Understanding the online therapeutic alliance through the eyes of adolescent service users

Aims: The therapeutic alliance is a concept that has received a great deal of attention within face-to-face counselling. Furthermore, links have been made between the creation of strong alliances and successful therapeutic outcomes. This study examines the therapeutic alliance when counselling services are offered online to young people. Method: Fifteen young people took part in online interviews (utilising synchronous and asynchronous methods), and Grounded Theory techniques were utilised to analyse the data. Findings: A core category of 'Client-Service Match' and three subcategories pertinent to the individuals' experiences of creating good quality relationships with the counsellors were identified: (1) initial engagement, (2) developing rapport, and (3) establishing control. Discussion: The themes elicited are all relevant to the matching process and viewed as a chronological process similar to face-to-face counselling. However, unlike face-to-face work, specific nuances related to the online work arise that counsellors should be mindful of, including the rationale behind each individual's choice to approach services online, their own computer-mediated communication skills, technical hurdles, and the perceived 'power' of the counsellor. © 2012 Copyright British Association for Counselling and Psychotherapy.