What’s New in Psychology?
LISTEN To Combat Loneliness in Adults
Jim Windell
In 2023, the Surgeon General declared a loneliness epidemic in the U.S. Have we made progress since then in reducing loneliness among adults?
According to a recent Gallup poll, a significant number of U.S. adults – an estimated 52 million, based on Gallup’s current estimate – still struggle with loneliness.
The most recent results, obtained during August and September, 2024, are based on 6,289 U.S. adults surveyed by web as a part of the Gallup Panel, a probability-based panel of about 100,000 adults across all 50 states and the District of Columbia.
Findings show that 20 percent of U.S. adults feel loneliness “a lot of the day yesterday.” This finding is a slight increase in the rate after several quarters when it hovered around 17 or 18 percent. Still, the current rate remains lower than the 25% highs measured three times – most recently in March 2021 – during the COVID-19 pandemic.
Loneliness, as a social construct, is defined as the difference between an individual's desired and actual social relationships. Based on research, loneliness is more than just a feeling; it is a significant biopsychosocial stressor with a mortality risk comparable with smoking more than 15 cigarettes a day and more deleterious than alcoholism, obesity, and physical inactivity.
Since, as the recent Gallup Poll suggests, loneliness in the U.S. is common among adults, and this is particularly worrisome as loneliness is linked to chronic physical health conditions including cardiovascular disease, stroke and hypertension. Studies show that loneliness’ influence on mental and cognitive health outcomes, including depression and Alzheimer's Disease and related dementias, is especially strong. That is one of the reasons the Surgeon General declared loneliness an urgent public health issue worthy of the “same investments” researchers and policy makers have made in addressing tobacco use, obesity, and the addiction crisis.
Laurie Theeke, Ph.D, and associate dean for the Ph.D. program in Nursing program at George Washington University, has been studying loneliness in older adults for 15 years. She says that simply socializing more or meeting new people is not the solution to addressing the issue of loneliness and social isolation,
Theeke points out that over the last decade evidence has mounted that confirms that loneliness is a perception of one’s ability to meet their human needs for belonging, and it contributes to negative health through the physiological, psychological, and social mechanisms associated with stress and behaviors. In 2014, Theeke developed the cognitive behavioral intervention LISTEN (Loneliness Intervention using Story Theory to Enhance Nursing sensitive outcomes).
Instead of focusing on the usual interventions for loneliness by treating it as a social problem, Theeke and her study team worked to understand the historical literature on loneliness. They concluded that the most effective intervention would be one that addressed dysfunctional thinking associated with loneliness so that people could understand their own need for belonging and make individualized choices for action to diminish their experience of loneliness.
Since then, the studies Theeke has conducted have shown LISTEN to be effective in diminishing loneliness and systolic blood pressure in older adults and adults who have suffered stroke.
LISTEN is a 10-hour cognitive behavioral intervention that is designed to be delivered in a determined logical sequence of five sessions, each focusing on the concepts relevant to loneliness as derived from the literature. For each session, intervention delivery is guided by the concepts from story theory (including intentional dialogue, nurse as listener, examination of self in relation to others and community, synthesizing concerns and patterns, and identifying messages) and the principles of cognitive restructuring, including self-assessment of maladaptive cognitions, emotions, and behaviors, identifying challenges of changing, reconceptualization of self, new skill acquisition through group interaction, and identifying patterns of meaning in loneliness.
Theeke recommends asking your patients about loneliness. “It’s important that we know if patients are lonely and that we make a plan for treatment,” Theeke says.
To read the original articles on which this blog is based, find them with these references:
Theeke, L.A., Horstman, P., Mallow, B., Culp, A.M., Lucke-Wold, A., Domico, J. and Barr, T.L. (2014). Quality of Life and Loneliness in Stroke Survivors Living in Appalachia. Journal of Neuroscience Nursing, 46, E3-E15.
http://dx.doi.org/10.1097/JNN.0000000000000097
Theeke, L. and Mallow, J. (2015). The Development of LISTEN: A Novel Intervention for Loneliness. Open Journal of Nursing, 5, 136-143. doi: 10.4236/ojn.2015.52016.
James, M.P. & Witters, D. (2024). Daily Loneliness Afflicts One in Five in U.S. Gallup. Available at: https: //news.gallup.com/poll/651881/daily-loneliness-afflicts-one-five.aspx
