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The art connection: disrupting social isolation and loneliness among transition age youth in eastern Kentucky

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The art connection: disrupting social isolation and loneliness among transition age youth in eastern Kentucky

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The Art Connection: Disrupting Social Isolation and Loneliness

Among Transition Age Youth in Eastern Kentucky

Andrea Sheerin Fiero

Final Capstone Project
Submitted in Partial Fulfillment of the
Requirements for the Degree
Doctor of Social Work
Suzanne Dworak-Peck School of Social Work
University of Southern California

SOWK 724
Jennifer Lewis, PhD, LCSW, Capstone Chair

November 1, 2021

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Table of Contents

Executive Summary 3
Theoretical Framework 4
Problem Statement 8
Efforts to Reduce Social Isolation and Loneliness 12
Theory of Change 14
The Innovation: The Art Connection 14
Competitive Analysis 16
Program Implementation 16
Implementation Timeline 20
Financial Plan 22
Contribution to Solving the Grand Challenges 25
Analysis of Obstacles 26
Program Sustainability 28
Evaluation Plan 27
Conclusion 29
References 30

Appendices 38

Appendix A: Capstone Prototype 39
Appendix B: The Art Connection Class Ground Rules 49
Appendix C: Sample Meditation 52
Appendix D: Logic Model 54
Appendix E: GANTT Chart 55
Appendix F: Budgets 56
Appendix G: Competitive Analysis Table 58
Appendix H: Evaluation Instruments 59

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Executive Summary

COVID and Social Isolation

Reflecting on the past 18 months, it would be difficult to deny the impact COVID-19 has
had on American society. The worry, the stress, wearing masks, maintaining 6 feet of personal
space in public, and working and going to school virtually have become a daily routine for the
past 20 months. Prior to the arrival of COVID-19, only social science researchers were aware of
the extent to which human beings decompensate without regular social connection. Now,
however, many Americans have felt the adverse effects of lockdown firsthand. Prior to the
pandemic, it was thought that primarily older persons were the most vulnerable to the physical
and emotional harms of loneliness and social isolation. Even though older persons are susceptible
to social isolation and loneliness, COVID-19 has made it clear that the effects of social distancing
restrictions on adolescents and young adults are also extremely harmful. In 2019, the Centers for
Disease Control and Prevention (CDC) found that 37% of students persistently felt sad or
hopeless. After COVID, 63% of this age group experienced significant symptoms of loneliness,
anxiety and depression (CDC, 2020)(Weissbourd, Batanova, Lovison, & Torres, 2021). Although
the federal Center for Mental Health Services defines Transition Age Youth (TAY) as individuals
between the ages of 16 and 25 (58 FR 29425), TAY are identified as individuals between the ages
of 14 and 25 for purposes of this paper. Terms are often used interchangeably, but social isolation
and loneliness are conceptually different. Social isolation is the objective lack of interactions with
others or the wider community (Lee, Malcein, & Kim, 2021); loneliness is the distress felt by
people without their social involvement or relationships (Coyle, 2020).

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Transition-Age Youth

The period of time between childhood and adulthood is a period of exploration in
independence, as well as a time of intense sociability. During this period, there are tremendous
cognitive, emotional and biological changes. TAY identify with peers differently than they do
with their family members. Peer relations are important for a person’s sense of belonging and
identity formation (Sargent et al, 2002). Recent research has shown that TAY neurological
development is dependent on the qualities of these social experiences and relationships. In fact, as
TAY social networks become more complex, the brain matures in both structure and function
through the myelination of long-range axonal pathways and continued synaptic pruning (Lamblin
et al., 2017). This period of social, developmental and neurological growth, however, is also
compromised with increased emotional vulnerability. TAY often have fragile self-esteem and
worry about being socially excluded. This age group is also particularly susceptible to mental
health problems (Ingram & London, 2021). Approximately 75% of adult mental health disorders
first appear before the age of 24 (Andrews, Ahmed & Blakemore, 2020).
Theoretical Framework
Human beings are biologically programmed to form strong bonds with others. Early
humans were able to protect each other from large prey by forming packs and sharing resources
with each other. Even though social bonds are not essential for our safety in modern day, our
bodies respond as if we are facing an immediate threat when we are alone. When we feel lonely,
our bodies respond in a “flight or fight” manner and high levels of cortisol surges into our
bloodstream. A continued state of flight or fight, unfortunately, can lead to chronic conditions,
such as elevated blood pressure, cardiovascular disease, infectious disease, impaired cognitive
function, anxiety and depression. As they grow older and mature, TAY form tight-knit social

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networks that grow in complexity as they transition to adulthood. In the context of human
development, early humans are believed to have evolved larger neocortices as the result of
increased social demands (Lamblin, et al., 2017). Although it is not completely understood why
early humans created art, it is thought that creative expression and communal creativity helped
solidify the social bonds among small groups or tribes.
Disconnection in Rural Areas

Heightened awareness about the harmful effects of social isolation and loneliness on TAY
during COVID-19 has raised some questions about other populations in the U.S. that may be
vulnerable. Since March 2020, there has been greater concern about the social isolation and
loneliness among TAY in rural areas. Rural areas tend to have much less access to reliable
internet. In fact, while 97% of urban areas have access to broadband or other high-speed internet,
only 65% of rural areas can reliably access effective and affordable internet. Under strict “stay at
home” orders, TAY without access to the internet are not able to connect socially with peers.
Living in poverty is also closely tied with social isolation and loneliness. Individuals with
lower socioeconomic status tend to have a higher rate of social isolation from others and lower
sense of belonging in the community (Stewart, et al., 2009). The Eastern Kentucky region of
Appalachia is one area of the country with small, disconnected communities. The region is home
to approximately 734,000 people and spans an area of 13,370 square miles, just slightly larger
than the state of Maryland (https://worldpopulationreview.com/states/maryland-population). In
some areas of the region, 35.5% of residents live in poverty, which is more than three times the
U.S. national average of 10% (U.S. Census Bureau, QuickFacts, www.census.gov/quickfacts). In
addition to rugged terrain, a sparse population and an underdeveloped highway system,
individuals in Eastern Kentucky are less likely to have extensive social networks outside their

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immediate families due to a general lack of trust of outsiders (Ginsberg, 2005). With all of these
factors combined, it is imperative that social isolation and loneliness among TAY in Eastern
Kentucky must be addressed. Social workers have a duty to serve individuals, groups and
populations, paying particular attention to the needs of those who are vulnerable, oppressed, and
living in poverty (NASW, 2021).
Leadership by the AASWSW

Five years prior to the spread of the COVID-19 virus, the American Academy of Social
Work and Social Welfare (AASWSW) recognized the complexity of and harmful effects of
loneliness and social isolation. In 2016, it announced its Grand Challenge to Eradicate Social
Isolation, which mobilized those in the social work sector, as well as organizations, schools and
individuals to create collaborative solutions to research and develop initiatives to reduce social
isolation and loneliness among vulnerable populations. The AASWSW also recognized that
reducing social isolation and loneliness is not always possible due to mobility and transportation
barriers. To address these barriers, the AASWSW urged social workers to work with
professionals in other fields to develop technological innovations. Its Grand Challenge to Harness
Technology for Social Good galvanized the profession’s efforts to address society’s most
complex problems using technological advancements. In 2020, for instance, the social work
profession worked quickly to respond to the needs of vulnerable populations during the first few
weeks of COVID-19-related lockdowns with technology-based solutions. Even though the
evolution to digital technology was already in process, social workers quickly shifted from what
was a high-touch field to one based on virtual contact (Erreger, 2020).

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Human-Centered Design

Researchers have known for decades that social isolation and loneliness are harmful to
human beings, especially TAY. In 2019 and 2020, approximately 30 interviews were conducted
with social workers, experts in the field of social isolation and loneliness and TAY, to explore this
topic and identify key issues. A number of interventions to help reduce social isolation and
loneliness were also examined. In March 2020, as Americans were asked to stay at home to
prevent the spread of the COVID-19 virus, the media reported that TAY taking part in school
online were experiencing a high level of anxiety and depression. Media helped to help define the
problem among this population. During this unprecedented time, a number of creative
organizations developed social activities through Zoom, Microsoft Teams, YouTube and other-
internet-based platforms to help individuals of all ages to stay socially engaged with others.
To generate ideas about online opportunities to help reduce social isolation and loneliness
among TAY in Eastern Kentucky, a meeting was held with a TAY via Zoom. TAY were asked
for their ideas about classes focusing on exploratory physics, art and storytelling. A follow-up
poll conducted in May 2021 revealed that therapeutic art classes were the preferred activity
among those surveyed. This small group of youth helped to create The Art Connection (TAC). In
June 2021, the new director of TAC completed therapeutic art facilitation training through A
Window Between Worlds (AWBW). A partnership was forged with Transition Age Youth
Launching Realized Dreams (TAYLRD) drop-in center in Louisa, Kentucky, in July 2021. The
prototype for TAC was developed and tested with two different groups. More details about the
prototype can be found in Appendix A. TAC is organized under the auspices of Bluegrass
Advocates, LLC, which seeks to bring about systems change on behalf of vulnerable populations.

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The Art Connection

With assistance from community partners and stakeholders, TAC will work to reduce
social isolation and loneliness among TAY in the Eastern Kentucky region of Appalachia using
virtual therapeutic art workshops. Providing virtual access to art workshops will give TAY in
rural areas unique opportunities to form social bonds and meet the developmental milestones to
thrive as adults. Classes will take place weekly for 6 weeks. A multiple-phase pilot project will
use Continuous Quality Improvement methods over three pilot test cycles to create capacity to
disrupt social isolation and loneliness in Eastern Kentucky.
Problem statement
TAY are biologically programmed to rely less on their families of origin and are driven to
engage in rich peer-based social networks as they grow older. Recent research has shown that the
neurological development of TAY is dependent on both the quality and quantity of these social
experiences and relationships. Efforts to reduce the spread of COVID-19 virus, however, run
counter to the needs of TAY social and neurological development. Social distancing requirements
imposed in March 2020 led to a surge of social isolation and loneliness among this population.
Immediate efforts must be made to: (1) help TAY who are living with depression and other
mental illness due to social distancing, and (2) prevent other youth from developing depression
due to social distancing.
TAY Social Development

Individuals between the ages of 14 and 25 transition between a distinct developmental
stage characterized by biological, psychological and social change (Tomova, Andrews, &
Blakemore, 2021). TAY develop a strong sense of independence through a process of “social
reorientation” in which they gradually shift their focus from the family to the peer group. Fitting

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in with the peer group is a key developmental goal in adolescence. In fact, affiliating with peers is
believed to facilitate the transition into independent adulthood and aid developmental steps, such
as establishing a social self-identity. Individuals transitioning from childhood to adulthood must
navigate internal and external pressures to increase responsibility, autonomy, and the pressure to
belong (Tomova et al., 2021). Without these social connections, TAY are not able to meet the
milestones needed to function in an adult world. TAY who do not have regular social connections
are at significant risk for depression, academic problems, high-risk sexual behavior, physical
health problems and substance use.
TAY Brain Development

As individuals transition from childhood to adulthood, a number of significant changes
take place in the brain, particularly in areas collectively known as “the social brain.” The social
brain is a network of brain regions involved in social perception, social and cognition, which
allows us to understand and interact with others. Each of these social brain systems is subject to
ongoing structural and functional development in parallel with changes in social behavior
(Lamblin et al., 2017). Recent research has shown that brain structure and functional maturation
cannot take place without social interactions in the environment. Changes in the social
environment trigger the refinement of synaptic connectivity and the maturation of long-range
axonal pathways that support the functional integration of wide-spread neural systems, including
those involved in the processing of social information (Lamblin et al., 2017).
Vulnerability During Brain Development

For TAY, disruptions in the developmental process can have negative implications for the
health, social and mental skills needed in adulthood. Left untreated, mental health problems
among TAY can result in many irreparable consequences, including physical ailments, stunted

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social development and learning difficulties (Rajabi, 2020). Individuals who report a perceived
absence of satisfying social relationships and difficulties processing social cues have reduced grey
matter volume in the left posterior superior temporal sulcus (Lamblin et al., 2017). Not being able
to interpret social cues may prevent TAY from gaining social acceptance in high school or
college. Lacking the ability to interpret social cues may also result in limited employment
opportunities in adulthood.
To prevent the spread of the novel coronavirus in March 2020, much of the United State
was restricted from engaging in social activities outside the home. These restrictions run counter
to the emotional needs of human beings, who evolved to work cooperatively with others. School
and extracurricular shutdowns significantly interrupted TAY social connectedness. COVID-19
restrictions, unfortunately, interrupted TAY social connectedness and delayed the adoption of
new social skills and advanced developmental tasks.
Depression and Suicide.

TAY encounter a critical developmental period marked by a series of tasks that include
strengthening and expanding self-concept, forming stable intimate relationships, making career
decisions, and achieving independence from parents. Resolution of these challenges is necessary
for successful transition from adolescence to adulthood, and failure to meet age-appropriate
demands may constitute a risk for later developmental disadvantage and psychiatric disorder
(Reinherz et al., 1999). Although the mechanisms used to cope with stressful situations is not
distinct from those of adults, TAY brains are still developing, and the consequences of their
decision-making may not be apparent. TAY experience a rollercoaster of emotions, including
hopelessness, anxiety irritability and negative thoughts, and unfortunately, drugs and alcohol can
provide short-term relief from these emotions (Meherali et al., 2021).

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TAY who are not able to resolve stressful situations or everyday challenges may develop a
perceptual bias that affects how future experiences are processed (van der Kolk, 2014). This bias
distorts the ability to accurately assess and respond in interpersonal relationships (Badenoch,
2018). TAY experiencing this kind of perceptual bias may find it difficult to function and
maintain relationships and may be vulnerable to depression and anxiety (Perryman, Blisard &
Moss, 2019). For some TAY, negative social interactions, social isolation and loneliness are
major precipitants of suicide (Brody, 2021). Based on data from the 2013 national Youth Risk
Behavior Survey (YRBS), 17% seriously consider attempting suicide (YRBS, 2013). Suicide was
the second leading cause of death of individuals between the ages of 15 and 24, death by suicide
in 2018 (https://www.cdc.gov/injury/wisqars/pdf/leading_causes_of_death_by_age_group_2018-
508.pdf) “
Approaches to Reducing TAY Social Isolation and Loneliness

In his 2018 book, Lost Connections: Why You’re Depressed and How to Find Hope,
Johann Hari, New York Times bestselling author, explains that the cause of depression in Western
society as a “function of disconnection” and that human beings need to find more ways to
reconnect. “To end loneliness,” he notes, “you need to feel you are sharing with another person,
or a group.” This thing that you share can be anything, “but it has to be meaningful to both of
you.” Indeed, researchers have known for decades that supportive relationships with others are
vital for both physical and mental health (Sapiro & Ward, 2020). For TAY, being in the presence
of friends with healthy moods increases the chances of recovering from the condition by 50
percent over a period of six to 12 months (Gregoire, 2015). Maintaining friendships with
individuals with healthy moods also doubled depressed people’s chances of recovery. In other
words, social support can be key to depression prevention and recovery.

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Efforts to Reduce Social Isolation and Loneliness

Social Prescribing

A new approach to helping individuals living with social isolation, loneliness and
depression has gained popularity in the United Kingdom. In 1997, in addition to providing
prescription options, the Bromely-by-Bow Center in London began referring clients to
community-based activity groups that foster social connections (Husk et al., 2019). Although
social prescribing does not rid every individual of social isolation, loneliness and depression, it
has shown to help participants gain greater self-esteem, confidence and improvements in well-
being (Foster et al., 2020). Evaluations of social prescribing have been positive. A study
conducted by Foster et al., (2020) found that participants felt the service supported people to
make what appeared small but significant social changes in their daily lives. In 2020, the British
National Health Service sought to expand the delivery of social prescribing nationally is now
considered a ‘key component’ of the country’s health care system. NHS’ goal is to have nearly
one million patients referred for social-prescription interventions by 2024” (Hanc, 2021). The
concept of social prescribing is starting to take hold in the United States. In his book, Together,
Surgeon General Vivek Murthy states, “Social prescribing ‘reflects a recognition that loneliness
affects our health, and we have a universal need to connect with one another” (Murthy, 2020).
Arts Interventions.

Since the beginning of time, human beings have used art as a source of expression and
healing. The arts have been known to help reduce stress and depression by creating bodily self-
regulation and have effectively used to heal emotional injuries, increase understanding of oneself
and others, develop a capacity for self-reflection, reduce symptoms, and alter behaviors and
thinking patterns (Christensen & Gomila, 2018). Art therapy is a form of dynamic emotional

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therapy that helps individuals develop insights and create change while utilizing creative
processes materials, and the creative product itself (Zeevi, 2021). For purposes of this paper, “art
therapy” refers to services provided by a state licensed art therapist. Therapeutic art activities,
however, are not necessarily facilitated by a licensed art therapist.
Art has been used as a powerful healing tool for individuals with histories of trauma,
whose emotions are too difficult to put into words. Indeed, creative arts activities offer a
nonthreatening avenue for the discovery and processing of an embedded traumatic experience
(Badenoch, 2008). These therapeutic activities can alleviate or diminish the effects of the
traumatic experience by creating a corrective experience, allowing clients to lead a more
productive life (Perryman, Blisard & Moss, 2019).
A Window Between Worlds (AWBW), established in 1991, has trained over 520
facilitators at 240 organizations helping others use art to promote empowerment, resilience and
healing for those with histories of trauma (AWBW, 2021). AWBW is guided by a philosophy that
the creation of art, particularly in community, can open “windows of safety,” self-expression and
connection that those who have been affected by violence and trauma may not experience through
other processes or in other settings (AWBW, www.awbw.org).
Art therapy and therapeutic art making have been shown to be helpful for young people
who have experienced loneliness and/or social isolation for extended periods of time.
For TAY who have had insufficient social connections, therapeutic art has been found to increase
affective sensitivity and help them become more attuned their own emotional states (Christensen
& Gomila, 2018). In addition to reducing anxiety and depression, TAY engaging in creative
processes experience an increased sense of connection with others.

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Theory of Change
There are several factors that contribute to social isolation and loneliness among TAY in
Eastern Kentucky. These factors include low population density, slow and unreliable internet,
poverty and social distancing measures created to reduce the spread of COVID-19. While
complying with local social distancing requirements, TAC will provide opportunities to TAY at
TAYLRD drop-in centers to meet and socially connect with others through virtual therapeutic art
classes. Research has showed that creative expression promotes emotional healing and fosters
social connection. Providing opportunities to TAY to connect socially will stimulate neurological
growth that will support new cognitive and social skills needed in adulthood.
The Innovation: The Art Connection
Beginning in January 2022, TAC will provide a 6-week course of virtual therapeutic art
classes to help TAY living in Eastern Kentucky build social relationships. TAC will use a
curriculum developed by A Window Between Worlds (AWBW). By giving TAY opportunities
for creative expression, they may develop the foundation for emotional expression, affirm their
identity, and refine their skills for socialization. It is hoped that participants will experience self-
discovery and will form healthy, positive connections with their classmates.
TAC will facilitate therapeutic art classes for groups of 5 or 6 transition-age youth.
Classes will be held at community-based locations or via Zoom once hour per week for 6 weeks.
The facilitator will begin each class with an invitation for participants to take part in a brief
meditation. The meditation will be followed by art activity focused on a specific theme related to
growth or self-discovery. Each art activity will encourage TAY to explore their thoughts, feelings,
needs, strengths, and hopes for the future. Although those taking part in the classes will learn to
express themselves creatively and experience self-discovery over the 6-week period, the goal of

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TAC is to provide a safe and supportive environment in which TAY may form healthy, positive
connections with other young people.
Each art activity will encourage TAY to explore their thoughts, feelings, needs, strengths,
and hopes for the future. After the art activity, participants will be encouraged to share their
experience with the activity and what they created, but this is completely optional. TAC is
committed to ensuring that all class discussions remain confidential. Through this process, TAY
will learn to express themselves creatively, experience self-discovery, and form healthy, positive
connections with other young people. It is hoped that TAY with histories of trauma will be able to
identify their needs, use metaphors and symbols to express their feelings, and identify their
strengths as they incorporate their new awareness into a more complete identity.
Through this pilot project, TAC hopes to accomplish the following goals among TAY in
Eastern Kentucky: (1) reduce social isolation, (2) increase social connection with peers, and (3)
reduce depression. It is anticipated that the outcomes from this project will bring a greater
understanding the impact of an art-based intervention among TAY in Eastern Kentucky and
across the country. It is hoped that the outcomes from this project will also bring a greater
understanding about social isolation among TAY and the impact of Information and
Communication Technology (ICT) based interventions on this population.
Stakeholder Benefits to Social Prescribing

If social prescribing was introduced in the U.S, it would provide a low-cost option for
individuals who would otherwise use time and resources of medical personnel. In rural areas,
social prescriptions would be more accessible than office-based medical care since prescribed
activities take place in the community. During this unprecedented time, the need for mental health
resources for TAY has strained the mental health workforce, and social prescribing provides a

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means of expanding the helping profession. Individuals who live in rural areas are hesitant to a
mental health facility due to the stigma of mental illness. Digital social prescribing can help TAY
in rural areas, not only by eliminating the need to travel to visit a mental health therapist’s office,
but also by preventing others from knowing the person is receiving services. In a sense, the use of
virtual mental health services from a safe space helps to preserve confidentiality of the client.
Competitive Analysis
Since the COVID-19 pandemic, a number of organizations providing therapeutic arts
classes have moved their services to virtual platforms. A thorough review of the existing market
revealed that a number of practices offering group and individual art therapy are now providing
services online. In addition to providing therapeutic art services, some organizations provide
individual wellness services, such as traditional psychotherapy and Reiki massage. Other
organizations providing group therapeutic art services are more workplace-focused and offer
teambuilding activities, strategic planning, and health fairs. Some organizations provide group
therapeutic art services that are donation-based or use a sliding scale, while others charge fees
ranging from $170 to $340 per session.
Of the therapeutic art practices reviewed, only one provides services for TAY. The Art
Therapy Project in New York City provides group therapy for individuals under the age of 18.
Let’s Art About It, based in Clawson, Michigan, provides art kits for its corporate clients, but
these kits must be purchased by clients for $39. Please see Appendix G for more details about
market competitors.
Program Implementation

The Art Connection is partnering with two Transition-Age Youth Launching Realized
Dreams (TAYLRD) drop-in centers located in Louisa and Ashland, Kentucky. TAYLRD works

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to help TAY, who face many different barriers on the road to adulthood (Kentucky Partnership
for Families and Children, Inc., www.kypartnership.org). Co-designed with local youth,
TAYLRD offers a range of services, including include peer support, goal setting, case
management, and employment and education services. Recreational activities include a computer
lab, pool table, video games, and art supplies (TAYLRD, www.taylrd.org).
Recruitment

Mental health therapists at TAYLRD will identify TAY who participate in TAYLRD
activities to take part in TAC’s 6-week virtual therapeutic art classes. The therapists know each of
the youth who come to the drop-in center and the extent to which they experience social isolation.
Upon registration in a therapeutic art class, participants will be mailed a supply kit containing all
the materials needed to take part in the 6-week class session. Each art supply kit will be
customized to include art activities to meet the specific developmental and emotional needs of the
individuals. For instance, specialized kits will be developed for youth who identify as LGTBQ,
those with a history of interpersonal violence, and youth who are adopted. The therapeutic art
worksheets included in each kit were developed by A Window Between Worlds (AWBW). Please
see Attachment A for more details about the art kits.
Each therapeutic art class session will be one hour in duration. Two classes will take place
each week, unless a class is scheduled on a federal holiday. No more than 5 or 6 youth will take
part in each art class session, so no more than 10 or 12 TAY will participate in therapeutic art
services each week. If more than 12 youth are eligible and interested in participating in
therapeutic art classes, a third class will be formed. The third class will take place at the same
time as the other groups, but on a different day.

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Ground Rules

At the beginning of Week 1 of the therapeutic art classes, the facilitator will explain what
the classes will be like. As part of the orientation process, the facilitator will review the types of
materials in the art supply kit and how to use them. A brief discussion of therapeutic art class
Ground Rules will also take place. TAC’s Ground Rules were developed to help ensure the
confidentiality and safety of class participants, the facilitator and the mental health observer.
Please see Appendix B for a copy of TAC’s Ground Rules.
Procedures

Once all participants are online and in the TAC Zoom classroom, the facilitator will
welcome classmates. She or he will state that even though the class is gathered electronically, it is
a safe space and that anything that is said in the room will not be repeated. The facilitator will
also explain that a mental health therapist from TAYLRD will serve as a passive observer (and
will have his or her video turned off) in each of the therapeutic art classes to give emotional
support to participants in need.
If a class participant feels overwhelmed during the therapeutic art class, he or she will be
able to send a private message to the therapist observer and ask to talk with him or her privately.
Upon this request, the therapist will bring the participant into a Zoom breakout room to provide
direct support. Should the therapist observer notice emotional difficulty by any of the participants
during the class, he or she could send a private message to that participant and suggest that they
meet in a private Zoom room. If the facilitator notices that one of the participants is upset, he or
she will send a message to the therapist observer and the participant and recommend that they
meet in a breakout room.

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Class Procedures

Sitting Meditation (10-15 minutes).

The facilitator will play soft, calming music and lead the class through a sitting, eyes-
closed meditation. The theme of the meditation will correspond with the theme of the art activity
for the day. For instance, an art activity addressing “finding your independence” may include a
meditation including a tree and the growth of its branches and roots. Please see Appendix C for a
sample meditation.
Artmaking Activity (20-30 minutes).

After the sitting meditation, the facilitator will introduce the art activity for the day and
suggest materials that may be used. The facilitator will make clear to participants all activities are
completely voluntary. After 20 minutes of independent time for artmaking, the facilitator will
check in with participants to determine if more time is needed. If needed, the facilitator may give
participants an additional 5 minutes to come to a stopping point with their artwork.
Open Participant Discussion (20 minutes).

When all participants have arrived at a stopping point with their artmaking, the facilitator
will ask if any members of the class would like to share what they created. If none of the
participants choose to share his or her creation, the facilitator will share his or her work to
stimulate discussion. During the discussion, the facilitator will ensure that all participants still
have the opportunity to share their work.
If any of the participants want to discuss their work beyond the class period, he or she can
do so with the facilitator. If any of the class participants are in a state of distress when the class
ends, the facilitator will provide support to the participant until he or she is ready to leave the
classroom. If the facilitator is not able to help the participant return to a more stable emotional

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state, the facilitator will ask the mental health therapist to enter the Zoom room to provide
support.
Implementation Timeline
Pre-Planning Stage

During the Pre-Planning Phase, the TAC director will work with staff at TAYLRD to
schedule meetings with potential stakeholders to discuss the launch of the TAC pilot project.
Potential partners include Pathways Regional Prevention Center in Louisa, Pathways Regional
Prevention Center in Ashland, Mountain Comprehensive Care in Louisa, Mountain
Comprehensive Care in Ashland, Ashland Community and Technical College, Morehead State
University, Lawrence County High School and Boyd County High School.
While the TAC director and TAYLRD staff are making contact with potential
stakeholders, they will also actively recruit individuals who would be suitable to sit on the TAC
Steering Team and for part time staff. TAC will recruit for a part time marketing specialist and a
part time program evaluator.
First Full Year of Operation (FFYO)

Phase I.

One week prior to Week 1 of therapeutic art classes, class participants will be required to
complete three baseline assessments: (1) Friendship Scale (Hawthorn, 2008), (2) Beck Depression
Inventory II (Beck, Steer & Garbin, 1988) and (3) Sense of Community Index (Long & Perkins,
2003). Please see Appendix H for instruments. Participants will also be asked to complete a brief
technology survey. The purpose of the technology survey is to determine if participants have
access to a laptop computer, desktop computer or a tablet. They will be asked if they have reliable
access to the internet from a private space, such as a bedroom. Laptops and internet hotspots will

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be provided to participants from Device Pitstop in Lexington, Kentucky. If a participant does not
have a private space from which virtual therapeutic art classes to join, TAC and TAYLRD will
work together to find a safe space for that participant. During the 6-week therapeutic art class
sessions, the facilitator and observer mental health therapist will identify participants who show
potential as future class facilitators.
Phase II.

After taking part in the six-week class session, TAY will re-take each of the following
assessments: (1) Friendship Scale, (2) Beck Depression Inventory II, and (3) Sense of Community
Index (SCI). For additional information about the implementation timeline, please see GANTT
chart in Appendix E. The Steering Team and the program evaluator will discuss outcomes from
the project and brainstorm how the project procedures could be improved. They will use a Plan-
Do-Study-Act (PDSA) process that will help the team incorporate new ideas into the next pilot
test cycle. At the end of the 6-week session, participants will be asked to complete an evaluation
form and to share their thoughts, ideas and suggestions for the program in a group discussion.
Phase III.

Phase III of the pilot project will take place immediately following the evaluation of the
Phase II outcome data. For the 6 weeks following the Phase II therapeutic art class session, the
program evaluator and TAC Steering Team will evaluate outcomes from Phase II. Any needed
changes will be made in the Phase III pilot test cycle. All of Phase II therapeutic art class and
evaluation procedures will be repeated in Phase III, with the exception of specific changes made
to improve project outcomes. During Phase III, the Steering Team will decide whether the pilot
project should be extended to include another phase.

22

Financial Plan

Financial Plan Summary

TAC has created budgets to support the project goals during its pre-planning period and
First Full Year of Operation (FFYO). These budgets may be found in Appendix F. TAC’s pre-
planning period will begin January 2, 2022 and will conclude September 31, 2022. It is
anticipated that TAC will receive a grant from The Commonwealth Fund, which “promotes a
high-performing health care system that achieves better access, improved quality, and greater
efficiency, particularly for society’s most vulnerable, including low-income people, the uninsured,
and people of color” (The Commonwealth Fund, https://www.commonwealthfund.org/). If TAC is
not awarded funding from The Commonwealth Fund, the director will be charged with applying
for funding from other sources. Since TAC activities are in line with the top priorities of The
Commonwealth Fund, it is anticipated that grant applications will be successful. Once TAC is
notified that it will be awarded grant funding, the director, under guidance of the TAC Steering
Committee, will begin recruiting for a marketing specialist and a program evaluator.
During the pre-planning period, TAC will establish an office in Lexington, Kentucky. The
TAC Steering Team will also begin building relationships with key stakeholders and working
with local and private businesses to raise funds. During the FFYO, TAC’s costs will include an
annual Zoom for Business membership, monthly internet and mobile phone service, maintenance
and hosting of the TAC web site, and staff travel. Due to COVID-19 restrictions, the majority of
TAC staff and Steering Team meetings and trainings will take place via Zoom.

23

Program Expenses

Personnel Expenses

TAC has budgeted $205,000 for the salaries and fringe benefits for its director, marketing
specialist and program evaluator. Since overhead is low, TAC’s personnel costs represent a
significant percentage of overall expenses at annually and 61% of the total planning year budget.
Director – Andrea Fiero.

When grant funding is awarded, TAC will allocate an annual salary of $60,000 for the
director for both its pre-planning period and FFYO. The director will be responsible for
facilitating the therapeutic art classes and training other facilitators during the pilot project. She is
expected to lead TAC’s efforts in fundraising and managing TAC’s grant programs. The director
will also be responsible for general accounting services supervising other TAC staff. The director
will report to the TAC Steering Team.
Marketing Specialist.

Once grant funding is approved, $30,000 will be allocated to pay the salary for the part
time marketing specialist. The marketing specialist will be paid $30,000 annually for both the pre-
planning period and the FFYO. The marketing specialist will be responsible for creating,
designing and overseeing TAC’s marketing efforts, including some messaging on the TAC web
site.
Program Evaluator.

Once grant funding is approved, $30,000 will be allocated $30,000 annually for the part
time program evaluator. This amount will be allocated for both the pre-planning period and the
FFYO. The program evaluator will work under minimal supervision to develop comprehensive
evaluation plans for the TAC pilot project. She or he must be familiar with Continuous Quality

24

Improvement (CQI) and PDSA cycles. If TAC extends the length of the pilot project, the program
evaluator will work to ensure that program activities and services further the goals and objectives
of the projects.
Non-Personnel Expenses

Non-personnel costs make up a very small amount of the TAC pre-planning and FFYO
budgets. Non-personnel expenses will include the cost of creating a new web site, purchasing a
laptop for the director, developing marketing materials, subscribing to internet service, leasing
mobile telephones, and signing up for Zoom for Business, which totals less than $5,000 and
represents less than 1% of the annual budget. It was initially anticipated that TAC would need to
rent office space in which key staff could work. Due to the ongoing problem of the COVID-19,
however, staff will work and communicate using Zoom from their home offices. Funds previously
set aside for rent and utilities will be applied to personnel.
Program Revenues

Revenue Strategies and Funding Types

TAC anticipates grant funding from The Commonwealth Fund grant. The Commonwealth
Fund provides funding to organizations that supports organizations in their efforts to promote
equity, diversity and inclusion, particularly in healthcare. It supports independent research that
works to better access, improved quality, and greater efficiency in healthcare, particularly for
society’s most vulnerable, including low-income people
(The Commonwealth Fund, https://www.commonwealthfund.org).
Donations.

To support the immediate financial needs of this pilot project, TAC has secured $5,000 in
donations from local businesses in Lexington, Kentucky. In addition to monetary donations, the

25

Parent-Teacher Store, a locally owned educational materials store, offered to donate art supplies
for 10-12 class participants. Device Pitstop, a computer repair franchise, will provide laptop
computers for those therapeutic art class participants who do not already have access to a
computer. If any of the class participants do not have access to the internet, a mobile hotspot will
also be provided for those participants.
Grants.

If TAC’s project is going well, the Steering Team may consider applying for a research
grant sponsored by the National Center for Complementary and Integrative Health (NCCIH) at
the National Institutes of Health. The grant opportunity addresses research areas focusing on the
individual, social and biobehavioral processes through which social isolation and social
connectedness have positive or negative impacts on health, wellbeing, illness and recovery
(NCCIH, 2021).
Contribution to Solving the Grand Challenges
Through its pilot project, TAC hopes to contribute to what is known about reducing social
isolation and loneliness through creative expression. This project can help the social work
profession better understand the extent to which TAY can make up for an absence of social
activity due to COVID-19-related social distance requirements. Outcomes from this project might
also help those in the healing arts profession understand that the creation of art can improve the
mental health outcomes of TAY living with social isolation, loneliness and depression. This
project will help multiple areas of study understand how social relationships may be fostered
through online platforms and whether these social relationships can be of high enough quality and
help reduce social isolation, loneliness and depression during TAY period of social and
neurological development.

26

Analysis of Obstacles

Confidentiality

Some TAY who take part in TAYLRD programs do not feel safe at home or have stable
housing. As TAYLRD is helping to find TAY a safe place to live, The Art Connection, in concert
with TAYLRD and other community partners, will provide a safe space from which they may still
take part in therapeutic art classes. Even though the use of technology has increased tremendously
in social work settings due to COVID, those in the profession still need to be aware of unique
challenges that the use of technology can present (NASW, 2021). TAC will work with TAY who
have histories of trauma, and it is of upmost importance that confidentiality be maintained at all
times. To maintain confidentiality, all participants will be required to sign a statement of consent
(included in Appendix A) prior to taking part in the therapeutic art classes to ensure that all class
discussions remain confidential. Each therapeutic art class will be limited to the class facilitator,
class participants, and the observing mental health therapist. Any unidentified participants in the
Zoom room will be asked to leave.
Stable Internet Access

As discussed earlier, areas of Eastern Kentucky are known for slow, unreliable internet
access. If any class participant loses access to the internet during class, he or she will be able to
call TAC’s toll-free telephone number to take part in the remainder of class via telephone. If a
participant’s internet becomes unstable or terminates, the facilitator and the participant will dial
into the toll-free number phone number. If the facilitator’s internet becomes unstable or
terminates, the facilitator and all participants will dial into the toll-free number so that class may
resume via telephone.

27

Ethical Concerns

Therapeutic art class participants may experience intense and troubling emotions during
class. It would be unethical invite TAY to explore their emotions through art without providing
support to those youth as they experience these emotions. Many TAY who visit the TAYLRD
drop-in center have been exposed to violence and have histories of trauma. Although The Art
Connection curriculum is trauma-informed, it is anticipated that art class participants will
experience emotions that may be overwhelming at times. The facilitator will be prepared to assist
TAY as they process these emotions. The facilitator has been trained to help art class participants
address their emotions so that healing can take place. During each art class, one of the social
workers from TAYLRD will take part in each art class as an observer, should any class
participant need additional emotional assistance.
Program Sustainability

Scaling the Project

The Art Connection will provide therapeutic art classes in three phases at the TAYLRD
drop-in centers in Ashland (Boyd County), Kentucky and Louisa (Lawrence County), Kentucky.
During each of the six class sessions, at least one participant will be identified as a potential
facilitator and will be trained by the TAC director to facilitate future therapeutic art classes.
Barring any interruption in grant funding, The Art Connection will expand exponentially as the
number of trained facilitators increases and therapeutic art classes are provided at additional
TAYLRD drop-in centers and a growing number of partner organizations in Eastern Kentucky.
Evaluation Plan
Pre- and post-intervention testing will help TAC assess the outcomes of its pilot site
intervention. It is hoped that the TAY taking part in the pilot project will have a positive

28

experience with the project. The team will also implement a Continuous Quality Improvement
(CQI) program and will synthesize and incorporate feedback from project participants and
Steering Team members using a PDSA cycle as the pilot project moves forward.
A number of factors will be taken into consideration as data is evaluated. These factors
article include: (1) the diversity of the program teams (beyond ethnic and cultural), (2) cultural
appropriateness and validity of program methods, (3) ability of the program designs to reveal
structural and systems-level drivers of inequity, and (4) the degrees to which those affected by
what is being evaluated have the power to shape and own how evaluation happens.
The pilot project will take place in Eastern Kentucky, an area of the country in which,
unfortunately, individuals of color generally represent less than 1% of the population (U.S.
Census Bureau, QuickFacts,
https://www.census.gov/quickfacts/fact/table/owsleycountykentucky/RHI225219). However, an
evaluation of the project will measure the extent to which program teams include individuals of
different ages, genders, sexual orientation, income and religion. Eastern Kentucky is known for its
unique culture and rich traditions. Prior to evaluating the pilot project, evaluation questions will
be reviewed by members of the project’s Steering Team from the region.
Individuals and families who live in Eastern Kentucky are among those with the lowest
income in the country. TAY who take part in the pilot site project will help the project team better
understand how limited access to jobs, mobile phone service, broadband internet, fresh fruits and
vegetables, and road access makes life very difficult for many in the area. Please see for see the
Logic Model in Appendix D for additional details.

29

Conclusion
Even at first glance, it would be difficult to deny that COVID-19 has had a significant impact on
American society. While most “stay at home” orders have been lifted, wearing masks and maintaining a
personal distance of 6 feet is still required in many public places and causes many Americans to still feel
alone. If we look beyond the challenges associated with COVID-19, however, one might recognize that we
have gained significant insight about who we are as human beings during this difficult time. COVID-19
has taught us that as social animals, we thrive when we are members of a tight-knit group with frequent
social interactions. Without constant reminders that we are not alone, our bodies go into “flight or fight”
mode, and we decompensate physically and emotionally. Because they are in a critical stage of
development and where they live, TAY in Eastern Kentucky are particularly vulnerable to the effects of
social isolation and loneliness. The Art Connection, in partnership with TAYLRD and other youth and
young adult serving organizations, will provide opportunities for TAY in Eastern Kentucky to use
creativity and art to heal, explore, grow and thrive through social relationships with their peers.

30

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Appendix A
Capstone Prototype

The Art Connection prototype model is an art supplies kit that will be provided to
Transition Age Youth (TAY)(ages 14-25) upon enrollment in an art class. The art kit container is
a sturdy cardboard box measuring 12” x 19” x 2.5” (see Appendix A). To reduce the risk of
transmitting COVID-19, the kit will be shrink-wrapped, mailed from the distribution center, and
left on the participant’s doorstep. The following art supplies are included in the kit: pencils, pencil
sharpener, crayons, colored pencils, paint brushes, watercolor paint, one paint palette, tempera
paint, finger paint, markers, scissors, glue stick, sketchbook, construction paper, scrapbooking
paper, washi tape, play-doh and glitter glue.
In addition to the art supplies, the art kit includes 6 art activity pages to be used during the
6 weeks of the art class session. Each activity page provides a brief suggestion as to how to carry
out the activity (see Appendix B for an example of a completed activity page). Each art supply kit
will be customized to include art activities to meet the specific developmental and emotional
needs of the TAY. The art activity in Appendix B, for example, would be included in the art
supply kit for TAY with a history of interpersonal violence. The activity pages were developed by
A Window Between Worlds, an organization that trains and supports other organizations and
individuals who use art to promote empowerment, resilience, and healing for those with histories
of trauma (AWBW, 2021). The inside cover of kit briefly states that the art activity pages were
developed by AWBW. Grant funding provided to The Art Connection will also be acknowledged
inside the front cover of the kit. The kit also includes Mandatory Reporting and Statement of
Confidentiality (Appendix C), a Photo Release Form (Appendix D), and Participant Evaluation
Forms (Appendix E).

39

The prototype was tested on two occasions. During both tests, participants asked if
additional materials could be mailed to their houses. One participant asked if he could have a
bigger sketchpad; another participant asked for construction paper. Unfortunately, the box
selected for the prototype was too small for construction paper or a standard size sketchpad. Since
that prototype test, a new box was used as the prototype art supply kit. The new prototype
includes a full-size sketchbook and construction paper.

40

References

A Window Between Worlds. (2021). Facilitator manual: Updated September 2021.

41

Images of Prototype

42

Therapeutic Art Worksheets (Weeks 1-6) & Example of Completed Worksheet

Week 1

Week 2

43

Week 3

Week 4

44

Week 5

Week 6

45

Example of Completed Worksheet

46

Mandatory Reporting and Statement of Confidentiality

47

Art / Photo Release Form

48

Participant Evaluation

49

Appendix B
The Art Connection Class Ground Rules

Ground Rules

The following ground rules were adapted from A Window Between Worlds’ examples of
Community of Practice (AWBW, 2021):
Everything is Voluntary
Class participants are provided with this special time to engage in the creative process. This class
is a completely self-directed process and participants do not need to do anything except practice
respecting their thoughts, feelings, and needs. Participation can take many forms, including
observing. Observing is of great value and beautifully sets the stage for the art workshop to take
place.
Observe Confidentiality
If someone shares, observe confidentiality. What happens in the class stays in the class
Take care of yourself
During the art class, participants should feel free to do what is best for them. They can doodle,
color, stretch, take breaks, get something to drink, or do whatever else they need as long as doing
so is not disruptive to others.
Judgment-free zone for ourselves and others
You can emphasize this point by sharing that we get a lot of messages about who is and who isn’t
empowered to create art, as well as about things being “good” or “bad” or “right” or “wrong.”
Acknowledge that judgmental thoughts may arise and encourage participants to let go of these
thoughts as much as possible. You may also want to create a judgment jar so participants can
write down any judgmental thoughts that are coming up for them on pieces of paper and release
them in the jar.
There’s no right or wrong way to participate

50

There is inherent power in your role as the art workshop facilitator and one way to mitigate that
power dynamic is to reinforce that participants may opt-into any aspect of the art workshop they
like and leave the rest. We found time and time again that simply providing time for participants
to explore the art supplies, make a mess, or simply sit and listen to the music is of great value —
particularly for participants whose trauma includes being under the control of an abusive person.
“Oops”, “Ouch” & “What”
This is a gentle way to let others know when something does not sit well with you when shared by
others (“ouch!”) or from yourself (“oops!”), especially when your feelings are impacting your
ability to stay present and connected. “What” is an invitation for participants to ask any questions
they may have. The aim is to encourage folks to speak up any time they have a question to help
mitigate any concerns participants may have about asking questions.
Provide strengths-based feedback
Windows workshops are not art classes. No one is “graded.” We are committed to focusing on
strengths and reinforcing that it does not matter what the art looks like as the goal is having an
opportunity to engage in the creative process in a safe and supportive environment.
This is our Window of Time
The art workshop is a Window of Time to respect your own thoughts, feelings and ideas. During
this time we allow each person to decide how their art looks. There is no right or wrong way to do
art.
Treat others as you wish to be treated
We care for ourselves and for each other. Allow each person to work at their own pace.
Everyone’s feelings are valuable and important
There is no such thing as “good” or “bad” feelings — only “big” feelings or “a whole lot of
Use “I” statements
We are the experts of our own experience, but not the expert of someone else’s experience.
Contain your sharing to “I” statements. As, however well intended we may be, when we speak for
others, we are actually speaking from our perspective rather than theirs.
Practice boundaries and consent
If an aspect of the workshop experience makes you feel unsafe or crosses your boundaries in any
way, you’re invited to speak up. Participant safety is our first priority.
“Share the Air” or “Move Up & Move Back”

51

We want to create spaciousness for all voices to be heard so we ask that we all be conscious of
time when we share to make room for one another.
Acknowledge the intent, attend to the impact
If something is said that negatively impacts a participant, while it is important to acknowledge
that it was not the intent of the person who said it, we encourage you to keep the emphasis on the
impact it had on the person who was harmed. This can be particularly helpful in supporting
participants to be empathetic towards one another.
Use pronouns
Before the workshop begins, we encourage you to invite folks to share their pronouns with the
group via writing them on a name tag, sharing verbally, or in virtual art sessions adding their
pronouns next to their name as it appears on the screen. This is especially important as one source
of trauma is folks being misgendered.

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Appendix C
Sample Meditation

Let's begin with a meditation practice 20. Please find a way wherever you are, where you can sit
comfortably. Feel your feet on the floor and yourself in a chair or on a cushion, or whatever way
allows you to settle on this earth. And when you can, establish a sense of groundedness in your
posture in your body.

Allow your eyes to close gently, and first take a couple of deeper breaths, just here and now this
evening, in the midst of everything going on in your life, in the world you take your seat halfway
between heaven and earth. Take a few deep breaths and go.

Then begin to notice as you bring your attention here into the present moment. Notice if there's
areas of tension or tightness in your body that you can easily release and do so. Let your eyes and
face be soft, loosen the jaw, roll your head in a circle to release your neck, and let it find a simple
upright that your shoulders relax and your hands and arms rest easily. Let the belly be soft from
the breath, natural. And let the heart be soft as well to receive whatever arises with kindness, with
a spirit of tenderness or compassion.

Notice the weight of your body feel the pull of gravity that connection of the buttocks and the legs
and the feet the chair or the floor into the earth below. And imagine you feel or sense
that you have roots like a great tree, like a redwood energetic roots that go down from your body
into the earth. Strong supportive roots you've taken your seat on this earth.

And now with this embodied presence, let yourself begin to notice how the body breathes itself.
You don't have to do anything with the breath or change it, but notice where you feel it most
directly. Coolness in the nostrils swirling, tingling in the back of the throat, or perhaps the rise
and fall of chest or belly and rest your attention to begin with feeling this life breath. With each
breath, invite a quality of calm or ease. You can even say it as a whisper in the mind, breathing in
and out calm ease.

And with that invitation, let the breath lead you to a deeper sense of presence and calm. Return to
the breath when the attention wanders, quite gently and kindly. The breath is so mysterious. It is
that the universe is breathing you and with each in-breath, you breathe the winds that carried
themselves across oceans and mountains and plains, through the lungs of the creatures of the
forests and the waters and the people around. We are exchanging air this biosphere with all of life
and our body is doing it as we breathe calm ease.

And as you feel each breath receiving it with a mindful kind attention, sense that you are
establishing yourself in loving awareness. The loving witness of the breathing the movement of
the body, and if you have difficulty sensing the breath, place one hand on your belly, and feel the
belly rise and fall in the palm of your hand. Just leave it there for the meditation, the gentle rise
and fall calm and ease each breath and when the attention wanders, as soon as you notice with the
same loving awareness, acknowledge and gently return to this breath, breathing in calm, reading
out with ease, and as you gradually and gently, let the mind settle and the attention and breath,

53

breath by breath, bring a sense of steady calm and ease, let us now open the field of mindful
loving awareness from the practice of attending to the breath.

As you feel each breath, gently steady the attention after three breaths or ten breaths, or however
long the attention will be pulled away by a different experience. It might be feelings sad or upset
or longing or love joy. It might be thoughts planning, remembering, imagining or sounds or
strong sensations. When you notice that the attention has left the breath, instead of struggling
against it as soon as you notice or wake up however long it's been as if to bow to it name where
you've gone name the wave of experience that has pulled your attention to it thinking planning.
Whatever you acknowledge, as if with a bowel you receive with the same loving awareness the
same kind of tension you give into the breath and notice as you name it doesn't last that long, the
thoughts or memories will dissolve emotion when acknowledged will rise like a wave or a time
and pass away.

And when these experiences have dissolved, or when you are at ease with them, then return back
to the breath for a time, calm and ease you sit like the buddha that you are calm and steady in the
midst of all things noticing the breath with loving awareness. And then when strong experiences
pull you away, noticing the human experiences all the human experiences that arise around the
breath, the longing the love, the sadness, or fear, the excitement the planning, can you name them
gently as if to bow. And they rise and pass and then again you return back to the breath, calm and
steady.

You are the loving awareness itself, spacious and kind, witnessing the breath, and witnessing all
of the human experiences that rise and fall around this ever-changing breath. And in the midst of
it all, you are still okay.

Source: Kornfield, J. (2020, September 26). Calm and Ease Meditation [Video].
https://www.youtube.com/watch?v=Ye8hiIROaII

54

Appendix D

55

Appendix E
GANTT Chart

56

Appendix F
Budgets

57

58

Appendix G
Competitive Analysis Table

59

Appendix H
Evaluation Instruments

60

Beck Depression Inventory II

61

Sense of Community Index (SCI)

Telephone Survey Items

62

Abstract (if available)

Abstract Reflecting on the past 18 months, it would be difficult to deny the impact COVID-19 has had on American society. The worry, the stress, wearing masks, maintaining 6 feet of personal space in public, and working and going to school virtually have become a daily routine for the past 20 months. Prior to the arrival of COVID-19, only social science researchers were aware of the extent to which human beings decompensate without regular social connection. Now, however, many Americans have felt the adverse effects of lockdown firsthand. Prior to the pandemic, it was thought that primarily older persons were the most vulnerable to the physical and emotional harms of loneliness and social isolation. Even though older persons are susceptible to social isolation and loneliness, COVID-19 has made it clear that the effects of social distancing restrictions on adolescents and young adults are also extremely harmful. In 2019, the Centers for Disease Control and Prevention (CDC) found that 37% of students persistently felt sad or hopeless. After COVID, 63% of this age group experienced significant symptoms of loneliness, anxiety and depression (CDC, 2020)(Weissbourd, Batanova, Lovison, & Torres, 2021). Although the federal Center for Mental Health Services defines Transition Age Youth (TAY) as individuals between the ages of 16 and 25 (58 FR 29425), TAY are identified as individuals between the ages of 14 and 25 for purposes of this paper. Terms are often used interchangeably, but social isolation and loneliness are conceptually different. Social isolation is the objective lack of interactions with others or the wider community (Lee, Malcein, & Kim, 2021); loneliness is the distress felt by people without their social involvement or relationships (Coyle, 2020).

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Asset Metadata

Creator Fiero, Andrea Sheerin (author)

Core Title The art connection: disrupting social isolation and loneliness among transition age youth in eastern Kentucky

School Suzanne Dworak-Peck School of Social Work

Degree Doctor of Social Work

Degree Program Social Work

Degree Conferral Date 2022-05

Publication Date 05/02/2022

Defense Date 12/10/2021

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag eastern Kentucky,OAI-PMH Harvest,social isolation,transition age youth.

Format application/pdf (imt)

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Lewis, Jennifer (committee chair)

Creator Email andreafiero@usc.edu,fiero@usc.edu

Permanent Link (DOI) https://doi.org/10.25549/usctheses-oUC111160297

Unique identifier UC111160297

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