Many young people experience loneliness – often defined as a subjective, unwanted feeling which occurs when we are unsatisfied with the quantity and quality of our social relationships (Paplau & Perlman, 1982). In fact, youth has been identified as a period associated with heightened levels of loneliness (Qualter et al, 2015; Barreto et al, 2021).

Unfortunately, loneliness has been associated with poorer mental and physical health, interrupted sleep, and lower wellbeing (Matthews et al, 2019; Rico-Uribe et al, 2018), resulting in its recognition as a public health issue in recent years. Consequently, loneliness is a significant issue that must be addressed to help young people all over the world.

This requires the development of evidence-based interventions addressing loneliness in young people. Three main types of loneliness interventions currently exist:

• social interventions, which aim to provide people with opportunities for social interaction and connection;
• interpersonal interventions, which work to strengthen social and emotional abilities; and
• intrapersonal interventions, which target an individual’s psychological processes.

Systematic reviews have been conducted to identify the issues with and future directions for current youth loneliness interventions (Eccles & Qualter, 2020; Pearce et al, 2021). They concluded that in order to be effective, interventions need to ensure that they target loneliness as the main issue rather than as a secondary outcome; be designed specifically for the target age group; and be tested to check whether the young people of the target age group view the intervention as acceptable and feasible. After all, how useful could an intervention be if young people don’t engage with it (acceptability) and it’s not practical to implement in the real world (feasibility)?

Therefore, Eager and colleagues (2024) conducted a qualitative study with young people aged 16-24 years, who self-identified as having experience of loneliness, to understand more about their views on the acceptability and feasibility of various types of loneliness interventions. They also aimed to establish how these young people thought the interventions could be improved.

Methods

The authors conducted 23 individual semi-structured interviews online with young people aged 16-24 years, who self-identified as having experience of loneliness (either past or current) and were living in the UK at the time that they were interviewed. Purposive sampling was used for 8 of the interviews, to ensure that the participants had a range of demographic characteristics.

The interviews were guided by a topic guide, with questions and prompts mainly asking about how acceptable and feasible they thought each type of intervention was, along with some general questions about the topic more broadly. To ensure that all participants had a similar level of understanding before the interview, they were given a presentation briefly explaining the three types of loneliness intervention.

Interview transcripts were analysed using reflexive thematic analysis (Braun and Clarke, 2006).

Results

The 23 young people who were interviewed were mostly heterosexual, living in urban areas, and had used mental health services. They had a diverse range of gender identities and belonged to various ethnic backgrounds. Six themes were identified based on these interviews, which reflected participants’ opinions on the acceptability and feasibility of interventions to combat loneliness for young people:

Choosing the appropriate intervention for each stage of loneliness

Many interviewees highlighted the value in tailoring intervention types to young people at different ages and stages of experiencing loneliness. For example, they thought that interventions using interpersonal strategies would be most effective and appropriate for young people aged 12-to-16, as this is an important time to start learning such social and emotional life skills.

Engaging people in interventions

Participants identified factors which could encourage or discourage young people from engaging in interventions for loneliness. Facilitators to engagement included the use of fun strategies, simple language, and positive alternatives to the use of the word loneliness. On the other hand, interviewees recognised that stigma around being viewed as lonely by others, and not always being aware that you are experiencing loneliness, might act as barriers to young people choosing to partake in an intervention addressing loneliness.

Optimising intervention setting and delivery

It was widely discussed that interventions for loneliness are more likely to be effective in certain settings, such as within a group, and when delivered at flexible lengths with short but frequent sessions.

Divergent views on the role of technology

Interviewees differed in how they thought technology should be utilised in interventions addressing loneliness. They recognised the significance of technology for this age group, with some believing that remote interventions or apps could increase accessibility and foster a more approachable environment. However, participants also discussed the negative role of social media in perpetuating loneliness amongst 16–24-year-olds, and shared concerns that online interventions might hinder young people’s ability to experience the same quality of interactions and skills learned in-person.

Clarity over the scope of an intervention

Participants identified the importance of clearly establishing the scope of an intervention. They proposed that general interventions aiming to help as many young people as possible would be effective for those feeling that they lack social connections, particularly when this is associated with a life transition; meanwhile a more targeted approach was deemed necessary for individuals struggling with more severe, prolonged loneliness.

Importance of using a combination approach

Almost all participants suggested that interventions for loneliness should be tailored to the individual person, as young people are likely to respond differently based on factors such as their preferred communication methods.

There were differing opinions over the best way to handle this. Some interviewees thought that the key parts of the three types of interventions for loneliness could be combined to produce a “comprehensive intervention, which targets loneliness from multiple angles”. Others argued that this might overcomplicate things and put people off taking part. An interesting suggestion was to present the intervention strategies in a hierarchy, with each type tried sequentially.

Conclusions

This study highlights the importance of the ongoing development of interventions that aim to reduce youth loneliness, as the current ones have limited acceptability and feasibility for this age group. These interventions should be flexible and personalised, in terms of the context, setting, duration and language used, to meet the diverse needs of this population.

Eager et al (2024) concluded that:

those designing interventions should consider the appropriate stage and scope of an intervention, how an intervention is delivered and the role of technology, and the importance of tailoring an intervention to meet a variety of needs.

The findings also emphasise the value in co-producing, research into and, the development of interventions alongside young people with lived experience of loneliness.

Strengths and limitations

The methodology employed by the authors had multiple strengths. The sample comprised a diverse range of young people with different marginalised identities, which is particularly important considering the evidence suggesting that members of marginalised groups disproportionately experience loneliness (Barreto, Qualter & Doyle, 2023). The study also addressed the limitations presented by previous research, making the results more specific and applicable to the population being investigated. For example, participants had direct, first-hand experience of loneliness, instead of just being a member of a group that was at high risk of loneliness.

Furthermore, public and patient involvement (PPI) input during the development of study materials helped to ensure that participants could understand and engage with the resources and that they all started out with a baseline understanding of the pre-existing interventions. However, I believe the authors could have incorporated further PPI work throughout the study. Involving young people at various stages – such as design, data collection and data analysis – would have been beneficial,  particularly since thematic analysis, the analysis technique used, is considered well-suited for engaging people with lived experience. The PPI work conducted could also have been reported in greater detail, clarifying how young people’s feedback was acknowledged and used to influence the study materials.

Another limitation was that the sample was likely to be influenced by voluntary participation bias, as discussed by the authors. In other words, the young people that volunteered to participate were likely to be aware of their loneliness, comfortable discussing their experiences, and not feeling severely lonely at the time of the study. As a result, severely lonely young people, those who feel uncomfortable discussing their experiences, or who lack insight into their loneliness are unlikely to be represented in, or resonate with the findings. Similarly, the sample only included one participant from a rural area, and did not assess participants’ socio-economic status, despite evidence indicating that individuals from both of these groups are disproportionately affected by loneliness.

Finally, it is important to consider that the study was conducted toward the end of the COVID-19 pandemic; a unique period during which young people were likely to have experienced loneliness more severely and in a tangibly different way. Consequently, some of the findings may not be generalisable to future generations of young people who were not adolescents during the pandemic. On the other hand, this could also be a strength of the study, as technology was particularly important during social distancing restrictions, which may mean that young people’s insights into the role of technology in loneliness interventions are better informed by personal experience.

Implications for practice

These findings provide valuable insight for clinicians, researchers and policymakers into young people’s views on the acceptability and feasibility of different loneliness interventions.

For researchers, a key takeaway is the need to explore which intervention characteristics are most appropriate for different stages of development and types of loneliness. Additionally, investigating the influence of societal and structural factors that impact loneliness, such as socio-economic status and urbanicity, will be essential to ensure that the views of a wider range of young people are represented in the literature and to gain a more nuanced understanding of the diverse experiences of loneliness. Importantly, future research should be conducted in collaboration with young people with lived experience of loneliness, involving them throughout the process.

As a young person that has felt lonely at times, I particularly recognise the importance of tailoring interventions to an individual’s specific needs and loneliness presentation. To me, this feels like a central idea that underpins all the themes identified by the authors, illustrating that a single approach to treating loneliness is unlikely to be effective for everyone, and that intervention design shouldn’t be approached with a “one-size-fits-all” approach (Eccles & Qualter, 2020). Clinicians should be mindful of this, ensuring that they work with young people experiencing loneliness to adapt treatments to their personal needs, and trying out different approaches if not initially successful.

Finally, policymakers should view these findings as a reason to invest in research focused on developing, implementing, and evaluating new interventions for youth loneliness. They should also recognise the issue of stigma surrounding loneliness, which was discussed by participants, and could be somewhat addressed through public health campaigns and school-based initiatives.

Statement of interests

I am currently working as a research assistant on the UNITE project which aims to understand the pathways to loneliness amongst socio-economically marginalised young people.

Links

Primary paper

Eager, S., Johnson, S., Pitman, A., Uribe, M., Qualter, P., & Pearce, E. (2024). Young people’s views on the acceptability and feasibility of loneliness interventions for their age group. BMC psychiatry, 24(1), 308.

Other references

Barreto, M., Qualter, P., Doyle, D. (2023). Loneliness inequalities evidence review. Wales Centre for Public Policy. WCPP-REPORT-Loneliness-Inequalities-Evidence-Review.pdf

Barreto, M., Victor, C., Hammond, C., Eccles, A., Richins, M. T., & Qualter, P. (2021). Loneliness around the world: Age, gender, and cultural differences in loneliness. Personality and Individual Differences, 169, 110066.

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.

Eccles, A. M., & Qualter, P. (2021). Alleviating loneliness in young people – A meta-analysis of interventions. Child and Adolescent Mental Health, 26(1), 17-33.

Pearce, E., Myles-Hooton, P., Johnson, S., Hards, E., Olsen, S., Clisu, D., Pais, S. M. A., Chesters, H. A., Shah, S., Jerwood, G., Politis, M., Melwani, J., Andersson, G., & Shafran, R. (2021). Loneliness as an active ingredient in preventing or alleviating youth anxiety and depression: a critical interpretative synthesis incorporating principles from rapid realist reviews. Translational psychiatry, 11(1), 628.

Perlman, D., & Peplau, L. A. (1981). Toward a social psychology of loneliness. In R. Gilmour & S. Duck (Eds.), Personal relationships, 3, 31-56. Academic Press.

Qualter, P., Vanhalst, J., Harris, R., Van Roekel, E., Lodder, G., Bangee, M., Maes, M., & Verhagen, M. (2015). Loneliness across the life span. Perspectives on psychological science: a journal of the Association for Psychological Science, 10(2), 250–264.

Photo credits

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