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Background: Digital mental health interventions comprise a potentially effective and accessible form of support for young people, particularly at times when traditional face‐to‐face service delivery is reduced, as in the COVID‐19 pandemic. Aims: This study assessed the demographic profile of young people using a digital mental health support service and evaluated outcome change over the course of a structured online counselling intervention (synchronous text‐chat sessions with a practitioner). Materials and Methods: The data were collected from 23,260 young people aged between 10 and 25 years engaging with the intervention between April 2019 and June 2021. Results: Young people accessing these services had high levels of mental health needs, particularly those identifying with non‐binary gender identity. Service users were mostly female, with equitable rates of access for young people from racialised communities. Overall outcome change demonstrated small effect sizes according to the YP‐CORE (0.19) and CORE‐10 (0.38), which increased to a moderate level when young people remained engaged with a dedicated practitioner for at least seven sessions (0.38, 0.58). Regression analysis illustrated the effect of the number of sessions on outcome change, but this can be also influenced by other variables such as age and gender. Discussion and Conclusion: Further research is required to explore ways to engage with young people using digital web‐based services for a longer period and to collect and analyse single‐session outcome data. [ABSTRACT FROM AUTHOR]

The study provides insight into counsellors' experiences of counselling clients online. The foci include (a) counsellors' experience of negotiating the therapeutic relationship online, (b) their experiences of utilising and adapting their clinical skills to assess clients in an online capacity, and (c) ethical issues associated with practicing online. Open-ended interviews were conducted with three counsellors located in Canada and one in the United States. Narrative analysis revealed eight major themes: convenience, therapeutic alliance, online counselling skills, assessing client suitability, reaching diverse clients, assessing client satisfaction, legal and ethical concerns, and personal and professional goals. [ABSTRACT FROM AUTHOR]

Technology‐delivered psychological interventions, particularly online and telephonic counselling, have flourished in recent years, with the need for such a flexible delivery method increasing due to the COVID‐19 pandemic. While empirical research on technology‐delivered psychological interventions is limited, findings indicate that therapists have a positive attitude towards online counselling. There is a particular lack of research on therapists' perceptions and experiences of using technology‐delivered interventions. The primary aim of this study was to explore therapists' experiences of providing online counselling, thereby gaining insight into the therapeutic experience, processes and efficacy from the therapists' perspective. Data were collected through semi‐structured interviews with five therapists, registered with organisations providing professional counselling and psychotherapy, with experience of providing synchronous/real‐time online video, audio or chat‐mediated counselling sessions. The interviews comprised open‐ended questions. Interpretative phenomenological analysis was used to analyse the data, through which two superordinate themes were identified: (a) environmental adaptation and (b) practice enhancement. Our findings suggest that therapists' online counselling experiences incorporate several factors related to environmental adaptation and practice enhancement that impact the therapeutic process, outcomes, progress and relationship. The findings could inform the development of training, awareness‐raising and skills‐enhanced interventions for psychotherapists already using and hoping to use online therapeutic interventions. [ABSTRACT FROM AUTHOR]

This paper reflects upon the history of online counselling and psychotherapy research. It provides a reflection upon the growing body of research in this field and discusses the impact of the recent global COVID‐19 pandemic upon it. It specifically argues that the pandemic has been an evolutionary catalyst for developments in online therapy. Therapeutic practices, and attitudes towards them, have changed in ways that will alter the shape and form of therapies in the future. As a consequence, research into online therapeutic work needs to be responsive and adapt to this changing world. Counselling and psychotherapy researchers therefore have to situate themselves in a way that allows them to keep one foot in the present and one foot in the future to stay abreast of technological developments. There may be a reluctance to do so from some areas in the therapeutic profession, but their presence might prove vital in ensuring that ethical sensitivity, which acknowledges and values the complexity of the human experience, remains at the foreground of psychological support. [ABSTRACT FROM AUTHOR]

Online service delivery is an alternative to face-to-face interventions for harmful alcohol use. However, little evidence evaluates its relative efficacy or the demographic characteristics of clients accessing these services. Archival demographic and treatment outcome data collected from 82 clients who undertook online or face-to-face extended brief interventions (EBI) were analysed. Measures included a pre-treatment Alcohol Use Disorder Identification Test (AUDIT) and pre/post well-being and drinking behaviour measures. Clients in the online sample were on average younger, scored higher on the AUDIT, were in work/training more days a month and attended a greater number of sessions. After controlling for differences in treatment mode and age, online EBI led to greater increases in quality of life and fewer drinking days. Online EBI may provide an important alternate service delivery mode for harmful alcohol use, which may be accessed more frequently by younger and higher risk clients. [ABSTRACT FROM AUTHOR]

Young people are increasingly turning to online support, especially when traditional mental health services are not immediately available. Using a cross-sectional design, sociodemographic information and self-reported perceptions of the strength of the working alliance and client satisfaction were collected from a sample of participants (n = 78) who were users of a service providing free online support using synchronous instant messaging. The results reported a significant positive relationship between the strength of the working alliance and client satisfaction, suggesting that the strength of the working alliance remains a key component in counselling, even online. Participants, however, scored significantly lower on both the strength of the working alliance and client satisfaction, compared to participants in offline settings as reported in past studies. [ABSTRACT FROM AUTHOR]

Despite the exponential growth of non-appointment-based web counselling, there is limited information on what happens in a single session intervention. This exploratory study, involving a thematic analysis of 85 counselling transcripts of people seeking help for problem gambling, aimed to describe the presentation and content of online conversations. Observed from the perspective of the client, we found that presentations were related to immediate help with a crisis and non-urgent assistance in developing strategies and skills. Almost all clients spent a great deal of time telling their story (i.e., the pattern, context, progression and impact of the problem, motivation for continuing and previous attempts to change) with less time spent exploring opportunities, readiness or self-efficacy related to change or relevant options and strategies. These findings provide important information that informs the application of traditional counselling approaches within web-based environments. [ABSTRACT FROM PUBLISHER]

The provision of online counselling and emotional support is a subject of intense debate among service providers. The subject is explored here by triangulating data from a statistical analysis of data from a children's helpline, interviews with practitioners and a focus group. Despite practitioners' concerns relating to misinterpretation, misrepresentation and the lack of non-verbal cues, online conversations are shown to span a greater variety of topics and focus on more sensitive issues than verbal sessions. Online services have potential for reaching clients in accessible and meaningful ways. However, practitioners need to consider online-specific issues, undertake specialised training and become comfortable with these new communication formats. [ABSTRACT FROM PUBLISHER]

Aims: The therapeutic alliance is a concept that has received a great deal of attention within face‐to‐face counselling. Furthermore, links have been made between the creation of strong alliances and successful therapeutic outcomes. This study examines the therapeutic alliance when counselling services are offered online to young people. Method: Fifteen young people took part in online interviews (utilising synchronous and asynchronous methods), and Grounded Theory techniques were utilised to analyse the data. Findings: A core category of 'Client‐Service Match' and three subcategories pertinent to the individuals' experiences of creating good quality relationships with the counsellors were identified: (1) initial engagement, (2) developing rapport, and (3) establishing control. Discussion: The themes elicited are all relevant to the matching process and viewed as a chronological process similar to face‐to‐face counselling. However, unlike face‐to‐face work, specific nuances related to the online work arise that counsellors should be mindful of, including the rationale behind each individual's choice to approach services online, their own computer‐mediated communication skills, technical hurdles, and the perceived 'power' of the counsellor. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to investigate the elements that characterize the formation of a therapeutic relationship when the sessions are conducted through videoconference. Method: Conversation analysis was used to analyse the first three counselling sessions with five clients, for a total of 15 sessions. Results: The phenomena detected in the conversational sequences dealt with the following issues: starting up (early definition of the problem, motivation to use a communication technology, and therapeutic rules), technological ruptures (interruptions and multimedia repair), environment, privacy, and going beyond videoconferencing, such as inter‐session contact and moving from videoconferencing to face‐to‐face meetings. The analysis of relational asymmetries also highlighted the relational dominance of the therapist. A series of these phenomena could be ascribed to the online modality; other ones are common in face‐to‐face sessions. The frequent request to integrate online sessions with face‐to‐face sessions might indicate that online psychotherapy is seen as a complement to face‐to‐face psychotherapy more than as a substitute for it. Conclusions: The potential of online psychotherapy is still underestimated and further studies should be conducted on the specificities of the computer‐mediated communication within the therapeutic relationship. [ABSTRACT FROM AUTHOR]