Exploring the influence of loneliness and social isolation in transdiagnostic ICBT for depression and anxiety

Why was the study done?

There is limited research on the effect of perceived and objective loneliness in patients receiving Internet-delivered cognitive behaviour therapy (ICBT), despite prior research showing that social factors (i.e. loneliness) influence mental health outcomes. A patient’s social circumstances could be especially relevant to ICBT, due to the treatment’s emphasis on independently applying self-help techniques and receiving asynchronous support from clinicians.

What was done in the study?

Participants received access to the Wellbeing Course: an 8-week course consisting of 5 core lessons that each focus on a different concept within CBT, as well as corresponding case stories and worksheets. Additionally, participants were matched with an e-therapist who they could correspond with weekly. Clinical outcomes were measured at the 8 week and 20 week timepoints, and included measures of depression, anxiety, loneliness, and social engagement. Analyses were performed to examine the interaction between loneliness and social isolation on both depression and anxiety.

What did we find out?

Loneliness and social isolation were highly prevalent among the sample at the beginning of treatment. High loneliness was associated with lower rates of treatment completion, and high social engagement was associated with higher rates of completion. The results indicated that loneliness, but not social isolation, moderated the change in symptoms of depression during the treatment. Neither loneliness nor social isolation had an observable effect on anxiety. However, both depression and anxiety tended to reduce in severity over the treatment period.

Where do we go from here?

Future studies on ICBT and loneliness could look at developing treatment materials (e.g. lessons, resources) specifically targeting loneliness and measuring their effects on treatment outcomes. This could be measured with a randomized trial comparing outcomes of ICBT with or without loneliness content.