Non-direct social skill-building groups such as walking groups, cooking groups and themed game and movie nights and social groups. These settings are less intensive than dedicated groups or one-on-ones and help clients become more comfortable socializing while doing shared activities. In particular, cooking groups allow clients to learn about meal etiquette and how to hold a conversation over the course of a lunch or dinner.
• We encourage recovery support such as AA, NA, OA, and especially Young People meetings. This can offer peer group support therapeutically while also creating a space where members are open and willing to create friendships.
• Seasonal field trips such as apple picking in the fall and Six Flags in the summer, allow clients to make connections with others that may not be in their daily groups and learn about other interests like roller coaster lovers vs. arcade game players.

Our Outcomes: Improved Well-being and Functioning as a Result of Social Skill Therapy

At The Dorm, we not only care about fostering social connection and social skills, but also measuring the impact of our model and programming. As part of our third-party validated, multi-year mental health research outcomes we are measuring the impact of building social connection and support systems on overall functioning and mental health.

The type of metrics we focus on to evaluate implementation of social skills include overall well-being, friendship/rejection scores (i.e. the level of close social connections individuals are able to build/ the reduced feelings of perceived isolation and rejections from others), and self-efficacy (i.e. how confident clients are in their ability to achieve and stick to their treatment goals).

As part of our rigorous methodology, clients are evaluated every three months throughout the course of treatment, and statistically significant improvements, indicated by marked changes, have been found between admission and discharge.

Outcome Findings: The Science of Friendship

At The Dorm, we are proud and excited to see the impact of our model on the lives of our clients.  This includes:

Statistically significant improvements in client well-being, with a 35% increase from admission to discharge. This measure of well-being encompasses clients’ ability to enjoy and accept their life circumstances across several domains (health, work and home), particularly as that pertains to daily functioning.

Our research outcomes also show that when clients’ build social connections in treatment with us, they experience significant and positive life-altering improvements in treatment outcomes.

In the scattergraph, we showcase the strong correlational relationship between friendships formed in care with us and increased levels of our clients’ personal self-efficacy.

What This Means:

• In psychology, self-efficacy is an individual’s confidence in their skills to control behavior and remain motivated in the pursuit of their goals
• These skills, which include clients’ growing adaptive coping skills, have been shown to be supportive in recovery and reduce the likelihood of relapse
• This also correlates to a reduction in clients’ feelings of rejection from peers and the impression that others are trying to avoid them

Learn more about Social Skills Therapy at The Dorm, or get in touch with our team if you or a loved one might need support.

Our Locations

• Social Skills Therapy Intensive Outpatient Program in New York City, NY
• Social Skills Therapy Intensive Outpatient Program in Washington, D.C. 

Sources

Breier A, Strauss JS. The role of social relationships in the recovery from psychotic disorders. American Journal of Psychiatry. 1984;141:949–955.

Stansfeld SA. Social support and social cohesion. In: Marmot M, Wilkinson RG, editors. Social Determinants of Health. 2. Oxford: Oxford University Press; 2006. pp. 148–171.

Habibi Asgarabad M, Steinsbekk S, Wichstrøm L. Social skills and symptoms of anxiety disorders from preschool to adolescence: a prospective cohort study. J Child Psychol Psychiatry. 2023 Jul;64(7):1045-1055. doi: 10.1111/jcpp.13787. Epub 2023 Mar 27. PMID: 36973946.