Is Online Counseling Effective for Adolescent Mental Health?: The Effectiveness and Challenges from the Perspective of Adolescents and Counselors

Background and Purpose: Due to the fact that online counseling had not been common given the closer distances between cities in South Korea, the utilization of online counseling is inevitable since the COVID-19 outbreak in which in-person counseling could not be carried out any longer as conducted previously and adolescents’ social interaction dramatically decreased, followed by the increase of their mental health problems, such as depression and anxiety (Korea Youth Counseling and Welfare Institute, 2020). In 2020, about 33% of the overall counseling in Korea Youth Counseling and Welfare Institute (KYCI) were conducted online (KYCI, 2021). Despite the dramatic and unprecedented transition from in-person to online counseling, few detailed guidelines or manuals exist in South Korea. To develop programs customized for online counseling for adolescent mental health in South Korea, this study aimed (a) to investigate the effectiveness and challenges of the online counseling that adolescents experienced and (b) to explore the useful counseling techniques and strategies, as well as challenges that online counselors experienced.

Methods: As a component of a mixed-method project, this qualitative study conducted in-depth individual interviews with (a) 8 adolescents and (b) 10 counselors who were involved in online counseling for adolescent mental health. The semi-structured 30-60 minutes individual interviews were conducted with open-ended questions regarding the challenges and effectiveness of the online counseling they participated in. The interviews were transcribed verbatim, and then interpretive analyses were performed. The coders read transcripts multiple times and created concepts from the transcripts. The coders then sorted the codes with corresponding quotes and produced categories and themes.

Findings: Since adolescents are accustomed to utilizing online counseling flatforms, such as Zoom, they can easily access online counseling when they need services. However, weak internet connection often prevents them from focusing on online counseling. During online counseling sessions, counselors stated that they can understand adolescents’ feelings through nonverbal expressions, such as facial expression and body language. Counselors suggested shorter duration of sessions about 30 minutes for online counseling, rather than 40-45 minutes for in-person counseling sessions. Counselors also reported that traditional counseling techniques, such as empathy and listening, may be still effective in online counseling. However, the physical environment for online counseling is still limited, such as lack of availability of private rooms, computers, or the internet, especially for the adolescents in low-income families. Additionally, since counselors are not familiar with conducting online counseling sessions, they have reported feelings of burnout using online counseling.

Conclusion and Implications: These findings provide implications for developing a manual and education program customized for online counseling for adolescent mental health. First, a specifically tuned manual of online counseling processes for adolescent mental health should be developed and conveyed to counseling organizations who offer online counseling as an option. Second, social workers or counselors should be trained in clear and detailed guidelines for practical and effective counseling techniques and strategies. Digital education and training programs for the social workers and counselors to improve online counseling skills could be useful to aid in improving adolescent mental health.