Interventions for loneliness
A wide range of interventions have been developed to address loneliness. Many of these interventions have at least some success in achieviving reductions in loneliness and social isolation. However, much of the evidence supporting these interentions is weak and continued research is still needed. Check out our scoping review to learn more about what you and those you know can do to end the loneliness pandemic.
Deckx et al. (2018)
A systematic literature review on the association between loneliness and coping strategies
Systematic Review
Primary finding: From 12 studies, the authors conclude that there is a significant association between loneliness and coping consistently showed that problem-focused coping styles were associated with lower levels of loneliness, and emotion-focused coping styles with higher levels of loneliness. Our findings suggest that learning how to use problem-focused coping strategies could be an important aspect of interventions targeting loneliness. This should be further explored in randomized clinical trials.
Campaign to End Loneliness (2020)
Promising Approaches Revisited: Effective action on loneliness in later life
Report
Primary finding: The guide is intended to (1) Help commissioners and funders of services who support older people – including adult social care, health commissioners and public health teams – to identify the gaps in provisions in their communities; (2) Support service providers to deliver more effective loneliness interventions; and (3) Shape future research to increase our understanding of loneliness, and how to address it
Siette et al. (2017)
Effectiveness of befriending interventions: a systematic review and meta-analysis
Systematic Review
Primary finding: Most trials showed improvement in symptoms associated with befriending but these associations did not reach statistical significance in all trials. Befriending was significantly associated with better patient-reported outcomes across primary measures (standardised mean difference 0.18 (95% CI, -0.002 to 0.36, I2=26%, seven trials)). However, there was no significant benefit on single outcomes, including depression, quality of life, loneliness ratings, self-esteem measures, social support structures and well-being.
Gardiner et al. (2016)
Interventions to reduce social isolation and loneliness among older people: an integrative review
Literature Review
Primary finding: The majority of interventions reported some success inreducing social isolation and loneliness, but the quality of evidence wasgenerally weak. Factors which were associated with the most effectiveinterventions included adaptability, a community development approach,and productive engagement.
Leavell et al. (2019)
Nature-Based Social Prescribing in Urban Settings to Improve Social Connectedness and Mental Well-being: a Review
Literature Review
Primary finding: Social prescribing can include a variety of activities linked with voluntary and community sector organizations (e.g., walking and park prescriptions, community gardening, farmers' market vouchers). These activities can promote nature contact, strengthen social structures, and improve longer term mental and physical health by activating intrapersonal, interpersonal, and environmental processes.More research is needed to understand the impact of Social Prescribing on high-risk populations and the supports needed to allow them to feel at ease in the outdoors.
Veazie et al. (2019)
Addressing Social Isolation To Improve the Health of Older Adults: A Rapid Review
Literature Review
Primary finding: Among 16 studies, authors conclude that physical activity interventions show the most promise at improving the health of older adults; however, effects were inconsistent and studies short term. Information on the effect of interventions on health care utilization is sparse and inconsistent. Health systems should target interventions to the needs of their population while keeping in mind that the documented impact of such interventions specific to social isolation, health, and health care utilization outcomes is limited. Health systems should rigorously evaluate their efforts to increase the evidence base and share results with other health care systems.
Ibarra et al. (2020)
A Systematic Review on Technology-Supported Interventions to Improve Old-Age Social Wellbeing: Loneliness, Social Isolation, and Connectedness
Systematic Review
Primary finding: Among 25 studies, Computer and Internet training was the dominant strategy, allowing access to communication technologies, while in recent years, we see more studies aiming to provide simple, easy-to-use technology. The technology used was mostly off-the-shelf, with fewer solutions tailored to older adults. Social interactions targeted mainly friends and family, and most interventions focused on more than one group of people. Discussion. All interventions reported positive results, suggesting feasibility.
Eccles et al. (2020)
Review: Alleviating loneliness in young people - a meta-analysis of interventions
Systematic Review and Meta-Analysis
Primary finding: Among 39 studies, authors found evidence that youth loneliness could be reduced via intervention. While interventions were shown to reduce loneliness among youth, the interventions included in the meta-analyses often targeted youth viewed to be at risk - for example those with health concerns - and rarely did the interventions target youth who reported loneliness. There is also no indication of whether youth experienced chronic or transient loneliness.
McElfresh et al. (2020)
Interventions for Loneliness Among Adult Cancer Survivors: A Systematic Review and Meta-Analysis
Systematic Review and Meta-Analysis
Primary finding: There are limited interventions addressing loneliness in cancer survivors. Development and testing of culturally-relevant programs are warranted.
Pu et al. (2019)
The Effectiveness of Social Robots for Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Studies
Systematic Review and Meta-Analysis
Primary finding: Based on 13 randomized control trials, social robots appear to have the potential to improve the well-being of older adults, but conclusions are limited due to the lack of high-quality studies. More randomized control trials are recommended with larger sample sizes and rigorous study designs.
Mann et al. (2017)
A life less lonely: the state of the art in interventions to reduce loneliness in people with mental health problems
Literature Review
Primary finding: We categorised interventions as 'direct', targeting loneliness and related concepts in social relationships, and 'indirect' broader approaches to well-being that may impact on loneliness. We describe four broad groups of direct interventions: changing cognitions; social skills training and psychoeducation; supported socialisation or having a 'socially-focused supporter'; and 'wider community approaches'. The most promising emerging evidence appears to be in 'changing cognitions', but, as yet, no approaches have a robust evidence base. Challenges include who is best placed to offer the intervention, how to test such complex interventions, and the stigma surrounding loneliness.
Hagan et al. (2014)
Reducing loneliness amongst older people: a systematic search and narrative review
Systematic Review
Primary finding: Among three studies reporting on new technologies and one on a group work intervention, significant reductions in loneliness were observed.
Ma et al. (2019)
The effectiveness of interventions for reducing subjective and objective social isolation among people with mental health problems: a systematic review
Systematic Review
Primary finding: Among 30 randomized control trials, the authors conclude that evidence is not yet strong enough to make specific recommendations for practice. Preliminary evidence suggests that promising interventions may include cognitive modification for subjective social isolation, and interventions with mixed strategies and supported socialisation for objective social isolation. We highlight the need for more thorough, theory-driven intervention development and for well-designed and adequately powered RCTs.
Cohen-Mansfield et al. (2015)
Interventions for alleviating loneliness among older persons: a critical review
Systematic Review
Primary finding: Twelve studies were effective in reducing loneliness according to the review criteria, and 15 were evaluated as potentially effective. The findings suggest that it is possible to reduce loneliness by using educational interventions focused on social networks maintenance and enhancement. Multiple approaches show promise, although flawed design often prevents proper evaluation of efficacy. The value of specific therapy techniques in reducing loneliness is highlighted and warrants a wider investigation. Studies of special populations, such as the cognitively impaired, are also needed.
Baker et al. (2018)
Combatting social isolation and increasing social participation of older adults through the use of technology: A systematic review of existing evidence
Systematic Review
Primary finding: From 36 papers reviewed, the authors conclude that technologies principally utilised social network services and touch-screen technologies; social outcomes are often ill-defined or not defined at all; and methodologies used to evaluate interventions were often limited and small-scale. The authors conclude that there is greater need for rigour in these studies.
Kall et al. (2019)
Internet-Based Cognitive Behavior Therapy for Loneliness: A Pilot Randomized Controlled Trial
Systematic Review
Primary finding: This randomized control trial showed that an 8-week internet-based cognitive-behavioural therapy program showed significant treatment effects on the primary outcome measure of loneliness as well as secondary outcomes measuring quality of life and social anxiety relative to control at postassessment.
Powell et al. (2019)
Companion dog acquisition and mental well-being: a community-based three-arm controlled study
Controlled Study
Primary finding: Companion dog acquisition may reduce loneliness among community dog owners. Our study provides useful direction for future larger trials on the effects of dog ownership on human mental well-being.
Newman et al. (2019)
The role of internet-based digital tools in reducing social isolation and addressing support needs among informal caregivers: a scoping review
Literature Review
Primary finding: From 23 papers, the authors conclude that internet-based digital tools can be a cost-effective and convenient way to develop programs that help unpaid caregivers form communities, gain support, and access resources. Furthermore, they reason that service providers can leverage digital tools to deliver support to caregivers within online communities.
Pearson et al. (2019)
Loneliness in adults: Evidence-based research and interventions for NPs
Literature Review
Primary finding: This article reviews the latest research on the negative health effects associated with loneliness. Evidence-based nurse practioner interventions aimed at improving patients' perceived social connections are also explored.
Anderson et al. (2015)
Can mental health interventions change social networks? A systematic review
Systematic Review
Primary finding: Based on five studies, the authors conclude that interventions directly targeting social isolation can be effective and achieve a meaningful increase in patients' networks. Thus, although limited, the existing evidence is encouraging, and the range of interventions used in the reported trials leave various options for future research and further improvements. Future research is needed to test the findings in different settings, identify which components are particularly effective, and determine to what extent the increased networks, over time, impact on patients' symptoms and quality of life.
Cotterell et al. (2015)
Preventing social isolation in older people
Literature Review
Primary finding: The paper first addresses the issues of identification and assessment, using an ecological framework to identify the risk factors for social isolation at four levels: individual, relationship, community, and societal. It then reviews different types of interventions to reduce or prevent social isolation in later life, including one-to-one, group, service provision, technology-based, neighbourhood, and structural interventions.
Chen et al. (2016)
The Effect of Information Communication Technology Interventions on Reducing Social Isolation in the Elderly: A Systematic Review
Literature Review
Primary finding: From 25 papers, the authors conclude that the effect of information communication technologies is inconclusive and that more high quality research is needed to ascertain what types of technology are beneficial and who would benefit from these.
Fakoya et al. (2020)
Loneliness and social isolation interventions for older adults: a scoping review of reviews
Literature Review
Primary finding: total of 33 reviews met the inclusion criteria, evaluating a range of interventions targeted at older people residing in the community or institutionalised settings. Authors of reviews included in this paper often used the same terms to categorise different intervention components and many did not provide a clear definition of these terms. There were inconsistent meanings attributed to intervention characteristics. Overall, interventions were commonly categorised on the basis of: 1) group or one-to-one delivery mode, 2) the goal of the intervention, and 3) the intervention type. Several authors replicated the categorisation system used in previous reviews. Many interventions have been developed to combat loneliness and social isolation among older people. The individuality of the experience of loneliness and isolation may cause difficulty in the delivery of standardised interventions. There is no one-size-fits-all approach to addressing loneliness or social isolation, and hence the need to tailor interventions to suit the needs of individuals, specific groups or the degree of loneliness experienced.
Noone et al. (2020)
Video calls for reducing social isolation and loneliness in older people: a rapid review
Literature Review
Primary finding: Based on this review there is currently very uncertain evidence on the effectiveness of video call interventions to reduce loneliness in older adults.
O’Rourke et al. (2018)
Interventions to address social connectedness and loneliness for older adults: a scoping review
Literature Review
Primary finding: Interventions were described or evaluated in 39 studies, and five studies described strategies to affect loneliness/social connectedness of older adults or their caregivers in a qualitative descriptive study. The studies were often conducted in the United States (38.6%) among community dwelling (54.5%), cognitively intact (31.8%), and female-majority (86.4%) samples. Few focused on non-white participants (4.5%). Strategies described most often were engaging in purposeful activity and maintaining contact with one's social network. Of nine intervention types identified, the most frequently described were One-to-One Personal Contact and Group Activity. Authors held divergent views of why the same type of intervention might impact social connectedness, but social contact was the most frequently conceptualized influencing factor targeted, both within and across intervention types.
Poscia et al. (2018)
Interventions targeting loneliness and social isolation among the older people: An update systematic review
Systematic Review
Primary finding: Eighteen interventions were reported across the quantitative studies. Six out of 11 group interventions (55%), one out of four mixed interventions (25%) and all three individual interventions reported at least one significant finding related to loneliness or social isolation. Our review suggested that new technologies and community engaged arts might be seen as a promising tool for tackling social isolation and loneliness among the older individuals.
Cacioppo et al. (2015)
Loneliness: clinical import and interventions
Systematic Review
Primary finding: The authors review assessments of loneliness and build on this meta-analysis to discuss the efficacy of various treatments for loneliness. With the advances made over the past 5 years in the identification of the psychobiological and pharmaceutical mechanisms associated with loneliness and maladaptive social cognition, there is increasing evidence for the potential efficacy of integrated interventions that combine (social) cognitive behavioral therapy with short-term adjunctive pharmacological treatments.
Dickens et al. (2011)
Interventions targeting social isolation in older people: a systematic review
Systematic Review
Primary finding: Thirty two studies were included in the review. There was evidence of substantial heterogeneity in the interventions delivered and the overall quality of included studies indicated a medium to high risk of bias. Across the three domains of social, mental and physical health, 79% of group-based interventions and 55% of one-to-one interventions reported at least one improved participant outcome. Over 80% of participatory interventions produced beneficial effects across the same domains, compared with 44% of those categorised as non-participatory. Of interventions categorised as having a theoretical basis, 87% reported beneficial effects across the three domains compared with 59% of interventions with no evident theoretical foundation. Regarding intervention type, 86% of those providing activities and 80% of those providing support resulted in improved participant outcomes, compared with 60% of home visiting and 25% of internet training interventions. Fifty eight percent of interventions that explicitly targeted socially isolated or lonely older people reported positive outcomes, compared with 80% of studies with no explicit targeting.
Chipps et al. (2017)
The effectiveness of e-Interventions on reducing social isolation in older persons: A systematic review of systematic reviews
Systematic Review of Systematic Reviews
Primary finding: The reviews were of moderate quality and the primary studies showed a lack of rigor. Loneliness was most frequently measured using the University California Los Angeles Loneliness Scale. Despite the limitations of the reviewed studies, there is inconsistent and weak evidence on using e-Interventions for loneliness in older people.
Lindsay et al. (2019)
Mindfulness training reduces loneliness and increases social contact in a randomized controlled trial
Randomzied Controlled Trial
Primary finding: In this dismantling trial, 153 community adults were randomly assigned to a 14-lesson smartphone-based intervention: (i) training in both monitoring and acceptance (Monitor+Accept), (ii) training in monitoring only (Monitor Only), or (iii) active control training. For 3 d before and after the intervention, ambulatory assessments were used to measure loneliness and social contact in daily life. Consistent with predictions, Monitor+Accept training reduced daily-life loneliness by 22% (d = 0.44, P = 0.0001) and increased social contact by two more interactions each day (d = 0.47, P = 0.001) and one more person each day (d = 0.39, P = 0.004), compared with both Monitor Only and control trainings. These findings describe a behavioral therapeutic target for improving social-relationship functioning; by fostering equanimity with feelings of loneliness and social disconnect, acceptance-skills training may allow loneliness to dissipate and encourage greater engagement with others in daily life.
Masi et al. (2010)
A meta-analysis of interventions to reduce loneliness
Randomzied Controlled Trial
Primary finding: The most successful interventions addressed maladaptive social cognition. This is consistent with current theories regarding loneliness and its etiology. Theoretical and methodological issues associated with designing new loneliness reduction interventions are discussed.
Pool et al. (2017)
Interventions to improve social determinants of health among elderly ethnic minority groups: a review
Systematic Review
Primary finding: Six studies (three randomized controlled trials, three non-controlled intervention studies) were included in the review. All studies were group-based interventions and had a theoretical basis. Five out of six studies showed improvement on a social participation, -isolation or loneliness outcome. Type of intervention included volunteering-, educational- and physical activities. In three studies active participation of the participant was required, these interventions were not more effective than other interventions.