Monday, April 5, 2021

Psychotherapy Aimed at Social Engagement Reduces Depression Associated With Loneliness

A form of psychotherapy aimed at helping older adults feel more connected to other people reduced depression and improved quality of life for those who had reported they felt lonely and/or were a burden to people around them, according to a study in the American Journal of Geriatric Psychiatry.

“Social connection is essential for health and quality of life at all ages and may be an especially useful intervention target for promoting mental health in later life,” wrote Kimberly Van Orden, Ph.D., an associate professor of psychiatry at the University of Rochester, and colleagues.

The researchers adapted a manualized form of behavioral psychotherapy called Engage Psychotherapy to specifically target social connection among older adults at risk for suicide. Engage is designed to help patients reengage with the pleasant, physical, and/or social activities they may have stopped doing because of their depression. Participants create “action plans” that involve setting a goal, brainstorming ways to achieve the goal, and selecting specific actions to take before their next session. The form of Engage used in the study is called Social Engage, which includes psychoeducational materials to address the importance of social connection and instructions to therapists to focus action plans on social engagement.

Participating in the study were 62 adults aged 60 years or older who endorsed feeling lonely and/or feeling like a burden to others in the prior two weeks. Thirty-two individuals were randomly assigned to 10 sessions of Social Engage, and 30 were assigned to usual care. Follow-up assessments were at three weeks, six weeks, and 10 weeks.

Outcomes were measures of depression and suicidal ideation using the 16-Item Quick Inventory of Depressive Symptomatology (QIDS-C) clinician interview, the Geriatric Suicide Ideation Scale, and measures of social-emotional quality of life using the World Health Organization Quality of Life Scale.

Social Engage was associated with statistically significant improvements in depression at all timepoints and in social-emotional quality of life. It was not associated with a perceived sense of being a burden or belonging.

“[F]eedback from participants suggests that improvements may unfold over time, indicating a longer duration of intervention and follow-up may be needed to document improvement in subjective connection,” the researchers wrote. “[P]articipants reported increased insight and awareness of the importance of social connection, increased social engagement, and acquisition of skills to manage barriers to social engagement; however, it may take more time (and practice) to build/improve social connections that impact perceptions about social connection.”

For related information, see the Psychiatric News article “Loneliness Persists Even When Older Adults Live in Social Environments.

(Image: iStock/kate_sept2004)




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