Bridging Disciplinary Boundaries (January 11 - 14, 2007)

Purpose: The Online Counseling Comfort Scale (OCCS) is a new three item scale measuring receptiveness to online counseling services. This exploratory study will examine both the validity of the OCCS, as well as explore the potential for using computer technology for delivering substance abuse services to adolescents in rural locations. Developing low cost computer-aided counseling models may benefit rural substance abusing clients, because these clients often have difficulty traveling to substance abuse treatment in urban centers.

Methods: Families participating in longitudinal substance abuse treatment research completed the OCCS. Participants for this study were recruited between June 2003 and March 2005 (N=190). An internal consistency estimate for the OCCS was computed, and correlations between this scale and self-reported frequency of client internet searches for substance abuse, mental health and physical health information were generated. Independent samples t-tests and ANOVA were used to determine if there were differences in comfort with using on-line services between rural and urban clients, male and female clients, majority and minority clients, clients with or without a history of previous treatment, and clients receiving services in different levels of care (i.e., outpatient, residential, early intervention). Descriptive analyses investigated both the overall percentage of clients with internet access at home, as well as if any demographic or level of care differences existed.

Results: Overall, 72% of participants reported that they have a computer with access to the internet at home and 10% report ever having used online health or social services resources. In the 90 days prior to recruitment, 22.1% of participants reported looking for information about alcohol and drugs on the internet, 10.5% looked for information about mental health, and 8.9% looked up physical health information on the internet. Internal consistency for the three-item OCCS was good (a=.72), but OCCS scores were not significantly associated with self-reported frequency of internet searches for substance abuse, physical health, or mental health information. No mean differences in OCCS scores existed for clients diverse on gender, minority status, rural status, prior treatment history, or treatment level of care. Forty five percent of minority clients reported that they did not have access to the internet on a home computer compared to 20% of majority clients, which was a statistically significant difference (c²=10.06, p<.01).

Conclusion. Clients differed in how receptive they were to receiving on-line counseling services. Results may be due to the limited exposure teens have had with computer-aided counseling models. Thus, self report surveys of how acceptable computer-aided counseling is to existing clients may need to be augmented by qualitative pilot testing of specific models. Program planners should be aware that internet access varies by minority status. Results are discussed in the context of interdisciplinary telemedicine efforts.

Implications for Policy & Practice. Social workers and other health professionals should consider the internet for provision of information that could be helpful for adolescents. Policies should be carefully developed to handle general and individual questions appropriately.