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Mindfulness, laughter and even robotic dogs may be some of the methods to help people cope with isolation and loneliness due to social distancing during COVID-19. 

Researchers from Cambridge’s School of Medicine undertook a review examining existing evidence on the different approach to curbing loneliness and isolation.

“We started planning this study back in March 2020 at the start of the first UK lockdown. We quickly realised that, with millions of people in the UK and worldwide suddenly unable to see their friends, family, and other social contacts, loneliness and isolation would become a major problem for potentially all members of society. In addition, while (quite rightly) a lot of attention and resources were devoted in the initial stages of the pandemic to preventing virus transmission etc, we didn’t want the mental health of the population to be overlooked,” Dr. Christopher Williams, lead author of the study told Theravive.

“As the first study evaluating interventions for loneliness and isolation in the post-COVID era, it provides the most up to date guide to available interventions. While not all interventions will be accessible and/or useful to everyone, we hope this serves as a starting point for policymakers, researchers and the general public to help relieve the burden of loneliness and isolation post-pandemic.” 

In undertaking the review, Williams and colleagues identified 58 studies examining interventions to reduce loneliness and social isolation. 51 of those studies related specifically to elderly people, who in the UK had some of the strictest restrictions relating to the pandemic. 

Among some of the approaches identified were laughter or reminiscence therapy. 

“The laughter therapy intervention involved a combination of laughter exercises, deep breathing exercises, singing songs loudly and laughter meditation. This can help to facilitate positive emotions in place of negative and can facilitate a sense of togetherness among other members of the group to improve overall mood and decrease loneliness,” Williams said.

“Reminiscence therapy involved structured weekly sessions involving topics that include sharing memories with each other, increasing participant awareness of their feelings, and recalling family history and life stories. By encouraging participants to share details about themselves with others, this can help develop and strengthen relationships as they begin to find common interests and experiences.” 

Another approach to combating loneliness and social isolation was robotic dogs.

“We identified a 2008 study (Banks et al) reporting the outcomes of weekly visits with Aibo, a robotic dog, in nursing homes. The study found that elderly patients interacting with Aibo had greater improvements in loneliness compared to control and a similar level of improvement compared to a third group who interacted with a living dog,” Williams explained.   

“This is an interesting observation when considered in the context of the COVID-19 pandemic, as a robotic dog may be much easier to sanitise etc than a living dog.

The exact mechanisms by which this helps with loneliness are unclear, but it is thought that participants perhaps become attached to the robot animal, forming an emotional bond in a similar way to that formed with living, breathing animals.” 

The researchers found that although the psychology-based interventions were often effective at combating loneliness, others were not as useful. 

“Many Psychological therapy interventions were effective, with studies of mindfulness-based therapies, Tai Chi Qigong meditation, laughter therapy and visual art discussions demonstrating significant improvements in loneliness outcomes. Similarly, education on how to make friends and how to address barriers to social integration was effective. In contrast, many interventions in the Leisure/skill development category were not effective – these include computer training interventions covering basic computer use and exercise-related interventions. Other effective interventions include an indoor gardening programme and video gaming,” Williams said. 

One of the main challenges, Williams says, with implementing some of the interventions studied is that those most in need may not have the means or knowledge to facilitate the use of complicated technology. 

“There is a considerable risk that those who are most likely to be lonely or isolated - and hence most in need of interventions - will not possess, or know how to use, electronic devices and/or a high-speed internet connection to facilitate intervention delivery. Any approach to help people suffering from loneliness or social isolation must therefore take these issues into consideration,” he said. 

He is hopeful policy makers, the general public and other researchers will be able to use the research to better assist those who are lonely during the pandemic. 

“Ultimately, there is no one-size-fits-all intervention that will work for everyone. Different people from different backgrounds may have different reasons for being lonely. For instance, some may not physically be able to set up daily video calls (and thus some form of Social facilitation device will be beneficial), whereas others may have had difficulty adjusting to the sudden loss of social contact and are unaware that their low mood is a result of loneliness – these people may benefit from learning more about what loneliness is, and how to address the feeling itself,” he said.

“This research provides an overview of what interventions are available for people to try, and we hope that one or more types of intervention can help reduce their feelings of loneliness or isolation.”