Regional and rural clients’ presenting concerns and experiences of care when engaging with an online substance use counseling service

Abstract

Introduction

People are increasingly turning to online services for help with substance use concerns. There has, however, been limited research on the use of online substance use services by regional and rural populations. This study explored: (1) the experiences of care of regional and rural clients of an Australian national online text-based substance use counseling service, Counselling Online; (2) their reasons for accessing the service; and (3) their interaction with the counselor.

Design and methods

We thematically analyzed transcripts of 31 online counseling sessions involving regional and rural clients seeking help for their alcohol, cannabis or amphetamine use.

Results

Regional and rural clients commonly experienced difficulties accessing local services, were often in distress, and were navigating rurally-influenced social challenges. Counselling Online provided support, education and helped clients explore their substance use. Clients generally found Counselling Online beneficial, however some counselors were unaware of the unique issues affecting regional and rural clients, such as transportation barriers and geographical isolation.

Discussion and conclusions

Online substance use services provide useful support to regional and rural clients, however we identified several opportunities for improving the service experience for regional and rural clients. These include training online counselors on the unique experiences of regional and rural clients, adapting referrals to match client preferences, and encouraging counselors to ask about the physical location in which clients are using the service.

Keywords:

• Rural population
• rural health services
• telemedicine
• substance-related disorders
• addiction

Ethical approval

The study was approved by the Eastern Health Human Research Ethics Committee (Approval number: LR53-1112) and Monash University Human Research Committee (ID: 8685).

Acknowledgements

We would like to acknowledge the support of Turning Point’s Counselling Online service, who provided the transcripts used in the analysis. We would also like to thank the two anonymous reviewers whose comments helped improve and clarify this manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data is not available.

Additional information

Funding

Adrian Carter is supported by a National Health and Medical Research Career Development Fellowship [APP1123311].