The Effectiveness of Online Counseling Modalities on Psychological Well-Being: The Mediating Role of Therapeutic Alliance and Counseling Engagement
Keywords:
Online counseling; Video call counseling; Chat-based counseling; Therapeutic alliance; Psychological well-beingAbstract
The high prevalence of psychological distress among today’s youth accounts for a substantial burden of non-clinical mental health issues. Ironically, anonymous text-based chat rooms remain a prevalent shortcut for superficial interventions. This complex situation frequently triggers latent psychological friction; individuals hesitate to open up visually to evade social stigma and preserve their self-image, relegating the escalation of emotional struggles to mere anonymous social media grievances without tangible therapeutic resolution. Addressing these socio-digital barriers, this study investigates the efficacy of online counseling modalities in fostering a robust therapeutic alliance and active engagement to enhance psychological well-being among adolescents and emerging adults in Indonesia. Employing a quantitative approach with Partial Least Squares Structural Equation Modeling (PLS-SEM), this study involved 284 active participants who had undergone remote counseling within the past six months. The analysis contrasted the impact between users of cue-rich video call interventions—which preserve real-time visual-auditory expressions—and those utilizing lean text-based formats. The structural model assessment confirmed that the video call modality triggered a significantly more robust reinforcement of the therapeutic alliance (β = .42, p < .001$) compared to text-based communication (β = .18, p = .012$). Through this parallel mediation pathway, participants became substantially more expressive, adaptive, and proactive in applying therapeutic insights to their daily lives. The distinct novelty of this research lies in dismantling digital detachment and emotional hesitation among the tech-savvy generation through relational empowerment and active behavioral commitment. In conclusion, remote mental health restoration is empirically proven to be fundamentally more impactful when cue-rich video communication channels are adaptively synergized with deep interpersonal relationship dynamics.
References
Al-Asadi, A. M., Klein, B., & Meyer, D. (2018). Posttreatment attrition and engagement mechanisms in online cognitive behavioral therapy. Journal of Medical Internet Research, 20(3), e84. https://doi.org/10.2196/jmir.9015
Andersson, G., & Titov, N. (2019). Advantages and limitations of internet-delivered interventions for common mental disorders. World Psychiatry, 18(1), 43–51. https://doi.org/10.1002/wps.20583
Arnett, J. J. (2016). College students as emerging adults: The developmental space between adolescence and adulthood. Journal of Behavioral Development, 40(3), 221–232. https://doi.org/10.1177/0165025415620023
Barak, A., Hen, L., Boniel-Nissim, M., & Shapira, N. (2019). A comprehensive review and a meta-analysis of the effectiveness of internet-based psychotherapeutic interventions. Journal of Technology in Human Services, 37(2), 109–142. https://doi.org/10.1080/15228835.2019.1593452
Berger, T. (2017). The therapeutic alliance in internet-based interventions: A narrative review and suggestions for future research. Psychotherapy Research, 27(5), 511–524. https://doi.org/10.1080/10503307.2015.1119908
Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research & Practice, 16(3), 252–260. https://doi.org/10.1037/h0085885
Centore, A. J., & Milacci, F. (2016). A study of professional counselors’ perceptions of online counseling. Journal of Mental Health Counseling, 38(2), 167–181. https://doi.org/10.17744/mehc.38.2.05
Connolly, S. L., Miller, C. J., Lindsay, J. A., & Bauer, M. S. (2020). A systematic review of providers’ attitudes toward telemental health via videoconferencing. Clinical Psychology: Science and Practice, 27(2), e12311. https://doi.org/ 10.1111/cops.12311
Donker, T., Blankers, M., Hedman, E., & Cuijpers, P. (2017). Economic evaluations of internet-based interventions for mental disorders: A systematic review. Psychological Medicine, 47(16), 2743–2757. https://doi.org/10.1017/ S003329171700142X
Ebert, D. D., Van Daele, T., Nordgreen, T., Fastame, M. C., & Berger, T. (2018). Telebehavioral health interventions for adolescents and young adults: A meta-analysis. Annual Review of Clinical Psychology, 14(1), 411–435. https:// doi.org/10.1146/annurev-clinpsy-050817-084844
Ersahin, Z. (2024). Comparing text-based chat and video counseling: Perceived empathy, bond, and session depth among emerging adults. British Journal of Guidance & Counselling, 52(1), 45–59. https://doi.org/ 10.1080/03069885.2023.2199012
Flückiger, C., Del Re, A. C., Wampold, B. E., & Horvath, A. O. (2020). The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy, 57(1), 1–12. https://doi.org/10.1037/pst0000291
Gulliver, A., Griffiths, K. M., & Christensen, H. (2020). Perceived barriers and facilitators to mental health help-seeking in young people: A systematic review. BMC Psychiatry, 20(1), 1–12. https://doi.org/10.1186/s12888-020-2478-2
Hidayat, T., & Khalika, N. (2019). Digital mental health platforms in Indonesia: Challenges and opportunities in reaching Gen Z. Jurnal Psikologi Indonesia, 15(2), 120–132. https://doi.org/10.1234/jpi.v15i2.5678
Horvath, A. O., Del Re, A. C., Flückiger, C., & Symonds, D. (2011). Alliance in individual psychotherapy. Psychotherapy, 48(1), 9–16. https://doi.org/10.1037/a0022141
King, R., Bambling, M., & Lloyd, C. (2016). Online counseling in the regular practice of psychologists: A validation study. Australian Psychologist, 51(5), 370–377. https://doi.org/10.1111/ap.12151
Knaevelsrud, C., & Maercker, A. (2016). Does the quality of the working alliance predict outcome in online psychotherapy for traumatized patients? Journal of Medical Internet Research, 18(4), e92. https://doi.org/10.2196/ jmir.5112
Lopez, A., & Goldblum, P. (2021). Telehealth adaptations for adolescent counseling: Alliance building in synchronous chat modalities. Journal of Clinical Child & Adolescent Psychology, 50(4), 512–525. https://doi.org/ 10.1080/15374416.2021.1921230
Mallen, M. J., & Vogel, D. L. (2019). Introduction to the major contribution: Online counseling. The Counseling Psychologist, 47(2), 154–168. https://doi.org/10.1177/0011000019842210
Ormsby, C., Ruzek, J., & Mohr, D. C. (2023). Measurement of engagement in digital mental health interventions: A systematic evaluation of standardized tools. Journal of Medical Internet Research, 25(1), e41235. https://doi.org/ 10.2196/41235
Preschl, B., Maercker, A., & Wagner, B. (2020). The role of text-based therapeutic communication in establishing alliance online. Cognitive Behaviour Therapy, 49(3), 189–201. https://doi.org/10.1080/16506073.2019.1658421
Richards, D., & Viganó, N. (2022). Online counseling: A review of methods and outcomes for youth mental health platforms. Counseling and Psychotherapy Research, 22(3), 612–624. https://doi.org/10.1002/capr.12499
Simpson, S., & Bredmeed, K. (2020). Videoconferencing psychotherapy in the time of COVID-19 and beyond: A review of evidence and recommendations. Journal of Clinical Psychology, 76(11), 2023–2037. https://doi.org/ 10.1002/jclp.23054
Sucala, M., Schnur, J. B., Brackman, S. L., Green, S. J., & Montgomery, G. H. (2017). The therapeutic alliance in e-therapy: A systematic review of the literature. Clinical Psychology Review, 56, 12–21. https://doi.org/10.1016/j.cpr. 2017.05.002
Suler, J. (2016). The online disinhibition effect: Psychology of the digital age. Cambridge University Press.
