JMIR Publications

ABSTRACT

Background:

Young people aged 10-24yrs are at the highest risk for mental health problems, while being the least likely to seek professional treatment due to various barriers to help-seeking. Owing to their high consumption of Internet content, e-Mental Health Services tailored to young people have globally proliferated as a means to address the barriers this population experiences to mental health care. A primary intervention at many such services is Text-Based Online Counselling, which while demonstrating promising findings in emerging literature, has shown greater variance in outcome compared with other e-Mental Health interventions for young people.

Objective:

The present pilot study aimed to qualitatively explore the characteristics of young service users accessing Text-Based Online Counselling services; their motivations for access; and their perceptions about factors believed to increase and decrease effectiveness on these modalities.

Methods:

E-surveys were administered naturalistically to 100 young service users aged between 15 and 25yrs accessing webchat and email counselling services via an Australian e-Mental Health Service. Thematic analysis of qualitative themes, and quantitative descriptive and proportional data, presented in E-surveys were examined across the areas of: user characteristics, motivations for access, and perceptions of Text-Based Online Counselling effectiveness.

Results:

Participants were predominately female high school students of Caucasian or European descent from low middle socioeconomic backgrounds living with parents in major cities. Four primary themes, and various subthemes, were related to participants’ motivations for selecting Text-Based Online Counselling and their perceptions of its effectiveness: Contextual factors (i.e., Physical and Mental Health syndrome, Perceived Social Difficulties, Low Social Support, Prior Negative Help-Seeking Experience); Selection factors (i.e., Safety, Avoidance Motivation, Accessibility, Expectation); and Factors perceived to increase effectiveness (i.e. General Therapeutic Benefits, Efficacious Modality and Service Factors, Persisting with TBOC Despite Substantial Benefit) or reduce effectiveness (i.e., Negative Modality and Service Factors).

Conclusions:

Findings suggest that unique contextual factors may influence the motivation of young people select to use Text-Based Online Counselling modalities; while unique therapeutic, service and modality factors may increase and decrease intervention effectiveness.