Robotic dogs, laughter therapy and mindfulness could help people cope with loneliness and social isolation during the Covid-19 pandemic, researchers at the University of Cambridge have found.

The team at the university’s School of Medicine, led by Dr Christopher Williams, reviewed 58 existing studies on loneliness and identified interventions that could be adapted for people living in lockdown or under pandemic-related social distancing measures.

Several of the studies involved initiatives to combat loneliness and isolation in nursing and care homes, likely to be hit hard under lockdown. Effective interventions in these settings included weekly visits from an interactive robotic dog, which proved just as effective as an actual dog in alleviating loneliness. Another study involving weekly sessions with Paro, an interactive robotic seal that responds to stimuli by moving or imitating the noises of a baby harp seal, significantly improved loneliness scores.

Psychological interventions seemed the most effective overall, Williams said, including mindfulness-based therapies, tai chi, qigong meditation and laughter therapy, which led to significant improvements in loneliness or social support outcomes. Educational programmes, particularly those focusing on wellbeing, friendship, addressing barriers to social integration and explaining loneliness, were also identified as potentially helpful.

A combination of educational and psychological interventions – understanding the source of the problem and what you can do about that – therefore, seemed most effective, Williams said.

Though they found the majority of studies improved loneliness, they had to be cautious with the findings. “A poor quality study that shows an improvement is promising but it’s not definitive,” Williams caveated, highlighting one visual arts therapy study which showed good outcomes. “And because there aren’t enough of these studies, we had to be very cautious with our conclusions.”

There was also no guarantee that any of these approaches would work as they haven’t been tested under pandemic conditions, said Williams. For instance, while Wii gaming was found to be effective at reducing loneliness, the studies involved group play, which would only be feasible in support bubbles during lockdown and it isn’t clear if the same benefits would be seen from online play.

The review was therefore intended to present options that may be feasible and could be the subject of future targeted trials, Williams added.

Another limitation was the lack of literature on social isolation in comparison with loneliness, said Williams. For instance, an introverted person can be socially isolated without feeling lonely. But the little evidence suggests that enabling or encouraging people to interact with their existing social circles, for example weekly video calls with family members, was more effective than trying to help them make new friends.

“Many of the activities could be delivered at a large scale in online groups, potentially at low cost,” said Dr Adam Townson, a co-author of the review. But in terms of the pandemic, a significant problem is those most likely to feel lonely or isolated may not own, or know how to use, electronic devices or have internet access. “Any approach to help people suffering from loneliness or social isolation must take digital exclusion into consideration,” Townson said.

Another drawback was the lack of studies on loneliness and isolation in younger student populations, people from low-income backgrounds, ethnic minorities and those in digital poverty, Williams said, suggesting further research into how different communities experience and can address loneliness and social isolation was needed.