Barriers and facilitators of young people's engagement with webchat counselling: A qualitative analysis informed by the Behaviour Change Wheel

Young people's engagement with online counselling remains an endemic obstacle faced by mental health services. This study utilises the Behaviour Change Wheel (BCW) framework to systematically explore the barriers and facilitators of young people's behavioural engagement with online webchat counselling. The current study defines behavioural engagement as any observable or active contribution by the young person in the webchat sessions, such as written verbalisation and self-expression. Semi-structured interviews with counsellors (n = 8) and open-ended questionnaire data from 43 young people (aged 18-25 years) were gathered and then coded. Nine core themes were identified including communication difficulties, the safety of the webchat environment, absence of face-to-face communication, ambiguity in messages or pauses, reaching goals, optimism about outcomes, pre-existing anxieties, mood or well-being and wanting/not wanting to attend. Using the BCW framework, these themes were mapped to broad intervention functions and behaviour change techniques (BCTs) to provide suggestions to optimise young people's engagement with online counselling. These include the application of persuasive design features, the use of social strategies, increased counsellor training and greater personalisation of the online therapeutic approach. Future research can determine the effectiveness of these proposed strategies and BCTs to enrich the emerging engagement strategy field and the wider digital and mental health behaviour change literature.