Abstract
BACKGROUND: The increasing use of digital technologies is reshaping working conditions and employee well-being. Although autonomy is often described as an important resource for digital work-related health, findings remain inconsistent, particularly in health and social work contexts. In these settings, digital work practices are becoming increasingly common, with counselling now frequently conducted by phone, email or video via company-specific online counselling platforms rather than traditional face-to-face methods. This study examines whether and how autonomy is related to health in these digital workplaces through direct, indirect, and moderated associations. METHODS: Social counsellors from a large German social welfare organisation, with varying frequencies of online counselling, completed a cross-sectional, web-based questionnaire assessing autonomy, job demands, resources, work-life balance (WLB), and health outcomes using validated scales. Data analyses included mediation and moderation models to examine indirect and interactional associations. RESULTS: Autonomy was significantly related to digital counselling frequency, with higher levels of autonomy observed among counsellors who more frequently used digital work practices. Although autonomy was positively correlated with work-related health, the association was not direct. Instead, autonomy’s impact emerged through interactions with specific job demands and resources, significantly buffering negative associations of work interruptions and the work environment with well-being. Moreover, intersectional WLB was identified as a key mediator in the indirect associations between autonomy and health, as well as between autonomy and burnout. CONCLUSION: Enhancing work autonomy can be beneficial in digital social work, as it can promote health and reduce burnout. However, these benefits are context-dependent, underscoring the complexity of digital work settings and the need for careful contextual analysis before implementing workplace interventions. Future research should further explore digital environments prior to enhancing work autonomy, particularly among high-strain employees such as social workers. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-026-27041-9.