[Internet-based self-help for loneliness from the users' perspective]

Loneliness is associated with a range of adverse health outcomes. Internet-based self-help interventions offer a low-threshold approach to reducing loneliness; however, little is known about users' experiences. The aim of this study was to qualitatively examine users' experiences with the internet-based self-help intervention SOLUS‑D for the reduction of loneliness. The data were derived from a randomized controlled trial evaluating SOLUS‑D. Following the 10-week intervention period, semistructured telephone interviews were conducted with the participants. For the present analysis, 17 interviews were selected and analyzed using reflexive thematic analysis. Three main themes were identified. 1: participants reported changes in thinking, feeling and behavior, including increased awareness of automatic thoughts, greater clarity in dealing with feelings of loneliness, behavioral activation and enhanced self-efficacy. 2: the role of guidance emerged as important: automated messages were primarily perceived as reminders, whereas human guidance fostered motivation, a sense of safety and the feeling of being seen. 3: the findings indicated that SOLUS‑D was not equally suitable for all users. In particular, participants seeking direct social interaction or concrete opportunities to form relationships perceived limitations of the self-help format. The results suggest that internet-based self-help interventions can represent a relevant low-threshold option for addressing loneliness. They also highlight the importance for greater personalization of content and guidance specifically addressing individual and social factors that influence loneliness.