Online counseling services have gained popularity in Ghana for mental health support, particularly in Accra where access to traditional healthcare is limited. A literature review will be conducted to identify existing theories and frameworks pertinent to understanding user engagement in digital healthcare services. Theoretical models will be developed to explain user behaviour change and long-term adherence to online counseling services based on these findings. Further research should focus on developing interventions tailored to specific therapeutic directions and feedback mechanisms within the existing frameworks of user engagement.