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Genetic studies indicate that heritability accounts for approximately 50% of loneliness while social circumstances account for the other 50% (7). Research also suggests that loneliness is common - reported by as many as 20 percent of the population at any given time (8). In addition, some evidence suggests that the prevalence of loneliness may be increasing, at least in the U.S. A recent national survey found a threefold increase in the number of Americans who indicated they had no confidant or person with whom to discuss important matters (9). Although differences between this survey and its 1985 predecessor may be sufficient to account for this increase, this suggestive report raises the possibility that contemporary societal factors may be interfering with the natural tendency for humans to form meaningful, long-term social connections. One factor is social mobility, which increased dramatically during the 20" century. A second is the aging of the U.S. population. In 1900, 4.1% of Americans were 65 years or older. By 2006, that percentage had increased to 12.4%, representing 37.3 million Americans (10). With less value placed on older individuals in the U.S., we have witnessed an increase in marginalization of this segment of society. Third, as life expectancy increases, more elders are living longer as widows or widowers and are therefore at increased risk for loneliness. Other factors which may place Americans at increased risk for loneliness include less intergenerational living, delayed marriage, increased dual- career families, increased single-residence households, and increased age-related disabilities and health conditions. Given the mental and health risks associated with loneliness described in Hawkley’s 132 Page chapter, interventions are needed to help lonely individuals regain normal social connections. As Bunyan’s account suggests, breaking through the wall of loneliness may require considerable effort. When individual effort is not sufficient, assistance from others may be needed. Unfortunately, contemporary interventions to reduce loneliness have fared more poorly than has been recognized. Repairing Broken Connections Almost a century ago, scholars began to propose strategies for reducing loneliness. Karen Rook (11), for instance, amassed over 40 interventions dating back to the 1930’s in her attempt to identify effective loneliness reduction strategies. Since Rook’s review, five scientific publications have provided qualitative reviews of strategies to reduce loneliness, social isolation, or both (12-16). The most recent publication identified 30 interventions published between 1970 and 2002 (16), and evaluated the effectiveness of those intervention studies that were not flawed by poor design. Among the thirteen trials deemed to be of high quality, six were considered effective, one was considered partially effective, five were considered ineffective, and one was inconclusive. The authors’ conclusions were similar to those of prior reviewers who found that interventions which emphasized social skills training and/or group activities were the most successful. However, qualitative reviews are subject to invisible biases that can color our judgments of the scientific evidence we see. Thomas Kuhn, a 20" century physicist and epistemologist, noted that scientists too easily accept results which conform to previous intuitions and too readily reject results which do not (17). HOUSE_OVERSIGHT_021378