Tracking and Profiling Repeated Users Over Time in Text-Based Counseling: Longitudinal Observational Study With...

Area of Science:

• Online Mental Health Services
• Digital Psychiatry
• User Behavior Analysis

Background:

• Web-based counseling is rapidly expanding, offering accessibility and anonymity.
• Repeated users, though few, consume significant resources by returning with similar issues.
• Understanding repeated users is crucial for improving service efficiency and effectiveness.

Purpose of the Study:

• To develop a systematic method for profiling repeated users of web-based counseling.
• To identify the drivers behind repeated users' engagement with online services.
• To provide insights for tailored interventions and improved service delivery.

Main Methods:

• Utilized hierarchical clustering on session data from 29,400 users (2018-2021).
• Classified users based on service journey duration, use frequency, and intensity.
• Compared psychological profiles, including suicide risks and primary concerns, across user subgroups.

Main Results:

• Identified three distinct repeated user clusters: episodic, intermittent, and persistent-intensive.
• Repeated users generally exhibited higher suicide risks and more complex issues than one-time users.
• Increased service use frequency and intensity correlated with higher suicide risk and mental disorder concerns.

Conclusions:

• A systematic, bottom-up clustering method effectively identifies and classifies repeated users in web-based counseling.
• Three distinct subgroups of repeated users with unique behaviors and psychological profiles were identified.
• Findings support more efficient interventions, better resource allocation, and enhanced service effectiveness for online mental health platforms.