The therapeutic alliance in online youth counselling

The number of people seeking out support via the Internet is steadily increasing. In response to this growing need, counselling services have become commonplace on the Internet. This study focuses upon Kooth, one such service that has specifically been created to support adolescents. In particular, the work examines the quality of the computer-mediated Therapeutic Alliance from the viewpoint of the young users. This is a naturalistic study which combines several mixed methods research designs to explore the online adolescentcounsellor Alliance. At the heart of the study, an explanatory mixed methods design utilised an online measure of Alliance (Therapeutic Alliance Quality Scale [TAQS]) supported by online interviews to provide a rich picture of the adolescent-counsellor Alliance. This is complemented by two further mixed methods designs, an embedded experimental design and a triangulation design, which focus upon the effectiveness of the therapeutic work and the potential of viewing the Alliance as a predictor of successful counselling. The findings from the project indicate that the service proves popular with adolescents and that approximately three quarters (79%) of the services users who completed the TAQS (n=47) reported the Alliance to be of a medium or high quality. Additionally, the interviews (n=15) highlighted the importance of having an appropriate match between client and service in the creation of strong Alliances. Key facets to this matching process included the initial engagement phase (related to gaining access), the development of rapport with the counsellor (related to the communication skills utilised), and the establishment of control (related to consensus over key issues between the counsellor and client). The investigation into the effectiveness of the counselling service proved less successful and the methodological reasons for this are discussed. It is concluded that strong Alliances can be created in online relationships with adolescents. The limited datasets for the latter parts of the study mean that generalised conclusions about the effectiveness of the service and the predictive value of the Alliance cannot be made. These findings are discussed in relation to the broader literature and recommendations for service providers and practitioners are outlined.EThOS - Electronic Theses Online ServiceGBUnited Kingdo