Empathetic Phone Call Program Reduces Loneliness, Depression & Anxiety In Older Adults: Study

A lonely man with a face mask looks his mobile phone during a sunny and warm Valentine’s Day on … [+]

A new study published in JAMA Psychiatry reported that a layperson-delivered, empathy-oriented telephone call program reduced loneliness, depression, and anxiety and improved the general mental health of participants within four weeks.

In the last year, the epidemic of loneliness has had significant consequences since lockdowns were enforced to prevent the transmission of the coronavirus.

According to the Harvard Graduate School of Education, 61 percent of young people between the ages of 18 to 25 reported experiencing serious loneliness — they said they are either lonely frequently, most of the time, or all the time.

Loneliness has been indicated as a risk factor for overall mortality and conditions from stroke to heart disease. It is also associated with depression and anxiety. Other than young people, older adults and those who are highly vulnerable socioeconomically are at a high risk of suffering from social isolation and loneliness.

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While the mental health workforce is constrained, not everyone has access to cognitive-behavioral therapy-based approaches — that are known to be effective in tackling loneliness — as they required trained counselors.

In March 2020, a group of researchers became aware of the challenges facing Meals on Wheels Central Texas clients because of reduced contact.

In response, they designed a program that could be rapidly spun up and deployed. The telephone calls program involved laypeople engaging regularly, with empathetic intention, through telephone calls with participants.

“Empathy was functionally defined as prioritizing listening and eliciting conversation from the participant on topics of their choice,” the researchers wrote.

The protocol included an initial exposure to daily calls. Once exposed to the experience, participants chose the frequency of calls they prefer. ‘Our goal was to test the program’s effectiveness in combating loneliness and other mental health conditions we expected might be worsening during COVID-19,’ the researchers wrote.

They first recruited 16 people as callers from the ages 17 to 23 years and trained them through a one-hour video conferenced session. The goal presented to callers was to learn from those they called by asking specific questions about topics raised by participants. No conversational prompts were provided nor training on CBT or its components. A short video was used to demonstrate techniques through role-playing.

Following that, from July 6 to September 24, 2020, the researchers also recruited and followed up 240 adults between the ages of 27 to 101 years who were assigned to receive calls (intervention group) or no calls (control group). Around 63 percent of the participants were 65 years old and 79 percent were women. More than half of them lived alone.

Loneliness, depression, and anxiety were measured at enrollment and after 4 weeks. The Meals on Wheels Central Texas clients received calls in their homes or wherever they might have been when the call was received. The study included clients who were homebound and expressed a need for food.

Each caller contacted 6 to 9 participants over 4 weeks daily for the first 5 days, after which clients could choose to drop down to fewer calls but no less than 2 calls a week.

“A four-week, telephone-based, empathy-focused program delivered during the summer of 2020 reduced loneliness, depression, and anxiety in homebound, largely single, adults who require meals from a community-based provider,” the researchers wrote. “The reminiscence intervention focused on participants sharing experiences rather than a structured approach. Both programs also significantly improved depression.”

Yet, the researchers noted that a major limitation of the study is that it was unclear whether these benefits could be sustained after four weeks. They further noted that future work should address whether improvements can be sustained, or enhanced, with a longer implementation period.

Anuradha Varanasi is a freelance science writer. She writes on the intersection of health/medicine, racial disparities, and climate change. She earned an MA in Science

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