Working with Loneliness: Interventions to Support Lonely Clients

Loneliness is common, but the best interventions to alleviate it depend on the cause, such as trauma, illness/disability, ageing, or modern technology.

Related articles: Working with Loneliness: Definitions and Characteristics, Working with Loneliness: The Pain and Costs, The Stigma and Shame of Loneliness.

Introduction

Whole books have been written to advise on specific aspects of loneliness. In this final article of our 3-part series examining loneliness (read the first two articles here, and here), we highlight the dynamics mainly at play, and therefore which interventions will be most effective, with loneliness arising from trauma, difference or disability, ageing, and modern technology. We are calling each these a loneliness “territory”. Trauma is first up.

Alleviating trauma-induced loneliness

A trauma survivor feels unsafe, unable to tell the trauma story in a meaningful and coherent way and disconnected from themselves and others, ushering in the profound loneliness-making sense that no one understands them.

Herman’s Stage 1: Safety and stabilisation

Judith Lewis Herman, a renowned trauma practitioner, divides the treatment of trauma into three stages, with the first one being “Safety and stabilisation”, the second (where talk therapy can happen effectively) called “Remembrance and mourning,” and the third and final stage referred to as “Reconnecting” (Herman, 1997). Here are the therapies that are recommended for each stage.

While overlapping, the distinct therapies for Stage 1 can help move a client from the overwhelm of trauma to a place of greater connectedness.

• Cognitive behaviour therapy (CBT)
• Dialectical behaviour therapy (DBT)
• Positive psychology
• Mindfulness
• Creative and expressive therapies, such as art and music therapy (Van Leeuwen, 2022)

These and other trauma-informed approaches can help enhance awareness of the trauma dynamics, ushering in a place of readiness to begin reconnecting to self, others, and their lives in general. That reconnecting begins in earnest at Stage 2.

Stage 2: Remembrance and mourning

At this stage of recovery, the main work involves reviewing and/or discussing memories to lessen their emotional intensity, to revise their meanings for one’s life and identity, and to reduce flashbacks and nightmares if they are ongoing problems. Once clients have achieved a firm foundation of safety, stability, and self-regulation skills, they can engage in the work of thinking and talking about painful memories, so what is needed are memory processing methods which can be used to help the brain achieve the memory reconsolidation.

Methods which involve re-experiencing the memories within a safe and healing therapy setting are effective here:

• Eye Movement Desensitisation and Reprogramming (EMDR)
• Exposure therapy (Cleveland Clinic, 2025)

Therapists need to be certain that the client has achieved some sense of safety and stability for exposure therapy to be effective and not overwhelming.

Stage 3: Reconnecting

The third stage of recovery focuses on reconnecting with people, meaningful activities, and other aspects of life. During Stages 1 and 2, the client learned about how the trauma made connecting difficult, if not impossible. Now, from a place of relative safety, stability, and emotional regulation, with emotionally disturbing material resolved, the client can wholeheartedly pursue a life of coming together with valued others.

By this stage, a trauma-affected lonely client is more ready than ever to do the meet-and-greet activities that would, at first glance, seem to be the most appropriate interventions for therapists to recommend for loneliness. Thus, therapist and client can jointly create a plan which brings the client into the vicinity of people with whom they might like to connect: for example, those of the same religious faith, those regularly engaging an activity that the client would like to do (e.g., rowing, tennis, or a book club), or friends or family with whom they wish to reconnect. Thus, the following interventions are likely to work.

• Behaviour activation therapy (BAT) (Villines, 2021)
• Social prescribing (in healthcare, a process wherein healthcare professionals, like GPs and nurses, connect patients to non-clinical services and activities in the community to improve their health and wellbeing. It focuses on addressing the social determinants of health (World Health Organization, 2022).

Decreasing loneliness from illness or difference/disability

As with those lonely due to trauma, those who withdraw from connection due to illness or disability must eventually get out and reconnect with others, but just saying, “Get out of the house and go meet up with people” is grossly inadequate. The person who is either unwell or has a disability or condition which makes them “different” also needs to know how to connect with others with regard to and in the context of their limitation(s). There are two crucial points about which you must psychoeducate an unwell client or one with disabilities: the importance of support and the (possibly modified) ways which they can (must) find to socialise.

Types of support

You can ask clients directly: “To whom do you turn when you need support?” “Whom do you have in your life to listen to you about how difficult this illness/condition can be?”

Sadly, in this time of ever-greater digital connection concomitant with ever-decreasing in-person sources of support, social support may be an area to be worked through therapeutically. It can come in many forms, such as appraisal (giving feedback and validation of one’s strengths and weaknesses or validating feelings and experiences), instrumental/practical (such as being given a ride to and from the hospital when one cannot drive oneself), informational (such as information that is available on community resources), and emotional (which offers comfort, non-judgmental listening, and empathy, especially when someone is undergoing tough times) (Scott, 2023).

An important point here is to alert the client to the idea that they may have to speak up to those supporting them about what type of support they would like. Family members may feel pressure to offer practical support, but your client might just want someone to stop, sit down, and converse with them.

Circles of Connection

One idea is to create a sociogram, giving the client a visual representation of who is in their life circles, what sort of connection they offer, and how close they are. British psychologist Robin Dunbar advocates asking clients to put themselves in the centre of four concentric circles. Outside oneself, there are qualitative, functional, and structural circles, moving outward. Former U.S. Surgeon General Vivek Murthy supports this notion (and adds alternative naming).

• Qualitative (also called “intimate”). The innermost circle represents those “qualitative” relationships: the intimate friendships with whom a client may share the deepest bonds of affection and trust, including romantic partners, family, and close friends. They are the strongest bonds, ones which provide ongoing protection and emotional support.
• Functional (also referred to as “relational”). The next circle moving outward is defined by the degree to which someone can rely on others for various needs. The functional circle contains people who offer shared support and connection primarily on a reciprocal basis.
• Structural (also known as “collective”). This outer circle is structural, containing members of the larger community, neighbours (who are not also friends), colleagues, classmates, and acquaintances (such as the checkout clerk at the grocery store) who help the client feel part of a collective (Murthy, 2020; Saint-Andre, 2023).

Dr. Dunbar warns that, without direct, face-to-face communication, relationships with the core people (in the inner circle) will wither. These relationships, particularly, need to be nurtured, with conflicts resolved and interactions occurring between parties who are fully present and available to one another (Murthy, 2020).

Where to go to increase socialising and connecting

Once your client has analysed which types of relationships they feel they most greatly lack, you can collaborate on a plan to enhance the socialising – and, hopefully, connecting – that may happen for them. The efforts are most successful when personalised to the person’s condition.

Andrea Wigfield (2024) has put together an extensive list of strategies which your client can tailor to their condition, and government and health systems increasingly help create groups to support particular illnesses/disabilities, such as those for cancer or deafness. While the Circles of Connection exercise tends to favour the alleviation of psychological loneliness, many of the suggested strategies below more directly address societal loneliness: that is, the sense that one does not belong or has not found their “tribe”.

• Support groups: online or in-person
• Exercise
• Engaging in meaningful activities
• Exploring YouTube
• Creating a bucket list
• Online coffee lounges
• Friendship and dating apps
• Gaining paid or voluntary employment
• Joining social media groups
• Peer Support
• Getting a buddy or befriender (adapted from Wigfield, 2024)

Assuaging loneliness arising from retirement, caregiving, bereavement, or ageing

Numerous life transitions usher in a period of loneliness. Unfortunately, many of them tend to occur in older age, when a person is already dealing with the unwelcome developments of increasing infirmity or frailty, diminishment of sensory capacity, and loss of power in life roles. Here we examine loneliness coming about as a result of the life transitions of retirement, caregiving, bereavement, and general ageing.

Retirement

People often look forward to their retirement, seeing it as a golden time of unlimited freedom. However, for many, the dynamics of loss of status, purpose, and identity; loss of income, the loss of social contacts with whom the person worked; and loss of income add up to a period more akin to bereavement as these multiple losses are grieved. Here are some strategies for helping a client drive out of this part of loneliness territory.

Plan for retirement

Where does the retiree think they’d like to live? With whom will they spend time? How will they structure time? Even a strong passion, such as golf, cannot be engaged 24/7 for years without losing its shine!

Find a hobby, skill, or cause to pursue

Did your client always fancy learning to play classical guitar? Become fluent in French? Alternatively, numerous studies have now demonstrated that volunteering yields many benefits for the volunteer as well as the parties they are helping. Would your client enjoy tutoring school students in a subject they used to enjoy?

Keep up existing connections and expand them

Is the person a member of a civic group, such as a local chamber of commerce? Are there people in their industry (not necessarily in their former company) with whom they would enjoy continuing to connect?

Keep body and mind active

Regular physical movement not only enhances physical and psychological wellbeing; it also tends to increase social interactions.

Work specifically on getting a sense of belonging

A subtle way you can suggest of enhancing that sense of “Yes, I belong here” is by encouraging the client to visit spaces, particularly green spaces, that they have always felt “at home” in; these are often a local park, hiking trail, beach, or other nature reserve where the person can take a deep breath, survey the natural beauty, and know that they belong to something much large then themselves (categories adapted from Wigfield, 2024).

Prioritise time with family

The client can enjoy the delights of the interaction and help the grandkids, too, given that loneliness is sharply rising for young people. Here’s an idea: can the young person teach the retiree any IT skills, such as to do with social media, gaming, or even how to access platforms such as YouTube or AI creative tools? It could be a win-win!

Caregiving

The (unpaid) caregiver’s lot is most often a lonely one, for several reasons. If the caregiver is also working at paid employment, there is little to no time to maintain friendships and other support networks after both paid work tasks and caregiving responsibilities have been tended to. Depending on the intensity of the caregiving tasks and other factors in the situation, the caregiver who is not working may be unable to leave the home (if that’s where the caregiving is happening) long enough to have an outing. They may feel embarrassed to invite friends over, and/or going out would trigger strong feelings of guilt. But not to tend to oneself in this role is a surefire way to arrive at burnout. Let’s look at what’s in play here.

Becoming a caregiver means relational changes

Your client may come to you exhausted with their caregiving responsibilities. These could be due to care for a chronically unwell or disabled child, for a spouse, or for a parent or other family member. The caregiving duties could have been increasing gradually (as with some terminal and/or degenerative conditions), or the need to become a caregiver could have come on suddenly, as when someone has a stroke. Either way, there is a period of adjustment to the role. Regardless of who it is that the client is caring for, the taking-up of the caregiving role usually means dual roles and it is the other role – as the person’s spouse or child – which tends to change significantly.

Role reversal

Growing up, your client was, hopefully, cared for by their parent, who met their various needs, nurtured them, and provided support, including emotional support. If the client is caring for a parent (the most common caregiver role seen), the roles are reversed, and it can be tricky to negotiate how the child-parent relationship looks now. With the role reversal, the child has lost the parent as a source of support and may not be able to easily access friend or other supports due to time and other constraints; in other words, it is a loneliness-making situation.

Unequal sibling responsibilities and resentment/guilt

Often, caregiving falls predominantly to one sibling (perhaps the only one who lives nearby, who does not work, or who is not stuck with other caregiving duties). In these cases, the one who takes on most of the care can feel resentful of the lack of support from others. Those not involved can feel guilty that they are not doing more. Either way, relationships between siblings can easily become strained and the caregiving sibling, who has already lost the nurturance of the cared-for parent, now finds that they have also lost closeness with some or all of their siblings.

Loss of intimacy

If your client is caring for their partner or spouse, the relational strain comes from the problem that the caregiving acts often dominate the marriage/partnership, crowding out moments of bonding and intimacy that earlier permeated the relationship. Moreover, the caregiving partner may come to regard the one needing care differently, perhaps less romantically, than before. Beyond that, the care-needing partner’s body (or mind) may not be able to enjoy intimate physical relations, so the caregiver becomes involuntarily celibate as well. Guilt may prevent the caregiving partner from going out to relax and take a break without their partner.

In general, the caregiver no longer has emotional support from the cared-for person but has little time available to seek loneliness-alleviating interactions with others. There is also little energy, and sometimes no budget, to maintain, let alone expand, the caregiving person’s circle of friendships and social support. But doing so is crucial. Wigfield (2024) reports on research stating that caregivers are about seven times lonelier than non-caregivers.  Here are some suggestions to  not only  reduce the caregiver’s loneliness but also enhance the relationship with the cared-for person.

What to do

1. Get help! Many communities offer respite care so that caregivers can take a break of a few hours, or even longer, allowing them to relax, exercise, or tend to needed errands and tasks in the community. In addition to formal respite care, there are online and in-person carer’s support groups and sometimes specialised, individual peer support, both of which meet regularly to share acknowledgement of the challenges, tips on how to cope, and general support.
2. When caring for a spouse, ask the kids to pitch in a bit of help, perhaps with small but regular slots caring for their parent. It can be empathy- and compassion-building for them.
3. Even if it feels impossible, it’s important to allocate (yes, formally diarise) time to re-connect with friends and other family members. Ask your client to remember that burnout is hard to come back from; it’s better not to go down that road at all. Even if some of the meet-ups are by phone or video call, it’s still crucial to do.
4. Self-care for the caregiver must include exercise, and relaxation or  mindfulness or other meditation would be helpful, too. The premature mortality rate for caregivers is said to be 63% higher than for non-caregivers (Roth et al, 2015). Self-care is essential to keep on caregiving.
5. Work with your client to find some things that your client can do with the person that they are caring for. It could be anything from looking at old photos to playing a game. Art and listening to music are particularly helpful. Even if the activity is short – say, 30 minutes – it is an opportunity to reconnect with the cared-for person outside of the caring role.

Bereavement

Whether your client loses someone suddenly, as through an accident or fatal heart attack, or the loss is gradual and slow, as through degenerative diseases like dementia, bereavement is a lonely-making time. Whatever role the person had in our life – and particularly if the deceased was our partner – there is now a gap, a hole that feels hard to fill. Loneliness is rife. While we echo here the general advice to the client to reconnect with friends and family, with community events, with spirituality or faith cohorts, and with life in general, there are several caveats if you are working with a bereaved client.

The client needs to be able to grieve in their own time and in their own way

Every grief journey is unique, and it is not helpful to push a person too quickly back into the thick of activity and busyness. Rather, they need time to honour the deceased, perhaps with shrines or memorial ceremonies (you can do some in session), time to reflect on what they gained and learned from the relationship, and time to come back from the most profound stages of grief (related reading: Assessing and Treating Prolonged Grief Disorder).

Grief has different stages

The classical Kubler-Ross Grief Cycle, which came out in 1969, proposes that people go through five stages: denial, anger, bargaining, depression and finally acceptance, in their grief journey, with much iteration back and forth between the stages. Kubler-Ross also noted that not all people go through all five stages (Health Central, 2022). There is the painful loss of companionship and, often, the breakdown of the social network. A bereaved client may be experiencing societal loneliness and freshly feeling a sense of not belonging.

Talking it out: Friends, family, and death cafes

Your bereaved and likely lonely client may not immediately want to talk about the death, but it’s a good idea for them to maintain connections with friends and family so that they are there when the person is ready. Peer bereavement support from those who have undergone similar experiences is always valuable. One option is death cafes.

These are a community-based approach of supporting individuals, families, and communities to prepare for illness, death, grieving, and the associated loneliness that often accompanies the process. Participating in a death café allows your client to share their experiences connected with dying and grief with strangers, which can reduce their loneliness and improve their wellbeing. The idea of a death café seems depressing, but people say they feel uplifted upon leaving them (Death Café, n.d.). If your client is interested in this, they can visit this website or Facebook page.  

Resuming life “out and about”

When your client feels ready to resume a more active life again, we have the same recommended list of sources to draw on to bring them back into people and connection – and away from loneliness – again. Refer back to our section on retirement to remind yourself of possibilities that you can bring forward to the client; small steps are ok. There are some sites which help people to meet up with others, such as Meetup.com. The old standbys of joining a gym for both exercise and possible connection and also volunteering are also available.

General ageing: a note

In ageing, psychological and societal loneliness are often rife. The ageing person loses many confidantes and intimates through bereavement and through all that happens in caregiving, so psychological loneliness is “front and centre”. Societal loneliness can strike, too, especially in retirement, but also through the other two. But even if the ageing client has dealt well with retirement, has not had to be a caregiver, and has been lucky not to lose the closest intimates (such as a partner) to death, there is still a huge possibility for loneliness to occur: existential loneliness.

If questions such as what a person’s purpose in life is have not been sufficiently processed, the person, eyeing up the dwindling years on the planet, cannot help but wonder: what is my legacy? What did I do while in this life that made a difference? What have I stood for? The perceived inability to answer those questions speaks to a lack of purpose and meaning at some level, one that may have constricted the client’s sense of wholeness as they choose how to engage with life in their golden years.

This is a time when many write their memoirs, finally get around to organising the plethora of photos into attractive photo albums or create other legacy work that can stand as a reminder to future generations of who they were and what they contributed while here.

Psychosynthesis or other transpersonal psychotherapy: Made to order for existential loneliness

While we advocate any general discussion around these matters as a valuable adjunct to whatever else you and client are dealing with therapeutically, we particularly here note the enormous potential of Psychosynthesis, or other transpersonal psychotherapies, to help assuage existential loneliness. Developed by Roberto Assagioli, a breakaway disciple of Freud’s, the Psychosynthesis model of consciousness posits a conscious mind (our everyday awareness) and a subconscious mind (the repository of hopes, dreams, and memories), but goes beyond Freud in also asserting a superconscious mind: the “something more than” which it says is part of every human being but is a level which is not always accessed by people living regular, “everyday” life. Psychosynthesis, therefore, says that everyone is a soul on a journey (Assagioli, 1973/1984).

Some clients – even in their very senior years – regard themselves as atheists or possibly agnostics, who are not certain about the existence of something or someone “divine”. Accordingly, Psychosynthesis has many user-friendly ways to talk about each person’s connection to something that is larger than themselves and to the possibility of ongoing existence after physical death: a potential comfort to those who do not have so many years remaining in the body. Thus, for a Psychosynthesis practitioner, the ultimate loneliness-destroying tool (belief proposition?) is a solid sense of connecting to oneself: that is, one’s whole Self, consisting of body, emotions, mind, and the part of ourselves which is greater than mind, which directs the mind as to which thoughts to think.

You can find numerous courses, especially ones which include Psychosynthesis-style relaxations/meditations inviting clients to that level of superconsciousness, in the Mental Health Academy course catalogue. This article exploring death anxiety also offers interesting insights. It can be the final piece of the loneliness jigsaw puzzle which helps a senior client accept the stage of life that they are at, and to know that their life did have relevance and purpose.

Reducing loneliness from modern technology

Modern technology can be a way of expanding one’s social sphere and connections with the possibility of alleviating loneliness but frequently has the opposite effect. That is, users of social media, smartphone, and other devices spend so much time relating to online “communities” that they fail to develop and maintain real, in-person relationships; users (often young) increasingly fail to find a sense of belonging to any community where they can meet up with other community members in person, having human interactions which can generate connection and reduce loneliness.

Moreover, the comparisons people make with others upon seeing the others’ curated version of their lives can yield a pervading sense of not being as good-looking, successful, or interesting, leading to anxiety, depression, and loneliness. Since smartphone usage tipped in 2012 in the United States to more people using a smartphone than not, depression and suicide rates have been climbing while student scores on tests of creativity and innovative thinking have been declining (Twenge, 2017).

What does that mean for how you may be able to help a lonely client, often a young person, reduce loneliness from this source?

Mainstream psychotherapies still ok

Earlier we outlined how various psychotherapies can be effective in dispensing with loneliness arising from other territories, such as trauma or illness/disability. These are also valid for aspects of helping clients who are lonely as a result of technology use:

• CBT
• DBT
• Positive psychology
• Mindfulness
• Creative/expressive therapies
• Behaviour activation therapy and social prescribing

Commonsense pan-theoretical suggestions for alleviating tech loneliness

There are also practical, on-the-ground strategies which clients can implement for themselves. You and your client can review the following ideas and further develop ones that resonate with the client. First, does the client have a phone/device addiction?

Behavioural addiction to the phone

The client could have a behavioural addiction to their phone or other device if they:

• Spend most of their time engaged in, thinking about, or arranging to engage in behaviours related to the phone/device;
• Depend on their normal phone/device behaviour (e.g., texting, checking for notifications, scrolling) to cope with emotions or feel “normal”;
• Neglect work, school, or family to engage the above behaviour more often;
• Minimise or hide how much time is spent with their phone/device;
• Continue to engage the behaviours despite physical or mental harm;
• Experience symptoms of withdrawal, such as depression or irritability, when trying to stop (Reynolds, 2024).

For further training on behavioural addictions, refer to these courses:

• Working with Behavioural Addictions (Micro-Credential)
• Addressing Behavioural Addictions: What Every Clinician Needs to Know
• Recognising and Responding to Adolescent Addiction: What Works?

Counter strategies for loneliness from overuse of modern technology

Here are ideas you can explore with your client for this:

• Don’t give up on technology but prioritise face-to-face contact
• Be a gamer, but do it interactively (so time with the opponent is a social encounter, not a chance to prove that the client can “kill” the opposition)
• Use technology for phone and video calls but limit social media. Research showed that those limiting their time on social media to 30 minutes a day were less lonely at the end of the experimental period than the control group, who did not limit their time on social media (Hunt et al, 2018).
• Try a friendship app
• Take up part-time work
• Becoming a befriender. Befrienders Worldwide and associated organisations in the U.S. and Commonwealth countries (e.g., Angelhands Befriending in Australia or Samaritans New Zealand) provide specially trained volunteer listeners to those who are lonely, unhappy, or in crisis (Befrienders Worldwide, 2025).
• Heading to the place of belonging. Is there any place where you go and feel instantly “at home”, a place where you just “know” that you belong? You can ask this question to a lonely client, especially one lonely due to overuse of technology. It is about understanding the power of a “special place” to give a sense of connection, be it at a beach, woodlands, or elsewhere. The enriched sense of connection upon accessing it can help the client move from lonely territory, motivating them to take other steps toward (re-)connection.

Ultimately, each technology user must face the reality that modern technology is a double-edged sword; it can instantaneously connect us with people halfway around the world, and it can also make us feel like we inhabit a lonely world where everyone else is more handsome, more successful, happier, or more (fill in the blank). It is up to each user to make of it a gift or a curse.  You can facilitate them using it in the way that ushers in the greatest amount of real (thus, loneliness-alleviating) connection.

Conclusion

There is a global epidemic of loneliness occurring. It affects brain, mind, body, and emotions, and the only way that we can inoculate ourselves against it is through the “vaccine” of human connection. We are biologically wired for that connection. This final article in our series of three has offered suggestions for how you can work with clients lonely from trauma, illness/disability, ageing, and overuse of modern technology to help them formulate counter strategies which encourage connection.

We propose that our challenge is to help clients build a more people-centred life, a more people-centred world. With connection as the antidote to loneliness, we enhance our health and our performance in most life domains, increasing our collective capacity to tackle large societal problems. In any case, your client’s wholeness demands connection. May you go well connecting with them to facilitate their connection with others.

Key takeaways

• The most effective interventions to help alleviate loneliness triggered by trauma vary according to the stage of trauma treatment, with the first stage best served by traditional approaches, such as CBT, DBT, positive psychology, mindfulness, and creative and expressive therapies, but the second stage being better served by therapies such as EMDR and exposure therapy.
• Those lonely due to illness or disability should first look to see where their support comes from, and then expand those circles through various strategies adapted to their situation, including online coffee lounges and peer support. They can seek specialist groups set up for their condition.
• Those dealing with loneliness triggered by life transitions common to ageing – we highlighted retirement, caregiving, and bereavement – must plan for the transition (when it is not suddenly thrust upon them), earnestly continue with (or begin) hobbies and causes dear to their hearts, and expect to see relational changes to which they must adapt. Reaching out for help from supports is wise, but – especially in bereavement – the return to a “new normal” of engagement with life must go at the client’s pace, when they are ready for it. Attending to concerns of purpose and legacy are important and are well addressed through Psychosynthesis approaches.
• Upon determining that a client may have an addiction to their phone or other devices, mainstream therapeutic approaches can be helpful; limiting online time and increasing in-person contacts is essential.

Questions therapists often ask

Q: How do I distinguish between ordinary solitude and clinically significant loneliness?

A: Look for distress plus a mismatch between the client’s desired and actual social connection. Many clients describe being “surrounded but alone.” Functional impairment, rumination about social inadequacy, and withdrawal patterns usually mark the shift from healthy solitude to problematic loneliness.

Q: What’s the first therapeutic move when a client is deeply entrenched in loneliness?

A: Slow down and create relational safety before diving into social-skills or behavioural plans. Many lonely clients arrive primed for rejection; the therapeutic relationship itself becomes the first corrective experience—predictable, attuned, and non-judgemental.

Q: How do I help clients who believe loneliness is a permanent feature of their identity?

A: Treat the belief as a cognitive–emotional knot: validate the pain, then collaboratively test the conviction. The article emphasises externalising loneliness (“something you’re experiencing, not something you are”) and using small, achievable relational steps to generate evidence of change.

Q: Skills work can feel artificial to clients. How do I keep it grounded?

A: Tie every skill to a real-life micro-context rather than generic “social skills.” For example, practise one conversation opener tailored to a specific environment (gym, work kitchen, uni tutorial). Behavioural activation aimed at connection works best when it’s concrete and customised.

Q: How do I manage clients whose loneliness is driven by avoidance rather than lack of opportunity?

A: Approach avoidance functionally: identify what it protects them from (e.g., shame, perceived incompetence). Then pair gradual exposure with compassion-focused practices to reduce the threat response. The aim isn’t to push them into crowds but to expand their tolerance for relational risk in manageable increments.

References

• Assagioli, R. (1973/1984). The act of will:  A guide to self-actualization and self-realization.  Wellingborough:  Turnstone Press.
• Befrienders Worldwide. (2025). About Befrienders Worldwide. Author. Retrieved on 6 May 2025 from: https://befrienders.org/about-befrienders-worldwide/              
• Cleveland Clinic. (2025). Exposure therapy. Author. Retrieved on 30 April 2025 from: https://my.clevelandclinic.org/health/treatments/25067-exposure-therapy         
• Health Central. (2022). Kubler-Ross Grief Cycle. Author. Retrieved on 6 May 2025 from: https://www.healthcentral.com/condition/depression/stages-of-grief
• Herman, J.L. (1997).  Trauma and Recovery: The Aftermath of Violence—from Domestic Abuse to Political Terror. New York: Basic Books.
• Hunt, M.G. et al., No More FOMO: Limiting Social Media Decreases Loneliness and Depression, Journal of Social and Clinical Psychology 37(10) (2018): 751–68, https://doi.org/10.1521/jscp.2018.37.10.751.
• Murthy, V. (2020). Together: Loneliness, health and what happens when we find connection. London: Profile Books Ltd. eISBN 9781782835639
• Reynolds, S. (2024). The loneliness problem: A guided workbook for creating social connection and ending isolation. New York: Chartwell Books, an imprint of the Quarto group. ISBN: 976-0-7858-4427-3
• Roth, D.L., Fredman, L., & Haley, W.E. (2018). Informal caregiving and its impact on health: a reappraisal from population-based studies. Gerontologist. 2015 Apr;55(2):309-19. doi: 10.1093/geront/gnu177. Epub 2015 Feb 18. PMID: 26035608; PMCID: PMC6584119.
• Saint-André, P. (2023). The circles of friendship. Philosopher-coach. Retrieved on 30 April 2025 from: https://philosopher.coach/2023/01/25/the-circles-of-friendship/
• Scott, E. (2023). The different types of social support. Very Well Mind. Retrieved on 30 April 2025 from: https://www.verywellmind.com/types-of-social-support-3144960
• Twenge, J.M. (2017).  Have Smartphones Destroyed a Generation?, Atlantic, September 2017, https://www.theatlantic.com/magazine/archive/2017/09/has-the-smartphone-destroyed-a-generation/534198.
• Van Leeuwen, J.E.P. et al. (2022). More Than Meets the Eye: Art Engages the Social Brain. Frontiers in Neuroscience 16 (February 25, 2022): 738865, https://doi.org/10.3389/fnins.2022.738865.
• Von Hippel, W. (2018). The Social Leap: The New Evolutionary Science of Who We Are, Where We Come From, and What Makes Us Happy. New York: Harper Wave.
• Villines, Z. (2021). What is behavioural activation? Medical News Today. Retrieved on 30 April, 2025 from: https://www.medicalnewstoday.com/articles/behavioral-activation
• Wigfield, A. (2024). Loneliness for dummies. Hoboken, New Jersey, USA: John Wiley and Sons, inc. (ePDF); ISBN 978-1-394-22933-8 (ePub)
• World Health Organization. (2022). A toolkit on how to implement social prescribing. WHO. Retrieved on 30 April 2025 from: https://www.who.int/publications/i/item/9789290619765