A Pilot Digital Intervention Targeting Loneliness in Youth Mental Health

Abstract

Background: Loneliness is an emerging issue for young people, but yet many interventions to address loneliness in this group focus on providing social opportunities. While these sorts of interventions may appear to increase social connections, loneliness is more related to quality rather than quantity of social relationships. Thus, interventions addressing loneliness should focus on maximizing the quality of current relationships. Together with youth consumers both with mental ill health and those without, we developed a digital smartphone application (app) called +Connect. The 6-week program delivers positive psychology content designed to improve relationship quality. We tested the acceptability, feasibility, and safety of the program in lonely young people with or without a mental health diagnosis of social anxiety disorder. We used a mixed method study design to triangulate pilot quantitative and qualitative data in young people with and without social anxiety disorder (SAD). Method: Nine participants with a diagnosis of social anxiety disorder ( M age = 21.00; SD = 1.41) and 11 participants with no mental health conditions ( M age = 20.36; SD = 2.16) completed the +Connect digital intervention. Results: Those with social anxiety disorder reported less acceptable ratings on outcomes. Feasibility ratings, measured by uptake and app completion, met a priori threshold criteria in both groups. Those with social anxiety disorder yielded more attrition, with almost double the attrition rate compared with those without the disorder. There were no safety issues elicited during the pilot study. In terms of outcomes, exploratory analyses indicated that the app itself is likely to be beneficial rather than cause harm. Our qualitative data indicated both groups reported no negative outcomes and noted that positive outcomes were driven by three processes: reflection, learning, and real-life application. Further exploratory data on usability indicated room for improvement in terms of giving more support for different components of the app (i.e., challenges). Conclusion: The pilot findings of this proof-of-concept app indicates some promise in terms of a second iterative version of +Connect.

The young Australian loneliness survey Understanding loneliness in adolescence and young adulthood

“…Educational programs designed to reduce loneliness however may be more effective if they include teaching cognitive reappraisal of social interactions that may be ambiguous, and how to signal a willingness to connect with others via positive affect. Indeed, solutions that adopt a cognitive-behavioural and positive psychology approach have already shown promise in terms of reducing loneliness in young people and other vulnerable groups [74,75,88,1] . Additionally, programs that are further augmented with the provision of safe social opportunities are likely to be more effective than those without.…”

Commentary: A Pilot Digital Intervention Targeting Loneliness in Youth Mental Health

“…An impressive 75%-100% of participants with SAD reported +Connect to be helpful. However, the researchers also noted a high attrition rate for participants with SAD, which was almost double the rate of those without the disorder (5).…”

“…To combat rising rates of loneliness, a number of interventions are available that focus on increasing social connections. However, as Lim et al (5) suggests, increasing the quantity of relationships is not, by itself, enough. In order to improve feelings of loneliness, it is also necessary to address the quality of relationships.…”

“…This is the central aim of the +Connect smartphone app. The pilot of +Connect offers exciting preliminary insights into the delivery of an intervention for loneliness in young adults (5). However, design choices in a number of areas-including the digital platform used in the intervention and a focus on current relationships-set boundaries on the utility of the current iteration of the app.…”

“…Another strength is that the app offers an alternative to medical approaches that posit that loneliness is a condition that requires pharmaceutical treatment (9). +Connect provides a non-medical, psychologically based intervention that offers users skills that also benefit the general population, irrespective of their mental health status or even whether they are lonely or not (5).…”