Online text-based psychosocial intervention for Youth in Quebec
Background: In 2013, Tel-jeunes created a text messaging intervention program to reach youth aged 12 to 17 years on their cell phones. Tel-jeunes was the first in the country to offer a text-based brief psychosocial interventions performed by professional counselors. Researchers were contacted to document and evaluate the program. Objectives: The research aimed to: 1) determine motives, contexts and issues that lead young people to use the SMS service; 2) document the characteristics of text-based brief intervention; and 3) assess the advantages and difficulties encountered by counselors who respounded to youth text-messages. Methods: We conducted a multimethod research from November 2013 to May 2014. We held four focus groups with 23 adolescents aged 15 to 17 who had or not used the SMS service, conducted a content analysis of a corpus of 13,236 text messages (or 601 conversations), and two focus groups with 11 Tel-jeunes counselors, just over a year after the implantation of the service. Results: Our findings show that the SMS service meets youth needs. They identify text messaging to be their prefered mode of communication with Tel-jeunes when they need support or information. Moreover, the service reaches young people who would not have felt confortable to contact Tel-jeunes by phone. We identified three dominant issues in youths demands: romantic relationships, psychological health and sexuality. Perceived benefits of the service include anonimity and privacy (cell phone providing the ability to text anywhere). Youth participants also appreciated writing to counselors as they felt they had more time to think abouth their questions and answers to the counselor. Counselors were more ambivalent. They considered text-based intervention to be very effective and satisfactory to adress youth information requests, but reported difficulties when dealing with more complex problems or with mental health issues. They reported that text-based communication makes it more difficult to assess youth emotional states, found the discontinuity of text-based conversations very frustrating, and experienced problems when dealing with several youth at the same time. They also struggled with some the computer-based platform features. Conclusions: Finding suggest that text-based intervention are now essential to reach out to youth seeking for information and help. But, Tel-jeunes text-based service required adaptations of the intervention model. Adjustment were made by the managment team when implementing the service which required taking into account youth needs, engaging in a continuous dialogue with counselors and working with the suppliers of the text-based platform to improve its features. Futur challenges include reaching out for boys, conducting interventions with younger youth who feel confortable contacting the service by SMS, and managing urgent requests initiated via web text-messaging apps rather than mobile phones.