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Effectiveness of befriending interventions: a systematic review and meta-analysis
  1. Joyce Siette1,
  2. Megan Cassidy2,
  3. Stefan Priebe2
  1. 1 Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
  2. 2 Unit of Social and Community Psychiatry, Barts and the London School of Medicine and Dentistry, University of London, London, UK
  1. Correspondence to Dr Joyce Siette; joyce.siette{at}


Objective Befriending is an emotional supportive relationship in which one-to-one companionship is provided on a regular basis by a volunteer. It is commonly and increasingly offered by the voluntary sector for individuals with distressing physical and mental conditions. However, the effectiveness of this intervention on health outcomes is largely unknown. We aim to conduct a systematic review of the benefits of befriending.

Design Systematic review.

Methods A systematic search of electronic databases was conducted to identify randomised controlled trials and quasi-experimental trials of befriending for a range of physical and mental health indications including depression, anxiety, mental illness, cancer, physical illness and dementia. Main outcomes included patient-relevant and disease-specific outcomes, such as depression, loneliness, quality of life, self-esteem, social support and well-being.

Results A total of 14 trials (2411 participants) were included; 7 were judged at low risk of bias. Most trials showed improvement in symptoms associated with befriending but these associations did not reach statistical significance in all trials. Befriending was significantly associated with better patient-reported outcomes across primary measures (standardised mean difference 0.18 (95% CI, −0.002 to 0.36, I2=26%, seven trials)). However, there was no significant benefit on single outcomes, including depression, quality of life, loneliness ratings, self-esteem measures, social support structures and well-being.

Conclusions There was moderate quality evidence to support the use of befriending for the treatment of individuals with different physical and mental health conditions. This evidence refers to an overall improvement benefit in patient-reported primary outcomes, although with a rather small effect size. The current evidence base does not allow for firm conclusions on more specific outcomes. Future trials should hypothesise a model for the precise effects of befriending and use specified inclusion and outcome criteria.

  • Befriending
  • Randomized controlled trials
  • Meta-analysis
  • Systematic Review

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  • Acknowledgements We thank the research team at the Unit for Community and Social Psychiatry for their continued contributions in discussing the content of this article.

  • Contributors JS was responsible for conceptualising the design of the study, identifying the included reviews and drafting the results. MC also contributed to the identification of relevant reviews. JS and SP were responsible for interpreting the data and revising the work for important intellectual content. All authors approve this version for publication and are accountable for the content of the work.

  • Funding The work presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research programme (Reference Number RP-PG-0611- 20002). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data extraction form and protocol available by request to

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