A positive virtual ecosystem. The theory of change for Kooth. Comprehensive Report

Kooth is an online mental health service for children and young people*. Since its launch in 2004, it has grown with the children and young people who use it, its humanistic approach shaped by their demand and our clinical expertise. Today it is a large, thriving and diverse community of young people who use it for multifarious reasons and in multifarious ways; importantly, they have the power to direct support themselves. They and are in control of their therapeutic journey. The service is full of choices in terms of how to get help, but also in terms of the therapeutic support available. As such, it is an extremely complex entity, perhaps reflecting the very nature of wellbeing and mental health. As well as making this an extremely rich environment where young people actively choose to spend their time, it has also taken the service well beyond what today’s quantitative outcomes measures of mental health services can capture. This paper signals the beginning of an important, ground-breaking journey to define the role and the impact of Kooth. We have explored, mapped and categorised activity within the service with a specific goal in mind: to define our Theory of Change. This describes the Kooth experience and the many routes in and out of the service, each reliant on our understanding of an individual’s unique building blocks for wellness. The Theory of Change (ToC) is not a clinical model and nor does it seek to be. It is not there to show how we can address specific standalone symptoms. Instead it is a characterisation of the broad, person-centred, holistic work Kooth does every day. It is also the foundation for a future set of mental health outcome measures, which will represent each child or young person’s journey.