People’s personalities may play a bigger role than expected in determining whether they turn to video calls, phone audio, or text messages when seeking mental health support online, according to new research from the University of Technology Sydney.
The study, led by Abrar Al Saleh and Daniel White, examined how 92 university students ranked their preferences and perceived effectiveness across three forms of digital therapy. It found that two personality traits in particular, extraversion and emotional stability, were closely linked to how people felt about these different modes of care. The findings were published in Psychreg Journal of Psychology.
Participants completed a widely used personality questionnaire before ranking video-, audio-, and text-based therapy for both preference and perceived effectiveness. Video therapy came out on top for both measures, while text-based therapy was consistently ranked as the least preferred and least effective option overall.
Despite this, a small group of participants still chose text therapy as their preferred format, even though not a single person believed it was the most effective. Researchers suggest this points to the appeal of convenience, privacy, and reduced social pressure, factors that can outweigh concerns about how well a treatment might actually work.
The analysis showed that more introverted participants were significantly more likely to favour text-based communication, echoing long-standing findings that people who are less socially outgoing often feel more comfortable expressing themselves through writing rather than speaking face-to-face. Extraverts, by contrast, tended to gravitate towards more interactive formats such as video and audio sessions.
Emotional stability also emerged as an important factor, particularly in shaping how effective participants believed video and audio therapy to be. Those with lower emotional stability were more likely to see video sessions as beneficial, while emotionally stable participants leaned towards audio therapy, especially when they believed it worked well.
The researchers argue that these findings have practical implications for mental health services expanding their digital offerings. Matching therapy formats to a person’s personality traits, they suggest, could improve engagement and reduce the risk of people disengaging from treatment altogether.
With telehealth and remote counselling now firmly embedded in everyday healthcare, understanding these psychological preferences could help clinics design more personalised digital mental health pathways. Short personality assessments taken during initial consultations, the authors note, could one day help guide decisions about which therapy format is likely to suit a particular patient best.
The authors acknowledge that their sample was drawn from a university population with high digital literacy, meaning the results may not fully generalise to older adults or those less familiar with online platforms. They call for further research involving more diverse and clinical populations, alongside longer-term studies tracking how preferences and outcomes evolve over time.
As demand for accessible mental health support continues to grow, the study adds weight to a wider conversation about how digital therapy can be tailored not just to convenience, but also to the individual differences that shape how people connect and communicate.
