, 2009) to one with high-risk Naval recruits at basic training who met for 45 minutes per week for 9 weeks to learn, discuss, and practice strategies for increasing one’s sense of belonging, decreasing thought distortion, and improving one’s coping and stress management (Williams et al., 2004). 162), while interventions to increase opportunities for social interaction (mean effect size = ?.062, n.s.) and interventions to improve social skills (mean effect size = ?.017, n.s.) were not found to be effective in lowering loneliness. These findings reinforce the notion that interpersonal contact or communication per se is not sufficient to address chronic loneliness in the general population.
This model points to a number of sources of dysfunctional and irrational beliefs, false expectations and attributions, and self-defeating thoughts and interpersonal interactions on which interventions might be designed to operate
One key to (social) cognitive behavioral therapy (CBT) in the framework of reducing loneliness is to educate individuals to identify the automatic negative thoughts that they have about others and about social interactions more generally, and to regard these negative thoughts as possibly faulty hypotheses that need to be verified rather than as facts on which to act (Anderson, Horowitz, & French, 1983; McWhirter, 1990a; Young, 1982). By aiming to change maladaptive social perception and cognition (e.g., dysfunctional and irrational beliefs, false attributions, and self-defeating thoughts and interpersonal interactions; Young, 1982; for reviews: Cacioppo & Patrick, 2008; Masi et al., 2011; McWhirter, 1990a), CBT approach implies that loneliness can be , McWhirter, 1990a, for reviews).
These studies ranged from one with elderly adults from a nursing home in Tapei who participated in eight weekly sessions designed to increase awareness and expression of their feelings, to identify positive relationships from their past, and to apply these prior experiences to their current relationships (Chiang et al
Research on social cognition as a function of loneliness has resulted in the model depicted in Figure 2 . According to this model, lonely individuals typically do not voluntarily become lonely; rather, they “find themselves” on one edge of the continuum of social connections (S. Cacioppo & Cacioppo, 2012) and feeling desperately isolated (Booth, 2000). The perception that one is socially on the edge and isolated from others increases the motive for self-preservation. This, then, increases the motivation to connect with others but also increases an implicit hyper-vigilance for social threats, which then can introduce attentional, confirmatory, and memory biases. Given the effects of attention and expectation on anticipated social interactions, behavioral confirmation processes then can incline an individual who feels isolated to have or to place more import on negative social interactions, which if unchecked can reinforce withdrawal, negativity, and feelings of loneliness (e.g., see J. T. Cacioppo & Cacioppo, 2014; J. T. Cacioppo & Hawkley, 2009). For instance, the attentional, confirmatory, and memory biases could be targeted by training in perspective taking, empathy, and identifying automatic negative thoughts about others and about social interactions and in regarding these negative thoughts as possibly faulty hypotheses that need to be verified, whereas faulty behavioral confirmation processes could be targeted by training in mindfulness (Baer, 2003; Creswell et al., 2012) and capitalization (sharing good times; Gable & Reis, 2010; Woods et al., 2014).
In sum, a primary criterion for empirically supported therapies is that they demonstrate efficacy in randomized controlled studies. Although more research is needed, the meta-analysis suggests that interventions designed to modify maladaptive social cognition may be especially worth pursuing. Such interventions can be expensive and time-consuming, and the client’s lack of openness to changing their thoughts about and interactions with others can be an obstacle to effective treatment. It is possible that these interventions may be more effective (or effective for a greater proportion of individuals) if augmented initially by an appropriate pharmacologic treatment.