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Moving towards decision making: Community Navigator Study Working Group Meeting 4

By Kate C Fullarton, on 30 August 2016

Over the past few meetings we have had the opportunity to listen, to think and to ask questions: we’ve heard from experts working to reduce loneliness and isolation, we’ve heard about the latest research evidence and we’ve learnt from each other’s experiences and expertise. Coming into our fourth meeting, we knew we would soon have to start making key decisions about the community navigator programme.  The focus of this meeting was to discuss two main questions:

1) Should we set up our own group as part of the support offered to service users, and if so, what kind of group?

2) How is the navigator support aiming to change service users thinking around their social relationships?

One of our experts by experience introduced the first question. We divided up into groups to discuss whether navigators should be linking people in to existing community groups, or whether we include an optional group element in addition to the ten community navigator sessions. We also were asked to discuss what type of group we think could be most beneficial for people, with five options suggested based on ideas from previous meetings. These were:

  • Wellbeing groups – for example, mindfulness, stress reduction, relaxation
  • Activity groups – for example, arts and craft, singing, walking, sports
  • Reflection and support – a less structured group where people could share their experiences of the support and how they’re finding working towards their goals
  • Collective event – an event or activity organised by people towards the end of their support from a community navigator
  • Groups4Health – a five week group programme targeting loneliness and social isolation through strengthening people’s social identities, that has been developed and trialled by researchers in the Social Identity and Groups Network at The University of Queensland.

As we went round the room to give feedback, it was clear that people thought it would be useful to offer a group, however, ideas about what type of group were more mixed. Some people felt that Groups4Health was the best option, as it is an established programme with a growing evidence base and complements the work that the community navigators will be doing on a 1:1 basis. Other people felt that an activity group would be best, although they thought it might be difficult to find a group to match everyone’s interests, to keep the support person-centred. For this reason, some people felt that a reflection group or collective event would be best, to allow group members to come together and set their own agenda. What are your thoughts? What type of group do you think would be most useful for people?

After a quick coffee break, we turned our attention to thinking about the psychological component of loneliness. Researchers De Jong Gierveld and colleagues (2011) propose three ways that programmes reduce loneliness:


1) Increasing use of the support available from existing relationships

2) Fostering and enabling new social connections

3) Helping people to change thinking about their social connections


We know our community navigators will be focusing on 1) and 2) by working to enhance social support from existing relationships and increasing opportunities to create new social contacts, so this discussion was to get people’s thoughts on the extent to which our navigators should be explicitly focusing on 3): helping people to change thinking about their social connections. We were asked to discuss the potential advantages and disadvantages of two approaches:


  • Solution-focused approach

Community navigators would be trained to be focused on identifying the next step that the person they are supporting could take to achieve their socially-oriented goals, equipping community navigators with the skills to look for positive solutions, rather than concentrating on the past and what is preventing the person from moving forwards. This appealed to people because it was consistent with the Wellbeing Enterprises approach that we heard about in Week 2, continually focusing on the ‘next step’.   The question raised, however, was whether this approach pays enough attention to the research evidence, albeit limited, which suggests that programmes which address our thoughts about the self and relationships are effective at reducing loneliness, when compared to programmes that just focus on social participation.


  • A targeted, individual approach

Community navigators would be trained to look for opportunities to help service users reappraise thoughts about relationships and barriers to social engagements, using tools such as motivational interviewing, basic cognitive behavioural therapy (CBT) and social skills training. The advantage of this approach is that it goes beyond increasing social participation to address thoughts and feelings around loneliness, which is after all a subjective state and can exist even if you have social contact. The drawback of this approach, however, is that community navigators could end up focusing more on people’s mental health, than on their social world, which goes against the purpose of the role.


From the group discussion it was clear that people felt that using a solution-focused approach was most appropriate, and though community navigators may be ‘psychological minded’, they should be clear that this is not psychological support. Community navigators should be focused on improving the person’s social networks and community connections, rather than changing cognitions. What do you think? What role should community navigators play in changing people’s thinking about social relationships?


With the details of the programme of support getting somewhat clear, and decisions starting to be made, it is an exciting time on the study. We have recently shortlisted candidates for the community navigator roles and will be interviewing shortly. We were delighted by the number of applicants, showing this is a role that people feel is important and worthwhile.


At the next meeting we will return to these big questions and try and get creative as we plan what mapping tools and goal setting tools navigators can use with participants. In the meantime if you have any thoughts or questions about the study, or would like more information, contact Kate via k.fullarton@ucl.ac.uk or @ucl_loneliness.



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