Willingness and barriers to utilizing e-therapy services: A Nigerian general population qualitative study

ABSTRACT

We explored the willingness and barriers to utilizing e-therapy services in Nigeria where the prevalence of mental illness is high. A qualitative open-ended study was conducted with a heterogeneous sample of 100 Nigerians with an age range of 18–52 years. Participants were members of the general Nigerian population, recruited from social media. Data were analyzed using thematic analysis. Eighty-eight participants were willing to utilize e-therapy services in Nigeria. Their willingness was driven by factors such as their experiences during the coronavirus disease 2019 (COVID-19) pandemic, “perceived comfort in pouring out one’s heart to a therapist that is guaranteed in e-therapy,” and curiosity to explore what e-therapy entails. On the other hand, nine participants were unwilling, and their unwillingness was mostly driven by the perception that the Nigerian environment was disenabling for e-therapy (for instance, poor electricity supply in Nigeria). While three participants were neutral about their willingness. Twelve barriers to utilizing e-therapy services in Nigeria were identified, they were; “poor internet service”, “high internet service charge”, “limited communication”, “lack of trust in the efficacy of e-therapy services”, “preference for face-to-face therapy”, “concerns about confidentiality”, “anticipated stigmatization”, “technological illiteracy”, “ignorance of existing e-therapy services in Nigeria”, “absence of e-therapy services in Nigeria”, “uncertainty about what to expect from e-therapy service”, and “perceived distraction during e-therapy session.” While our findings contribute to strengthening the utility of e-therapy services in Nigeria, future studies should replicate the current study with the digitally excluded Nigerian general population.

KEYWORDS:

• E-therapy
• qualitative research
• Nigeria

Acknowledgments

We thank Chinyereugo Udensi and Daniel Chidozie Nnadi for the expert validation of analysis that they offered. We thank Akinbitan Olushola Olusanjo, Arueze Amaka, Yekeen Musediq Adewale, Adedayo Adegoke Olajide, Emmanuel Ururu, Akinrinola Mofopefoluwa Samuel, Adeyemi Demilade Emmanuel, Chisom C. Chijiuba, Ojima Zechariah Wada, and our other colleagues for their contributions. We also acknowledge all participants for giving up their time to participate in this study.

Authors’ contribution

Ogueji – Conceptualization, design, data collection/analysis, article writing, review/editing for intellectual content, proofreading, and approval of the final manuscript.

Amusa – Design, data collection/analysis, article writing, proofreading, and approval of the final manuscript.

Olofe – Design, data collection/analysis, article writing, proofreading, and approval of the final manuscript.

Omotoso – Design, data collection/analysis, proofreading, and approval of final manuscript.

Declaration of interest statement

The authors have no conflict of interest to declare.

Data availability statement

The data associated with this study are available from the corresponding author upon request.

Ethics

The study was in accordance with the ethical standard of the institutional and/or national research and ethics committee, and the 1964 Helsinki ethical declaration, its later amendment, or its comparable standard. An online consent form was used to obtain consent from all participants, and all participants consented that findings from their data should be published in this paper.