Perceived social isolation—commonly known as loneliness—is a psychosocial stressor that is associated with
increased mortality, opioid use, and precipitants of relapse among individuals with opioid use disorders (OUD).
Despite its association with greater clinical severity among individuals with OUD, there are no efficacy trials of
perceived social isolation interventions among individuals with OUD. Importantly, there are effective
interventions that can decrease perceived social isolation; however, there are no fully-powered efficacy trials
that have directly intervened on perceived social isolation among individuals with OUD. Cognitive-Behavioral
Therapy for Perceived Social Isolation (CBT-PSI) addresses negative beliefs that perpetuate perceived social
isolation, increase negative affect, and reduce one’s ability to engage in social activities. For an individual with
OUD, this is critical as addressing cognitive biases, negative affect, and having a sense that one has and
engages social support are key aspects of recovery. The proposed R01 tests the efficacy of this brief,
telehealth-delivered, evidence-based intervention, CBT-PSI, to decrease perceived social isolation Participants
will be recruited nationally and will be randomized to either (a) therapist-delivered CBT-PSI, (b) therapist-
delivered Health Education, or (c) self-guided Health Education. Each intervention will occur across 6 sessions
delivered/administered on a weekly basis. The specific aims are to: (1) assess group differences in perceived
social isolation among individuals with OUD, (2) assess group differences in opioid use among individuals with
OUD, and (3) assess the reciprocal relationship between opioid use and perceived social isolation. Additional
outcomes of interest include mental health symptoms, and the quality and quantity of social interactions.
Outcomes will be assessed post-treatment, 1-month post-treatment, 3-months post-treatment, and 6-months
post-treatment. This project has the potential of having a significant public health impact by evaluating an
intervention on a novel therapeutic target for OUD, perceived social isolation. Elucidation of the efficacy of
CBT-PSI can help advance prevention and augment existing treatment strategies for OUD.
