JMIR Publications

ABSTRACT

Background:

University students experience high levels of mental health difficulties. However, due to limited capacity and high demand, university counselling services can only provide brief, time-limited support, and some students may therefore require further support after counselling ends. Moderated Online Social Therapy (MOST) combines self-directed therapeutic content with therapist support, peer support, and an online social network. MOST has shown promise across youth mental health settings, but its acceptability as a follow-on support after university counselling has not previously been examined, and comparatively little is known about its acceptability from the perspectives of those involved in delivery and referral.

Objective:

To explore how university students, peer support workers, MOST therapists, and university counselling staff perceived the acceptability of MOST as a follow-on intervention after university counselling including factors influencing implementation and integration.

Methods:

A qualitative study was conducted within a university setting where MOST was offered as a follow-on support from counselling. Semi-structured interviews were conducted with university students who had used MOST (n = 9), peer support workers (n = 6), MOST therapists (n = 2), and university counselling staff involved in referral (n = 5). Separate interview schedules were developed for each stakeholder group and informed by the Theoretical Framework of Acceptability. Interviews were analysed using Framework Analysis. Coding frameworks were developed separately for each stakeholder group before themes were developed within and across groups.

Results:

Four themes captured participants’ experiences of MOST, relating to its fit within university support, engagement with the platform, the importance of human connection, and the support required for effective delivery. MOST was viewed as an acceptable and valuable follow-on support after university counselling, filling a gap for students requiring ongoing support, although limited integration with the counselling service was highlighted as an issue. Human connection was central to MOST, with particular value placed on peer support. However, low activity within the social network and technological limitations reduced engagement. Participants also identified opportunities to further strengthen delivery through additional training, continuity, and communication within the MOST team.

Conclusions:

MOST appears to be an acceptable follow-on support for university students after counselling, with peer support identified as a clear strength of the intervention. Wider implementation may benefit from closer integration with university counselling services, improved platform functionality, and sufficient user activity to sustain the Community. Future research should examine MOST across additional university settings and among students with differing levels of engagement.