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COACH: Connecting Older Adults to Community for Health - an evidence-based program to address older adult social isolation and loneliness

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COACH: Connecting Older Adults to Community for Health - an evidence-based program to address older adult social isolation and loneliness

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Content COACH: Connecting Older Adults to Community for Health
An Evidence-Based Program to Address Older Adult Social Isolation and Loneliness
by
Samantha M. Day
A Capstone Project Presented to the
FACULTY OF THE USC SUZANNE DWORAK-PECK SCHOOL OF SOCIAL WORK
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the Requirements for the Degree
DOCTOR OF SOCIAL WORK
August 2021
Copyright 2021 Samantha Day
Dedication
This work is dedicated to my husband, Tim. Your never-ending support has allowed me to
achieve all my educational and professional goals. Thank you for keeping me motivated through
continued encouragement and humor. I couldn’t have done this without you.

Acknowledgments
I wish to thank Professors Samuel Mistrano, JD, and Cassandra Fatouros, LCSW, MBA for their
commitment, direction, and extremely helpful feedback throughout the DSW program. You
provided me with new tools, enhanced the skills I already possessed, and inspired me to do my
best work. I greatly appreciate the support and guidance.
A very special thank you to Cassie DeSena-Jacobs, my colleague and friend. You helped me
expand my viewpoint, sharpen my research, and provided a much needed outside perspective to
my work.

Table of Contents
Executive Summary .........................................................................................................................1
Problem: Conceptual Framework ....................................................................................................4
Solution, Innovation, &Theoretical Framework ..............................................................................7
Project Structure, Methodology, & Action Components ...............................................................12
Methods to Assess Impact .............................................................................................................22
Conclusions and Implications ........................................................................................................28
References ......................................................................................................................................32
Appendix A (COACH Implementation Timeline) ........................................................................43
Appendix B (COACH Prototypes) ................................................................................................44
Appendix C (COACH Operating Budgets) .................................................................................102
Appendix D (COACH Logic Model) ..........................................................................................10 4
1
Executive Summary
Social isolation and loneliness affect millions of older adults in the United States, causing
increased risk for mental and physical health issues and, ultimately, higher mortality rates (Holt-
Lunstad, 2018; NASEM, 2020; Perissinotto et al., 2019). Prior to COVID-19, Medicare alone
spent $6.7 billion annually in attempts to address the effects of this issue, yet over 46 million
adults aged 60 and older reported feeling lonely or alone on a regular basis (Henning-Smith et
al., 2019; NASEM, 2020). That number has skyrocketed during the COVID-19 pandemic along
with the belief that older adults are frail, helpless, non-contributing citizens, amplifying ageism
and worsening older adult outcomes (Gorenko et al., 2021; NCOA, 2021a). Though the personal
effects and systemic costs of this issue are well-documented, social isolation and loneliness
aren’t regularly assessed within healthcare or social service settings (Perissinotto et al., 2019).
Theoretical/Conceptual Support
Social connection is a fundamental human need and one of the most significant predictors
of overall wellness across the lifespan. It can prevent isolation and loneliness, improve mental
health symptoms, help maintain physical functioning, and can reduce instances of illness (AARP
Foundation, 2012, NASEM, 2020). Further, intergenerational interactions have been identified as
a way that social connection can be fostered for multiple groups at once, improving wellness
trajectories for current and future generations of older adults (Stanford Center on Longevity,
2016). Continuity Theory supports this research and suggests that older adults who can substitute
new activities, roles, and social connections for those they lost due to aging transitions will
adjust better to the aging process and experience better social, emotional, and physical outcomes
(Atchley, 1989; Schroots, 1996). When applied to social isolation and loneliness, it provides a
basis for why the problem occurs and how it can be improved.
2

An Innovative Solution
Connecting Older Adults to Community for Health (COACH) is an evidence-based
program designed to address the emotional effects, root causes, and sustaining factors of older
adult social isolation. The program consists of two weekly group sessions facilitated by a
licensed behavioral health professional: one therapeutic group focused on reminiscence and
cognitive-behavioral interventions, and one intergenerational storytelling group in which each
older adult is paired with a college student. COACH aims to improve older adult behavioral
health outcomes, positively shift perceptions of aging, and increase social connection. COACH
furthers the Grand Challenges to Eradicate Social Isolation and Advance Long and Productive
Lives by creating opportunities for older adults to find meaning and purpose, generating
programming that can positively alter health trajectories, and adding to the knowledge base of
healthy aging (Crewe et al., 2018; Gonzales et al., 2018).
Implementation Plan Summary
The EPIS Framework was utilized in COACH implementation planning, and is broken
down into four phases: exploration, preparation, implementation, and sustainment. The
exploration phase is complete and consists of stakeholder engagement, problem identification,
and solution options. Currently in the preparation phase, tasks have focused on pilot plans and
prototype creation, formalized partnership agreements, and funding source/structure
solidification. The implementation phase centers on COACH pilot facilitation and data
evaluation. In the sustainment phase, the main task is pursuing evidence-based certification of
COACH through the Administration for Community Living (ACL) which will allow service
agencies across the United States to receive funding through the Older Americans Act (OAA) to
be trained in COACH implementation. Once these phases are complete, the goal of the first full
year of operations is to train 5 agencies in California to implement the COACH Program. The
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long-term goal is for COACH to be implemented in one Tribal and one non-tribal entity per state
and U.S. territory (122 sites total) within the first 15 years of operation.
Project Design and Projected Outcomes
COACH pilots will be quasi-experimental in design with equivalent comparison groups,
which is cost-effective and allows for evaluation of real-world effectiveness (Schweizer et al.,
2016). Each pilot run will be 15 weeks and will consist of 16 community-dwelling adults aged
60 and older. Eight will receive a standard outpatient individual counseling for 15 weeks while
the other eight will receive the COACH intervention. The three main outcome aims of this
research are to: improve older adult behavioral health outcomes (depression, anxiety, loneliness),
increase older adult social connection, and positively shift older adult and student attitudes
toward aging. It is projected that participants receiving the COACH intervention will show
greater outcome improvement than those receiving the standard intervention.
COACH as a Social Innovation
When compared to other programming or services that target the effects of older adult
social isolation, COACH is unique in that it combines evidence-based, culturally responsive
techniques to address the negative effects and sustaining factors of the problem. Once COACH is
certified as an evidence-based program through the ACL, it will be nationally available with
funding from the OAA, increasing the reach and impact potential. COACH is also distinctive in
that it is scalable, sustainable, and it addresses issues for the current aging population while
promoting healthy aging for future generations to impact social isolation over time.
4
Problem: Conceptual Framework
Social isolation and loneliness of older adults in the United States is a pervasive public
health issue that negatively impacts mental and physical functioning while placing a significant
strain on the healthcare system (NASEM, 2020; Smith et al., 2020). Prior to the COVID-19
pandemic, Medicare alone spent $6.7 billion annually in attempts to address the effects of these
issues, yet over 46 million older adults aged 60+ were socially isolated, lonely, or alone on a
regular basis (Henning-Smith et al., 2019; NASEM, 2020). Though closely interrelated
phenomena, social isolation most often refers to the objective lack of social interactions (with
family, friends, or community) while loneliness describes subjective social isolation, or the
feelings and experience associated with not having the desired quantity or quality of social
connections (Fakoya et al., 2020; Smith et al., 2020; Taylor, 2020).
In addition to increased risk for depression, anxiety, and suicide, socially isolated older
adults are at higher risk for falls, strokes, and chronic disease, resulting in increased
hospitalizations and premature death (NASEM, 2020; Pohl et al., 2020). In fact, social isolation
and loneliness are considered as lethal as smoking 15 cigarettes per day (NASEM, 2020;
Perissinotto et al., 2019). To add insult to injury, older adults are already more likely to
experience chronic illness and physical health issues as part of normal aging, in turn, increasing
their risk of developing mental health symptoms (Cherry et al., 2016; Forum, 2016; Shankar et
al., 2017). For instance, an older adult who develops mobility impairment is more likely to
experience increased symptoms of depression and anxiety due to loss of independence.
Grand Challenge Context
The issue of older adult social isolation and loneliness has implications within the Grand
Challenges to Advance Long and Productive Lives and Eradicate Social Isolation. The
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combination of ageism and population aging has highlighted social and health disparities that
lead to poor outcomes for older adults, diminishing their ability to continue to lead meaningful
and productive lives (Crewe et al., 2018; Gonzales et al., 2018). Both Grand Challenges identify
ageism and stigma as a major aspect that needs to be addressed to reduce social isolation and
increase social connection within communities and across generations (Crewe et al., 2018;
Gonzales et al., 2018). The COVID-19 pandemic has increased the belief that older adults are
frail, vulnerable, helpless, non-contributing members of society, amplifying the existing ageism
and worsening overall outcomes (Ayalon, 2020). In addition to being 65+, the highest risk
factors for contracting COVID-19 include having a chronic/underlying medical condition and
living in a long-term care facility such as a nursing home; older adults are the most likely to fall
into all categories (APA Committee on Aging, 2020; Ayalon, 2020; de Medieros, 2020). As a
result, seemingly logical inferences about the need to “protect” older adults during the pandemic
actually reinforced negative beliefs and attitudes that homogenize this group, resulting in
increased ageism (Ayalon, 2020; Swinford et al., 2020). The formal definition of older adults as
a high-risk group during this pandemic was also problematic because it further pushed them into
social exclusion and isolation, when they are already among those who are most likely to
experience social isolation in the first place (Rahman & Jahan, 2020).
Social Implications
Despite the negative mental and physical health effects of social isolation being well-
documented and, on the rise, evaluation of these issues is not common practice within healthcare
and social service settings (Perissinotto et al., 2019). While many of the risk factors for social
isolation are often unavoidable and, in fact, typical in the aging process, they can be improved
through increased opportunities for new social connections and roles (AARP Foundation, 2012;
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Flowers et al., 2017; NASEM, 2020). Research suggests that targeting the subjective experience
of social isolation (i.e., loneliness) is paramount to improving socio-emotional functioning (Cho
et al., 2019). As of 2018, there were 72.8 million adults aged 60 and older in the United States
(ACL & AoA, 2020). That number is expected to rise to 100 million by 2040, accounting for
over 25 percent of the population (U.S. Census Bureau, 2020). The combination of population
growth, the reciprocal nature of social isolation and poor mental and physical outcomes, and the
long-lasting effects of the COVID-19 pandemic suggests that this issue will not only continue to
persist into the future, but it will be significantly magnified.
Key Indicators of Well-Being
Maintained social connection is a significant predictor of overall health and wellness
throughout the lifespan (Forum, 2016). As older adults experience aging-related stressors and
transitions, social connection remains a key protective factor, improving and maintaining well-
being even into very old age (85+) (Cherry, et al., 2013; Cherry et al., 2016; Fogleman & Canli,
2013). As one ages, the likelihood of experiencing depression, anxiety, and general cognitive
decline significantly increases. Coupled with changes in physical functioning, new illnesses,
role/identity shifts, and loss, older adults as a group are at a greater risk for suicide, loneliness,
and isolation (Forum, 2016; Lazar et al., 2014; SAMHSA, 2015). While it is often assumed that
older adults often have more time for social activities, research shows that for those aged 60-74,
only 11 % of that time is dedicated to social relationships and communication; for those 75+, that
number drops to 9% (Forum, 2016). The development of meaning and purpose, often fostered
through social connection, is significantly associated with healthy aging outcomes including
reduced instances of dementia, cardiovascular events, and decreased mortality. Older adults who
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have strong social connection, purpose, and identity have even been shown to recover from
social stressors faster than those without (Fogleman & Canli, 2013; Han et al., 2019).
Continuity Theory and Older Adult Social Isolation
Continuity Theory asserts that successful aging and well-being is achieved when older
adults can substitute new activities and roles for those that they lost due to aging transitions
(Atchley, 1989; Schroots, 1996). Centered on the idea that self-identity is a crucial factor in
overall wellness, this theory suggests that these new activities or roles should complement and
amplify self-identity so that older adults are able to successfully adapt to their changing lives. In
viewing the problem of older adult social isolation through this lens, it helps to contextualize
both reasons for why it is occurring and how the issue can be improved. When meaningful roles,
activities, and connection are maintained, older adults will have better overall emotional
adjustment to life in the wake of aging transitions such as an empty nest, retirement, and the
increase in physical ailments (AARP Foundation, 2012; NASEM, 2020). Given this information,
it stands to reason that providing opportunities for both older adults and younger generations to
connect can improve the wellness trajectories and reduce social isolation for current and future
older adults.
Solution, Innovation, and Theoretical Framework
Connecting Older Adults to Community for Health, or the COACH Program, is a time-
limited therapeutic offering designed to address the emotional impacts of and contributing
factors to older adult social isolation (Day, 2020b). COACH aims to: improve older adult mental
health outcomes; positively shift older adult and student perceptions of aging; and increase older
adult social connection. This will be achieved by incorporating the use of intergenerational
pairings (with university students), storytelling, and evidence-based reminiscence and cognitive-
8
behavioral interventions that when combined will target the causes and impacts of social
isolation at multiple levels. COACH would be best supported within a community agency setting
that serves older adults. The initial pilot runs will be run within Humboldt Senior Resource
Center Behavioral Health Services department (HSRC-BHS), partnering with the Humboldt
State University (HSU) Social Work Department to utilize student interns. Consistent with other
manualized treatments and health promotion programs for older adults, COACH is designed to
be completed in 15 weeks of participation (Day, 2020a).
The program will consist of two weekly group sessions: one therapeutic group focused on
reminiscence and cognitive-behavioral interventions, and one intergenerational pairing group
focused on the telling and creation of a digital story. Groups will consist of 8 community-
dwelling older adults and content explored in the therapeutic group will be further developed in
the intergenerational pairing group. Participants will work with intergenerational partners to tell
their story in a digital format. The culmination of the program will include a community
presentation of these digital stories to bring greater understanding and awareness of the wisdom,
knowledge, and value that older adults bring to the world (Day, 2020a). COACH furthers the
Grand Challenges to Eradicate Social Isolation and Advance Long and Productive Lives by
creating opportunities for older adults to find social connection, directly targeting ageism,
generating programming that can positively alter health trajectories, and adding to the knowledge
base of healthy aging (Crewe et al., 2018; Gonzales et al., 2018).
Supporting Evidence for COACH Components (Why it Will Work)
There are several evidence-based treatments to effectively improve older adult depression
and anxiety that will, in turn, increase physical health, reduce functional disability, and mitigate
suicide risk. Among those most highly recommended are group cognitive-behavioral therapy and
9

group life review/reminiscence therapy (APA, 2019; SAMHSA, 2011; Wetherell et al., 2013).
CBT is a mainstay of mental/behavioral health treatment across groups and focuses on helping
individuals in understanding the connection between thoughts, feelings, and behavior to improve
functioning (APA, 2019). RT is a talk therapy intervention that focuses on using the five senses
to prompt memories with the goal of increasing self-esteem, reducing social isolation, and
improving cognitive functioning. Both treatments are considered highly efficacious for older
adults and are demonstrated to reduce anxiety and depression, increase physical activity and
social interaction, and improve mental well-being in older adults (Huang et al., 2015; Lazar et
al., 2014; Wu et al., 2017). In fact, group CBT and RT interventions can be as effective at
treating depression and anxiety as psychotropic medication (APA, 2019; SAMHSA, 2011).
Research has long shown the benefits of intergenerational pairings. They offer a more
community-oriented avenue through which socio-emotional functioning of older adults can be
addressed, with the bonus of improving wellness outcomes for all involved (Stanford Center on
Longevity, 2016). This type of pairing yields significant increases in generativity, well-being,
self-satisfaction, and feelings of accomplishment (Aguilera-Hermida et al., 2019; Mitchell et al.,
2015). Other outcomes of these pairing types include increased social connectedness, meaning,
purpose, self-continuity, and self-confidence (Stanford Center for Longevity, 2016; Wildschut et
al., 2018; Wlodarczyk, 2019). Perhaps most notably, these pairings have been shown to result in
increased generational and cultural understanding as well as reduced ageism and stereotyping,
directly impacting individual and societal beliefs that harm older adults (Dinkins, 2019; Hahn et
al., 2018).
Additionally, storytelling has been identified as an appropriate technique to use across
cultures to improve mental and physical health, increase social connection, meaning, and
10
purpose, and promote multicultural understanding and respect (Bieti et al., 2019; Chongruska et
al., 2010; Nguyen et al., 2018). It is a key component of RT and often the mechanism through
which intergenerational interactions are facilitated. Digital storytelling can further enhance
wellness as it provides older adults with a tangible, visual, and historical record of their life that
offers validation for their lived experience. When older adults can engage in storytelling of any
sort, they strengthen their self-identity, resilience, and overall life satisfaction (Mager, 2019).
Stakeholder Perspectives
Interviews with key stakeholders surrounding this issue mirrored the research and
provided deeper insight as to root causes and sustaining factors of social isolation. Though a
range of older adults with differing cognitive functioning, job status, education levels, income
status, social supports, and racial backgrounds were interviewed, almost all felt that negative
stereotypes and ageism negatively impact their overall well-being (Day, 2020b). They also noted
that natural transitions associated with aging reduced their social connections and it became
harder to create and maintain new ones. Family members interviewed expressed frustration with
lack of support and opportunities to provide sufficient health and social care for their aging loved
ones, noting that the burden often fell to them. Research and stakeholder interviews also pointed
to the benefits and usefulness of intergenerational pairings as an avenue to meet the socio-
emotional needs of older adults (Day, 2020b; Mitchell et al., 2015).
Interviews with healthcare and social service professionals echoed older adult sentiment
about ageism and harmful societal messaging. It was suggested there was a shortage of
practitioners adequately trained to understand the unique experience and needs of older adults,
let alone tailor programming for them (Day, 2020b). Top officials within the California
Department of Aging (CDA) and the Administration for Community Living (ACL) highlighted
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continued social connection as the highest predictor of older adult well-being and suggested that
societal beliefs about older adults need to be changed to increase positive outcomes for older
adults (Day, 2020b). The ACL acknowledges social isolation of this group as a top concern and
is currently promoting the #CommitToConnect campaign, which seeks to address social isolation
through building a nationwide network, developing a user-friendly online tool to help those who
are socially isolated, establish partnerships in communities and government, and share success
strategies that can be implemented in communities (CommitToConnect, 2021).
Universities are another stakeholder group in that they educate and train future
generations of professionals that will interact with this problem. Humboldt State University
(HSU) Social work department churns out 20-30 new graduates each year that are going directly
into the social service field. Interviews with students and the Director of Fieldwork revealed that
specific education, training, and internship opportunities in the field of gerontology and geriatrics
is severely lacking. The Director also shared that while the department teaches the value of
intergenerational relationships, they still need help cultivating community opportunities for
students to engage in these interactions (Day, 2020b).
Potential for Success
The COACH program has a significant likelihood of success. The problem it targets is a
widespread issue that is acknowledged by multiple stakeholder groups, including older adults
themselves. The methods used to target the problem components (depression, anxiety, loneliness,
negative perception on aging) are evidence-based and demonstrated to be effective at improving
older adult outcomes. COACH already has a “home” in HSRC-BHS and a strong connection
with the HSU Social Work Department Director of Field Education. The pilot design provides
the opportunity to gather strong data, evaluate real-world effectiveness, and reduce costs as
12
compared to other design types. It has a well thought out methodology, implementation plan, and
evaluation plan that promotes scalability and expansion of the program into areas other than
Humboldt County. Perhaps most importantly, plans to pursue evidence-based certification of
COACH upon pilot completion reduces barriers to access for agencies looking for ways to
address older adult social isolation and loneliness in their community, increasing the likelihood
that they will pursue COACH as an option.
Project Structure, Methodology, and Action Components
Over 80 organizations, initiatives, and programs targeting older adults and healthy aging
were examined to identify the range and accessibility of services available, needs targeted, and
areas for innovation and opportunity. Current solutions to address issues associated with aging
often fall under the category of Home-Based Community Services (HBCS) and care
management programs, which seek to reduce high healthcare utilization by offering frail older
adults supportive services in or close to their home in efforts to avoid institutionalization (CMS,
2019, Day, 2020b). Several organizations exist that help to propel innovation in aging forward,
notably the National Institute on Aging (NIA), whose goal is to engage in research that helps
increase lifespans, enhance health, and reduce illness and disability (NIH, 2017). The American
Society on Aging (ASA) supports cross-disciplinary connections and research in aging needs and
services and created the Reframing Aging Initiative to address the stigma and stereotypes that
lead to widespread misunderstanding and discrimination of older adults (ASA, 2020).
Many organizations look to the Administration for Community Living (ACL) for
guidance on older adult programs, as they proctor the Older Americans Act (OAA) which
establishes the basis older adult services across the nation, provides funding opportunities, and
certifies older adult programming as evidence-based (ACL, 2018; Boutaugh & Lawrence, 2015;
13
NCPSSM, 2018). Of 59 programs meeting evidence-based criteria under the ACL, most focused
on reducing fall risk, managing chronic diseases, and increasing physical activity, while only 5
focused on addressing mental health. Each program improves older adult depression and
integrates evidence-based models and techniques such as psychoeducation, CBT, skill-building,
and collaborative care.
IMPACT (Improving Mood—Promoting Access to Collaborative Treatment) is an
integrated collaborative-care model implemented in primary care settings to address older adult
depression through a collaborative care/integrated model (AIMS Center, 2019; SPRC, 2012).
PROSPECT (Prevention of Suicide in Primary Care Elderly: Collaborative Trial) is a primary
care screening/triage program for older adults to prevent suicide, reduce risk of death, and reduce
suicidal ideation and depression (NREPP, 2016). Healthy IDEAS (Identifying Depression,
Empowering Activities for Seniors) is a program for depression awareness and management that
is meant to be integrated into existing care management programs for older adults to help
improve quality of life (Healthy Ideas, 2017). PEARLS (Program to Encourage Active,
Rewarding Lives for Seniors) is designed to reduce depressive symptoms and improve health-
related quality of life for older adults with minor depression and who are receiving home-based
social services (ACL, 2007). WISE (Wellness Initiative for Seniors) is a psychoeducational
prevention curriculum for older adults focusing on substance use, early signs of depression, and
psychological well-being (NJPN, n.d.). While these programs utilize evidence-based techniques
to address mental health symptoms, the COACH Program takes it one step further by integrating
culturally responsive techniques of storytelling and intergenerational interactions to directly
address the negative effects and root causes of older adult social isolation and loneliness.
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COACH Implementation Planning
The EPIS (Exploration, Preparation, Implementation, Sustainment) Framework was
chosen to guide the COACH implementation process as it primarily focuses on the
administration of evidence-based practices (EBPs) within social/health service settings. There is
a high focus on planning, evaluation, testing, and adaptation, which are all paramount to an EBP
achieving desired client, process, and implementation outcomes. It prompts implementation
teams to identify inner context (organizational environment) and outer context (external
environment) features at each stage that can act as barriers or facilitators to the process (Moullin
et al., 2019). It also encourages consideration of bridging factors that provide connection
between inner/outer context features, as well as characteristics of the EBP being implemented
that can promote success. Though implementation strategies vary during each phase based on
specific activities, the use of evaluative/iterative strategies was a constant throughout and is
identified as a main strategy for the COACH Program. Key tasks and timeframes for each stage
are described below (see Appendix A for COACH Gantt Chart).
Exploration
The exploration phase was completed in one year and focused on the identification of a
problem (social isolation/loneliness), a target beneficiary group (adults aged 60+), and a practice
through which to address it (COACH). Federal/state policies and legislation such as the Older
Americans Act (OAA) and the California Master Plan for Aging (MPA) were identified as key
facilitators as they champion the creation of programming that meets the unique needs of older
adults and acknowledge social isolation and loneliness of older adults as a pressing concern
(ACL, 2020; CDA, n.d.; NCOA, 2020). Characteristics of HSRC (the implementing agency)
was identified as a potential barrier as many staff available to assist with COACH
15
implementation did not possess the necessary knowledge or skills and did not demonstrate a
readiness or perceived need for change (movement toward addressing the problem).
Though difficult to address, this barrier was mitigated through the HSRC CEO’s
leadership and champion status, a key bridging factor. Her positionality/authority within HSRC
carried weight in both the internal structure and within interorganizational relationships and
helped gain staff commitment. Main strategies used at this phase were evaluative/iterative, and
focused on activities such as needs assessments, readiness assessments, and skills development
to increase staff buy-in. The task of developing stakeholder relationships was a focus and
included getting approval from the HSRC Board of Directors/CEO and engaging HSU Social
Work Fieldwork Liaison in the process as a partner.
Preparation
The preparation phase is in process and will last up to a year and a half. It is focused on
planning for the incorporation of COACH into HSRC. During this time, it has been solidified
that COACH will be operated through the new Behavioral Health Services (BHS) department of
HSRC. This has helped address the continued barrier of role specialization/skills, as BHS clinical
staff are being hired and earmarked for COACH implementation support. Funding has been a
facilitator with the creation of BHS, with two grants being already received and the development
of a fee-for-service structure to promote self-sustainment (insurance billing).
This phase puts considerable focus on how easy the COACH processes are for the team
to learn and understand, their perception of feasibility in integrating it, and the cost in both time
and resources to increase the likelihood of the team getting on board (Moullin et al. 2019).
Evaluative/iterative strategies such as creating the implementation plan, fidelity and quality-
monitoring system, and scalability plan are being used to set the groundwork for successful
16
implementation and sustainment phases.
COACH prototypes were created during this phase. Facilitator lesson plans were
completed for all 15 weeks of each COACH group (therapeutic and intergenerational) that show
the overall content of each group session, including objectives, facilitator scripts, activities, and
handouts. The lesson plans provide a detailed explanation of what an older adult participating in
COACH will experience in each group weekly. A mock-up of the pilot flyer was also created to
show that the participant recruitment process has been well-thought out and planned. Both
prototypes will be used to demonstrate functionality and implementation readiness of the
COACH pilot to the HSRC CEO, Board of Directors, and the HSU Social Work Department
Staff (see Appendix B).Tasks left to complete include execution of formalized written
agreements with HSRC and HSU outlining rights, roles, and responsibilities related to COACH
implementation and pilots.
Implementation
The implementation phase will focus on the actual facilitation of the COACH pilots and
may take up to 2 years. Interorganizational networks/relationships could act as facilitators or
barriers depending on how well they are developed and monitored. This is a crucial piece to the
implementation phase as organizational partnerships are paramount to COACH pilot success.
During initial stakeholder engagement, pursuing partnership with United Indian Health Services
(UIHS) and/or Open-Door Health Clinics (ODHCs) for the COACH pilot runs was considered,
but the logistics navigating a partnership of four of the largest community organizations in
Humboldt County proved too complicated. Due to this, it was decided that HSRC would
complete the first pilot in partnership with HSU only so that clear roles could be established,
implementation could be streamlined, and barriers to testing the solution could be reduced. Once
17

pilot results are evaluated and organized, they will be presented to UHIS and ODHC Behavioral
Health leadership respectively to gage their willingness to facilitate another pilot in conjunction
with HSRC. Facilitation of a second pilot will help demonstrate that COACH can be translated to
another subgroup of older adults such as Tribal Elders. Strategies such as obtaining and
integrating beneficiary feedback will be used in this stage to assess where implementation could
be improved from a user standpoint. Providing interactive assistance to the implementation team
through facilitation, clinical supervision, and technical assistance will promote fidelity, problem-
solving, clarification, and understanding of the implementation process.
Sustainment
The sustainment phase focuses on ensuring the integration of COACH within HSRC-
BHS and the expansion (scalability) to other agencies, with special attention to quality assurance,
monitoring, and funding maintenance (Aarons et al., 2011; Moullin et al., 2019). Though this
phase is indefinite, most activities described below will occur within the first 2 years. Like other
phases, legislation, client advocacy organizations, and funding sources act as facilitators. The
Administration for Community Living (ACL) represents all those domains. The ACL has a
process by which they certify senior services EBPs while also being the body that proctors the
Older Americans Act (OAA) (ACL, 2018). Once a program is certified as an EBP, a senior
service agency can access funds to implement that program through the OAA Title III-D and
Title VI (ACL, 2020). Possible barriers to expansion include agencies not having the appropriate
structure, skills, specialization, or fidelity monitoring knowledge to implement COACH
effectively. Activities during the first year will include publishing data from the pilot run and
pursuing evidence-based status through the ACL. Activities during the second year are
18
predicated upon that certification and include creating a dissemination plan, training 5 agencies
in California to implement COACH, and marketing COACH nationwide.
Financial Plans and Strategy
The COACH Program will operate under the financial auspices of the Board of Directors
of Humboldt Senior Resource Center (HSRC), a private, non-profit 501(c)(3) agency. During
the first full year of operations (FFYO) and beyond, COACH will expand interactions with the
public and private for-profit sector but will remain oriented within HSRC-BHS. Approximately
3 years and $265,965 are needed to complete the COACH start-up phase (implementation and
sustainment) which focuses on pilot runs and the evidence-based program certification process.
Costs for the FFYO total $82,925 and focuses on training 5 agencies in California to implement
the COACH Program (Day, 2020b; Day, 2020c). Costs for both the COACH start-up phase and
the FFYO total $348,890, for an average expense of $87,223 per year (see Appendix C for
COACH Operating Budgets).
Personnel costs for the Start-Up phase total $212,800 and include direct salary and
fringes for four staff. Costs for the COACH Director, Clinical Coordinator, and Research
Assistant will be seen for all three years while costs for the Marketer/PR Specialist will be seen
during the final year only. The COACH Director requires certification as a Licensed Clinical
Social Worker (LCSW) with a minimum of 5 years of experience in the administration, training,
and implementation of evidence-based therapy programs within social service agencies.
Additional requirements include 5+ years of facilitating group therapy and a minimum 2 years
providing clinical supervision. This position requires approximately 10 hours per week at a rate
of $46.38/hr for a total 3-year cost of $73k. The Clinical Coordinator requires certification as an
LCSW with a minimum of 2 years’ experience providing cognitive-behavioral therapy. Position
19
tasks include assisting the COACH Director in pilot participant recruitment, training
intergenerational student partners, and providing individual counseling to the pilot comparison
group. This position is 10 hours per week at a rate of $32.66/hr for a total 3-year cost of $51k.
The Research Assistant requires a minimum of a Bachelor’s in psychology, social work,
or related field with at least one year as a research assistant. Duties include administering
psychometric outcome measures pre and post pilots, evaluating and interpreting the data, and
presenting the data to the COACH team and other stakeholders. This position requires
approximately 10 hours per week at a rate of $25/hr, for a total 3-year cost of $39k.
The Marketer/PR Specialist requires a minimum of a Bachelor’s in journalism, public relations,
communications, or related field and 5 years of experience with marketing for a social service
agency. The Marketer/PR Specialist will create marketing and dissemination plans, promote the
program and its results, and create relationships with agencies interested in implementing the
program. This position is needed 5 hours per week at a rate of $38.46/hr for the final year of the
start-up phase, for a total cost of $10k.
Operating expenses for the Start-up phase total $56,135 over three years. The three
largest expenses include Occupancy/Rent ($10,665), Pilot Tech ($10,000), and Staff Tech
($6,500) for a total of $27,165 over 3 years. Other expenses of note include $5k for
Communication and Materials (costs associated with advertising in print, digital, and virtual
media as well as psychometric outcome measures and materials for COACH Program groups)
and $5k for Professional Fees (costs associated with the process of getting the COACH Program
certified as an evidence-based practice through the ACL).
Personnel costs for the FFYO total $52,925 and include salaries/fringes for three staff:
COACH Director, Marketer/PR Specialist, and an Administrative Assistant. Approximately 600
20
hours will be allotted for the Director at $46.38/hr, for a total cost of $27,828. Tasks will include
presenting about COACH to key stakeholders and providing implementation training to 5
agencies in California. The Marketer/PR Specialist will be needed 5 hours per week at a rate of
$38.41/hr, for a total cost of $10k. Important tasks include COACH promotion and connecting
the COACH Director with target populations to provide presentations about the program. The
Administrative Assistant position requires a high school diploma or equivalent, at least 2 years of
experience performing administrative and clerical duties and working knowledge of the HSRC
agency and its services. Tasks include scheduling training sessions, making travel arrangements,
preparing materials, and fielding initial calls about COACH. This position requires 5 hours per
week at a rate of $20/hr, for a total cost of $5,200.
Operating expenses for the FFYO total $30,000. Communications and Materials
represent one of the largest non-personnel operating expenses at $10k. This includes materials
for presentations, the creation of physical and digital copies of a COACH Program Manual, and
any print, digital, or virtual advertising costs to promote the program to the public. Travel
represents the other largest expense at $10k and accounts for flights, mileage reimbursement,
lodging, and meals for the COACH Director when presenting at conferences or training agencies
on COACH implementation. Lastly, Professional Fees account for $5k of the FFYO budget, and
include costs for professional association memberships, conferences, and symposiums.
Program Revenues
COACH will be embedded within the BHS department of the non-profit HSRC agency
and take advantage of existing revenue sources. Most funds for the Start-Up phase will come
from BHS insurance billing ($90k) and two grants totaling $114k (Webb Foundation and
Headwaters Fund) which have already been received. Community donations comprise $40k in
21

revenue, with a $25k gift received from a local lumber company (Schmidbauer) and $15k in
individual donations generated from a targeted BHS Spring 2021 mailer campaign. In-kind tech
donations of $10k is currently being pursued through Humboldt Area Foundation, who has a
long history of in-kind tech giving to HSRC, recently providing tablets and Chromebooks to
older adult program participants to improve their access to services and socialization. Surplus
funds generated from HSRC’s Redwood Coast PACE (a managed health plan) will provide the
remaining $11,965.
During the FFYO, COACH will be a revenue-generating product through the
transactional fee-for-service method. Generated revenue will combine with funds from the
HSRC-BHS budget to cover both personnel and other operating expenses of the FFYO.
Projected revenue for the FFYO totals $82,925 and will come from BHS insurance billing
($42,925) and fees charged to agencies for COACH implementation training ($40k). Agencies
will be charged $6k in training fees and $2k for COACH Director travel, lodging, and meals, for
a total of $40k. Revenue generated from COACH fees will continue to grow after the FFYO and
move toward funding the entire operating budget.
Financial Conclusions
Though revenue generation from COACH is not projected to occur until the FFYO, start-
up costs are time-limited, relatively low for the time frame, and revenue sources are already
solidified. Revenue needed during the FFYO is even lower, at $82,925, requires funding from
less sources, and begins to generate its own revenue from fee-for-service transactions, increasing
the potential for sustainability. In the FFYO, COACH becomes a product marketed to outside
agencies and is a logical addition to the HSRC-BHS department, which also uses a fee-for-
service model to generate revenue. While the cost for COACH training is on par with other
22
evidence-based therapeutic programs, it may still present a barrier to agencies. This risk is
mitigated through pursuit of EBP certification with ACL, which makes funding available
through the OAA to Tribal and non-Tribal agencies who wish to implement EBPs.
Methods to Assess Outcomes and Impact
Each pilot run of COACH will be completed over 15 weeks with a sample size of 8
community-dwelling adults aged 60 and older and a matching number of social work students
from Humboldt State University (Day, 2020a). Outcomes will be measured pre and post
intervention through psychometric measures validated for use with the older adult and/or student
populations and across cultures. Measures will be administered for target groups by the same
trained staff member pre and post intervention to aid in fidelity and increase comfort of the
participants. The shortest versions of each measure were chosen for use unless they did not
demonstrate comparable reliability and validity to their full item versions. This can help reduce
the fatigue that individuals may experience when being asked to complete too many lengthy
questionnaires. Qualitative data will be gathered through focus groups and/or individual
interviews facilitated upon pilot completion to gather insight as to the older adult and student
participants’ thoughts and experience during COACH. A COACH team staff trained in
strengths-based interviewing will facilitate the focus groups/interviews (Day, 2020c)
COACH pilots are quasi-experimental in design with an equivalent comparison group of
8 adults who are receiving standard outpatient counseling through HSRC-BHS. While quasi-
experimental design is limited in its ability to discern causality of outcomes, it is more
advantageous for use in a social service setting as it evaluates real-world intervention
effectiveness. By using a comparison group and multiple measures over time (as planned in
COACH pilots), the strength of data is increased, and selection bias limited (Schweizer et al.
23
2016). Perhaps most importantly, the cost (in time, resources, and money) is significantly lower,
which increases the likelihood that the COACH pilots will be able to be completed within the
structural and financial confines of HSRC and Humboldt County.
Sampling Method and Ethical Considerations
Pilot samples of older adults aged 60+ will be gathered through convenience sampling.
The COACH pilots will be advertised via electronic and printed flyers sent out through Area 1
Agency on Aging (A1AA) and HSRC email lists and posted on the websites (see Appendix B).
Flyers will be physically posted and available to take home in the HSRC Behavioral Health,
UIHS Behavioral Health, and Open-Door Clinics Behavioral Health offices and in local coffee
shops. Informed consent paperwork will be completed prior to participation. Though samples
will be composed of older adult volunteers, some may be screened out prior to participating if
they do not meet the minimum criteria, with specific regard to their scores on social
connectedness and loneliness scales. Any individuals not chosen for pilot participation will
receive referrals for other behavioral health or support services. Staff at each site where flyers are
posted will be instructed to refrain from asking older adults to participate to reduce any real or
perceived coercion. Participation will be free of charge and participants will receive a gift card to
a local coffee shop for their time. A total of 16 volunteers will be chosen for participation. The
COACH Research Assistant will administer the psychometric measures to the volunteers and a
simple Excel formula will be used to assign them to random groups of 8. Group A will receive
standard outpatient individual counseling with the COACH Clinical Coordinator and Group B
will receive the COACH intervention with the COACH Director.
Goals and Outcome Objectives
Goal 1 is to improve mental health outcomes of older adults participating in COACH.
24
Outcome Objective 1 is to reduce older adult depression by 30%, anxiety by 20%, and loneliness
by 20% as measured by the Geriatric Depression Scale (GDS-15), Generalized Anxiety
Disorder-7 (GAD-7), and the UCLA Loneliness Scale (ULS-6). A 30% reduction was chosen as
randomized controlled trials utilizing cognitive behavioral group psychotherapy with older adults
yielded an average of 37% improvement in depression (Hummel et al., 2017). A 20% reduction
for anxiety was chosen as it is consistent with improvement outcomes in the literature examining
CBT use with older adults (Gorenstein, 2007). Research shows that when older adults are treated
for depression and anxiety using CBT, their loneliness improves at similar rates, leading to the
choice of a 20% reduction in loneliness (Smith et al., 2020).
Goal 2 is to positively shift older adult and student perceptions of aging. Outcome
Objective 1 is to increase positive attitudes about aging in older adults as measured by the
Expectations Regarding Aging-12 (ERA-12) Survey. Outcome Objective 2 is to increase
students’ positive attitudes as measured by the Kogan’s Attitudes Toward Old People Scale.
Process Objective 2 is to conduct 1x weekly intergenerational pairing groups for 15 weeks as
indicated by COACH Program structure. A meta-analysis of 63 studies showed that
interventions with intergenerational interactions produced the most profound improvements on
the specific criterion of attitudes toward aging as opposed to knowledge about aging,
comfort/interest in working with older adults, and anxiety about aging (Burnes et al., 2019).
Goal 3 is to increase older adult social connection. Outcome Objective 1 is to increase
the number of older adult social connections by 1 as measured by the Abbreviated Lubben Social
Network Scale (LSNS-6). Social connectedness is considered a social determinant of health and
research shows that increasing the number of connections even by an increment as small as 1
will improve outcomes (NASEM, 2020). Measures to assess the three COACH aims were
25
chosen for their ease of use and reliability and validity with older adults (Cronbach’s alpha for all
measures were between .82 and .94) (Day, 2020c).
Process Outcomes and Operational Efficiency
A logic model was created to functionally demonstrate how the COACH program will
achieve desired outcomes and impact (see Appendix D). The COACH team provides a range of
inputs including trained staff and student partners, a physical/virtual program space, technology
and equipment, materials, and funding. Evidence-based techniques, knowledge and experience
implementing EBPs within social service systems, implementation team time, and community
partnerships are some of the key inputs that will help facilitate success. Output activities focus on
COACH Program pilot facilitation, which consists of administering measures to assess
participant functioning pre and post COACH participation and providing 2x weekly groups for15
weeks.
In the short-term, older adults who participate in the COACH Program are projected to
show a decrease in depression, anxiety, and loneliness, and a positive shift in attitudes about
aging, assessed using validated psychometric measures. Intergenerational student partners are
anticipated to demonstrate a positive shift in their perception of older adults and aging, assessed
through validated attitudes toward aging scales (Day, 2020a). Long-term outcomes include
improved older adult mental health symptoms, COACH being certified as EBP though the ACL,
and implementation of COACH in 5 agencies within California within the first year and 1 Tribal
and non-Tribal agency per state (total 122 sites) within 20 years. Overall systemic and direct
impacts include decreased ageism, reduced social isolation for current and future generations of
older adults, increased intergenerational connectedness, and reduced older adult healthcare
utilization (Day, 2020c).
26
Potential Pivot Points
It is also important to assess implementation effectiveness so that if projected
intervention outcomes are not reached, it can be discerned whether it was because the
intervention was ineffective or because the intervention was not correctly executed (Proctor et
al., 2011). The Acceptability of Intervention Measure (AIM), the Intervention Appropriateness
Measure (IAM), and the Feasibility of Intervention Measure (FIM) will be used to assess
acceptability, appropriateness, and feasibility. Though relatively new, these three measures were
developed to address a gap in psychometric measures of these implementation outcomes and
demonstrated structural validity and internal reliability with a Cronbach’s alpha between .87 and
.89 in early examination (Weiner et al., 2017). Fidelity will be measured through a facilitator
checklist that will be completed at the end of each group session during the pilot. Sustainability
will be measured through the Program Sustainability Assessment Tool (PSAT). This tool was
designed for use within public health programs and demonstrates high internal validity on all
subscales, with an average Cronbach’s alpha of .88 (Luke et al., 2014).
Acceptability and appropriateness will be measured during the Preparation phase as it is
important to assess these features prior to the actual adoption/implementation (Proctor et al.,
2011). Feasibility and fidelity will be measured during the Implementation phase; this will yield
the most useful information about how the actual processes are occurring as well as individual
team member perception about functionality in uptake of the program (Proctor et al., 2011).
Sustainability will be measured during the Sustainment phase by the implementation team.
Survey measures will be administered to the implementation team anonymously and reconciled
by the lead evaluator to increase likelihood of honest answers. Measurements that rely on
observation and/or checklists will be completed by the COACH Director.
27
Ethical and Cultural Considerations
Stakeholder engagement has been made a priority throughout the creation process of
COACH and will remain so during the pilot and evaluation phases (Day, 2020c). A range of
older adults were interviewed throughout the design process with respect to gender,
socioeconomic status, race, ethnicity, work status, and physical functioning status to gain their
insights as to current needs and possible solutions. The COACH core components of
intergenerational pairings, storytelling, and cognitive behavioral and reminiscence therapy
interventions were selected because of their effectiveness with older adults across cultures, their
ability to address the issues identified in the research and through stakeholder interviews, and
their efficacy in achieving the three main goals of COACH (Day, 2020c).
While psychometric measures were chosen for their reliability and validity in measuring
specific outcomes across cultures, using other evaluation tools such as open-ended interviewing
provides another way to gather relevant feedback and data. This qualitative approach is an
evaluative tool that is more inclusive of all voices, especially those who have been historically
marginalized or overpathologized (Rodriguez et al., 2011). Interviews or focus groups can also
provide a wide range of rich data that would not normally be captured through psychometric
means. Upon completion of each pilot round of COACH, individual interviews and/or focus
groups will be conducted based on the preferences of each COACH participant cohort (Day,
2020c). Participants will be asked for their permission for the interview to be recorded and will
have the option of video and audio, audio only, or not being recorded at all. The interview will
be conducted by a staff member trained in strengths-based interviewing. Questions will be open-
ended and neutral in efforts to allow for the participants to share their thoughts in a way that is
most meaningful to them. Interviews will center on the prompt, tell me about your experience
28
participating in this program. Prompting and clarifying questions will be asked as participants
share their thoughts. Insights gathered through this process will be used to adjust or improve the
COACH model (Day, 2020c).
Conclusions and Implications
Social isolation of older adults in the United States is an issue that continues to grow,
significantly impacting healthcare systems, federal spending, social service programs, families,
and older adults themselves. In viewing this problem within the context of the Grand Challenges
to Advance Long and Productive Lives and Eradicate Social Isolation, the COACH Program can
be seen as an avenue through which systems can take a more proactive and preventative
approach to solving the issue rather than simply being reactive, as is the status quo (Crewe et al.,
2018; Gonzales et al., 2018). The COACH Program has high impact potential to promote healthy
aging for future generations by emphasizing the importance of continued social connection to
mitigate the effects of negative experiences in earlier life, which are amplified in older age (Holt-
Lunstad, 2018). The COVID-19 pandemic has made social isolation of older adults even more
salient, increasing the urgency of an already widespread issue (Day, 2020a). By improving older
adult mental health functioning, COACH increases the potential for a reduction in their
healthcare utilization, decreasing the amount of federal spending that goes into addressing the
current effect of older adult social isolation and helping to prevent it in the future.
Relevance in Aging Services
The Administration for Community Living (ACL) offers funding for evidence-based
health promotion and disease management programs through Title III-D and Title VI of The
Older Americans Act (OAA). This makes these programs available to agencies in all U.S. States
and Territories as well as 282 Indigenous entities representing service to 400 Tribes (ACL, 2020;
29
NCOA, 2020). Upon completion of a successful pilot(s), certification as an evidence-based
program through the ACL will be pursued to make COACH nationally available with funding,
acting as a disruptive innovation with the potential to help start a big shift toward successfully
addressing older adult social isolation in the United States (Satell, 2017). This disruption would
work to change harmful societal beliefs about older adults while instilling new beliefs in younger
generations about the importance of social connection throughout the lifespan. Once available to
be funded through the OAA, the largest and farthest-reaching entity of older adult services,
COACH will be a part of putting this disruption into action.
When compared to other evidence-based programs for older adults, COACH is unique in
that it integrates multi-level interventions, uses culturally responsive techniques and approaches,
and engages both the individual and community to improve mental health outcomes and reduce
social isolation (Day, 2020b, NCOA, 2020). The COACH Program acts as a breakthrough
innovation in that it combines evidence-based approaches in a new way to improve the
intractable problem of older adult social isolation at the individual, community, and national
level (Satell, 2017). It is unlike other evidence-based programs targeting older adult mental
health because it concurrently works to address the negative emotional impacts of social
isolation while mitigating the stigma that serves to sustain it in the first place.
Advancing Further Action and Next Steps
To promote COACH sustainability after achieving evidence-based status, a targeted
communication/dissemination plan is vital to reach the desired audience. Marketing and outreach
will first be targeted to aging service agencies in California to help reach the first-year goal of
training 5 agencies to implement COACH. Facilitating a series of in person and web-based
presentations, attending aging service or evidence-based practice conferences, and sending out
30
informational materials to agencies will be the three main approaches. The COACH Director
will leverage their position as secretary of the MSA, an association of Multipurpose Senior
Service Program (MSSP) sites across California, as a networking opportunity for COACH.
Individual virtual meetings will be held with MSSP site directors to share about COACH and
gauge agency interest. This positionality will also be used to gain audience with the Director and
Deputy Director of the California Department of Aging (CDA), which is the state governing
body of MSSP. The California Institute for Behavioral Health Solutions (CIBHS) will also be
approached to propose including COACH in their annual evidence-based practice symposium.
Informational materials will include a short form video detailing the COACH elements and its
efficacy as well as a “one sheet” outlining the program objectives, components, training cost, and
training timeframe. After implementation goals have been reached in California, steps for
expansion into other states will include applying to present about COACH at national
conferences put on by key entities such as the American Society on Aging (ASA), the National
Council on Aging (NCOA), and the National Association of Social Workers (NASW).
Relevance and Future Implications
It is clear that new approaches should be taken to respond to the unique needs of the ever-
changing older adult population. The COACH Program provides an innovative way to address
these needs while helping to challenge social misperceptions that all older adults are needy,
dependent, and have nothing to contribute (Morrow-Howell et al., 2015). Instead of focusing
solely on aspects of physical health promotion, as most evidence-based programs for older adults
do, COACH works to target socio-emotional factors that, when improved, have a positive impact
on health perception and overall wellness. By connecting older adults to community using
intergenerational pairings, the fight to champion healthy aging can be addressed for future
31
generations as well, instilling the importance of service and societal engagement, and
highlighting the value of the wisdom and knowledge of older adults. Systems that choose to
engage in innovative approaches for older adult programming will not only expand their reach,
but they will help shift societal views about the growing aging population being a problem to
seeing it as an untapped resource (Morrow-Howell et al., 2015). The COACH Program can help
systems take a step in that direction.
32
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Appendix A
8/23/19 1/4/21 5/19/22 10/1/23 2/12/25 6/27/26 11/9/27
Exploration
Preparation
Implementation
Sustainment
COACH Implementation Timeline
Start Date Duration
44
Appendix B
COACH Therapeutic Group Session Plans
Group 1: Intro/Orientation/Psychoeducation
Group 2: The Relationship Between Thoughts, Feelings, and Behavior
Group 3: Self-Regulation, Relaxation, and Coping Skills
Group 4: Self-Regulation, Relaxation, and Coping Skills 2
Group 5: Feelings Identification and Monitoring
Group 6: Recognizing Physical Cues
Group 7: Recognizing Internal/External Triggers
Group 8: Common Thought Traps
Group 9: Thought Reframing and Self-Instructional Reminders
Group 10: Responding vs. Reacting
Group 11: Putting it All Together
Group 12: Role-Play Practice
Group 13: Role-Play Practice
Group 14: Role-Play Practice
Group 15: Review and Goodbyes
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Group 1: Intro/Orientation/Psychoeducation (60 mins)
Objectives:
1. Outline purpose and goals of the group
2. Define group commitments
3. Increase knowledge of mental health symptoms
Materials Needed:
1. Dry-erase board or Large Post-It Pads
2. Pens (dry-erase and enough regular for each participant to have one)
3. Enough small note pads for each participant to have one
Prior to the Group:
Facilitator will set up enough comfortable chairs in a large circle for all participants to have one
Activities:
1. Welcome/Orientation (5 mins)
2. Getting to know you (10 mins)
3. Group commitments (10 mins)
4. Facilitated psychoeducation discussion (30 mins)
5. Wrap-up/preview of next week’s group (5 mins)
Welcome/Orientation:
Facilitator welcomes all members to the group and briefly explains professional background.
Shares that the purpose of the group is improve understanding and recognition of mental health
symptoms and to learn productive ways to manage them.
Getting to Know You:
Facilitator explains that everyone will get a turn to share their response to the prompt “Let’s get
to know each other by sharing our name. Please also share a fun fact about your name such as
who chose it, if it runs in the family, if you wish you had a different name, or if you prefer a
nickname.”
Facilitator will write the prompt on the dry-erase board/post-it pad for group reference and will
start the group off by sharing their answer. As participants share, facilitator will write their
answers on the board/pad and write down any themes. At the end of the activity the facilitator
will thank participants and highlight any commonalities seen to being prompting connection
between group members
Group Commitments:
Facilitator will share that in any group it is important for the members to have a set of
commitments/agreements to make things productive and comfortable for all. Facilitator will
prompt participants to share what commitments are important for them to feel safe in the group.
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Facilitator will offer suggestions to help participants along. If participants do not mention them,
facilitator will make sure to include confidentiality, attendance, refrain from advice-giving/use
“I” statements, the right to speak/the right to pass, one person talks at a time, and meetings
will start and end on time. Facilitator will write group commitments down for future meetings.
Facilitated Psychoeducation Discussion:
Facilitator will share that most of the group will be spent talking about our understanding of
mental health symptoms and learning some fact we may not have known. Facilitator will ask the
following questions and write down group answers. Facilitator will be available to interpret and
provide supplemental definitions to concepts as well as various symptoms.
1. What is mental health?
2. What is depression? What are some symptoms?
3. What is anxiety? What are some symptoms?
Facilitator will give a review of what was learned during the discussion and provide the
following facts to help reduce stigma and begin shifting older adult perceptions:
1. Over 20% of those 55 and older experience some type of mental health concern
2. Most common experiences include depression, anxiety, or cognitive impairment
3. Depression can lead to impairments in social and physical functioning as well
4. Mental health concerns come with increased risk of substance use
5. Depression and anxiety are NOT a normal part of aging
6. Depression and anxiety symptoms can be improved
Wrap-Up/Preview:
Facilitator will thank participants for their engagement and participation and ask if there are any
lingering questions. Facilitator will share that next week’s group will focus on the relationship
between thoughts, feelings, and behaviors.
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Group 2: The Relationship Between Thoughts, Feelings, and Behaviors (60 mins)
Objectives:
1. Assess participant understanding of group commitments and group purpose
2. Continue to foster group connection and comfort
3. Help participants understand how thoughts, feelings, and behaviors are connected
Materials Needed:
1. Dry-erase board or Large Post-It Pads
2. Pens (dry-erase and enough regular for each participant to have one)
3. Enough small note pads for each participant to have one
4. Printed copies of group commitments (including one large copy on Post it-Pad)
5. Printed copies of the Cognitive Triangle Handout (included after group lesson plan)
Prior to the Group:
Facilitator will set up enough comfortable chairs in a large circle for all participants to have one
and will have printed copies of the group commitments for participants to take home.
Activities:
1. Welcome and Review (10 mins)
2. Reminiscence Activity (15 mins)
3. Facilitated Discussion (10 mins)
4. Cognitive Triangle (20 mins)
5. Wrap-Up/Preview (5 mins)
Welcome and Review:
Facilitator welcomes participants to the group and thanks them for returning. Begin review of
group commitments by prompting participants to share which they remember. Provide personal
copies of commitments and post large copy on the wall where everyone can see.
Reminiscence Activity:
Facilitator will ask participants to briefly participate in a reminiscence activity. Facilitator will
read the prompt questions and write them on the board for participant reference: Tell us about the
best meal you have ever had? Where were you? Were you with someone or alone? Who cooked
it? Was it a special occasion or a typical day? Each participant will have a chance to share. Upon
completion, facilitator will provide a synopsis of the activity and thank them for their
participation.
Facilitated Discussion:
Facilitator will share that the rest of the group will be spent talking about our understanding of
the relationship between thoughts, feelings, and behaviors and will begin with a guided
discussion. Facilitator will ask the following questions and write down group answers. Facilitator
will be available to interpret and provide supplemental definitions.
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1. How do our thoughts affect us?
2. How do our feelings affect us?
3. How do thoughts and feelings affect our behaviors?
Facilitator will provide a synopsis of discussion and thank participants for participation.
Facilitator will explain that the next activity builds upon this discussion.
Cognitive Triangle:
Facilitator will draw the cognitive triangle on the white board/post it pad, large enough that all
can see and will pass out individual copies of the Cognitive Triangle Handout (included) to each
participant. Explain that:
1. This is a visual representation of how our thoughts, feelings, and behaviors are linked
2. A representation of how we respond to events
3. Demonstrate how the triangle works using the example below:
Script: Let’s walk through how this plays out in real life. The sequence begins with the
occurrence of an event. For example, say I go see my doctor and they tell me I have high blood
pressure and need to go on medication.
(Prompt participants to help answer the following questions and write answers on the white
board/post it pad.)
1. What thoughts might I have?
2. What feelings might I have?
3. How might I act in response? What might I do?
Facilitator will then ask for a volunteer (or two depending on time) to walk through the
Cognitive Triangle with their own example event and share how it might affect their thoughts,
feelings, and behaviors.
Wrap-Up/Preview:
Facilitator will end with the question: So, if we wanted to change our behaviors or reactions to
an event, at what point in this sequence could we do something different? I encourage you to
think about that over the next week. In our next group we will begin identifying regulation and
coping skills that we can use to help influence this thoughts, feelings, and behaviors sequence.
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Cognitive Triangle Handout

Feelings
Event
Behaviors Thoughts
Event
Thoughts Feelings Behaviors
Something
happens
I tell myself
something
I feel
something
I do
something
50
Group 3: Self-Regulation, Relaxation, and Coping Skills (60 mins)
Objectives:
1. To build upon previous group content and help participants make connections
2. Continue to foster group connection and comfort
3. Help participants create a toolkit of self-regulation/relaxation/coping skills
Materials Needed:
1. Dry-erase board or Large Post-It Pads
2. Pens (dry-erase and enough regular for each participant to have one)
3. Enough small note pads for each participant to have one
Prior to the Group:
Facilitator will set up enough comfortable chairs in a large circle for all participants to have one
Activities:
1. Welcome and Review (5 mins)
2. Reminiscence Activity (15 mins)
3. Facilitated Discussion (35 mins)
4. Wrap-Up/Preview (5 mins)
Welcome and Review:
Facilitator welcomes participants to the group and thanks them for returning. Begin with a
review of last week’s group content, asking for a volunteer to give a synopsis of the cognitive
triangle. If no one volunteers, facilitator will provide review.
Reminiscence Activity:
Facilitator will ask participants to briefly participate in a reminiscence activity. Facilitator will
read the prompt questions and write them on the board for participant reference: I want everyone
to think back to their school days. What was your favorite subject in school? What did you like
best about it? Each participant will have a chance to share. Upon completion, facilitator will
provide a synopsis of the activity and thank them for their participation.
Facilitated Discussion:
Facilitator will share today’s discussion will be the first of two groups that focus on learning and
practicing self-regulation, relaxation, and coping techniques. Start with a few questions to gage
what the participants know. Write them on the board/post it pad and record any answers given.
Encourage participants to use their notepads to write down any answers they find helpful.
1. What are some ways to relax?
2. What always helps you calm down if you are upset?
3. What helps you improve your mood?
51
Facilitator will thank participants for their engagement, provide a synopsis of their answers, and
read the script below.
Script: Today I want to teach you one of the easiest and most convenient regulation skills. Deep
breathing. It can be used anywhere, anytime, and doesn’t require anything but you! When we
feel sad, mad, or upset, our bodies can go into overdrive, sending negative energy into our
system that makes it difficult to relax or calm down. Deep breathing sends a signal to your brain
to tell your body to slow down so that your nervous system can slow down, and you can begin to
regulate. I am going to demonstrate the technique and once you are comfortable, I would like
you to join me.
I am going to start by sitting in my chair with my feet flat on the floor and my hands resting in
my lap. I’m going to breathe in slowly through my nose, and out through my mouth. Pay
attention to my belly going in and out. Notice that my shoulders are not going up and down. With
deep breathing it is important to get full breaths that expand into the diaphragm and stomach.
You know you’re doing it right if you begin to look like you’re pregnant. (you will likely get
giggles here).
Now if you haven’t started already, please join me in the deep breathing exercise. To make sure
that your breaths are long enough, you can slowly count to three on inhale, and slowly count to
three on exhale. A good rule of thumb is to do at least three full deep breaths, inhale and exhale.
After participants have engaged in the practice, facilitator will prompt them to share how the
deep breathing made them feel physically, if they could see themselves using the skill, and in
what situations would they use it. Facilitator will provide a synopsis of participant feedback and
move on to the next skill.
Script: Our other skill for today is another one that does not require anything but your brain and
body to do. It’s called pleasant imagery, and it can be done anywhere and anytime. This skill
focuses on visualizing a pleasant place or memory that brings you positive feelings. The goal is
to imagine that place or memory through the five senses. What smells are in your pleasant
place? What do you hear? What do you feel? What do you see? What do you taste?
Facilitator will provide their own example or use the one provided below:
What pleasant image helps me is thinking of quiet mornings alone before everyone else in the
house is awake. I sit in my comfy recliner with a fuzzy blanket that feels soft and cozy. I usually
have my cat in my lap who I can hear purring. I smell the coffee that is warming up my hands in
my favorite mug I got on a memorable vacation. The first sip is hot on my tongue and tastes
perfectly bittersweet. I look out the window and see birds in my yard looking for food.
Facilitator will then ask if the group has any questions before asking for volunteers to practice
the pleasant imagery skill. The number of volunteers to practice this skill will depend on the time
52
left at this point in the group. Facilitator will provide positive feedback and validation to
participants who volunteered.
Wrap-Up/Preview:
Facilitator will bring the group to a close by providing a brief review of the two skills practiced
today and encourage participants to try one out over the next week. Facilitator will share that
next week will be part 2 of self-regulation, relaxation, and coping skills and will include learning
another technique and creating individual coping skills lists to take home.
53
Group 4: Self-Regulation, Relaxation, and Coping Skills 2 (60 mins)
Objectives:
1. To build upon previous group content and help participants make connections
2. Continue to foster group connection and comfort
3. Help participants create a toolkit of self-regulation/relaxation/coping skills
Materials Needed:
1. Dry-erase board or Large Post-It Pads
2. Pens (dry-erase and enough regular for each participant to have one)
3. Enough small note pads for each participant to have one
4. Copies for group of the Progressive Muscle Relaxation Script (included)
5. Coping Strategies List (included)
Prior to the Group:
Facilitator will set up enough comfortable chairs in a large circle for all participants to have one
Activities:
1. Welcome and Review (5 mins)
2. Reminiscence Activity (15 mins)
3. Facilitated Discussion (35 mins)
4. Wrap-Up/Preview (5 mins)
Welcome and Review:
Facilitator welcomes participants to the group and thanks them for returning. Begin with a brief
review of last week’s group content. Check-in with participants and prompting anyone to share if
they tried out deep breathing or pleasant imagery over the last week. How did that go?
Reminiscence Activity:
Facilitator will ask participants to briefly participate in a reminiscence activity. Facilitator will
read the prompt questions and write them on the board for participant reference: Tell us a about a
song that always makes you happy when you hear it. What do you like best about it? Do you
remember the first time you heard it? Each participant will have a chance to share. Upon
completion, facilitator will provide a synopsis of the activity and thank them for their
participation.
Facilitated Discussion:
Facilitator will share today’s group is a continuation of last week’s group on self-regulation,
relaxation, and coping techniques. Facilitator will share with the group that today’s discussion
will center on the technique of progressive muscle relaxation (PMR) and working together to
create a coping skills list. Facilitator will use the Progressive Muscle Relaxation Script to guide
participants through the exercise.
54
After exercise is completed, facilitator will debrief with participants asking them to share their
reactions to it.
Facilitator will then lead the group in an exercise to create a list of other self-regulation,
relaxation, or coping skills/activities. Prompt group to share ideas that work for them or things
that they would like to try. Facilitator will write everyone’s answers on the white board/post it
pad to create a group-generated list. If participants are having difficulty thinking of things,
facilitator can refer to the Coping Strategies List to give them ideas.
Wrap-Up/Preview:
Facilitator will bring the group to a close by providing a brief review of the techniques practiced
and identified. Facilitator will encourage participants to try out one new coping skill this week
and be prepared to share about it next week. Make sure to thank everyone for their participation.
55
Progressive Muscle Relaxation Script
Progressive muscle relaxation is a technique that can reduce stress and nervous energy in your
body. It works by slowly tensing your muscles, then relaxing them. This simple technique can
help give your body an immediate physical release, helping you to calm down and begin to
regulate. It is a skill that can be used anytime you notice tension in your body. If you have any
trouble areas in your body, you should skip tensing those areas to prevent any injuries.
I am going to lead you through a short exercise to show you how it works. It will only take a few
minutes.
Now I want you to make sure you are sitting in a position that is comfortable to you. Some
people like to close their eyes, but it is optional. We will also be focusing on our breathing
during this exercise. While I guide you, I want you to practice focusing your mind on the
physical feelings in each part of your body. Try to let other thoughts drift away.
Let’s begin with everyone taking a deep breath. Slowly in through the nose (pause) and out
through the mouth.
Now let’s do that one more time. Slowly in through the nose (pause) and out through the mouth.
Make sure when you are breathing that you are filling up your belly with air and that your
shoulders are staying put.
Let’s do one more breath and make it even slower. In through the nose (pause) and out through
the mouth.
Now bring your focus to your attention to the lower half of your body. Begin by slowly curling
your toes and arching your foot. Hold that position and notice how it feels physically (pause).
Don’t hold it too tightly, but just enough to notice the tension.
Now being adding to that tension by tensing your legs and bottom. Now tighten your lower half
just a bit more and hold it, making sure to keep a slow, steady pace with your breathing.
Now begin to slowly release the tension in your lower half beginning with your feet (pause).
Now slowly release the tension in your calves (pause).
Now slowly release the tension in your upper legs and bottom. Notice how your body feels now
that you have released the tension. Make sure to continue taking your slow and steady breaths.
Now bring your focus to the upper half of your body. Begin by clenching your fists and then
slowly clenching your arms (pause).
56
Maintain your breathing and stay tensed.
Now start tightening your abdomen and back. Hold that tension for a few seconds.
Now slowly release it beginning with your hands (pause) then arms (pause) abdomen (pause) and
back.
Notice the feeling the of relaxation in your body from the tension release.
Take one big deep breath. In (pause) and out (pause).
Now I want you to tense your entire body. Your feet, legs, bottom, abdomen, arms, hands, and
neck.
Tense a little tighter and hold it for a few seconds.
Now allow your entire body to release and go limp. Notice how relaxed your body feels and
maintain your steady, even breaths.
Now slowly start to move your body with a gentle stretch or repositioning in your chair. If your
eyes were closed, please open them when you are ready.
Thank you for participating in this exercise.
57
Coping Skills List
● Deep breathing
● Pleasant imagery
● Progressive muscle relaxation
● Listen to music
● Think of something funny
● Stretch your body
● Slowly count to ten
● Get enough sleep
● Eat a healthy snack
● Read a book
● Write in a journal
● Watch a favorite movie
● Garden
● Take a bath
● Drink cold water
● Take a break
● Do a puzzle
● Give someone a hug
● Cuddle your pet
● Look at old pictures
● Use a stress ball
● Make a gratitude list
● Smile in the mirror
● Drink some warm tea
● Dance
● Meditate
● Write a letter
● Doodle on paper
● Sing
● Play an instrument
● Do something you love
● Use a relaxation app
● Watch a funny video
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Group 5: Feelings Identification and Monitoring (60 mins)
Objectives:
1. To build upon previous group content and help participants make connections
2. Continue to foster group connection and comfort
3. Help participants learn to identify, label, and understand feelings
4. Help participants learn how to assess frequency and severity of feeling through scaling
Materials Needed:
1. Dry-erase board or Large Post-It Pads
2. Pens (dry-erase and enough regular for each participant to have one)
3. Enough small note pads for each participant to have one
Prior to the Group:
Facilitator will set up enough comfortable chairs in a large circle for all participants to have one
Activities:
1. Welcome and Review (5 mins)
2. Reminiscence Activity (15 mins)
3. Facilitated Discussion (35 mins)
4. Wrap-Up/Preview (5 mins)
Welcome and Review:
Facilitator welcomes participants to the group and thanks them for returning. Begin with a brief
review of last week’s content. Check-in with participants, prompting anyone to share if they tried
out any of the techniques from their coping skills list over the last week. How did that go?
Reminiscence Activity:
Facilitator will ask participants to briefly participate in a reminiscence activity. Facilitator will
read the prompt questions and write them on the board for participant reference: Tell us a little
bit about where you grew up. What was the area like? What was your favorite part about living
there? Each participant will have a chance to share. Upon completion, facilitator will provide a
synopsis of the activity and thank them for their participation.
Facilitated Discussion:
Facilitator will share today’s discussion and activity will surround the topic of feelings and how
to monitor them. Start with a few questions to gage what the participants know. Write them on
the board/post it pad and record any answers given. Encourage participants to use their notepads
to write down any answers they find helpful.
1. What are feelings?
2. What are the most common feelings you experience?
3. How do you know what you are feeling?
59
Next, lead group in making a list of every feeling they can think of off the top of their head. If
they have difficulty or can’t come up with many, utilize the Feelings Words List to help fill in
the gaps. Facilitator will also use this list to help participants understand which words are
variations of the same feeling. Write the list on the white board or post it pad.
After the feelings discussion, facilitator will gage what participants know about monitoring and
examining their feelings by asking the following questions:
1. What are ways to monitor how often you feel specific feelings?
2. How do you tell how strong your feelings are?
3. How do you reduce the strength of those feelings/how do you manage them?
Next, lead the group in learning how to scale the strength and frequency of their feelings. Draw
the following graphic on the board for reference and explain that this is a technique that is
helpful in monitoring feelings over time.
Script: Let’s say I notice that I am feeling angry often and I want to get a better idea of just how
often it’s happening. I can check in with myself once a day for a week and rate the strength of my
anger that day on this scale. If there was a day I didn’t feel angry, there would be no rating. At
the end of the week I would look at the data I collected to see how many days I had the angry
feelings, and how strong they were.
This scale also helps to give a visual representation of what is a reasonable expectation for
reducing the strength of the feeling. For instance, if I was experiencing anger at a strength of 8,
it is reasonable to work toward reducing it to a 5 or 6, rather than going all the way down to a 1.
In working to reduce the strength of emotions, you get better results if you go for an achievable
amount. Imagine if I was at an 8 in anger trying to reduce it all the way down to a 1. It probably
wouldn’t go very well and I could end up frustrated that it wasn’t working, making my anger
even stronger.
Now I want everyone to think of a feeling they experience frequently that you’d like to experience
less. You can share it with the group or write it down on your note pad. Over the next week, I’d
like everyone to practice scaling this feeling and when we come back next week, we will discuss
how it went and any thoughts you had about the process.
Wrap-Up/Preview:
Facilitator will thank participants for their engagement and share that next week they will learn
about how to recognize physical cues and how they may signal specific feelings.
60
Feelings Word List
Angry Feelings
Annoyed
Agitated
Bitter
Critical
Disgusted
Fed-up
Frustrated
Furious
Irritated
Irate
Mad
Outraged
Raging
Resentful
Seething
Sad Feelings
Awful
Crushed
Depressed
Devastated
Disappointed
Distressed
Down
Gloomy
Heartbroken
Helpless
Hopeless
Hurt
Isolated
Lonely
Miserable
Powerless
Terrible
Fear Feelings
Afraid
Alarmed
Anxious
Fearful
Frightened
Horrified
Insecure
Intimidated
Jumpy
Nervous
Scared
Shaky
Shy
Tense
Timid
Vulnerable
Worried
Panic/Confused Feelings
Desperate
Disoriented
Lost
Mixed-Up
Frozen
Paralyzed
Perplexed
Shocked
Stunned
Trapped
Unsure
Happy Feelings
Content
Cheerful
Delighted
Ecstatic
Excited
Glad
Jolly
Joyful
Jovial
Pleased
Satisfied
Thankful
Vibrant
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Group 6: Recognizing Physical Cues (60 mins)
Objectives:
1. To build upon previous group content and help participants make connections
2. Continue to foster group connection and comfort
3. Help participants learn to identify, label, and understand physical cues
4. Help participants understand how physical cues can signal certain feelings
Materials Needed:
1. Dry-erase board or Large Post-It Pads
2. Pens (dry-erase and enough regular for each participant to have one)
3. Enough small note pads for each participant to have one
Prior to the Group:
Facilitator will set up enough comfortable chairs in a large circle for all participants to have one
Activities:
1. Welcome and Review (5 mins)
2. Reminiscence Activity (15 mins)
3. Facilitated Discussion (35 mins)
4. Wrap-Up/Preview (5 mins)
Welcome and Review:
Facilitator welcomes participants to the group and thanks them for returning. Begin with a
review of last week’s group content, providing a brief synopsis. Check-in with participants,
prompting anyone to share if they utilized the scaling techniques learned in last group.
Reminiscence Activity:
Facilitator will ask participants to briefly participate in a reminiscence activity. Facilitator will
read the prompt questions and write them on the board for participant reference: Tell us about
your favorite holiday? What are some of your traditions? With whom do you celebrate the
holiday? Each participant will have a chance to share. Upon completion, facilitator will provide a
synopsis of the activity and thank them for their participation.
Facilitated Discussion:
Facilitator will share today’s discussion and activity will surround the topic of feelings and how
to monitor them. Start with a few questions to gage what the participants know. Write them on
the board/post it pad and record any answers given. Encourage participants to use their notepads
to write down any answers they find helpful.
1. What are physical cues?
a. Share this definition after they answer to make sure they understand. Physical
cues are the sensations in your body that let you know something is different.
They let you know, or “cue” you, that you may be feeling a new emotion.
62
2. What are the most common physical cues?
3. How often are you aware of the physical sensations in your body?
Next, lead the group in generating a list of physical cues. Start by asking these prompts and
recording the groups answers on the white board/post it pad.
1. What are some physical cues that might indicate you are feeling angry?
2. What are some physical cues that you might be feeling anxious?
3. What are some physical cues that you might be feeling happy?
Wrap-Up/Preview:
Facilitator will thank participants for their engagement and share that next week they will learn
about how to recognize internal and external situations (triggers) that might cause them to feel or
react a certain way
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Group 7: Recognizing Internal/External Triggers (60 mins)
Objectives:
1. To build upon previous group content and help participants make connections
2. Continue to foster group connection and comfort
3. Help participants learn key situations/events that trigger a negative emotional response
4. Help participants learn how their internal thoughts can amplify an external trigger
Materials Needed:
1. Dry-erase board or Large Post-It Pads
2. Pens (dry-erase and enough regular for each participant to have one)
3. Enough small note pads for each participant to have one
Prior to the Group:
Facilitator will set up enough comfortable chairs in a large circle for all participants to have one
Activities:
1. Welcome and Review (5 mins)
2. Reminiscence Activity (20 mins)
3. Facilitated Discussion (30 mins)
4. Wrap-Up/Preview (5 mins)
Welcome and Review:
Facilitator welcomes participants to the group and thanks them for returning. Begin with a
review of last week’s group content, providing a brief synopsis. Check-in with participants,
prompting anyone to share if they were able to recognize physical cues and utilize a coping skill
to regulate.
Reminiscence Activity:
Facilitator will ask participants to briefly participate in a reminiscence activity. Facilitator will
read the prompt questions and write them on the board for participant reference: Today I’d like
to talk about pets. Tell us about a favorite pet you have had. If you have never had a pet, what
type of animal interests you the most and why? Each participant will have a chance to share.
Upon completion, facilitator will provide a synopsis of the activity and thank them for their
participation.
Facilitated Discussion:
Facilitator will share today’s discussion and activity will surround the topic of triggers and how
to manage them. Start with a few questions to gage what the participants know. Write them on
the board/post it pad and record any answers given. Encourage participants to use their notepads
to write down any answers they find helpful.
1. What is a trigger
2. What is the difference between an internal and external trigger.
64
Help participants understand that an external trigger is a situation or event that happens outside
of our control, like other people’s behavior. An internal trigger is something that happens inside
of us, like a negative thought that can make our feelings and reactions to an event worse.
Facilitator will have participants help generate a list of their most frequent external triggers and
also share some of their own (i.e. when you go to make coffee and there is none left, when you
are late and there is no gas in the car, etc.). Provide positive feedback and validation during.
Facilitator will then have participants help generate a list of their most frequent internal triggers,
helping them link to the external triggers they identified. Prompt participants to answer questions
like “What would be your internal trigger (thoughts) if you experienced _______________.”
End the activity by having a conversation of how participants think they could begin to manage
their reactions to triggers? How would they approach it? Would they attempt to control external
factors? Share with participants that being successfully able to manage a trigger reaction happens
when we can do something to keep our internal triggers in check like using a coping skill.
Wrap-Up/Preview:
Facilitator will thank participants for their engagement and share that next week they will learn
about how to recognize some common thought traps that contribute to increased internal triggers.
Ask participants to work on recognizing their triggers over the next week and trying to use a
coping skill in response.
65
Group 8: Common Thought Traps (60 mins)
Objectives:
1. To build upon previous group content and help participants make connections
2. Continue to foster group connection and comfort
3. Help participants learn common thinking traps that worsen responses to external events
Materials Needed:
1. Dry-erase board or Large Post-It Pads
2. Pens (dry-erase and enough regular for each participant to have one)
3. Enough small note pads for each participant to have one
4. Thought Traps handouts (8 copies)
Prior to the Group:
Facilitator will set up enough comfortable chairs in a large circle for all participants to have one
Activities:
1. Welcome and Review (5 mins)
2. Reminiscence Activity (15 mins)
3. Facilitated Discussion (35 mins)
4. Wrap-Up/Preview (5 mins)
Welcome and Review:
Facilitator welcomes participants to the group and thanks them for returning. Begin with a
review of last week’s group content, providing a brief synopsis. Check-in with participants,
prompting anyone to share if they were able to recognize triggers and utilize a coping skill to
help manage their reactions.
Reminiscence Activity:
Facilitator will ask participants to briefly participate in a reminiscence activity. Facilitator will
read the prompt questions and write them on the board for participant reference: Today we are
going to talk about jobs; the good, the bad, and the ugly. Tell us about the worst job you ever
had. What were your duties? How long did you stay in the job? What was the best job you ever
had? Each participant will have a chance to share. Upon completion, facilitator will provide a
synopsis of the activity and thank them for their participation.
Facilitated Discussion
Facilitator will share that today will focus on common thought traps that help contribute to
increased internal triggers that lead us to feeling, behaving, or responding in ways we don’t like.
Facilitator will use the Thought Traps handout to help participants go through common
situations. With each trap, prompt participants to share if/when they have experienced it.
Wrap-Up/Preview
66
Facilitator will thank participants for their engagement and share that next week they will learn
about how to reframe thoughts through self-instructional reminders. Encourage participants to
pay attention over the next week to see if they fall into any of the Thought Traps.
67
Thought Traps
All or Nothing Thinking
All or nothing thinking is when we see things purely in black/white, as either/or; there is no room
for a gray area. You know you are having these types of thoughts when you think in absolutes
like every, always, or never. Everything is seen as good or bad or a success or failure.
Example: If you get a dollar raise at work, but you thought you were going to get a two dollar
raise, so you feel like a failure or must not be good at your work.
Jumping to Conclusions
Jumping to conclusions is when we make a negative interpretation or prediction even though
there is no evidence to support our conclusion. This type of thinking is often made when thinking
about how others feel towards us. We often think we can read other people’s minds, we assume
the worst thoughts or intentions from others, we anticipate the worst and take it as fact.
Example: You have plans to see a friend then they call to cancel, telling you they aren’t feeling
well. You assume they just don’t want to see you and that they are lying to you so they don’t
have to tell you the truth.
Magnifying or Minimizing
The pitfalls of this trap are when we exaggerate the importance of negative events and minimize
or downplay the importance of positive events. We over emphasize the positive characteristics of
others and tend to under-emphasize their negatives. We do the opposite with ourselves. We are
often only able to focus and amplify our negatives and sometimes completely leave out the
positives.
Should, Ought, Must
This thought trap is where we get wrapped up in what we think we should, ought to, or must be
doing. It is characterized by rigid views or rules can lead to anger, frustration, resentment,
disappointment, and guilt when we don’t do the things we think we should, ought to, or must.
Emotional Reasoning
This trap is when we assume that our feelings reflect fact, even if there is no evidence to support
it. The idea here is “I feel it, therefore it must be true”. This type of can lead to self-fulfilling
prophecies in which our thoughts can end up prompting the very thing we predicted, just because
we changed our behavior because we thought so strongly that our feeling was fact.
68
Group 9: Thought Reframing and Self-Instructional Reminders (60 mins)
Objectives:
1. To build upon previous group content and help participants make connections
2. Continue to foster group connection and comfort
3. Help participants learn ways to combat unhelpful thinking
Materials Needed:
1. Dry-erase board or Large Post-It Pads
2. Pens (dry-erase and enough regular for each participant to have one)
3. Enough small note pads for each participant to have one
Prior to the Group:
Facilitator will set up enough comfortable chairs in a large circle for all participants to have one
Activities:
1. Welcome and Review (5 mins)
2. Reminiscence Activity (20 mins)
3. Facilitated Discussion (30 mins)
4. Wrap-Up/Preview (5 mins)
Welcome and Review:
Facilitator welcomes participants to the group and thanks them for returning. Begin with a
review of last week’s group content, asking if any participants were able to recognize if they
engaged in any thought traps the last week.
Reminiscence Activity:
Facilitator will ask participants to briefly participate in a reminiscence activity. Facilitator will
read the prompt questions and write them on the board for participant reference: Today I want to
talk about places. Where is the best place you have ever been? It can be a town, a country, a
state, a landmark, anything goes. What did you like best about it? If you could go anywhere else
in the world you have never been, where would you go? Each participant will have a chance to
share. Upon completion, facilitator will provide a synopsis of the activity and thank them for
their participation.
Facilitated Discussion:
Facilitator will share today’s discussion and activity will surround the topic of thought reframing.
Start with a few questions to gage what the participants know. Write them on the board/post it
pad and record any answers given. Encourage participants to use their notepads to write down
any answers they find helpful.
1. How can we reframe our thinking?
2. What is positive self-talk?
69
Facilitator will then lead participants in a discussion about ways to reframe thinking. Instead of
trying to change or stop the thought all together, which can be really frustrating, thought
reframing helps us look at the thought differently. Using positive self-instructional reminders can
help us manage the unhelpful thoughts. Prompt participants to help generate a list of reminders
that can be used in the midst of unhelpful thoughts. Tell participants that this may be difficult for
some, and it helps to think of what you would tell someone you care about if they were having
unhelpful thoughts. How would you help them reframe their thinking? We often are better at
helping others than helping ourselves.
Wrap-Up/Preview
Facilitator will thank participants for their engagement and share that next week they will learn
about responding versus reacting. Encourage participants to try and utilize positive self-
instructional reminders over the next week when they notice unhelpful thoughts.
70
Group 10: Responding vs. Reacting (60 mins)
Objectives:
1. To build upon previous group content and help participants make connections
2. Continue to foster group connection and comfort
3. Help participants learn the difference between responding and reacting
4. Help participants learn ways to shift from reactivity to proactivity/responsivity
Materials Needed:
1. Dry-erase board or Large Post-It Pads
2. Pens (dry-erase and enough regular for each participant to have one)
3. Enough small note pads for each participant to have one
Prior to the Group:
Facilitator will set up enough comfortable chairs in a large circle for all participants to have one
Activities:
1. Welcome and Review (5 mins)
2. Reminiscence Activity (15 mins)
3. Facilitated Discussion (35 mins)
4. Wrap-Up/Preview (5 mins)
Welcome and Review:
Facilitator welcomes participants to the group and thanks them for returning. Begin with a
review of last week’s group content, asking if anyone practiced using reminders.
Reminiscence Activity:
Facilitator will ask participants to briefly participate in a reminiscence activity. Facilitator will
read the prompt questions and write them on the board for participant reference: Today let’s talk
about skills and talents. What skill or talent are you best at? How did you learn it? How do you
use it? What do you like best about it? Each participant will have a chance to share. Upon
completion, facilitator will provide a synopsis of the activity and thank them for their
participation.
Facilitated Discussion:
Facilitator will share today’s discussion and activity will surround learning how to respond vs
react. Start with a few questions to gage what the participants know. Write them on the
board/post it pad and record any answers given. Encourage participants to use their notepads to
write down any answers they find helpful.
1. What does it mean to be reactive?
2. What does it mean to be responsive?
3. How can we shift from being reactive to being responsive?
71
Facilitator will then engage participants in a discussion about how to move from being reactive
to responsive. Ask them how they think any of the techniques they have learned in group so far
could help them with this. Ask them how they could use each of the following in this task.
1. The cognitive triangle
2. Regulation, relaxation, and coping techniques
3. Feelings identification and monitoring
4. Recognizing physical cues
5. Recognizing external and internal triggers
6. Recognizing thought traps
7. Utilizing positive self-instructional reminders
Wrap-Up/Preview
Facilitator will thank participants for their engagement and share that next week will focus on
putting all the concepts learned so far together into one sequence of self-management. Encourage
participants to try and utilize positive self-instructional reminders over the next week when they
notice unhelpful thoughts.
72
Group 11: Putting It All Together (60 mins)
Objectives:
1. To build upon previous group content and help participants make connections
2. Continue to foster group connection and comfort
3. To help participants put all concepts together into a cohesive sequence of self-
management
Materials Needed:
1. Dry-erase board or Large Post-It Pads
2. Pens (dry-erase and enough regular for each participant to have one)
3. Enough small note pads for each participant to have one
4. Self-Management Sequence handout (8 copies)
Prior to the Group:
Facilitator will set up enough comfortable chairs in a large circle for all participants to have one
Activities:
1. Welcome and Review (5 mins)
2. Reminiscence Activity (15 mins)
3. Facilitated Discussion (35 mins)
4. Wrap-Up/Preview (5 mins)
Welcome and Review:
Facilitator welcomes participants to the group and thanks them for returning. Begin with a
review of last week’s group content, asking if any participants used any skills this week.
Reminiscence Activity:
Facilitator will ask participants to briefly participate in a reminiscence activity. Facilitator will
read the prompt questions and write them on the board for participant reference: Today we are
going to talk about best friends. Who was your best friend growing up? Are you still friends?
How did you meet? What do you remember most about them? Each participant will have a
chance to share. Upon completion, facilitator will provide a synopsis of the activity and thank
them for their participation.
Facilitated Discussion:
Facilitator will share today’s discussion and activity will surround learning how to put
everything we have learned together into one self-management sequence. Distribute Self-
Management Sequence handout to participants. Also write the sequence on the board large
enough for everyone to see. Review the handout and steps briefly before demonstrating how to
use the sequence via a role-play. Ask participants to give feedback on the roleplay and ask any
clarifying questions. Facilitator may demonstrate another roleplay if there is time.
73
Wrap-Up/Preview
Facilitator will thank participants for their engagement and share that the next three weeks will
focus on having participants practice using the Self-Management Sequence by doing roleplays
like the facilitator did today. Encourage participants to try and think of an example situation over
the next week that they could use for the role play. Everyone will get to do at least one role play,
with 2-3 people going per group.
74
Self-Management Sequence
Triggers Physical Cues Feelings Coping Skill Reminders Respond

Triggers
Physical Cues Feelings Coping Skills Reminders Respond
External
(Event)
Internal
(Thoughts)
What is my
body
telling me?
What
feeling(s)
am I having
What
skill(s) can
I use to
regulate
What
reminders
can I tell
myself to
maintain
my
regulation
How will I
respond to
the
situation
now that I
am
regulated
75
Group 12: Role-play Practice (60 mins)
Objectives:
1. To build upon previous group content and help participants make connections
2. Continue to foster group connection and comfort
3. To help reinforce learned concepts through in-vivo role-play
Materials Needed:
1. Dry-erase board or Large Post-It Pads
2. Pens (dry-erase and enough regular for each participant to have one)
3. Enough small note pads for each participant to have one
4. Self-Management Sequence handouts for all participants (included in Group 11)
Prior to the Group:
Facilitator will set up enough comfortable chairs in a large circle for all participants to have one
and will have printed copies of the group commitments for participants to take home.
Activities:
1. Welcome and Review (5 mins)
2. Reminiscence Activity (15 mins)
3. Role-Plays (35 mins)
4. Wrap-Up/Preview (5 mins)
Welcome and Review:
Facilitator welcomes participants to the group and thanks them for returning.
Reminiscence Activity:
Facilitator will ask participants to briefly participate in a reminiscence activity. Facilitator will
read the prompt questions and write them on the board for participant reference: Let’s talk about
accomplishments today. What is the thing you are most proud of achieving in your life? Why is
it important to you? How did you work to achieve it? Each participant will have a chance to
share. Upon completion, facilitator will provide a synopsis of the activity and thank them for
their participation.
Role-Plays
Facilitator will write the Self-Management Sequence on the board and provide brief review. Will
distribute handouts to participants who want them. Will prompt 2-3 participants to engage in a
role play of how they would use the sequence in a real situation. Facilitator will provide
encouragement, support, and feedback throughout.
Wrap-Up/Review
Facilitator will thank the group for their work, giving special kudos to the participants who
volunteered to do role-plays this first group. Share that next week will look the same.
76
Group 13: Role-play Practice (60 mins)
Objectives:
1. To build upon previous group content and help participants make connections
2. Continue to foster group connection and comfort
3. To help reinforce learned concepts through in-vivo role-play
Materials Needed:
1. Dry-erase board or Large Post-It Pads
2. Pens (dry-erase and enough regular for each participant to have one)
3. Enough small note pads for each participant to have one
4. Self-Management Sequence handouts for all participants (included in Group 11)
Prior to the Group:
Facilitator will set up enough comfortable chairs in a large circle for all participants to have one
and will have printed copies of the group commitments for participants to take home.
Activities:
1. Welcome and Review (5 mins)
2. Reminiscence Activity (15 mins)
3. Role-Plays (35 mins)
4. Wrap-Up/Preview (5 mins)
Welcome and Review:
Facilitator welcomes participants to the group and thanks them for returning.
Reminiscence Activity:
Facilitator will ask participants to briefly participate in a reminiscence activity. Facilitator will
read the prompt questions and write them on the board for participant reference: Let’s talk about
seasons. Fall, summer, winter, spring. What is your favorite and why? Each participant will have
a chance to share. Upon completion, facilitator will provide a synopsis of the activity and thank
them for their participation.
Role-Plays
Facilitator will write the Self-Management Sequence on the board and provide brief review. Will
distribute handouts to participants who want them. Will prompt 2-3 participants who haven’t yet
gone to engage in a role play of how they would use the sequence in a real situation. Facilitator
will provide encouragement, support, and feedback throughout.
Wrap-Up/Review
Facilitator will thank the group for their work, giving special kudos to the participants who did
roleplays this group. Share that next week will look the same.
77
Group 14: Role-play Practice (60 mins)
Objectives:
1. To build upon previous group content and help participants make connections
2. Continue to foster group connection and comfort
3. To help reinforce learned concepts through in-vivo role-play
Materials Needed:
1. Dry-erase board or Large Post-It Pads
2. Pens (dry-erase and enough regular for each participant to have one)
3. Enough small note pads for each participant to have one
4. Self-Management Sequence handouts for all participants (included in Group 11)
Prior to the Group:
Facilitator will set up enough comfortable chairs in a large circle for all participants to have one
Activities:
1. Welcome and Review (5 mins)
2. Reminiscence Activity (15 mins)
3. Role-Plays (35 mins)
4. Wrap-Up/Preview (5 mins)
Welcome and Review:
Facilitator welcomes participants to the group and thanks them for returning.
Reminiscence Activity:
Facilitator will ask participants to briefly participate in a reminiscence activity. Facilitator will
read the prompt questions and write them on the board for participant reference: Tell us about a
family member that you had a special connection with. What is great about them? Each
participant will have a chance to share.
Role-Plays
Facilitator will write the Self-Management Sequence on the board and provide brief review. Will
distribute handouts to participants who want them. Will prompt the remaining participants who
haven’t yet gone to engage in a role play of how they would use the sequence in a real situation.
Facilitator will provide encouragement, support, and feedback throughout.
Wrap-Up/Review
Facilitator will thank the group for their work, giving special kudos to the participants who did
roleplays. Share that next week will be our last week. Any participants who didn’t get a chance
to roleplay will have the chance next week.
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Group 15: Review and Goodbyes (60 mins)
Objectives:
1. To build upon previous group content and help participants make connections
2. Continue to foster group connection and comfort
3. To review and synthesize what was learned
Materials Needed:
1. Dry-erase board or Large Post-It Pads
2. Pens (dry-erase and enough regular for each participant to have one)
3. Enough small note pads for each participant to have one
4. Light refreshments
Prior to the Group:
Facilitator will set up enough comfortable chairs in a large circle for all participants to have one
and a table with refreshments
Activities:
1. Welcome and Review (5 mins)
2. Reminiscence Activity (15 mins)
3. Group Review/Reflection (35 mins)
4. Wrap-Up/Goodbyes (5 mins)
Welcome and Review:
Facilitator welcomes participants to the group and thanks them for returning for the last group.
Reminiscence Activity:
Facilitator will ask participants to briefly participate in a reminiscence activity. Facilitator will
read the prompt questions and write them on the board for participant reference: Think back as
far as you can to you first memory. What do you recall? What were you doing? How did you
feel? Each participant will have a chance to share.
Review/Reflection
Facilitator will prompt any participant who hasn’t done a roleplay to do theirs now. Facilitator
will lead participants in a review of all concepts using the Self-Management Sequence.
Throughout the facilitator will prompt participants to share what they learned to help with the
review.
Wrap-Up/Goodbyes
Facilitator will thank the group for their work throughout the last 15 weeks. Provide
encouragement about their ability to use the skills they learned to improve their lives.
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COACH Intergenerational Storytelling Group Session Plans
Group 1: Intro/Orientation/Getting to Know You
Group 2: Getting to Know You 2
Group 3: Getting to Know the Digital Media
Group 4: Getting to Know the Digital Media
Group 5: What is a Life Story?
Group 6: Beginning the Life Story
Group 7: Life Story Planning
Group 8: Life Story Planning
Group 9: Beginning to Create the Life Story with Digital Media
Group 10: Continuing to Create the Life Story with Digital Media
Group 11: Continuing to Create the Life Story with Digital Media
Group 12: Continuing to Create the Life Story with Digital Media
Group 13: Continuing to Create the Life Story with Digital Media
Group 14: Completing the Life Story
Group 15: Sharing Life Stories
*Community Presentation of Digital Life Stories where family and other community members
can attend will be held at date/location to be determined by facilitation team. This presentation
is optional for group members but will be encouraged.
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Group 1: Intro/Orientation/Getting to Know You (60 mins)
Objectives:
4. Outline purpose and goals of the group
5. Define group commitments
6. Help participants get to know each other
Materials Needed:
4. Dry-erase board or Large Post-It Pads
5. Pens (dry-erase and enough regular for each participant to have one)
6. Enough small note pads for each participant to have one
7. Getting to Know You handouts (included), 8 copies of each
Prior to the Group:
Facilitator will randomly pair older adult participants with student partners using a simple Excel
list randomizer. 8 tables with 2 chairs each are needed for partners to sit together and engage.
Activities:
6. Welcome/Orientation (10 mins)
7. Getting to Know You (40 mins)
8. Wrap-up/preview of next week’s group (10 mins)
Welcome/Orientation:
Facilitator welcomes all members to the group and briefly explains professional background.
Shares that the purpose of the group is to facilitate intergenerational connection and partnership
with the ultimate goal of students helping the older adult participant create a digital life story.
Group sessions will be focused on how to get information for a life story, how to use technology,
and how to put the two together. There will be an optional community showcase of the digital
stories as a culminating activity of the group. Participants will be given a copy of their life story
to keep.
Facilitator will have everyone take turns introducing themselves, stating their name and which
town they live in. After everyone has made introductions, facilitator will discuss group
commitments which include:
1. Being willing to talk to each other
2. Being willing to learn new things
3. Being willing to ask for help
4. Taking a break when needed
5. Showing up
6. Having fun!
Getting to Know You:
Facilitator will share that for the next 40 minutes partner pairs will be asked to fill out a Getting
to Know You sheet about their partner. Each partner will have 20 minutes to interview the other
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and record their answers. Facilitator will let them know when to switch. Facilitator will hand out
the sheets to the partner pairs and make sure they each have a pen.
Wrap-Up/Preview:
Facilitator will thank group for their participation and ask if any partners want to share thoughts
about their experience. Facilitator will share that next week’s group will again focus on partners
getting to know each other.
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Getting to Know You (Student Copy)
Questions Answers
Where were you born?
When were you born?
Where did you grow up?
How long have you lived in this area?
What was your first job?
How many people are in your family?
Do you have children? How many?
What piece of advice would you give
someone my age today?
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Getting to Know You
Questions Answers
Where were you born?
When were you born?
Where did you grow up?
How long have you lived in this area?
What was your first job?
How many people are in your family?
Do you have children? How many?
What do you wish older adults knew about
your generation?
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Group 2: Getting to Know You 2 (60 mins)
Objectives:
1. Outline purpose and goals of the group
2. Define group commitments
3. Help participants get to know each other
Materials Needed:
1. Dry-erase board or Large Post-It Pads
2. Pens (dry-erase and enough regular for each participant to have one)
3. Enough small note pads for each participant to have one
4. Getting to Know You 2 handout (included), 16 copies
Prior to the Group:
8 tables with 2 chairs each are needed for partners to sit together and engage.
Activities:
1. Welcome/Orientation (5 mins)
2. Getting to Know You 2 (45 mins)
3. Wrap-up/preview of next week’s group (10 mins)
Welcome/Orientation:
Facilitator welcomes all members to the group, shares that today will be a continuation of getting
to know each other and reminds them of the group commitments.
1. Being willing to talk to each other
2. Being willing to learn new things
3. Being willing to ask for help
4. Taking a break when needed
5. Showing up
6. Having fun!
Getting to Know You:
Facilitator will share that for the next 45 minutes partner pairs will be asked to fill out a second
Getting to Know You sheet about their partner. Each partner will have just over 20 minutes to
interview the other and record their answers. Facilitator will let them know when to switch.
Facilitator will hand out the sheets to the partner pairs and make sure they each have a pen.
Wrap-Up/Preview:
Facilitator will thank group for their participation and ask if any partners want to share thoughts
about their experience. Facilitator will share that next week’s group will focus on learning the
digital media software that will be used to create the digital life story.
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Getting to Know You 2
Questions Answers
What is one of your favorite movies? Why?
What is the best part of the movie?
What is one of your favorite songs? Why?
What is your favorite food? Why?
Tell me about one of your most memorable
holidays.
Tell me about your hobbies.
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Group 3: Getting to Know the Digital Media (60 mins)
Objectives:
1. Outline purpose and goals of the group
2. Help participants learn how to use Canva
Materials Needed:
1. Dry-erase board or Large Post-It Pads
2. Pens (dry-erase and enough regular for each participant to have one)
3. Enough small note pads for each participant to have one
4. 8 Laptops or Large Tablets connected to the internet
Prior to the Group:
8 tables with 2 chairs each are needed for partners to sit together and engage. Make sure tables
are spaced far enough apart so that pairs don’t get overwhelmed by the voices of others. Each
group needs access to chargers for their laptops/tablets. Make sure they are fully charged before
the group.
Activities:
1. Welcome/Orientation (5 mins)
2. Getting to Know Canva (45 mins)
3. Wrap-up/preview of next week’s group (10 mins)
Welcome/Orientation:
Facilitator welcomes all members to the group, shares that today will focus on learning how to
use the Canva site to create a digital video.
Getting to Know Canva:
Facilitator will share that for the next 45 minutes student partners will be showing partners the
basics of navigating Canva, tools for making a video, and available elements (music, pictures,
graphics, words, clips) that can be included in the video.
During the activity, Facilitator will be available for questions and will check in briefly with each
pair to see how things are going or if they need any technical assistance.
Wrap-Up/Preview:
Facilitator will thank group for their participation and ask if any partners want to share thoughts
about their experience. Facilitator will share that next week’s group will continue focusing on
learning the digital media software, but this time, they will practice by making a mini story.
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Group 4: Getting to Know the Digital Media (60 mins)
Objectives:
1. Outline purpose and goals of the group
2. Help participants learn how to use Canva
Materials Needed:
1. Dry-erase board or Large Post-It Pads
2. Pens (dry-erase and enough regular for each participant to have one)
3. Enough small note pads for each participant to have one
4. 8 Laptops or Large Tablets connected to the internet
Prior to the Group:
8 tables with 2 chairs each are needed for partners to sit together and engage. Make sure tables
are spaced far enough apart so that pairs don’t get overwhelmed by the voices of others. Each
group needs access to chargers for their laptops/tablets. Make sure they are fully charged before
the group.
Activities:
1. Welcome/Orientation (5 mins)
2. Getting to Know Canva - practice (45 mins)
3. Wrap-up/preview of next week’s group (10 mins)
Welcome/Orientation:
Facilitator welcomes all members to the group, shares that today will be a continuation of
learning Canva but that this time, they will be tasked with creating a mini video story. Ask if
there are any questions before diving in.
Getting to Know Canva:
Prompt the participants to make a video story of “A Day in the Life of a Cat” that is:
1. Minimum of four different slides
2. Has pictures
3. Has music
4. Has text
Facilitator will write the prompt on the white board/post it pad for partner pair reference. During
the activity. Facilitator will be available for questions and will check in briefly with each pair to
see how things are going or if they need any technical assistance.
Wrap-Up/Preview:
Facilitator will thank group for their participation and ask if any partners want to share thoughts
about their experience. Facilitator will share that next week’s group will focus on elements of a
life story and how to deal with complex topics.
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Group 5: What is a Life Story? (60 mins)
Objectives:
1. Outline purpose and goals of the group
2. Explain components of a Life Story
3. Help participants be prepared to manage complex topics
Materials Needed:
1. Dry-erase board or Large Post-It Pads
2. Pens (dry-erase and enough regular for each participant to have one)
3. Enough small note pads for each participant to have one
4. Life Story Outline handout (included) 8 copies
Prior to the Group:
8 tables with 2 chairs each are needed for partners to sit together and engage.
Activities:
1. Welcome/Orientation (10 mins)
2. What is a Life Story? (40 mins)
3. Wrap-up/preview of next week’s group (10 mins)
Welcome/Orientation:
Facilitator welcomes all members to the group, shares that today will focus on learning the
components of a Life Story as well as getting prepared to handle any complex topics that are
brought up in the process. Take this time to remind participants of the group commitments:
1. Being willing to talk to each other
2. Being willing to learn new things
3. Being willing to ask for help
4. Taking a break when needed
5. Showing up
6. Having fun!
What is a Life Story:
Facilitator will explain that a life story can focus on the entire life of a person so far, a specific
period of time, or a specific experience. The point is that the story is meaningful and provides an
opportunity to reflect on a period of time that is missed, that we wish could be different, or that
we just simply want to remember. A good life story has:
1. A beginning, middle, and end
2. It highlights the thoughts, feelings, and actions associated with the events being described
Dealing with Complex Topics:
Facilitator will explain to the group that in the process of creating the Life Story, emotional or
hard to talk about subject may come up. Explain that:
1. Storytellers have the right to share what they want
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2. Storytellers have the right to leave things out
3. Student partners are there to help by asking open-ended questions and get more details
4. The Facilitator is available if anyone needs any support during groups
5. If topics become uncomfortable, it is okay to take a break to utilize a relaxation or coping
skill such as deep breathing.
Prompt participants to take the next 30 mins to brainstorm a story idea and outline with their
student partner using the Life Story Outline handout.
Wrap-Up/Preview:
Facilitator will thank group for their participation and ask if any partners have any questions,
want to share thoughts about their experience, or wish to share their ideas for a story. Facilitator
will collect each partner pair’s Life Story Outline to hold onto for next week. Facilitator will
share that next week’s group will focus on officially beginning to put the Life Story together.
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Life Story Outline Worksheet
Category Idea(s)
Topic: Whole life story, growing up,
my favorite vacation, my first child, the
college years, my first love, etc.
Beginning (main points)
Middle (main points)
End (main points)
Thoughts: what did you think then
about the topic of your story? What do
you think now?
Feelings: how did you feel at the time?
how do you feel now?
Actions: what are the main behaviors,
choices you made during this part of
your life that are critical to the story?
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Group 6: Beginning the Life Story
Objectives:
1. Outline purpose and goals of the group
2. Help participants begin creating their life story
Materials Needed:
1. Dry-erase board or Large Post-It Pads
2. Pens (dry-erase and enough regular for each participant to have one)
3. Enough small note pads for each participant to have one
4. Completed Life Story Outlines from prior group
Prior to the Group:
8 tables with 2 chairs each are needed for partners to sit together and engage.
Activities:
1. Welcome/Orientation (5 mins)
2. The Beginning (40 mins)
3. Wrap-up/preview of next week’s group (15 mins)
Welcome/Orientation:
Facilitator welcomes all members to the group and asks how their week has been. Facilitator
shares that today is the official launch of writing the Life Story.
The Beginning:
Distribute completed Life Story Outlines to the partner pairs. Share that today’s activity will
focus on writing the beginning section of the story. Explain that student partners will listen and
take notes while the older adult tells the story. Remind student partners that it is okay to ask
questions to get more information or clarification. Facilitator will be available for questions and
will check in briefly with each pair to see how things are going or if they need any technical
assistance.
Wrap-Up/Preview:
Facilitator will thank group for their participation and collect outline and beginning stories to
hold onto until next week. Facilitator will ask if any partners have any questions or want to share
how it went beginning to write the story. Facilitator will share that next week’s group will focus
on writing the middle section of the story.
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Group 7: Life Story Planning (60 mins)
Objectives:
1. Outline purpose and goals of the group
2. Help participants continue creating their life story
Materials Needed:
1. Dry-erase board or Large Post-It Pads
2. Pens (dry-erase and enough regular for each participant to have one)
3. Enough small note pads for each participant to have one
4. Completed Life Story Outlines and Beginning story sections from previous group
Prior to the Group:
8 tables with 2 chairs each are needed for partners to sit together and engage.
Activities:
1. Welcome/Orientation (5 mins)
2. The Middle (40 mins)
3. Wrap-up/preview of next week’s group (15 mins)
Welcome/Orientation:
Facilitator welcomes all members to the group and asks how their week has been. This is a time
to see if there are any questions before beginning.
The Beginning:
Distribute completed Life Story Outlines and Beginning story sections to the partner pairs. Share
that today’s activity will focus on writing the middle section of the story. Explain that it is okay
if their beginning section isn’t all the way finished and that there will be time to refine things in
later groups. The main goal at this point is to get the basic elements of the story outlined.
Explain that student partners will listen and take notes while the older adult tells the story.
Remind student partners that it is okay to ask questions to get more information or clarification.
Facilitator will be available for questions and will check in briefly with each pair to see how
things are going or if they need any technical assistance.
Wrap-Up/Preview:
Facilitator will thank group for their participation and collect outline and story drafts to hold onto
until next week. Facilitator will ask if any partners have any questions or want to share how it
went continuing to write the story. Facilitator will share that next week’s group will focus on
writing the end section of the story.
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Group 8: Life Story Planning (60 mins)
Objectives:
1. Outline purpose and goals of the group
2. Help participants continue creating their life story
Materials Needed:
1. Dry-erase board or Large Post-It Pads
2. Pens (dry-erase and enough regular for each participant to have one)
3. Enough small note pads for each participant to have one
4. Completed Life Story Outlines and Beginning story sections from previous group
Prior to the Group:
8 tables with 2 chairs each are needed for partners to sit together and engage.
Activities:
1. Welcome/Orientation (5 mins)
2. The Middle (40 mins)
3. Wrap-up/preview of next week’s group (15 mins)
Welcome/Orientation:
Facilitator welcomes all members to the group and asks how their week has been.
The Beginning:
Distribute completed Life Story Outlines and Beginning story sections to the partner pairs. Share
that today’s activity will focus on writing the end section of the story. Explain that it is okay if
their other sections aren’t all the way finished and that there will be time to refine things in later
groups. The main goal at this point is to get the basic elements of the story outlined.
Explain that student partners will listen and take notes while the older adult tells the story.
Remind student partners that it is okay to ask questions to get more information or clarification.
Facilitator will be available for questions and will check in briefly with each pair to see how
things are going or if they need any technical assistance.
Wrap-Up/Preview:
Facilitator will thank group for their participation and collect outline and story drafts to hold onto
until next week. Facilitator will ask if any partners have any questions or want to share how it
went continuing to write the story. Facilitator will share that next week’s group will focus on
beginning to put the rough elements of the story so far into digital format with Canva.
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Group 9: Beginning to Create the Life Story with Digital Media (60 mins)
Objectives:
1. Outline purpose and goals of the group
2. Help participants begin to create their digital story
Materials Needed:
1. Dry-erase board or Large Post-It Pads
2. Pens (dry-erase and enough regular for each participant to have one)
3. Enough small note pads for each participant to have one
4. 8 Laptops or Large Tablets connected to the internet
5. Completed Life Story Outlines and story drafts from previous group.
Prior to the Group:
8 tables with 2 chairs each are needed for partners to sit together and engage. Make sure tables
are spaced far enough apart so that pairs don’t get overwhelmed by the voices of others. Each
group needs access to chargers for their laptops/tablets. Make sure they are fully charged.
Activities:
1. Welcome/Orientation (5 mins)
2. Digital Story Creation (45 mins)
3. Wrap-up/preview of next week’s group (10 mins)
Welcome/Orientation:
Facilitator welcomes all members to the group, shares that today will focus beginning to create
their digital Life Story in Canva. Use this opportunity to see if there are any questions before
beginning.
Digital Story Creation:
Distribute Life Story Outlines and story drafts to partner pairs. Facilitator will share that for the
next 45 minutes student partners will be assisting older adult partners with beginning to
formulate their story on Canva. Instruct partners to work together, taking turns at using the
computer. The main goal of today is to begin making a rough outline of what will be included.
Facilitator will encourage partner pairs to take some time at the beginning to brainstorm the
vision of the visual representation of the Life Story.
During the activity, Facilitator will be available for questions and will check in briefly with each
pair to see how things are going or if they need any technical assistance.
Wrap-Up/Preview:
Facilitator will thank group for their participation and collect outline and story drafts to hold onto
until next week. Facilitator will ask if any partners have any questions or want to share how it
went using the technology and beginning to create the story. Facilitator will share that next
week’s group will continue focusing on creating and refining the digital story.
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Group 10: Continuing to Create the Life Story with Digital Media (60 mins)
Objectives:
1. Outline purpose and goals of the group
2. Help participants continue to create their digital story
Materials Needed:
1. Dry-erase board or Large Post-It Pads
2. Pens (dry-erase and enough regular for each participant to have one)
3. Enough small note pads for each participant to have one
4. 8 Laptops or Large Tablets connected to the internet
5. Completed Life Story Outlines and story drafts from previous group.
Prior to the Group:
8 tables with 2 chairs each are needed for partners to sit together and engage. Make sure tables
are spaced far enough apart so that pairs don’t get overwhelmed by the voices of others. Each
group needs access to chargers for their laptops/tablets. Make sure they are fully charged.
Activities:
1. Welcome/Orientation (5 mins)
2. Digital Story Creation (45 mins)
3. Wrap-up/preview of next week’s group (10 mins)
Welcome/Orientation:
Facilitator welcomes all members to the group and asks how their week was. Shares that the rest
of the groups (except the last one) will be focused on creating the digital Life Story. This is a
time where the facilitator will answer any questions participants may have before beginning.
Digital Story Creation:
Distribute Life Story Outlines and story drafts to partner pairs. Facilitator will share that for the
next 45 minutes student partners will be assisting older adult partners with continuing to
formulate their story on Canva. Instruct partners to work together, taking turns at using the
computer. The main goal of today is to continue making a rough outline of what will be
included. Facilitator will encourage partner pairs to continue to discuss the story as they create it.
Ask that student partners be willing to clarify pieces of the story they don’t understand and that
older adults be willing to answer and share their vision for the story.
During the activity, Facilitator will be available for questions and will check in briefly with each
pair to see how things are going or if they need any technical assistance.
Wrap-Up/Preview:
Facilitator will thank group for their participation and collect outline and story drafts to hold onto
until next week. Facilitator will ask if any partners have any questions or want to share how it
went using the tech and creating the story.
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Group 11: Continuing to Create the Life Story with Digital Media (60 mins)
Objectives:
1. Outline purpose and goals of the group
2. Help participants continue to create their digital story
Materials Needed:
1. Dry-erase board or Large Post-It Pads
2. Pens (dry-erase and enough regular for each participant to have one)
3. Enough small note pads for each participant to have one
4. 8 Laptops or Large Tablets connected to the internet
Prior to the Group:
8 tables with 2 chairs each are needed for partners to sit together and engage. Make sure tables
are spaced far enough apart so that pairs don’t get overwhelmed by the voices of others. Each
group needs access to chargers for their laptops/tablets. Make sure they are fully charged before
the group.
Activities:
1. Welcome/Orientation (5 mins)
2. Digital Story Creation (45 mins)
3. Wrap-up/preview of next week’s group (10 mins)
Welcome/Orientation:
Facilitator welcomes all members to the group and asks how their week was. This is a time
where the facilitator will answer any questions participants may have before beginning.
Digital Story Creation:
Distribute Life Story Outlines and story drafts to partner pairs. Facilitator will share that for the
next 45 minutes student partners will be assisting older adult partners with continuing to
formulate their story on Canva. Instruct partners to work together, taking turns at using the
computer. The main goal of today is to make sure the elements of thoughts, feelings, and actions
are added into the digital story.
During the activity, Facilitator will be available for questions and will check in briefly with each
pair to see how things are going or if they need any technical assistance.
Wrap-Up/Preview:
Facilitator will thank group for their participation and collect outline and story drafts to hold onto
until next week. Facilitator will ask if any partners have any questions or want to share how it
went using the tech and creating the story.
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Group 12: Continuing to Create the Life Story with Digital Media (60 mins)
Objectives:
1. Outline purpose and goals of the group
2. Help participants continue to create their digital story
Materials Needed:
1. Dry-erase board or Large Post-It Pads
2. Pens (dry-erase and enough regular for each participant to have one)
3. Enough small note pads for each participant to have one
4. 8 Laptops or Large Tablets connected to the internet
Prior to the Group:
8 tables with 2 chairs each are needed for partners to sit together and engage. Make sure tables
are spaced far enough apart so that pairs don’t get overwhelmed by the voices of others. Each
group needs access to chargers for their laptops/tablets. Make sure they are fully charged before
the group.
Activities:
1. Welcome/Orientation (5 mins)
2. Digital Story Creation (45 mins)
3. Wrap-up/preview of next week’s group (10 mins)
Welcome/Orientation:
Facilitator welcomes all members to the group and asks how their week was. This is a time
where the facilitator will answer any questions participants may have before beginning.
Digital Story Creation:
Distribute Life Story Outlines and story drafts to partner pairs. Facilitator will share that for the
next 45 minutes student partners will be assisting older adult partners with continuing to
formulate their story on Canva. Instruct partners to work together, taking turns at using the
computer. The main goal of today is to make sure they are integrating multiple mediums such as
text, music, pictures, clips, and voice audio. Encourage partner pairs to aim for making their
video no more than 15 minutes long.
During the activity, Facilitator will be available for questions and will check in briefly with each
pair to see how things are going or if they need any technical assistance.
Wrap-Up/Preview:
Facilitator will thank group for their participation and collect outline and story drafts to hold onto
until next week. Facilitator will thank group for their participation and collect outline and story
drafts to hold onto until next week. Facilitator will ask if any partners have any questions or want
to share how it went using the tech and creating the story..
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Group 13: Continuing to Create the Life Story with Digital Media (60 mins)
Objectives:
1. Outline purpose and goals of the group
2. Help participants continue to create their digital story
Materials Needed:
1. Dry-erase board or Large Post-It Pads
2. Pens (dry-erase and enough regular for each participant to have one)
3. Enough small note pads for each participant to have one
4. 8 Laptops or Large Tablets connected to the internet
Prior to the Group:
8 tables with 2 chairs each are needed for partners to sit together and engage. Make sure tables
are spaced far enough apart so that pairs don’t get overwhelmed by the voices of others. Each
group needs access to chargers for their laptops/tablets. Make sure they are fully charged before
the group.
Activities:
5. Welcome/Orientation (5 mins)
6. Digital Story Creation (45 mins)
7. Wrap-up/preview of next week’s group (10 mins)
Welcome/Orientation:
Facilitator welcomes all members to the group and asks how their week was. This is a time
where the facilitator will answer any questions participants may have before beginning.
Digital Story Creation:
Distribute Life Story Outlines and story drafts to partner pairs. Facilitator will share that for the
next 45 minutes student partners will be assisting older adult partners with continuing to
formulate their story on Canva. Instruct partners to work together, taking turns at using the
computer. The main goal of today is to refine the digital story and begin making sure all the
elements they wanted were included. Encourage partner pairs to aim for making their video no
more than 15 minutes long. During the activity, Facilitator will be available for questions and
will check in briefly with each pair to see how things are going or if they need any technical
assistance.
Wrap-Up/Preview:
Facilitator will thank group for their participation and collect outline and story drafts to hold onto
until next week. Facilitator will ask if any partners have any questions or want to share how it
went using the tech and creating the story. Facilitator will remind everyone that next week is the
last week to finish stories before sharing them in the final group.
99
Group 14: Completing the Life Story with Digital Media (60 mins)
Objectives:
1. Outline purpose and goals of the group
2. Help participants continue to create their digital story
Materials Needed:
1. Dry-erase board or Large Post-It Pads
2. Pens (dry-erase and enough regular for each participant to have one)
3. Enough small note pads for each participant to have one
4. 8 Laptops or Large Tablets connected to the internet
Prior to the Group:
8 tables with 2 chairs each are needed for partners to sit together and engage. Make sure tables
are spaced far enough apart so that pairs don’t get overwhelmed by the voices of others. Each
group needs access to chargers for their laptops/tablets. Make sure they are fully charged before
the group.
Activities:
1. Welcome/Orientation (5 mins)
2. Digital Story Creation (45 mins)
3. Wrap-up/preview of next week’s group (10 mins)
Welcome/Orientation:
Facilitator welcomes all members to the group and asks how their week was. This is a time
where the facilitator will answer any questions participants may have before beginning.
Digital Story Creation:
Distribute Life Story Outlines and story drafts to partner pairs. Facilitator will share that for the
next 45 minutes student partners will be assisting older adult partners with continuing to
formulate their story on Canva. Instruct partners to work together, taking turns at using the
computer. The main goal of today is to finish the digital story and be ready to share it with the
group next week. Encourage partner pairs to aim for making their video no more than 15 minutes
long.
During the activity, Facilitator will be available for questions and will check in briefly with each
pair to see how things are going or if they need any technical assistance.
Wrap-Up/Preview:
Facilitator will thank group for their participation and collect outline and story drafts to hold onto
until next week. Facilitator will ask if any partners have any questions or want to share how it
went using the tech and creating the story. Share that next week is the final group. It will be 2
hours and everyone will have a chance share their stories with the group.
100
Group 15: Sharing the Life Stories (2 hours +)
Objectives:
1. To have the group share their stories
Materials Needed:
1. A projector screen or TV with laptop hookups
2. A laptop
3. Light refreshments
Prior to the Group:
Chairs and tables put in a circle around the tv/projector screen. Make sure all tech works and is
fully charged.
Activities:
1. Welcome (5 mins)
2. Digital Story Viewing (up to 2 hours)
3. Wrap-up/Thank You (5 mins)
Welcome:
Facilitator welcomes all members to the group and asks how their week was. This is a time
where the facilitator will answer any questions participants may have before beginning.
Digital Story Viewing:
Each participant will have a chance to share their story.
Wrap-Up/Thank You:
Facilitator will thank group for their participation, validate their hard work, and provide praise.
Will remind everyone that they have the option to present their stories to the community.
101
102
Appendix C
103
104
Appendix D

Abstract (if available)

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Asset Metadata

Creator Day, Samantha Michelle (author)

Core Title COACH: Connecting Older Adults to Community for Health - an evidence-based program to address older adult social isolation and loneliness

School Suzanne Dworak-Peck School of Social Work

Degree Doctor of Social Work

Degree Program Social Work

Degree Conferral Date 2021-08

Publication Date 10/06/2021

Defense Date 07/29/2021

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

Tag aging,evidence-based programs,intergenerational,Loneliness,OAI-PMH Harvest,older adult,social connection,social isolation

Format application/pdf (imt)

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Mistrano, Samuel (committee chair), Fatouros, Cassandra (committee member), Rank, Michael (committee member)

Creator Email samanthadayconsulting@gmail.com,sday@usc.edu

Permanent Link (DOI) https://doi.org/10.25549/usctheses-oUC16022043

Unique identifier UC16022043

Legacy Identifier etd-DaySamanth-10136

Document Type Capstone project

Format application/pdf (imt)

Rights Day, Samantha Michelle

Type texts

Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

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Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA

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