Active counselling for child and adolescent mental health: A qualitative investigation

Talk-based psychotherapy and physical activity are both recognised as effective treatments for child and adolescent mental illness. Despite this, talk therapy and physical activity are rarely integrated-an approach hereafter termed "active counselling (AC)" -in clinical practice for youth mental health. The purpose of this study was to explore parents' perspectives of AC for their child who had been receiving this type of therapy from a provider in Australia. Parental perceptions were also used to identify possible psychological mechanisms underpinning the effects of AC. Reflexive thematic analysis was conducted on the results of fourteen semi-structured interviews with parents of children and adolescents aged 7 - 15, eleven of whom have been diagnosed as neurodiverse. Ten themes were generated and organised into three categories. First, parents believed that AC works because its active elements distract their children from the therapeutic processes, making them feel as though they are not being observed. Second, parents recommended increasing the availability of therapists and providing parents with additional information to maximise the effectiveness of AC. Finally, six mechanisms were identified as underpinning the perceived effectiveness of the approach: autonomy, connection, success, confidentiality, integration into life, and motivation. The results suggest that self-determination theory may serve as a model to generalise the benefits of AC beyond the study population and provide a theoretical framework on which to further develop the effectiveness of the approach.