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Lonesome No More? A Two-Year Follow-Up of Internet-Administered Cognitive Behavioral Therapy for Loneliness


Lonesome No More? A Two-Year Follow-Up of Internet-Administered Cognitive Behavioral Therapy for Loneliness

Anton Käll et al. Internet Interv.


The current study sought to investigate the long-term effects of an internet-administered programme based on CBT principles for which the initial efficacy has been reported in Käll, Jägholm, et al. (In press). Seventy-three participants who were recruited on the basis of experiencing frequent and prolonged loneliness were contacted to complete questionnaires measuring loneliness, quality of life, and symptoms of psychopathology two years after the conclusion of the initial treatment period. Additional items regarding use of the treatment techniques and strategies contained in the programme during the follow-up period was included. In total, 44 participants provided data for the loneliness measure at follow-up. The outcome data were analyzed with a piecewise mixed effects model to provide estimates of change for the continuous measures. Linear multiple regression analysis was used to investigate the relationship between use of treatment techniques and reliable change on the primary outcome measure. The results showed decreases in loneliness during the follow-up period for the sample as a whole. Additionally, an increase in quality of life and a decrease in social anxiety were noted, but no significant changes of depressive symptoms or generalized anxiety. Effect sizes for the observed changes from baseline to follow-up were in the moderate to large range for all measures. Reported use of the treatment techniques was not significantly related to reliable change in loneliness after the two-year period. In conclusion, the results of the study support the utility of internet-based CBT targeting loneliness and indicate that the benefits from the intervention can be enduring.

Keywords: CBT; Guided self-help; Internet-based cognitive behavior therapy; Loneliness.

Conflict of interest statement

We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome.


Fig. 1
Fig. 1
The flow of the participants through the study.
Fig. 2
Fig. 2
Timeline for the treatment and measurement points. Abbreviations. ULS-3 = UCLA Loneliness Scale Version 3; BBQ = Brunnsviken Brief Quality of Life Scale; SIAS = Social Interaction Anxiety Scale; PHQ-9 = Patient Health Questionnaire 9; GAD-7 = Generalized Anxiety Disorder 7-item scale.

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