Our Research & Evaluation

Leading the way in evidence-based digital support

Research & Evaluation

In line with XenZone’s mission to use technology to create access to the very best mental health support and treatment, its Research and Evaluation strategy focuses on developing an evidence base for early help models in digital therapeutic support.

The scope of this work is broad. Current projects span the therapeutic lifecourse, from identification of need, to impactful intervention as measured by appropriate outcome measures. 

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Visit Kooth

An Evidence based support model for Kooth

Kooth supports individuals between 11-25 years old, from rural and urban demographics across the country, presenting with a wide range of issues and backgrounds. The journey to developing an evidence base has been and continues to be complex. 

  • We have recognised unique mechanisms of change in Kooth
    • Needs based access: providing children and young people with access to digital support as and when the need arises
    • A choice of support: whether through information, peer support or contact with a professional 
    • Anonymous: Kooth offers autonomy of use at the point of registration
    • A model of early intervention: the potential to identify issues earlier than they may have been otherwise
  • We are defining a theory of change model for Kooth
    • Through conducting an in-depth review of data accrued over the past 15 years, with consultative support from the University of Manchester and other experts in the field. A full report will be available in Autumn 2019.
  • We have identified the requirement to understand the nuances of digital intervention
    • Helpful Aspects of Online Therapy have been researched by PhD student Meera Dhesi at the University of Roehampton. Interviews with children and young people on Kooth identified four core themes of online therapy and their accompanying helpful and unhelpful elements.
    • This paper is in the development process for publication in a peer-reviewed journal. 

Designing an outcomes framework for digital support

We know we are helping thousands of young people every year. We see goals being achieved, countless testimonials about change and improvement, and evidence of therapeutic alliance. 

There are visible outcomes which are not yet being quantified and cannot be captured through existing standardised measures used in face-to-face settings, given the dynamic, anonymous and needs-led work occurring in Kooth. 

We have long recognised how important it is to keep the relationship at the heart of any ways we develop to capture impacts and evidence. It is this humanistic approach to capturing outcomes that is driving our development work in evaluating Kooth. 

This year, thanks to a close steer from our Research Advisory Group, and a partnership with the University of Manchester, we are working to develop a range of new outcome measures that fit all aspects of the Kooth service model and its different support channels. 


  • Identification of several pathways within Kooth, defined by frequency and type of usage, including synchronous chats, asynchronous messages, and peer-support content. 
  • Analysis of existing transcripts from each pathway to determine the types of outcomes and intervention process mechanisms. 
  • Working with the University of Manchester and other experts in the field, develop a theory of change model for each pathway, and Kooth.
  • Convert findings into outcomes measures for use within Kooth supported by a theoretical framework, to be tested within Kooth.
  • Evaluate measures for acceptability, reliability and validity.