Introduction to loneliness and befriending
This page presents a concise overview on the topics of loneliness and befriending, with some technical explanation designed to clarify key concepts and develop relevant information. Our aim is to support clients, volunteers, and anyone in the wider public who would like to understand WAL’s activity more clearly, providing deeper detail for those who want to go further.
This content is provided for information and learning purposes only and does not replace professional advice specific to particular circumstances. If you have questions or feedback, we welcome you to get in touch.
In lay terms, loneliness is a common, human signal to change behaviour – like hunger or thirst, 1 that all humans experience at one time or other, a subjective unwelcomed feeling of lacking quality companionship, common among senior adults (broadly, an age range of 50+/60+), where there is the probability of a higher impact due to the various social risk factors associated with ‘old age’. 2 A deeper view of the concept reveals that loneliness is one of our body’s aversive signals (also known as a negative stimulus), triggered to help avoid harmful consequences for the individual’s health. In fact, by alerting for the need to renew the social connections required to survive, we recognise that it is not about the number of relationships but rather the “presence of others who value them, whom they can trust, and with whom they can communicate”, 1(p219) elements that are foundational of an effective befriending service.
Befriending is an initiative mainly implemented to provide social contact to individuals experiencing loneliness and isolation, where a client is introduced to one or more individuals that provide them with social support through the development of an affirming, non-directive emotion-focused relationship over time, monitored via an organisation. 3 At a practical societal level, it also fills “the emotional and social gap that is not being met by existing statutory and social service provision”. 4(p2)
Research shows that befriending services work better if voluntary by nature and are supported by four key mechanisms: reciprocity, in a context of matching befriender and client; empathy, as a key ability for deep connection; autonomy, linked to a long-term support; and privacy, enabled by the one-to-one confidential interaction. 4 Altogether, they make every befriending connection unique.
Loneliness and Social Isolation – related, but different
Although related, and both impacting health outcomes, loneliness and social isolation are distinct experiences. The former reflects the way people perceive and experience social isolation, and the latter is an objective measure of frequency of meaningful and sustained social interactions and social support 1,5-6 and the subjective judgment on the quality of the social support provided by others – in short, the lack of quantity and quality of social support. 7
Loneliness can be approached from two different angles. The social one, focuses on the affective and emotional side, and the cognitive one, linked to the individual perception of discrepancy between desired and achieved level of social engagement. 8 Building around these contrasting perspectives and human individuality, one can say that a person can live a solitary life and not feel lonely, and others my experience loneliness regardless of being part of extensive social networks.
The health effects of loneliness
Short-term or acute loneliness can arise from one or “an interplay of risk factors (e.g., socioeconomic status, health, environment) and stressors (e.g., bereavement, relocation)”. 9(p5) These episodes, particularly when meaningful social connections are perceived as severed, often triggered by significant life transitions, may develop into chronic loneliness – defined as feeling lonely often or always.
Official data in Britain 10 refers that chronic loneliness has risen to 7.1%, approximately 3.8 million people, becoming a public health issue. In general, loneliness has been indicated as a risk factor for overall mortality, 6,8,11-12 potentially leading to social isolation and depression, 13 with health effects including increased functional decline and frailty, worse cardiovascular disease outcomes, 6,12 and affecting restorative sleep, immunity, and systolic blood pressure in older adults, 1 among others. Therefore, the consequences of loneliness in our health are quite relevant and there is a need for interventions to address it, 9 even if it is unclear the direction and degree of causality. 11
The positive impact of telephone-based befriending services in loneliness relief
Several empathy-focused, telephone-based befriending services programmes for older adults have been evaluated in the last decade, with results showing evidence of improvements on general mental health, 11 with a recent systematic review demonstrating that remotely delivered interventions can result in loneliness relief. 13 In another contribution to telephone befriending research, Cattan et al. found that people who used the service said it benefited them by improving their confidence and self-esteem, and alleviating loneliness and anxiety, 14 while Landwehr et al. referred a concurrent positive impact on the quality of life, particularly the facet life satisfaction. 2 Moreover, because the interaction is with someone outside their social circle and occurs in a non‑visual format, some clients find it easier to discuss sensitive topics and feel less judged – both for their views and their appearance. 8
Telephone-based befriending services are also a practical option for reducing loneliness since many older adults may have physical/mobility limitations, 4 difficulties to accessing support groups or specialists, 5 and online platforms may not be a feasible option, due to sensory deficits impairing communication or even limited internet access, lack of knowledge or economic constraints. 9
The effectiveness becomes more significant when the callers are subject to training, their empathy and characteristics likely affect participants, the service is a continual support programme with high frequency of contact, 11 delivered individually, 13 and when programme design and execution reflect skills, knowledge, intent and commitment. 12
There are diverse loneliness relief intervention strategies. Masi et al. refer four primary typologies, namely “improving social skills, enhancing social support, increasing opportunities for social interaction, and addressing maladaptive social cognition”. 1(p.222)
However, one should note that the typology of service that WAL provides cannot be considered a psychological or therapeutic intervention, and it is not ‘a cure to all ills’ in what refers to minimising or even eliminating (purposely
avoiding the term ‘treating’) the feelings of loneliness, and that a combination with other approaches would be necessary for robust, long-lasting effects. 13 The population served is a heterogenous group, and there is still additional research needed to understand more about how and why befriending might function differently according to individual characteristics and environmental settings. 4
Nonetheless, it is essential to evaluate effectiveness, not only to ensure service enhancement but also for benchmarking purposes, via country- or international-level comparisons. From 2026, WAL is implementing the Three‑Item Loneliness Scale, 15 a brief, validated measure that asks how often someone feels they lack companionship, feels left out, or feels isolated. While useful for the quantitative screening purpose, one shall not underestimate qualitative information, retrieved from the befriending interactions, so relevant for a deeper understanding around different client perspectives, patterns of engagement, and a broader view about changes in wellbeing. 9
Ultimately, the work of our befriending volunteers and the satisfaction of our clients give us evidence of the value of our contribution on loneliness relief, and the positive effects in our clients’ holistic wellbeing, and the strength to drive our continuous improvement and reach out for more people in need.
References
1. Masi C, Chen H, Hawkley L, and Cacioppo J. A meta-analysis of interventions to reduce loneliness. Personality and Social Psychology Review 2011;15(3):219-266. doi:10.1177/1088868310377394
2. Landwehr A, Pollack L, Schütt S, Kals E. “telephone angels” against loneliness: Experimental evaluation of the effectiveness of telephone partnerships with older adults. Journal of Gerontological Social Work 2025;68(7):911-932. doi:10.1080/01634372.2025.2450210
3. Mead N, Lester H, Chew-Graham C, Gask L, Bower P. Effects of befriending on depressive symptoms and distress: Systematic review and meta-analysis. British Journal of Psychiatry 2010;196(2):96-101. doi:10.1192/bjp.bp.109.064089
4. Fakoya O, McCorry N, Donnelly M. How do befriending interventions alleviate loneliness and social isolation among older people? a realist evaluation study. PLoS ONE 2021;16(9):e0256900. doi:10.1371/journal.pone.0256900
5. Poscia A, Stojanovic J, La Milia D, et al. Interventions targeting loneliness and social isolation among the older people: An update systematic review. Exp. Gerontol. 102 2018;133. doi:10.1016/j.exger.2017.11.017
6. Patil U, Braun K. Interventions for loneliness in older adults: A systematic review of reviews. Frontiers in Public Health 2024;12. doi:10.3389/fpubh.2024.1427605
7. Tong F, Yu C, Wang L, Chi I, Fu F. Systematic review of efficacy of interventions for social isolation of older adults. Frontiers in psychology 2021;12:554145. doi:10.3389/fpsyg.2021.554145
8. Preston C, Moore S. Ringing the changes: The role of telephone communication in a helpline and befriending service targeting loneliness in older people. Ageing and Society 2019;39(7):1528-1551. doi:10.1017/S0144686X18000120
9. Escueta D, Tha S, Hough K, Burnes P, Perissinotto C, Kotwal A. The role of daily calls to telephone companionship lines for older adults experiencing chronic loneliness. Annals of the New York Academy of Sciences 2025;1553(1):133-139. doi:10.1111/nyas.70058
10. Office for National Statistics (ONS). Campaign to end loneliness, the state of loneliness 2023. https://www.campaigntoendloneliness.org/wp-content/uploads/The-State-of-Loneliness-2023-ONS- data-on-loneliness-in-Britain.pdf Accessed February 14, 2026.
11. Kahlon M, Aksan N, Aubrey R, et al. Effect of layperson-delivered, empathy-focused program of telephone calls on loneliness, depression, and anxiety among adults during the covid-19 pandemic: A randomized clinical trial. JAMA Psychiatry 78 2021;616. doi:10.1001/jamapsychiatry.2021.0113
12. Perissinotto C, Hough K, Tha S, et al. Implementing a telephone-based support program to address
loneliness in older adults. Annals of the New York Academy of Sciences 2025;1552(1):174-185.
doi:10.1111/nyas.70029
13. Fu Z, Yan M, Meng C. The effectiveness of remote delivered intervention for loneliness reduction in older adults: A systematic review and meta-analysis. Frontiers in Psychology 2022;13.doi:10.3389/fpsyg.2022.935544
14. Cattan M, Kime N, Bagnall A. The use of telephone befriending in low level support for social isolated older people – an evaluation. Health and Social Care in the Community 2011;19(2):198-206.doi:10.1111/j.1365-2524.2010.00967.x
15. Hughes M, Waite L, Hawkley L, Cacioppo J. A short scale for measuring loneliness in large surveys. Research on Aging 2004;26(6):655-672. doi:10.1177/0164027504268574