Of Today - A Year In Review 2018/2019 - XenZone
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of Today A Year In Review 2018/2019
02 KO OT H O F TO D AY A YE AR IN RE VIEW 2018/ 2019 03
Contents
Introduction from the CEO 04
2018 Headline Stats 06
Early Intervention and Prevention 10
Choice 18
Outcome Informed, User Led 22
Autonomy 28
Flexibility 32
Kooth Face-to-face 34
Growth 36
Get in Touch 41
References 42
04 KO OT H O F TO D AY A YE AR IN RE VIEW 2018/ 2019 05
Introduction
from the CEO
There is no doubt that the world has moved Building a strong evidence-base is vital and A common question we face is how
on since Kooth launched in 2004. Back then we are working with many thought leaders we marry our safety message with the
we were at the bleeding edge of innovation, in their fields to contribute to this at the anonymity we offer young people on Kooth.
if not a lone voice, then one among just a widest scale. You will find more detail on Often is it the power of anonymity that
few shouting the benefits of using digital our activities and vision within this report. allows someone to share their thoughts
technology to reach those unlikely or unable and experiences. Through this report
to access traditional mental health services. From experience of delivering public you will see how our team build trusted
services to young, often vulnerable people, relationships to help the young person to
Today, because of the ground laid by we know that there cannot be a trade-off a better place; through this process many
disruptive thinkers and the brave decisions between safety and the drive to do new will share their identity, but even where
made by those seeking to transform things in new ways. Our commitment to they choose not to, safety is always at the
dysfunctional systems from within, digital safeguarding is evident in everything we do. forefront of what we do.
mental health services are commonplace.
This is apparent by the attention given Our experienced clinical team carefully I hope you will find the insight in this
to digital in the NHS Long Term Plan. monitor issues both at an individual and report of value. XenZone is a special
Which is all good news. aggregated level. They oversee support organisation, made up of wonderfully
given, ensuring those at risk receive offers committed and visionary people with
The potential of digital to give more people of regular, additional help. They know shared values and a core purpose of
access to great mental health services is when and how to bring in specialist support helping everyone find their way to
why XenZone was established. We have if needed and work in partnership with better mental health.
been at the forefront of this revolution, services in the ‘real world’, always ensuring
breaking new ground in the early days and that those accessing our services are at
now delivering services at scale to almost the heart of all decision-making. Online Zoë Blake
100,000 people last year. From experience mental health workers are professional, CEO
and not out of any disillusionment around experienced and appropriately accredited
the potential, we offer a word of caution. and receive ongoing training and
supervision. This isn’t to say we don’t see
Digital has become common vernacular the value in bringing non-professionals
for mental health and healthcare in general, into our support infrastructure.
with many great examples of innovation Our Ambassador and Peer Supporter
delivering new models of care, providing programmes are excellent, and will grow
advice, support and treatment. But as a both in scale and impact. There is no
category it is all-encompassing, without substitute for those offering support from
distinction on the breadth of offer, the lived experience. They too receive clinical
clinical model of care or the scale of impact. supervision to keep them and those they
support safe.
06 KO OT H O F TO D AY A YE AR IN RE VIEW 2018/ 2019 07
2018 Headline Stats
LOGINS 98,744 38,580 ARTICLES &
Total counselling DISCUSSION FORUMS
Unique young chat sessions
people logins
257,764
Total article views
18,815
638,344 Unique YP
223,417
using chat Total forum views
Total logins This is live messaging
with a counsellor
CHAT &
MESSAGING
335,698
Total asynchronous
messages sent
53,231
Asynchronous messaging involves sending Unique YP using
or receiving a message through an ‘inbox’ asynchronous
style messaging system messaging
36,654
Unique YP
viewing articles
08 KO OT H O F TO D AY A YE AR IN RE VIEW 2018/ 2019 09
GOALS Top 5 goal types Top 5 presenting issues OTHER
1 Getting professional help 1 Anxiety/stress
12,313 2 Self help/self care 2 Self-worth
72%
Total number of Out of hours login
goals moved 3 Emotional exploration 3 Family relationships
Counselling is available to
10pm daily, 365 days a year
4 Feeling happier 4 Friendships
5 Emotional regulation 5 Depression
95% Would recommend
the service to a friend
(*Of 16,687 responses to
End of Session Questionnaire)
19% Avg. of new
registrations
identify as BAME
10 KO OT H O F TO D AY A YE AR IN RE VIEW 2018/ 2019 11
Early Intervention
and Prevention
K ooth is predicated on providing
easy access to professional help.
In eliminating all the barriers in the way
For those choosing a booked or drop-in
counselling session, we have a large team
of experienced therapists and emotional
of support, we enable earlier preventative wellbeing practitioners on hand. Children
intervention for children and young people. and young people present with a huge
variety of issues and are supported
Anonymity is an important component according to need; counsellors are flexible
of this accessibility. It gives children and and use therapeutic approaches best
young people a sense of autonomy and suited to an individual, often trying and
control over their support: they can get combining different approaches to find
help on their own terms. the right path.
This help can be found in a number Each practitioner is aware of the critical
of ways. Some young people choose to importance of safeguarding. This is
engage in a one-to-one session with supported at XenZone through rigorous
a counsellor, some read and contribute and ongoing training and via a clinical
therapeutic content, some use online tools team who have oversight of vulnerable
like our mood tracker or online journal Kooth clients.
and some take part in moderated
peer-to-peer forums.
12 KO OT H O F TO D AY A YE AR IN RE VIEW 2018/ 2019 13
Safeguarding is our Priority
There can be no greater priority than In 2018 there were 146 safeguarding calls Unique Young People Presenting Our counsellors are prepared for any
safeguarding children and young people. made to the out of hours ‘on-call’ manager; with these Issues in 2018 number of presenting issues when making
For this reason we have a dedicated these calls are made internally by the team contact with a young person on Kooth.
safeguarding team which oversees and and often require outreach to emergency Eating Issues From eating disorders, suicidal ideation and
supports the work of our online and services or out of hours social services. self-harm to depression and bereavement,
face-to-face counsellors. The team
carefully assesses the ‘at risk’ nature
of individuals engaging in one-to-one
A total of 668 cases were reviewed over the
year to facilitate supporting young people
who presented with high safeguarding risk.
867 they have the support and training they
need to help each individual.
counselling sessions, ensuring that staff In 2018, following the implementation of Sometimes issues presented can be life
and clients are fully supported. As we a Child Exploitation intelligence reporting threatening, which is why safeguarding
Self-Harm
regularly help vulnerable young people protocol, in addition to our safeguarding is paramount.
who might be experiencing complex
mental health difficulties, we work closely
with organisations such as CAMHS, the
processes in place, over 20 cases of Child
Exploitation intelligence were shared with
local and regional police forces.
3,401 According to one of our Kooth counsellors:
“Often young people need someone to hear them
police, child protection investigation teams out and help them discover what other options
and local authority social care services All our online workers undergo they have. Young people who have come on to
and safeguarding teams. Clinical and safeguarding training at induction and
Suicidal Thought Kooth and disclosed their plans for suicide have
3,213
safeguarding reviews occur on a weekly annually thereafter, adhering closely to then gone on to share their details to receive help
basis to review individual cases, all of our safeguarding policy and escalation or they have committed to a safety contract.”
which are overseen by the Head procedures. We work to the latest
of Safeguarding. safeguarding guidance and are guided In other ‘at risk’ situations, such as
by the Common Assessment Framework child sexual exploitation or domestic
as the basis for case note recording. We Depression abuse, counsellors work on harm
4,435
are committed to working with our local reduction strategies.
authority partners and their Safeguarding
Boards to align safeguarding procedures “In these instances we work with young people
and ensure proper integration. As Kooth to find ways they can keep themselves safe,
is accredited by the BACP, we also abide all the while finding appropriate means of
by its ethical principles and code of Bereavement encouraging them to identify themselves to us
1,038
professional conduct. so we can support them further. Every time a
young person enters a chat, we remind them of
the contract they have with a Kooth counsellor.
This sets out our boundaries of confidentiality
and our duty of care to support them if they
disclose that they are at risk of harm.”
14 KO OT H O F TO D AY A YE AR IN RE VIEW 2018/ 2019 15
Therapeutic Alliance
Safety is as much about processes and protocols as it is about the relationship between
the young person and the counsellor. Therapeutic alliance is the foundation of therapy.
We measure the strength of the counsellor-client relationship through end of session
questionnaires. Outcomes from 2018 demonstrate the strength of the therapeutic
alliance through Kooth.
“The session was
“I felt listened to” useful for me”
97% agree 96% agree
“The session covered what “I would recommend
was important to me” Kooth to a friend”
97% agree 95% agree
“I could work well with
the practitioner”
95% agree
16 KO OT H O F TO D AY A YE AR IN RE VIEW 2018/ 2019 17
I think I said this last time but last summer
it felt like what you’ve done had saved my life
it got that bad for me. The state of mind I
was in could have gone one way or another.*
For years I’ve felt unable to do anything with
my life. Now, I want to live it. I wouldn’t be
able to do that without the help of yourself
and this service. You kept me alive and safe
when others couldn’t.
Thank you for last night. You really helped
me out of a tough and dangerous time and
situation. It is much appreciated, thank you
for being the only one to listen.
*All quotes from young people are anonymous
18 KO OT H O F TO D AY A YE AR IN RE VIEW 2018/ 2019 19
Choice
A s a digital service Kooth has the
opportunity to offer a variety of
channels for intervention across the
Working within the Thrive framework1 it
has become clear that young people require
a choice of approach in order to thrive.
How Young People within Kooth
fit within the Thrive Quadrants
platform. In 2018 93.5% of young people
who used chat chose to ‘drop-in’ rather than
‘schedule’ a chat. This indicates that Kooth
is used on a needs led basis. Additionally
40%
Kooth is largely used outside of traditional
of YP who logged on to Kooth stayed
working hours with 60% of all online
forums and articles being viewed outside
in ‘getting advice’ last year
working hours.
54% of YP who logged into Kooth moved
into ‘getting help’ last year
Getting Getting
advice help
THRIVING
4.5% of YP who logged into Kooth moved
on to ‘getting more help’ last year
Getting risk Getting
support more help
2.5% of YP who logged into Kooth moved
on to ‘getting risk support’ last year20 KO OT H O F TO D AY A YE AR IN RE VIEW 2018/ 2019 21
Mental health is such a complex field that Professor Mick Cooper offered his thoughts
choice of treatment would seem an obvious from a pluralistic therapeutic perspective;
requirement. But across a field increasingly Professor Miranda Wolpert was keen to
focused on quantitative evidence, we were look closely at need. Dr Terry Hanley made
concerned therapeutic choice was being the point that one size does not fit all.
limited to approaches based on a narrow And Tim Tod, who works with young
definition of evidence base. people and families in schools, maintained
that making that first conversation easy for
We know that choice is imperative to a young person without the medicalised
support and that there are ‘A Thousand language that often goes with it, was
Ways to Therapy’. In 2018 we launched important so that they could go forward
this campaign having consulted with in whichever direction they chose.
experts, compiling a powerful repository
of transcript interviews and videos about Our clinical lead, Dan Mills-Da’Bell, offered This work reflects our philosophy of
therapeutic approaches and choice. his direct experience of working with a therapeutic choice being intrinsic to
boy without the emotional language to what we do and how we do it.
communicate his feelings. He responded
incredibly well to drama, play and music As Professor Mick Cooper stated: “Research
therapy using a variety of therapeutic makes clear that there is no one best ‘therapy’.
frameworks. XenZone Research and Different clients need different things at
Evaluation Director Aaron Sefi was keen to different points in time. There’s a thousand
push for innovation in the field of therapy, ways to therapy and a democratic culture
but maintained that spending years building honours that diversity.”
a top-down evidence base would risk
blocking the availability of such treatments This campaign has been the most
to those who could benefit today. successful campaign run by XenZone
to date, achieving significant reach and
engagement in a few short months.
The ongoing campaign continues to
be shared widely and evolve.22 KO OT H O F TO D AY A YE AR IN RE VIEW 2018/ 2019 23
Outcome Informed,
User Led
A primary way of measuring outcomes
on Kooth is through recording the
achievement of goals set by young people.
In 2018 over 12,000 goals were partly or
fully achieved by over 3,700 young people
in online counselling and support.
In 2018, all the most common goals were
achieved above and beyond a 3-point
increase benchmark, with Getting further
Goals around Emotional exploration and
Managing low moods also scored a 7-point
average or above. Emotional exploration
For this we developed CoGS – Counselling help from professionals both in and outside could be considered the primary activity
Goals System, to demonstrate the types There is a general recognition that any the Kooth service as the highest achieved in counselling; through exploring our
of goals young people achieve within our goal moving over 3-points is considered a goals. These are important goals; within the emotional reactions to events and people
service. Based on the Goal based Outcome significant movement. In 2018 the average service it develops the therapeutic bond or we can learn so much about ourselves and
(GBO) Measure that is used extensively goal movement for all moved goals on alliance to Kooth practitioners, and goals consider strategies to improve our situation
in CAMHS, CoGS was researched by the Kooth was 6.8-points (out of ten). to get help outside the service are crucial to where necessary.3
University of Manchester2, validating the ensure digital is embedded within the wider
types of goals set online. support structure of young people. Examples of typical goals set for emotional
exploration and managing low moods:
Examples of typical goals set for getting
The ten most common goal types further help – in service:
• To identify positives in my
and their average achievement • Fill out safety plan and message
behaviour and attitudes
counsellor with it before next session
• Practice positive self-talk
and deep breathing
Count of Average • To get the courage to speak to
• To sit with my feelings until
Goal Category Movement someone in one-to-one chat
they become less intense
Getting professional help – in service 1,890 8.10
Getting professional help – outside our service 490 8.02
Examples of typical goals set for around Setting and achieving goals like these give
Emotional exploration 1,255 7.43 getting further help – outside service: young people power and autonomy, not
Managing depression or low mood 268 7.34 just in Kooth but in their own lives as
Managing suicidal thoughts 281 7.22
• Speak to pastoral support about well. There is increasing evidence to show
getting a safe space in school setting and achieving goals in themselves
lead to improved mental health.
Speaking up – communicating better 188 6.80
• To join support group in local centre
Family relationships 169 6.78
Overcoming anxiety 875 6.63
Self Help – Skills for life 611 6.58
Emotional regulation 725 6.5324 KO OT H O F TO D AY A YE AR IN RE VIEW 2018/ 2019 25
The Future of Outcomes and Evaluation on Kooth
When Kooth was created more than 15 Our goal-based outcome (GBO) measure, We are providing support at specific We have long recognised how important
years ago, it represented a truly fresh and Counselling Goals System (CoGS), is a times. This means that often we are there it is to keep the relationship at the heart
innovative service. Co-developed with powerful way of being able to describe ‘in the moment’ for previously undetected of any ways we develop to capture impacts
children and young people looking for what is being achieved in our online service. issues, and for early and timely intervention and evidence. It is this human approach
mental health support, it signalled a major In fact, NHS England is currently reviewing for emerging and more complex issues. to capturing outcomes that is driving our
shift in the way services were provided. CoGS with a view to incorporating it Measures that capture the impact of this development work in evaluating Kooth.
within the outcome metric for the Mental early intervention are critical but also
As the service has grown and expanded, Health Service Data Set (MHSDS)4. extremely complicated to develop.6 This year, thanks to a close steer from our
we have developed a range of ways to Research Advisory Group, and a partnership
interpret and demonstrate activity on But we want to go further. Continuing our None of this takes account of the with the University of Manchester and the
Kooth, focusing on its impacts. proud history of innovation, we are going therapeutic work we do beyond the Centre for Mental Health, we are working
beyond the standardised measures used in counselling space where we are enabling to develop a range of new outcome measures
Today we continue to capture the rate face-to-face services to capture outcomes. facilitated peer support and therapeutic that fit all aspects of the Kooth service model
and trend of presenting issues, the extent content. There are very few measures for and its different support channels.
of the therapeutic alliance experienced by Taking the counselling element of our service this kind of work in face-to-face settings;
children and young people and the volume alone, there are so many reasons why standard the richness of the ways in which emotional Using research methods that draw on the
and progress made against co-created measures designed to capture reduction of and informational support provided here practice wisdom of our most experienced
therapeutic goals (see page 22). We also specific symptoms are not sufficient: impacts children and young people requires clinicians, the wealth of data accrued over
value the incredible testimonials closer investigation. the past 15 years, and, crucially, direct
from young people We provide children and young feedback from young people, we are
themselves. people access to Kooth as and when There is also a wider question of whether developing co-created measures that will
the need arises. This immediacy of service, the measures currently used in face-to-face tell us the truest story possible of what is
and the range of different levels of access – services are even applicable in the settings achievable in online therapeutic support.
from a single session to intermittent drop-in, for which they were designed. The recent
and from regular sessions with a named King’s Fund report7 highlights: “a risk of We look forward to sharing some of our
practitioner to long-term support over-emphasising the tangible, measurable, early findings in next year’s report.
for more protracted needs – are all central more scientific dimensions of health and care
to the choice we offer. But are also too at the expense of the less tangible, less easily
complex a challenge for a single standard measurable humanitarian dimensions of care.” Aaron Sefi
outcomes measure. Research and Evaluation Director
The report goes further in questioning the
We offer clinical support in a digital need for ‘quality metrics’ of scientifically
space. All standard measures were built for a measurable change, asking whether they
different environment. We know the digital are in fact impacting negatively on the
space changes some of the ways children therapeutic relationship.
and young people receive and experience
therapeutic support5. We also know this
autonomy affects how they complete
forms and questionnaires, especially in the
immediate ‘nowness’ of the digital world.26 KO OT H O F TO D AY A YE AR IN RE VIEW 2018/ 2019 27
Jake’s story
Outcomes play an important role in In 2018 we once again opened the “My passion for mental health grew when I was
influencing how the service develops but programme up to those young people diagnosed with a brain tumour at the age of
they are limited by those who engage with who wanted to play an active role in 11 and sadly lost my sight as a result. I didn’t
them and the domain in which they are talking about mental health within their want anybody else to be treated the way that
used. As a person-centred service we value communities. This cohort of ambassadors I was. Throughout my own personal struggles
engagement with service users to drive were asked to complete a Kooth training with mental health, I was always being told to
service development. One example programme, which they helped to create. “man up,” and to “grow a pair,” and it was this
of user involvement is the Kooth experience that made me want to change the
Ambassador programme which has social stereotype towards males. I had recently
run for a number of years. learnt that suicide was and still is the biggest
killer of young men, and I now realised why.
I wanted to make it easier for young men and
all young people to come out about their mental
health, I wanted to tell them that it’s okay not
to be okay.
The Kooth Ambassador Programme was a This year we have
remarkable experience. I felt able to make also built an online training
a difference. I was given the opportunity to speak portal for Kooth Peer Supporters.
at various conferences; I got to speak to over Enabled by funding awarded by the
500 different practitioners at two mental health Small Business Research Initiative, and
events about the transition between children’s building on our experiences running
services and adult services, a subject close to my the Kooth ambassador programme, we
heart. The most important thing that I got from have co-designed learning modules to
the programme was that I wanted to continue up-skill young people in their delivery of
doing this. It finally made me realise that I peer support. Measuring outcomes, and
wanted a job in mental health. I’m honoured advancing channels for peer support within
to have been given this opportunity.” Kooth are a key focus for the coming year.28 KO OT H O F TO D AY A YE AR IN RE VIEW 2018/ 2019 29
Autonomy
T he autonomy obtained through
remaining anonymous on Kooth is a
big reason for young people to continue
Registrations of harder
to reach groups on Kooth
Males generally are also harder to reach.
This is why our teams have been working
with schools to deliver Personal, Social,
Reasons for Choosing
Online Counselling
returning to the service, giving them Health and Economic (PSHE) sessions In 2017, the Education Policy Institute
incredible freedom to express themselves. to young men to encourage more wrote an independent report about online
19%
It is cited as the main reason young people communication around mental counselling using data from Kooth. The value
choose online counselling.5 and emotional wellbeing. of anonymity for autonomy emerged through
the survey, asking young people to select their
This anonymity also gives young people a According to Tim, a Kooth worker in top 3 reasons for using online counselling:
10%
sense of control and autonomy that may London who supports young males as
not be there is other aspects of their life. well as other groups such as young people I want to discuss my issues without my parents or anyone else knowing
Inviting co-produced content does the within the Jewish community and 51%
same, encouraging young people to share young carers:
their feelings and own the service. It paves I like being anonymous
45%
the way for peer support and identification “The truth is, while there has undoubtedly been
with others, as well as involving young a shift in attitude, there is still a patriarchal
I like not having to talk to someone in person
people in the continued development of culture of the alpha male needing to take
Average number General Kooth- 41%
the platform. responsibility for their family and present
of 2018 Kooth aged population
outwardly as hard or strong. This is most I feel I can express myself more clearly
registrations who identifying
The consequences of this accessibility and prevalent in low income or disadvantaged 40%
identify as BAME as BAME in
autonomy are that Kooth holds an appeal households where young people are more
commissioned I am more comfortable online
for typically hard-to-reach groups, some likely to have faced hardship and would in
areas5 26%
of which tend to be the most vulnerable. fact benefit from a service like Kooth.”
The service sees comparably high rates of
I don’t have to wait for an appointment
Black and Minority Ethnic young people, “Going into schools to work directly with these
24%
for example: 4.4%
groups of people provides a space for young
males to listen, generate their own thoughts I can talk about whatever I like
0.2%
about emotional wellbeing, and leave knowing 23%
that Kooth is available for them to use in
privacy, outside of school hours. It’s important I can get help whenever and wherever I need it
to recognise that Kooth is not there so that 20%
2018 Kooth Average number of young people don’t need to seek help from
registrations who those recorded in I feel safer
trusted adults or services, but it can be a
identify with CAMHS as having 16%
gateway to shifting help-seeking attitudes and
nonconforming ‘other’ gender5 supporting young people in building wider Other
Gender (Agender support networks where needed.” 7%
or Gender fluid)
I don’t know where/how to find face-to-face services
7%
*Each young person selected up to 3 reasons30 KO OT H O F TO D AY A YE AR IN RE VIEW 2018/ 2019 31
I love how this conversation is easier to
have behind a computer screen than it
would be with a person I could see.
Also I would like to thank the Kooth team
for creating a safe place for people like me
to come to this place maybe after school
or during the day to express their feelings,
give advice or vent about their day or problems
to try and get solutions. So thank you!
I just wanna say thank you for the support
and help you give to people like me.
I’ve got lots of help from LGBT+ groups on
here, I finally feel like I can be who I wanna
be and not feel like I have to hide anymore.
… Thank you lot so so so much for
helping me be who I am!!!32 KO OT H O F TO D AY A YE AR IN RE VIEW 2018/ 2019 33
Flexibility
F lexibility within Kooth refers to the
options available to young people, such
as how they engage with the counselling
13-15 year old females use proportionately
more synchronous chat-based counselling
than any other user demographic on
I also like that with Kooth you can come
and join in at a time that is convenient to
team, what time they choose to log on, Kooth, though they do so for a shorter you – especially as it’s open until 10pm!!
whether they write article posts or just amount of time than their older peers.
view them. The most popular mode of interaction
with Kooth for this demographic is the
13-15 year old females are the highest asynchronous messaging; messages which
demographic on Kooth, making up 35% can be composed and sent in their own
of all users. To demonstrate the choices time at any time of the day. They are I love the article bit because people
available to young people we have zoomed particularly active in the peer support and
in on this cohort of Kooth users to self-help domains of Kooth, with 40% of are so brave and you can relate to
understand how they used Kooth in 2018. this cohort regularly viewing co-produced their posts and write your own.
articles, in comparison to 32% of their
To contextualise the reasons for these male counterparts. Though they are active
young people to seek support on Kooth users of forums, it is those who identify as
we can turn to the presenting issues of this agender or genderfluid across all age groups
cohort. Compared with the previous four who are the most avid forum users.
years, 2018 saw the highest prevalence
I really enjoyed last night live forum,
of self-harm as a presenting issue in The flexibility offered through Kooth
this age group, replacing ‘confidence’ is further demonstrated by usage of the despite it being so hard it was so
issues which reduced in presentation platform out-of-hours. In 2018, 13-15 year lovely to support everyone and get
frequency compared to previous years. old females predominantly used Kooth
Friendship, self-worth and anxiety have between the hours of 18:00pm and 21:00pm
advice from everyone.
been consistently prevalent issues for this every day of the week. This is similar
demographic over the past 5 years. across all age groups, however logins spike
over lunch time for those who identify as
genderfluid or agender.34 KO OT H O F TO D AY A YE AR IN RE VIEW 2018/ 2019 35
Kooth Face-to-face
I n all areas where Kooth is commissioned,
we provide a joined up model of care,
building close relationships with local
Kooth face-to-face services differ
depending on the needs of the area,
and include targeted support for the
A 2018 snapshot of Kooth Face-to-face
face-to-face services, including the local reduction of CAMHS waiting lists, as
CAMHS providers. well as specific therapeutic approaches
such as Interpersonal Psychotherapy for
In seven of our commissioned areas Adolescents. Where appropriate young
Kooth delivers a blended service which people are encouraged to use Kooth
combines a Kooth online contract with a online whilst waiting for a face-to-face
14,215
face-to-face counselling service. Our face- intervention, to use the self-help and
to-face services are operated and managed peer-support during an intervention, 5,692
locally, being delivered by qualified or as part of sustaining their process
counsellors, associate counsellors and after a face-to-face intervention. Total number of Unique young people
counsellors-in-training. sessions delivered who received a Kooth
As with all Kooth services, safeguarding face-to-face session
As with Kooth online, choice and flexibility young people is our priority. In face-to-face
are paramount operational values. There is services this is possible to achieve ‘in the
flexibility around the type of intervention, moment’ with young people, and through
with some areas offering group work our established relationships with local
focusing on techniques such as Dialectical safeguarding boards, or safeguarding
Behaviour Therapy or on specific issues leads in schools.
such as self-harm. We endeavour to
provide ease of access through the chosen
locations of our counselling teams, who
often see young people in schools, as well
“I love working in the North-West managing a Top presenting issues
team of 17 Counsellors, made up of face-to-face,
as offering flexible hours for those who online and blended workers, who see over 120
wish to attend outside of school hours. young people a week for face-to-face counselling. 1 Anxiety/Stress
Recently I have seen value in working to the
Thrive model providing joint appointments
through the community hubs with our CAMHS 2 Family Relationships
partners and providing support in schools,
colleges and community centres.”
3 Anger
Lisa Cary,
Kooth Area Manager
4 Confidence
5 Self-worth36 KO OT H O F TO D AY A YE AR IN RE VIEW 2018/ 2019 37
Growth
X enZone’s clinical model has been
developed over many years, in
response to what our young people
Supported by a dedicated clinical, research
and technology leadership team means we
are well placed to combine the best clinical
Who are the online team?
The Kooth Senior Practitioner The Kooth Counsellor
tell us they want. The changing nature and digital approaches to meet the ever
in presenting issues is an interesting changing needs and wants of our Through line management of the 70-strong Kooth counsellors are autonomous
barometer of the mental health of children young population. online team, Kooth senior practitioners and empowered in their role to provide
and young people; it’s critical that we are encourage personal development and counselling in line with their skill set and
aware of what they are managing and to 2018 saw a 21% staff increase within support to deliver the service. What this expertise, whether this is wholly person-
ensure we are offering consistent support the online team of senior practitioners, looks like in practice is assurance of policy centred, cognitive behavioural therapy
in the best way we can. counsellors, emotional wellbeing adherence, dissemination of good practice, focused, through transactional analysis,
practitioners (EWPs) and the content running informative surgeries focused or other integrative approaches.
Choice has always been at the heart of our and community team. on the issues affecting young people,
therapeutic philosophy; we aim to see ‘the and supporting staff in more complex The support counsellors on Kooth get is
whole person’ as opposed to just seeing the presentations or cases. quite unique, with access to a community
difficulties or presenting ‘symptoms’ and of more than 70 other online workers
are strong advocates for an integrative who can and do offer support alongside
model, working alongside other agencies “It’s a real luxury to truly empower a young regular supervision.
as appropriate. person because they are choosing to be there
rather than being coerced to sit in a room with
someone. It’s their world, it does completely “More than anything for me, online counselling
belong to them.” is about developing a relationship. A huge
number of our young people will say ‘I can’t tell
Jo Gilbert, the school counsellor that, I can’t tell mum that’.
Senior Practitioner For them there’s a safety, a freedom, in
being able to tell someone is who making no
judgement. For the young person it can be a
very powerful experience.”
Rachael Pickett,
Counsellor38 KO OT H O F TO D AY A YE AR IN RE VIEW 2018/ 2019 39
The Kooth Emotional The Kooth Content Technology Vision for Growth The vision for Kooth to develop new, user
Wellbeing Practitioner (EWP) and Community Team and Development of Kooth centric models of care backed by evidence
will be enabled through the use of data
EWPs have a varied role on Kooth; they The content and community team run live Technology has always been a critical enabler
and experimentation contributing to
offer support through chats and messages, forums three nights a week, and moderate to Kooth, empowering it to provide young
an evidence base of efficacy. XenZone’s
and safeguard journals written by young all content written by young people before people with a unique support platform they
world-class engineering team is rapidly
people as well as daily management of it is published on Kooth (if it adheres to can access safely, remotely, and anonymously.
growing to support the needs of children
the chat queue. community guidelines). Technology has never been viewed as a
and young people; made up of engineers
substitute for skilled clinical workers but as
with a thorough understanding of user
The experiences and skills of an EWP They sit between counsellors and young a critical enabling tool for delivering high
behaviour and a deep commitment to the
contribute to the diversity in the multi- people, facilitating the growth, safety and quality choice of care.
safeguarding and well-being of service
disciplinary online team. EWPs tend to health of the community. The live forums are
users and providers.
come from backgrounds working with a discussion space for a whole range of topics The engineering team at XenZone is
children and young people in different from sex education to religious holidays. continuously seeking to improve the
capacities, such as youth work, social quality of care operations. Our approach
work, schools, pupil referral units, and Identifying risk within individuals who to quality is two-fold, focusing on the
young offender institutions. post any content is a significant part of the efficiency of the service, and increasing
community engagement team’s role who the models of intervention available to
are on hand to engage with individuals and children and young people. Through 2019
“When I told people I was going to [work at] signpost them to channels within Kooth, and beyond, this will be achieved through
Kooth there were a few sceptics ‘how can online or crisis support where necessary. working closely with young people as
work support people when you don’t know who well as XenZone’s clinical, content and
they are?’. I have found anonymity doesn’t user engagement teams. Identified
impact the number of people we can help and “Kooth has that holistic approach of counselling pain points and opportunities
the level of help we give. People on Kooth make support and peer support. The fact it’s online for improving outcomes for
claims like they want to ‘save lives’ and from means they’re in control of it, they can login young people will drive the
where I’m sitting it’s definitely achievable.” when they want to. They can be a slightly developments of Kooth.
different person: you can be more confident
James Tyler, than you might be in a big group in real life.
EWP It’s a service that’s mouldable to your needs.”
Helen Rhodes,
Editorial and Content Lead40 KO OT H O F TO D AY A YE AR IN RE VIEW 2018/ 2019 41
Map of
commissioned areas* Get in Touch
Contact Details
If you would like to find out more about
anything in this report, or about Kooth
in general you can contact us at:
contact@xenzone.com
If you are a young person who uses Kooth
and would like to give us feedback, you can
leave anonymous feedback by logging into
Kooth and heading to the feedback page.
LONDON
ENGLAND & WALES
*Accurate data as of April 201942 KO OT H O F TO D AY A YE AR IN RE VIEW 2018/ 2019 43
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& Hebron, J. (2017). ‘Comparing Online 5. Frith, E. (2017). Online Mental Health
and Face-to-Face Student Counselling: Support for Young People. London:
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