Understanding experiences of 'Gig Buddies': A befriending scheme for people with intellectual disabilities

BACKGROUND

Research into befriending for people with intellectual disabilities is limited. This study aimed to explore the impact, mechanisms of change, and limitations of a befriending scheme for adults with intellectual disabilities and/or autism.

METHODS

Participants were recruited using convenience sampling. Thirteen individuals with intellectual disabilities and/or autism were interviewed and data thematically analysed.

RESULTS

Four themes were generated: 'Something fun for me'; 'A good connection'; 'Increasing independence'; and 'A life less quiet'. Befriending had direct benefits through the activities undertaken and the befriending relationships themselves being fun and reducing isolation. Befriending facilitated belonging, improved access to mainstream activities, and fostered independence by providing safety and support. The importance of shared interests and external support for the relationship was highlighted.

CONCLUSIONS

Positive outcomes of befriending were found, supporting existing literature and revealing new information from the voices of participants with intellectual disabilities themselves.

Psychological and social outcomes of befriending interventions for adults with intellectual disabilities: A systematic review

BACKGROUND

Befriending is an intervention intended to provide companionship and support to socially isolated populations. This review aimed to understand the key characteristics and psychological and social outcomes of befriending interventions for adults with intellectual disabilities.

METHODS

Systematic searches of electronic databases (PsycINFO, MedLine and Web of Science) identified 11 studies for inclusion. A narrative synthesis of the findings was completed, along with critical appraisal of study quality.

RESULTS

Increased community participation, positive changes to social networks and mood were frequently reported outcomes for befriendees. Increased knowledge, new experiences and opportunities to 'give back' were most reported for befrienders.

CONCLUSIONS

The review highlighted that existing research in this field is limited in scope and methodologically diverse. Future research should focus upon the effectiveness and long-term impact of befriending interventions, understanding the mechanisms of change, and eliciting the views of people with intellectual disabilities on their experiences.

Is befriending a valuable intervention in schizophrenia? A scoping review

Background

Schizophrenia is a severe, chronic mental disorder that involves disruptions in cognitive processes, emotional responsiveness, and social interactions. Psychotherapeutic and social integration practices have increasingly been added to the pharmacological treatment in an effort to improve the level of functioning and the quality of life of individuals affected by this condition. Befriending, defined as a one-on-one companionship provided by a volunteer who aims to act as an emotionally supportive liaison, is hypothesized to be an effective such intervention, offering support for building and maintaining social relationships in the community. Despite its increase in popularity and acceptance, befriending remains poorly understood and under-researched.

Methods

We performed a systematic search for studies targeting befriending either as an intervention or a controlled condition in studies on schizophrenia. Searches were performed in four databases: APA PsycInfo, Pubmed, Medline and EBSCO. The keywords "schizophrenia," AND "befriending," were searched for on all databases.

Results

The search yielded 93 titles and abstracts, of which 18 met the criteria for inclusion. The studies included in this review have all incorporated befriending as an intervention or a controlled condition, as per our search criteria, and aimed at depicting the value and feasibility of this intervention to address social and clinical deficits in individuals with schizophrenia.

Conclusion

The studies selected for this scoping review revealed inconsistent findings regarding the effect of befriending on overall symptoms and the subjective reporting of quality of life in individuals with schizophrenia. This inconsistency may be attributed to differences between the studies and their specific limitations.

Friendship in Befriending? Older Service Users' Notions of Friendship in a Befriending Scheme

Social isolation and feelings of loneliness are main reasons that befriending services are approached by older adults. The promise of an individually matched volunteer, a befriender, paying them regular visits, offers hope of increased social interaction, meaningfulness, and connectedness in everyday life. The current consensus in qualitative research literature is that loneliness and isolation may be alleviated by such home visits. Still, the actual mechanisms of successful befriending have not been identified. In this small-scale qualitative study, we highlight older befriendees' notions of friendship in befriending. Drawing on in-depth interviews with seven Norwegian befriendees over the age of 80 years, we suggest that having a befriender visit regularly spurs a new bond and supports befriendees' notions of a relationship consistent with a traditional understanding of friendship. Our findings illustrate how the older befriendees identify and portray notions of friendship in terms of bonding, compatibility and meaningful activities, commitment, appreciation, and insecurities. Understanding how a formalized volunteer service is recognized and valued as a friendship may contribute to a better starting point for improving befriending services. Furthermore, it can improve our understanding of the significance of friendship in old age.

A Volunteer-Run, Face-to-Face, Early Intervention Service for Reducing Suicidality

Background: Befriending is one of many strategies with the potential to reduce suicidal ideation and decrease the risk of suicide. Aims: To measure change in suicidal ideation and behavior among visitors (service users) supported at The Listening Place (TLP), a charity which offers volunteer-run, face-to-face befriending to people who are suicidal. Method: This study was peer reviewed and preregistered on the Open Science Framework prior to data extraction. Anonymized data were extracted for visitors at the point of referral and after 3 months of receiving support. Paired-sample tests were used to test whether self-reported suicidal ideation and behaviors changed after 3 months of support from TLP. Multivariable regressions were used to test whether change in suicidal feelings was associated with demographic characteristics or baseline self-reported suicidality. Results: TLP received 13,938 referrals from July 2016 to February 2022. Self-reported suicidal ideation, suicidal behavior, and feelings of distress decreased after 3 months, while feelings of support increased. Only self-reported suicidal behavior prior to referral was associated with a lesser reduction in self-reported suicidality after 3 months. Limitations: In the absence of a control group, it cannot be concluded that TLP causes the reduction in self-reported suicidality. Conclusions: An empathetic, nonjudgmental, listening service for people who are feeling suicidal was well received by users, who experienced a reduction in suicidality.

Lessons from an aborted controlled trial on the impact of befriending in an early intervention in psychosis population

AIM

The current study aimed to explore the effects of organized befriending for an Early Intervention in Psychosis (EIP) population.

METHODS

Participants were randomly assigned to control or intervention groups. Those in the befriending arm were paired based on a shared interests questionnaire. Qualitative and quantitative methods were planned to assess experience and impact of the intervention across clinical and recovery outcomes. We aimed to recruit 60 participants, however only 16 participants completed the trial.

RESULTS

The study was unsuccessful due to issues with recruitment and retention of participants. We gathered feedback from those who withdrew, to understand this better.

CONCLUSIONS

We offer our observations to other clinicians who may be considering similar research. A more assertive researcher-led approach over the first few meetings between matched pairs is likely to have been more effective in retaining participants' engagement in the study.

'Guid times wi the bad times': The meanings and experiences of befriending for people living alone with dementia

Befriending is a service in which volunteers provide companionship and support usually to people who are lonely or isolated. Such services are promoted in Scotland’s national strategy to improve the lives of people with dementia, around a third of whom live alone. However, little is known about the perspectives of recipients. Taking a holistic qualitative case study approach, the aim of this research was to explore how people living alone with dementia experienced befriending and the contexts in which their befriending relationships were meaningful. Three people were visited on five separate occasions. Largely unstructured conversations allowed individuals to prioritise areas of importance to them within the broad topics of befriending, everyday life, social networks and biography. Participants also had the option of ‘showing’ how they spent their time with their befriender. Data were analysed using the voice-centred relational method. Three key messages emerged: befriending satisfied unmet needs and wishes for particular kinds of relationship; befriending was a facilitated friendship; and befriending was a human response to contingent and existential limitations.

Older Users of a Befriending Service in Ireland and the Maintenance of Personal Autonomy during the COVID-19 Pandemic

In the Republic of Ireland (RoI), COVID-19 public health guidelines have been most restrictive for people aged 70 and over. Such individuals are most likely to avail of befriending services offered by a network of Irish organisations. The aim of this study was to explore the impact of COVID-19 guidelines on befriending service users, and to develop recommended adaptations to befriending services compatible with such guidelines. A qualitative constructivist grounded theory approach was taken to the study design and analysis, using semi-structured interviews to collect data from 11 participants by telephone between May 2020 and January 2021. Results show a grounded theory describing how older users of a befriending service maintained their personal autonomy in the face of strict government guidelines. Participants described living life as usual, often contravening guidelines, and how they chose to adapt to the situation, yielding both positive and negative outcomes. Some potential adaptations were discussed to the befriending service (including a preserved focus on the social and emotional functions of the befriending relationship, and the accommodation of collaborative decision making about communicative alternatives), but ultimately it was made clear that participants would tailor the services to their own preferences. Results have implications for befriending service design and delivery, and for public health officials who wish to support the health of older adults during the COVID-19 pandemic.

Loneliness Among College Students: The Influence of Targeted Messages on Befriending

The objective of the current research was to examine the influence of targeted messages in increasing helping behaviors towards lonely individuals. Previous research on loneliness interventions typically focuses on the lonely individual and working to reduce feelings of loneliness. The current study expands on this research by targeting individuals around lonely others to notice and consider helping those who might be lonely. Five targeted messages, based on Latané and Darley's (1970) bystander intervention model, were utilized. These messages included a "notice" condition (increasing awareness of lonely others), an "assume responsibility" condition (awareness and responsibility towards helping lonely others), a "decide" condition (awareness, responsibility, and steps to reach out to lonely others), and two control conditions. Participants in the "decide" condition were significantly more likely to report feeling prepared to help lonely others in the future. Those in the "assume responsibility" and "decide" conditions also reported more awareness of lonely individuals during a one-week follow-up. Overall, findings indicate that it might be advantageous to approach reducing loneliness from the perspective of those around lonely individuals. Future research and implications of these findings are discussed.

Friendship and money: A qualitative study of service users' experiences of participating in a supported socialisation programme

BACKGROUND

Social opportunities can be limited in the lives of people with enduring mental illness (EMI) due to psychiatric stigma, restricted home environments and employment barriers. Supported socialisation programmes have the potential to redress the impact of social isolation.

AIM

To explore the experiences of service users with EMI taking part in a supported socialisation programme, using written diary entries.

METHODS

This article reports on the qualitative component of a randomised controlled trial of supported socialisation for people with EMI (published previously in this journal). Trial participation involved (1) being matched with a volunteer partner and engaging in social/leisure activities while receiving a stipend of €20 or (2) receiving this stipend only and engaging in self-driven socialisation. Participants completed written diaries documenting their perspectives on their experiences of supported socialisation. Data were analysed using Thematic Analysis.

RESULTS

Experiences of participation were characterised by involvement 'normalising' life, fostering a sense of connectedness, improving physical health, and facilitating engagement with culture. Taking part helped participants integrate socialising into their identity, enhanced their perceived capacity to be social, and cemented/expanded social networks. Participants also experienced significant obstacles to socialisation.

CONCLUSION

Supported socialisation can increase confidence, social competence and self-agency; buffer against psychiatric stigma; build social capital; and afford opportunities to enhance social integration, inclusion and belonging.

Volunteer peer support and befriending for carers of people living with dementia: An exploration of volunteers' experiences

With ageing populations and greater reliance on the voluntary sector, the number of volunteer-led peer support and befriending services for carers of people with dementia in England is set to increase. However, little is known about the experiences of the volunteers who deliver these interventions, many of whom are former carers. Using in-depth semi-structured interviews with 10 volunteer peer supporters and befrienders, this exploratory study investigated volunteers' experiences of delivering the support, the types of relationships they form with carers and their perceptions of its impact upon them and on carers. Data were analysed using framework analysis. Findings showed that volunteers benefitted from their role due to the 'two-way' flow of support. Experiential similarity and having common interests with carers were considered important to the development of mutually beneficial relationships. Volunteers perceived that carers gained emotional and social support, which in turn improved the carers' coping ability. Being able to see positive changes to carers' lives was important for volunteers to gain enjoyment and satisfaction from their role. However, volunteers also identified challenges with their role, such as dealing with carers' emotions. Future research should investigate ways of reducing potential burden on volunteers and explore the impact of volunteering specifically on former carers of people with dementia.

Friendship, curiosity and the city: Dementia friends and memory walks in Liverpool

The city is not just a context for friendships or a problem to be solved through them; it can be a catalyst for these relationships, sparking and strengthening connections between individuals and groups. Shared experiences of and curiosity in cities - expressed through practices that include revisiting familiar places and exploring others for the first time - can draw people together in beneficial ways. These principles underpin a health and wellbeing agenda, pioneered in Liverpool, which encourages people to 'take notice' and 'connect' - two of five 'ways to wellbeing' promoted through the Liverpool Decade of Health and Wellbeing. This paper focusses upon one particular set of schemes and relationships which brings all this into focus: befriending schemes designed to support people with dementia, which engage with objects and places as catalysts for connection. These observations shed a broader light upon the meanings and uses of friendship, with particular reference to cities.

The impact of telephone-delivered cognitive behaviour therapy and befriending on mood disorders in people with chronic obstructive pulmonary disease: A randomized controlled trial

OBJECTIVES

The main objectives of this pragmatic randomized controlled trial were to investigate the impact of cognitive behaviour therapy (CBT) and an active social control (befriending) on depression and anxiety symptoms in people with chronic obstructive pulmonary disease (COPD).

METHODS

Eligible participants were randomly allocated to receive eight weekly telephone interventions of CBT (n = 54) or befriending (n = 56). Repeated-measures ANOVA was used to assess changes in scores and Cohen's d was used to assess effect sizes.

RESULTS

Significant improvement was observed in anxiety symptoms for the befriending group from baseline (T1) to post-intervention assessment (T2) and to 8-week follow-up assessment (T3), with a small to medium effect size (Cohen's d = 0.3). Significant improvement was noted in depression symptoms from T1 to T2 for both groups, but only the CBT group had a significant difference at T3, with a small to medium effect size (Cohen's d = 0.4). For secondary outcomes, there was a significant change in COPD symptoms from T1 to T2 for the befriending group; however, at T3 this change was no longer significant. Finally, there was a significant change in general self-efficacy for both groups between T1 and T2, and T1 and T3.

CONCLUSION

Cognitive behaviour therapy reduced depression symptoms but not anxiety. Befriending reduced depression symptoms in the short term and anxiety symptoms in both the short term and long term. Further research is needed to demonstrate non-inferiority of telephone delivery compared with other formats, and to understand the impact of befriending which has the potential to be a cost-effective support for people with COPD. Statement of contribution What is already known on this subject? Depression and anxiety are common comorbidities in people with chronic obstructive pulmonary disease. Mood disorders are not commonly routinely treated in people with chronic obstructive pulmonary disease. Telephone-administered CBT has been shown to be as effective as face-to-face CBT in reducing depression and anxiety. What does this study add? Telephone-administered CBT can reduce depression symptoms in people with COPD. Telephone-administered befriending can reduce anxiety and depression symptoms in people with COPD. People with COPD who have mood disorders would prefer to have CBT than befriending.

Befriending to Relieve Anxiety and Depression Associated with Chronic Obstructive Pulmonary Disease (COPD): A Case Report

Chronic obstructive pulmonary disease (COPD) is a chronic lung disease characterized by airflow obstruction and shortness of breath, which as a result can severely limit activities of daily living. COPD sufferers are 85% more likely to develop anxiety disorders than healthy matched controls. Some of the factors that have been suggested to be associated with high anxiety in people with COPD include dyspnoea, the inability to perform daily activities or fulfil social roles, rehospitalisation and some COPD treatments. There is substantial evidence that cognitive behaviour therapy (CBT) is effective in managing mood disorders, but there is also some evidence that befriending can assist people. Befriending is an intervention that focuses on everyday conversation topics and can be delivered by volunteers with training and supervision. The case presented here illustrates the use of befriending provided over the phone for a participant with severe anxiety and depression. It was part of a larger RCT comparing CBT and befriending for the management of anxiety and depression in people with COPD. Symptoms were alleviated after a course of 8 weeks of befriending telephone calls from a volunteer. While befriending is not a substitute for CBT it may be useful in circumstances where CBT is not easily accessible.

Community Families: Bridging the gap between mental health services and civil society - A qualitative study from users' perspective

BACKGROUND

Social interventions to support people with severe mental illness are important to improving the quality of life. The perspectives of users are essential in this process. This article explores users' experiences, investments and concerns of a befriending programme.

MATERIAL

Focus group and individual qualitative interviews with service users.

DISCUSSION

Overall, the experiences with the programme were positive, and the social interaction was highly valued. However, that the relationships were arranged and facilitated by mental health workers remained an unresolved concern even after several years.

CONCLUSION

People with severe mental illness benefit from relationships despite the need of professional assistant.

Community families: A qualitative study of families who volunteer to support persons with severe mental illness

BACKGROUND

Social interventions targeted at people with severe mental illness (SMI) often include volunteers. Volunteers' perspectives are important for these interventions to work. This article investigates the experiences of volunteer families who befriend a person with SMI.

MATERIAL

Qualitative interviews with members of volunteer families.

DISCUSSION

The families were motivated by helping a vulnerable person and by engaging in a rewarding relationship. However, the families often doubted their personal judgement and relied on mental health workers to act as safety net.

CONCLUSION

The volunteer involvement is meaningful but also challenging. The families value professional support.

Only available to a selected few? Is it feasible to rely on a volunteer workforce for complex intervention delivery?

This paper recounts the process of undertaking a randomised controlled trial which was designed to examine the effectiveness of an intervention for socially isolated older people aged 75 years and over. It describes the reasons for early cessation of the study and raises the implications of this outcome for policy, practice and research. The intervention under investigation was designed to alleviate loneliness and foster companionship. It involves participants being linked with a small group of others through a teleconferencing system with each group being facilitated by trained volunteers. There was a requirement to recruit and train a minimum of 30 and a maximum of 60 volunteers over 1 year to facilitate 20 friendship groups to meet the number of older people required to be recruited to the study. Problems with recruiting and retaining the volunteer workforce by the voluntary sector organisation, who were commissioned to do so, led to the study closing even though older people were recruited in sufficient numbers. The paper draws upon analysis of various data sources from the study to identify the potential reasons. The discussion raises considerations regarding the extent of infrastructure required to deliver community services to vulnerable user groups at scale, identifies some of the issues that need to be addressed if such volunteer-initiated services are to be successful and informs future research programmes in this area.

Effectiveness of one-to-one volunteer support for patients with psychosis: protocol of a randomised controlled trial

INTRODUCTION

Social isolation is common in patients with psychosis and associated with a number of negative outcomes. Programmes in which volunteers provide one-to-one support-often referred to as befriending-have been reputed to achieve favourable outcomes. However, trial-based evidence for their effectiveness is limited.

METHODS AND ANALYSIS

This is a randomised controlled trial comparing the effects of one-to-one volunteer support with an active control condition for patients with psychosis over a 1-year period. Patients in the intervention group will receive the support of a volunteer for 1 year, who will meet them weekly and engage them in social and recreational activities. Patients in the control group will not receive support from a volunteer. In both groups, patients will be given a booklet detailing locally available social activities and otherwise receive treatment as usual. Patients, volunteers, clinicians and researchers involved in the delivery of the intervention will not be blinded to group assignment, while researchers carrying out data collection will be blinded. Data collection will be conducted at baseline, at 6 and 12 months. The primary outcome is the amount of time spent engaging in social activities per day. Secondary outcomes include symptoms, quality of life, self-esteem and costs of care. Attitudes of volunteers towards mentally ill people will be assessed. Finally, in-depth interviews will be conducted with patients and volunteers.

ETHICS AND DISSEMINATION

The study has been approved by the National Research Ethics Service (NRES) Committee London-Camden & Kings Cross (reference 15/LO/0674). The findings of the trial will be published in open access peer-reviewed journals and in the National Institute for Health Research (NIHR) journals library, and presented at scientific conferences. In addition, findings will be summarised for a lay audience and circulated to all relevant National Health Service (NHS) and voluntary organisations.

TRIAL REGISTRATION NUMBER

ISRCTN14021839; Pre-results.

Study protocol for a randomized controlled trial of telephone-delivered cognitive behavior therapy compared with befriending for treating depression and anxiety in older adults with COPD

BACKGROUND

COPD is an umbrella term to describe chronic lung diseases that cause limitations in lung airflow, including emphysema and chronic bronchitis. The prevalence of depression and anxiety in people with COPD is high, although these comorbidities are often undiagnosed, untreated, or undertreated. There is a need to identify efficacious treatments for depression and anxiety in people with COPD. Cognitive behavior therapy (CBT) for the treatment of anxiety and depression has a strong evidence base. There has been some success delivering this treatment over the telephone in limited studies. The aim of this study is to evaluate the efficacy of both telephone-administered CBT and befriending on outcomes for patients with diagnosed COPD who have at least mild levels of depression and/or anxiety.

METHODS

The protocol described in this paper is of a pragmatic randomized controlled trial comparing eight sessions of telephone CBT to an active social control, referred to as befriending. Primary outcome measures will include depression and anxiety symptoms, and secondary outcome measures will include quality of life, self-efficacy, and COPD symptom severity. Participants' satisfaction with the intervention and therapeutic alliance will also be assessed. Measures will be taken pre- and postdelivery of the intervention and again at 8 weeks following the intervention.

CONCLUSION

People with COPD often have limitations to their mobility because of their breathlessness. They are often already attending many medical appointments and could be reluctant to attend for face-to-face psychological treatment. The results of this study should identify the relative efficacy of CBT delivered over the telephone to this population, which, if successful, may be a cost-effective and more palatable alternative to face-to-face treatment of depression or anxiety for this population.

A randomised controlled trial of acceptance and commitment therapy (ACT) for psychosis: study protocol

BACKGROUND

Cognitive behavior therapy for psychosis has been a prominent intervention in the psychological treatment of psychosis. It is, however, a challenging therapy to deliver and, in the context of increasingly rigorous trials, recent reviews have tempered initial enthusiasm about its effectiveness in improving clinical outcomes. Acceptance and commitment therapy shows promise as a briefer, more easily implemented therapy but has not yet been rigorously evaluated in the context of psychosis. The purpose of this trial is to evaluate whether Acceptance and Commitment Therapy could reduce the distress and disability associated with psychotic symptoms in a sample of community-residing patients with chronic medication-resistant symptoms.

METHODS/DESIGN

This is a single (rater)-blind multi-centre randomised controlled trial comparing Acceptance and Commitment Therapy with an active comparison condition, Befriending. Eligible participants have current residual hallucinations or delusions with associated distress or disability which have been present continuously over the past six months despite therapeutic doses of antipsychotic medication. Following baseline assessment, participants are randomly allocated to treatment condition with blinded, post-treatment assessments conducted at the end of treatment and at 6 months follow-up. The primary outcome is overall mental state as measured using the Positive and Negative Syndrome Scale. Secondary outcomes include preoccupation, conviction, distress and disruption to life associated with symptoms as measured by the Psychotic Symptom Rating Scales, as well as social functioning and service utilisation. The main analyses will be by intention-to-treat using mixed-model repeated measures with non-parametric methods employed if required. The model of change underpinning ACT will be tested using mediation analyses.

DISCUSSION

This protocol describes the first randomised controlled trial of Acceptance and commitment therapy in chronic medication-resistant psychosis with an active comparison condition. The rigor of the design will provide an important test of its action and efficacy in this population.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry: ACTRN12608000210370. Date registered: 18 April 2008.

The impact of volunteer mentoring schemes on carers of people with dementia and volunteer mentors: a systematic review

This systematic review aims to examine the differences and similarities between the various types of volunteer mentoring (befriending, mentoring and peer support) and to identify the benefits for carers and volunteers. Literature searching was performed using 8 electronic databases, gray literature, and reference list searching of relevant systematic reviews. Searches were carried out in January 2013. Four studies fitted the inclusion criteria, with 3 investigating peer support and 1 befriending for carers. Quantitative findings highlighted a weak but statistically significant (P =.04) reduction in depression after 6 months of befriending. Qualitative findings highlighted the value carers placed on the volunteer mentors' experiential similarity. Matching was not essential for the development of successful volunteer mentoring relationships. In conclusion, the lack of need for matching and the importance of experiential similarity deserve further investigation. However, this review highlights a lack of demonstrated efficacy of volunteer mentoring for carers of people with dementia.