Abstract

The purpose of this study was to identify clients’ perceptions of online counseling for mental health challenges. This qualitative exploratory study involved thematic analysis of threads and comments made on the social media platform Reddit for counseling clients to share their experiences with online counseling services. A total of 415 paragraphs by 198 unique users were analyzed by five coders. Six themes emerged, which included quality of care, therapeutic relationships, rights and responsibilities, systemic inequity, advice, and benefits. The findings revealed that clients’ perceptions of online counseling are not unanimous. Specifically, differing opinions regarding the benefits and challenges of online counseling varied as a function of individual needs and circumstances. Many clients reported having technology problems as well as issues with privacy. Others felt that online counseling gave them greater accessibility and choice regarding treatment. For mental health disorders involving severe and disruptive symptoms, such as trauma-related dissociation, clients expressed that online counseling was not as effective as in-person services. Recommendations include counselors offering both in-person and online options to clients. Additionally, there are implications for community organizations and insurance providers to increase the accessibility of counseling for clients with diverse clinical needs.