Reaching Young People Through Texting-Based Crisis Counseling: Process, Benefits, and Challenges

Texting-based crisis intervention counseling reaches young people who suffer from mental health issues at high rates yet hesitate to seek help. As a new interface, it is neither well-researched nor well-understood. This study examined 49 randomly selected text counseling transcripts and key informant interviews with two counselors to identify unique characteristics of the text counseling process and learn texter reactions to the sessions. Texters presented problems that were similar to those reported in voice-based hotlines. Texters valued the privacy and flexibility of texting that permitted them to receive help immediately rather than delaying. Counselors reported that they must be brief and direct with questions and avoid assigning emphasis to words. The written format required that both parties must be explicit and clear to convey their messages accurately. Both texters and counselors suggested that the texting option might lead young people to seek help that they might otherwise avoid. Recommendations include specialized training on strategies to assess and connect with texters using only the written word and research to develop best practices for texting-based crisis intervention services.