10 June 2021

Some 5% of the Swedish population report that they feel alone – often or always. Doctoral student and LiU graduate Anton Käll is studying methods used in internet-based cognitive behavioural therapy for helping people with loneliness.

Anna Nilsen

Trying remotely to help people who feel alone might sound rather strange at first. But it has been tested years before the pandemic forced many of us to livein isolation.

“Our starting point is that the behaviours and thought patterns that occur in loneliness resemble those that have been observed in certain psychiatric conditions for which internet-based cognitive behavioural therapy has been successfully applied” says Anton Käll, who is also a licensed psychologist.

Photo credit Anna NilsenAnton Käll is part of a research group led by Professor Gerhard Anderssonwhere internet-based cognitive behavioural therapy(CBT) has put Swedish research and Linköping University on the world stage. For some 20 years, Andersson, together with students and colleagues, has created methods that help people manage sleeplessness, tinnitus and heart failure.

What is the definition of loneliness? 

“Simply put, it’s a signal that is present ineveryone. We define it as the difference between the current social situation and how one wishes it was. Often it's a temporary difference.”

  Photo credit Anna Nilsen

Afraid of being rejected

Anton Käll points out that unwanted loneliness is not a condition or necessarily a problem. But it can become an experience that recurs during long periods.

People who feel alone for longer periods appear to have behavioural and intellectual obstacles that help cause the condition to persist. They also tend to remember when they have failed in social situations. 

“You become less inclined to try to break the loneliness; perhaps you’re afraid of being rejected. ‘If I say how I feel, I won’t be taken seriously – these people don’t actually like me’. Negative thoughts like these seem more common in this group.”

 

“You withdraw, and don't fight as actively to satisfy your social needs.”

Internet-based treatment aims to identify a negative spiral, to get the patient to understand it, and then to stop this behaviour. The patient gets assignments and regular contact with a treating psychotherapist.

“You log onto a web platform, and you have written contact on a weekly basis by way of a notification system with the persontreating you.”

Roughly the same

Anton Käll says that the arrangement would have been roughly the same if patient and treater had met face-to-face. But since everything is written down, the assignments are very clear. The patient can follow the instructions and review the information.

“Internet-based treatment shows clearly that the patient has the power and the capacity to affect his or her own situation. The patient has the potential for change, and can create the conditions required to feel better.”

As licensed psychologist, Anton Källbegan his doctoral studies in 2017, based partly on a pilot study of an internet-based treatment programme he co-developed during his psychology training at Linköping University.

“The study had 73 participants , and there were indications that the method helped them improve their quality of life and reduce their feeling of loneliness.”

The results were followed up after two years. The reduction in loneliness that was observed in the study was still present, and roughly 40% of the group demonstrated a clinically significant improvement.

“This shows that the results of the treatment were lasting, which is important. However, many don't feel a significant improvement. How can we offer help to this sizeable group?”

Similar projects

The research has continued with similar projects, including trials with interpersonal psychotherapy (IPT), which is based on past events involving the patient’s family and loved ones – for instance a divorce or the death of someone close.

“These could be common causes of loneliness. But the results of the study showed that it was more difficult to achieve good results with IPT than with CBT in internet-based therapy, in the treatment of loneliness.”

Photo credit Anna NilsenDo you have any advice for someone who feels lonely? 

“In CBT we take care to not make evaluations based on how the meeting seemed at the time. In social relations it can take time before you discover what you have in common. You often have to think in the long term. Initially it can feel awkward or tentative. But with time it can lead to valuable social contact.”

 

Anton Källhas published three scientificarticles in his subject, and he plans to finish his doctorate in 2021. Then he wants to continue studying the treatment of loneliness.

“There is not very much research in this field, and very little that is grounded on internet-based therapy. It's interesting to be involved in building the foundation of something that could help many people.”

 

Facts/Anton Käll

Profession: Licensed psychologist and doctoral student at Linköping University.
Age: 28.
Currently: Researching loneliness. 
Best thing about research: I get to satisfy my curiosity during working hours. 
Last book read: Let’s Go (So We Can Get Back) by Jeff Tweedy

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