Enhancing treatment access: evaluation of an Australian Web-based alcohol and drug counselling initiative

Abstract

Introduction and aims: The provision of counselling and other health interventions over the Internet is an emerging treatment modality. In 2007, an evaluation of the first Australian pilot Web-based alcohol and other drug (AOD) counselling initiative, known as CounsellingOnline, was completed. This paper explores whether CounsellingOnline enhanced AOD service accessibility for clients.

Design and methods: Service utilisation data (n = 2004) and client survey data (n = 277) were collected and analysed to evaluate service responses, service impact, client characteristics and client satisfaction. Comparative client data were obtained from a state-wide conventional counselling dataset (Alcohol and Drug Information System; n = 19,283) and a statewide telephone counselling database (DirectLine; n = 59,863). Results. Service responses, such as fast counsellor connection speed, low client attrition and anonymous login, contributed to good service accessibility. CounsellingOnline clients differed from conventional and telephone counselling clients, representing much higher proportions of young, employed and female clients. Notably, the majority of CounsellingOnline sessions occurred outside standard business hours.

Discussion and conclusions: CounsellingOnline has showed enhanced AOD service accessibility through its service responsiveness, high level of after-hours service utilisation, and appeal to a client group that differs from those seen in conventional and telephone AOD counselling services. The capacity of Web-based services such as CounsellingOnline to enhance service accessibility is significant, particularly for clients whose access to conventional treatment services is limited.