For over 15 years, staff based in the Manchester Institute of Education have been engaged in research exploring the development of online counselling services for young people. Here, Dr Terry Hanley and Professor Pamela Qualter discuss their research findings and make recommendations for the UK Government’s strategy for tackling loneliness.

• Our research findings act as a counterbalance to some of the wholly negative reporting about the way that children and young people engage with technology.
• There are a variety of reasons that young people prefer using online counselling services.
• It is important that policy makers view online services as an essential part of the future counselling and mental health infrastructure.

Our research has ranged from supporting the growth of ethically minded services at the time when such services were emerging to contributing to recent select committee consultations focusing upon the impact of screen use and social media on young people’s health . Along the way we have worked with core service providers, such as Kooth and the NSPCC, to explore the ways in which individuals engage with services. Importantly, the findings of our work typically act as a counterbalance to some of the wholly negative reporting about the way that children and young people engage with technology.

What is online counselling?

Online counselling can take on many forms. It can be text-based, use videoconferencing technologies like Skype, and include programmes in which individuals interact as avatars (online constructions of themselves) – we won’t even consider getting into discussions of more immersive technologies here! Despite the variety of methods available, the most commonly used approach for young people still appears to be text-based methods that use asynchronous communication (like email) or synchronous communication (real-time chat) systems. Kooth, an online service that includes asynchronous and synchronous support receives 1500 logins a day and exchanges 300,000 messages with young people in a year period. This is a phenomenal amount of support being sought by young people and offered by Kooth.

But why is online counselling proving so popular? Below we talk about two major strands of our work. There is the potential that online counselling can increase access to services for young people and for it to support people in connecting with others.

Increasing access

The major benefit of online support that comes through loud and clear is that it can help to increase access to services. In a recent book chapter focusing on technological advances in therapeutic work with young people, we listed the following reasons why individuals might approach an online counselling service. They included that individuals may:

• have concerns, or fears, about approaching a face-to-face counselling service
• live in an area where they are unable to get to a face-to-face counselling service
• have a physical disability which makes it difficult/impossible for them to get to a face-to-face counselling service
• have other commitments/time limits that mean they wouldn’t ordinarily seek counselling
• prefer chatting online.

For some professionals, the idea of compromising face-to-face conventions can be seen as sacrilege, but for young people the difficulty of accessing face-to-face services should not be underestimated either. When interviewed about such services, one young person noted:

jellykid3: oh yea part my life would never been discussed if was not for online work

jellykid3: words you can’t always say face-face to people

Further, when comparing the therapeutic goals that individuals set in online and face-to-face therapy there appeared to be tangible differences. For instance, setting goals related to improving intimate relationships appeared to be more commonplace online and individuals also used web-based support as a means to accessing other forms of support – a form of psychological triage. With this in mind, we therefore highlight the need for policy makers to view online services as an essential part of the future infrastructure and for professionals to be involved in meeting this need.

Reducing loneliness

There is evidence that loneliness is becoming an increasing issue in Western societies. In the UK, recent ONS reports show that many young people report feelings of loneliness, but how do we mitigate against loneliness or find sources of support during those lonely times? Might online counselling services be an option?

There are few academic studies offering solutions to loneliness, but where evidence has been gathered, addressing maladaptive cognitions, via counselling, has been shown to be the most effective intervention for those experiencing prolonged loneliness. In the recent BBC Loneliness Experiment, the largest study of loneliness in the world, people were asked how they had overcome loneliness. Even for transitory loneliness, being able to talk to someone removed from the situation was a preferred option for people; counselling also provided opportunities for guided reflection. Online counselling, then, has the potential to support those suffering from loneliness.

In 2017-2018, Childline provided 278,440 counselling sessions, with 73% of those provided online. They reported a 14% rise in counselling sessions for loneliness.  Offered support and guidance through counselling, children and young people were able to manage feelings of loneliness and think of alternative strategies for dealing with their loneliness – Lucy’s story detailed in This Action for Children document shows how a ChildLine counsellor got her to think about the causes of her loneliness and ways to overcome it. That empowered her to change her behaviour and reduced her feelings of loneliness.

Despite the popularity of online counselling, particularly for young people, and the fact that it is likely to help people reporting loneliness, as an intervention approach it is missing from the UK Government’s strategy for tackling loneliness.  In that report, the UK Government notes the importance of embracing digital technology in order to militate against loneliness, but discusses digital technology only in a physical sense; digital advancement in the form of online counselling should be considered a valuable tool to help those stuck in loneliness and looking for ways out of it.

So what should the future have in store?

During a time when the mental health provision of young people is supposedly being ‘transformed’ so that it is fit for the future, it is vitally important that we do not just consider face-to-face services as the only option. Without doubt, the pendulum should not swing too far the other way – online services will certainly not be for everyone – but choice does matter. Our research highlights that, with this in mind, online counselling is one very powerful means of using technology to good effect. It can increase access to valuable mental health services and will help those who are suffering from loneliness.