Do Internet Based Interventions for Loneliness Work?

As a psychologist, I am highly aware that psychotherapy is a luxury to which the vast majority of people do not have access, whether for financial or other reasons. The question now is: Can internet-based psychological interventions fill the gap and offer effective treatments for the many people who cannot access one-on-one mental health services?

The issue is even more important given emotional health concerns such as loneliness were considered to be at "epidemic" levels even before the coronavirus pandemic. In 2017, Surgeon General Vivek Murthy declared loneliness to be a public health crisis that rivaled smoking and even obesity. Indeed, chronic loneliness is as damaging to our long-term health and longevity as smoking 15 cigarettes a day, research suggests. Now, after several months of quarantines, working-from-home and social distancing practices, loneliness has become more widespread and more severe for many.

The good news is that new studies are investigating internet-based psychological interventions to loneliness. If effective, these kinds of interventions could be an incredibly cost-effective way to help millions of people who do not have access to in-person mental health services.

One recent study assessed the efficacy of an 8-week internet-based cognitive behavioral treatment for loneliness on 73 participants. Results showed a significant improvement in loneliness and quality of life compared to a control group. What set this study apart was the comprehensive approach they took to addressing loneliness and the various ways it impacts our perceptions and relationships.

Specifically, the intervention included 8 different modules that participants took over a period of 8 weeks. Each module included psycho-educational and behavioral assignments. Among the modules were (1) Increasing understanding of loneliness and its impacts (2) Identifying goals and values (3) Identifying and challenging dysfunctional thoughts and beliefs (4) strategies to reduce rumination (5) Behavioral techniques aimed at increasing social contact including a rationale for why doing so is important, and (6) relapse prevention.

One rather big caveat is the study did use some therapists-in-training to provide feedback and on homework assignments and answer questions via a messaging function. However, the feedback was generally focused on providing reinforcement, expressing “empathetic utterances,” and highlighting participants’ successes. So yes, actual people were still required to support the intervention but all of their human functions could conceivably be done by artificial intelligence programs, if not today, in the near future.

Am I worried my job as a therapist will someday be taken over by a machine? Not really. We're far from the point of a computer passing the Turing test (which involves a computer being able to respond in such human ways as to be indistinguishable from a real person) and an AI could pass such a test, the ability to pass as human is not sufficient to make a machine a competent therapist—even real humans need years of training and experience for that.

That said, might we be close to a time when conditions such as loneliness could be treated with decent efficacy online and be available to anyone with an internet connection? I very much hope the pandemic-induced surge in loneliness might result in increases in both funding and urgency, so such efforts can move forward.

Copyright 2020 by Guy Winch Ph.D.