Efficacy of Online Counseling During Pandemics in Zambia: A Client and Therapist Perspective

Abstract

Abstract Population-based studies show that a growing number of counsellors have been providing counselling via the Internet. There are mixed findings regarding the efficacy of online counselling when compared to traditional face-to-face counselling and other modalities. During the COVID-19 outbreak, online counselling services were advanced as the only safe means of attending to mental health conditions, especially during lockdowns. However, the efficacy of online counselling remained unclear especially in developing countries with low digital literacy and poor Internet connectivity. The study's main purpose was to investigate and determine the clients' and therapists' perspectives about the efficacy of online counselling during the pandemic based on the level of preparedness, mode of delivery and challenges faced. The study used mixed methods employing parallel convergent design and collected data from 284 participants (44 therapists and 240 counselling clients). The study found that therapists were not prepared to offer online counselling services but were compelled by high demands for counselling services from clients during the pandemic. Both clients and therapists cited the cost of data bundles to connect to the Internet. Further, both the clients and therapists agreed that the most efficacious platform was video conferencing. Findings also show that therapists observed slowed progress on the client's recovery due to clients missing sessions. Logistic regression results on factors associated with preparedness and positive perception of online counselling showed that older therapists and lay counsellors were more likely to be less prepared and evaluate session as less efficacious respectively. Living in Lusaka (the capital) was associated with a higher odd of perceiving online counselling as efficacious. Client results showed that older clients had lower odds while being female, and the counsellor being prepared increased the odds of the session being efficacious. The researcher concluded that online counselling, in the context of a developing country, was inefficacious due to poor network connectivity, the multiplicity of ICT channels, concerns with privacy, low digital literacy, and lack of knowledge or experience using these platforms.