Creating an application for Crossreach Counselling

Designing a self-referral and clinical counselling app experience.

Client Problem: How to handle an increase in demand for remote counselling and helping to transform Crossreach’s current counselling service delivery to venerable people during the coronavirus pandemic.

CrossReach teamed up with the innovative technology group — [the Scottish Tech Army] to create a new online referral and assessment system.

Question: How may we serve Scottish people access to counselling services online during this pandemic?

Case: CrossReach Counselling Services needed to strategically review and build a solution for clients across Scotland.

Who? for categories of people in need of support to sign-up for vital counselling services.

Scale of this case study: There were many aspects to this triage application build including many people, for this case study I will focus on the user experience,user interface, user testing aspects, there was also new service delivery and a new CRM build.

Direct project team: Dev Scrum Master, 2 PM’s, Database Developer Genius, 2 Full Stack Developers, 1 UX/UI Designer, 1 Business/UX Analyst, Client facing Development Manager. We worked directly with crossreach staff and hosted remote workshops, meetings, brainstorming sessions and live demo’s of each stage of the project from user stories to full prototypes of the product.

A snapshot during one of our lovely daily 3pm stand ups❤

Team: Fully remote team, mon-fri 5 day week.

Product design timeframe: 4–8 Sprints

Recruitment: the team were put together based on skillset (read; mostly total strangers)and it was an outstanding team of exceptionally talented lovely friendly people all round.

Agile Project & Design Processes

When working on a new project, I begin my process with design thinking and gathering generative research through empathy and a deeper understanding of user needs and desires, speaking to subject experts and real people and researching topics and consuming lectures and academic papers in the field. I’m big on the topic of behaviours and psychology so will often look at the field abstract from the design entirely. Afterward, I’ll combine the systems and design thinking methodology during the phases of evaluating, defining and developing the product. I’ll consider the big picture first and the specific interactions later. What are the core components in the product, how are they connected, what does the overall purpose of these elements serve? Do these elements solve my persona’s problems? By understanding the inter-relatedness of the collective system, I can better design for the user journey and behavior through the entire ecosystem.

As part of this project we worked in a team using scrum and agile methodologies also as illustrated below:

Agile Scrum framework that we followed.

In addition to using Atlassian tools and Agile Ceremonies with the rest of the team — for this Crossreach Project I liked to reference a ux project checklist especially because the project was completely fresh without legacy.

  • Competitive Analysis
  • Data analysis
  • User feedback
  • User stories
  • User flows
  • Red routes
  • Brainstorm & sketch
  • Wireframe
  • Prototype
  • Communicate
  • IA
  • Language
  • Accessibility
  • Sustainable
  • Ethical
  • Inclusive
  • UI elements
  • Gestures
  • Responsiveness
  • Waiting times
  • Errors
  • Completed actions
  • Finalise Mid - Hi Fidelity
  • Use of images and icons
  • Font & colours hierarchy
  • Micro copy
  • Micro interactions
  • Transitions
  • Analyse
  • KPI Setup
  • AB Test plan
  • Test

Discovery

— Research on existing features, user types, demographics to inform decisions:

https://www.tandfonline.com/doi/abs/10.1080/87568225.2016.1254005?journalCode=wcsp20

https://www.england.nhs.uk/wp-content/uploads/2020/01/online-consultations-implementation-toolkit-v1.1-updated.pdf

https://www2.health.vic.gov.au/mental-health/practice-and-service-quality/service-quality/mental-health-triage-service

https://bjgp.org/content/69/682/e336

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6478479/

https://bmjopen.bmj.com/content/9/8/e027743

https://www.ahsnnetwork.com/total-triage-five-benefits

https://www.lsntap.org/sites/lsntap.org/files/TIG_TOOLKIT_IW_ONLINETRIAGEandINTAKEJUN2018.pdf

https://medium.com/nyc-design/applying-ux-triage-on-a-medical-mvp-3b6f6e75630e

https://www.publictechnology.net/articles/features/how-online-triage-transforming-access-nhs-gps-east-london

https://www.medvice.io/en/news/pain-points-urgent-care

https://www.researchgate.net/publication/330620328_When_Do_People_Seek_Internet_Counseling_Exploring_the_Temporal_Patterns_of_Initial_Submissions_to_Online_Counseling_Services

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3961801/

Online examples:

https://www.bark.com/en/gb/

https://my.app.myonlinetherapy.com/

https://www.betterhelp.com/start/

https://www.counselling-directory.org.uk/adv-search.html

https://www.faithfulcounseling.com/

https://www.teencounseling.com/parent_start/ (specific to 3rd party referral)

Problem Mapping & Definition Done in Miro:

Key Takeaways:

  • Health and wellness is the highest ranked expert category needed for those seeking expert advice.
  • People more frequently find an expert through a personal network of colleagues, friends and family referrals.
  • My survey results state that 54% of users search for an expert on their own rather than any other form. That said, in my moderated user interviews 75% of people would rather have someone provide expert recommendations to them rather than researching on their own.
  • 66% of users would prefer to receive an experts advice by phone or video call than any other form.
  • People appreciate when experts follow up with their questions after the service has been provided for no additional charge.
  • Having a virtual consultation between expert and customer will help speed up the process for receiving help.
  • Providing expert ratings, qualifications, reviews, price, location, and measurable goals are what people are looking for when making a final decision on working with an expert.
  • More than 70% of the time people will check Google and Yelp reviews and ratings even after receiving a referral. How can I incorporate google and yelp ratings and reviews in the app? How can I validate and build trust with the ratings and reviews of an expert?

Client Solution: Transform Crossreach’s current counselling service delivery to venerable people during the coronavirus pandemic through an online user accessible and self referral triage assessment.

User Archetypes we categorised from user interview and user database

Defining and Discovering User Archetypes

Who will we build a solution for?
What is their true problem to solve?

User Archetypes

Personas are useful tools for business decision makers. The demographic data contained in a persona can help guide consumer and market positioning, as well as inform marketing and sales strategies

While embarking on discovery research for a User Experience that archetypes are a better, more accurate model than personas. Archtypes are modeled around a motivational and behavioral perspective. Don’t refer to any one person. Using archetypes gives us a better view of behavior in interaction.

Archetypes are steeped in user behavior. They contain details from user interviews around a group’s needs, motivations and pain-points. Archetypes focus on the “who does what, when they do it, and why” of your audience research.

Each User Archetype for this Crossreach project was defined within a category of role as listed below and categorised from information gathered from clearly outlined Crossreach user databases, user interviews and user personas. Information from each was carefully read and examined as part of the design process in order to map the User needs and Motivations as accurately as possible.

  1. Caregiver

2. Adolescent
2.1 — Perinatal
2.2 — Emergency
2.3 — Non Emergency

3. Adult
3.1 — Perinatal
3.2 — Emergency
3.3 — Non Emergency

In this instance of Crossreach the goals of all users may intersect because archetypes typically refer to a group of people or a type of people with similar behaviours and potential thought processes — the core thought process is find help. (Simply put, personas are archetypes that are layered with specific characteristics)

Needs:

  1. Basic Survival — This is the need for food, drink, shelter, sleep and oxygen

(People deprived at this level who is cold, sick or hungry will not be very interested in socialising, learning or working, if looking for help through online services it is possible a healthcare care provider will assist in their stead and facilitate counselling issues to help facilitate solving the problems of lack of basic needs met)

  1. Safety — When a person is fearful, all concentration goes to calming the fear with no thought for any other task.

(People deprived at this level who are in a fearful/emergency/stressed situation due to factors such as pregnancy are priority, considerations require a very fast, non intrusive approach, — anonymous with simple language — privacy, multi lingual translation and accessibility is key for these users)

  1. Family or belonging — the need to belong to a group, family, religion, town or class / Acceptance and understanding — the need to feel alright and to know that others accept you as you are.

(People deprived at this level seem bored and joyless, even if they are doing well at their chosen tasks. They have feelings of loneliness, pain, sadness, separation and unworthiness)

  1. Self esteem needs — Respect from others includes recognition, attention and appreciation.

Within each of these needs groups there is a portion of people that the online triage feature must cater to.

User Stories Ideas

As a adolescent user I want to know how much this may cost me or someone else before I give information so that I am able to make the right choice and do not have financial worries as an excuse to forgo treatment

As an adult user I want to be able to complete this form for someone else who is unable to do so with their consent

As a health/care/provider provider I want to be able complete some information to make a referral for a patient so they may receive help faster

As an adolescent/adult user I want to know what you can offer someone like me in simple terms so that I know this is the right service

As an adult/caregiver/adolescent user I want to know how long this will take to complete online so I can make sure I have time now to complete it

As a user I want to know the kinds of questions you may ask so that I can be prepared for any triggers to complete them successfully

As a adolescent / adult user I want to know if you will require my data so that I do not have any privacy worries

As a adolescent / adult / caregiver user I expect validation that my request has been submitted so that I know my time has not been wasted and I will receive help

As a user who is classed as emergency I want to get my details reviewed quicker so I can receive help

As a user who is classed as perinatal I want to get my details reviewed quicker so I can receive help faster

As an adult user I expect to be able to add additional people to a request online so that a councillor can help two people as a couple

How we will solve it technically:

Creation of a new feature implemented via existing responsive website.

Matches users to therapists who are psychologists — Process Map

Solution:
As part of the problem solving we defined that a triage assessment service was one aspect of the service that could categorise and funnel people towards the correct health service based on our previous user research and knowledge base. It was important to map the touch points of the full user’s journey

User Flow and Service Delivery Mapping

User journey Mapping through card sorting

Exploratory User stories were sorted and defined into clear User Stories and stages and these User Stories translated into a well scoped out Roadmap of Epics and JIRA tickets.

User Triage Question Mapping

Defining the user question flows in the right order was vital to minimise stress and to encourage reassurance at every stage, especially considering the subject matter and potential emotional state of the person assessing the triage service.

Mapping Question/Triage Flow

A sample of the high level user stories outlined translated into epics and tasks in JIRA.

Wireframing:

We started with mobile prototyping first to define the correct question flow and interactive experience.

Style and Tone:

Defining the colour range was important with key clinical colour considerations part of the decision making, finding a palette that was fresh, approachable and one that was complimentary to the brand colour palette

Lo-Fi Prototype

During the lo fi prototype stage we hosted remote client sessions to walk through each interactive touchpoint and question stage to get the right user flow to help balance trigger questions along with compliance issues.

Illustration

Part of the design was finding an approachable set of scalable relatable illustrations that spoke to the demographics identified in the discovery stage

The illustration choice was to help emphasis and alleviate anxiety that a person may be experiencing at the time of filling out the form. There was an a/b test case proposed post launch whereby we removed the illustrative elements versus the illustrative version to see whether the illustrations gave the meaning intended and thus users time spent on understanding was reduced through visual understanding as well as reading each question.

Micro Copy

Microcopy refers to the tiny bits of copy on products — the small bits of copy in UI that really help users do things. As part of this project I was happy to initially write the microcopy and work with the Crossreach and the rest of the team to finalise the microcopy. In most instances we looked at medical terms, compliance regulations as well as keeping tone of voice aligned with the Crsooreach brand and existing Crossreach platforms.

High Fidelity Prototype

Sample of Mobile Prototype
Sample of Desktop Prototype

Throughout the project working file I had the team working collaboratively within the Figma tool to reach a successful conclusion of the prototype for this triage system. Of course the project didn’t stop with the prototype. I also worked closely with our team’s front-end developer throughout to transform my prototype into a live front facing functioning application who was involved from the very start of the project.

Further on from this prototyping we went to user testing phases with defined test plans which were handled by other team members as well as client testing phases with the MVP of the application. There was also more to this such as an overhaul of the system of the service itself. However overall a successful project which you can hear Kirsty chat about in the podcast episode below.

Retrospective: In just 10 weeks the team including myself created a secure and confidential system, which makes it quicker and simpler for people to gain access to counselling.

Jackie Walker, head of service for counselling at CrossReach, said: “I’m delighted that the Scottish Tech Army chose to work with us to help realise a project that we could not complete alone.

“Their skills and experience have helped us to review our existing service provision, and their system will make it easier for those in need of support to contact our counselling services and for us to respond.”

A link on the CrossReach website will take those seeking help to a web application where they will be able to refer themselves, family members or people in their care to counselling services.

The new referral site will also allow information about each person to be stored securely and simplify how donations can be made.

— — — — — — — — — — — — — — — — — — — — — — — — — — — — — — —

An excerpt from Crossreach:
“this strategy was not something that sprung to mind simply due to Covid-19; introducing digital counselling was something we had already been working. Back in 2015, we contacted the Digital Health & Care Institute with a proposal to expand our provision of perinatal counselling to the remote areas of the Highlands and Islands where there was an increasing need of support and limited availability. Since then, we’ve worked to find solutions, welcoming the expertise and guidance of those in the field of Health Care such as the Glasgow School of Arts; NHS Attend Anywhere; University of Aberdeen Applied Health Sciences; University of Edinburgh Innovation Consultancy; and now the STA.”
https://www.crossreach.org.uk/news/scottish-tech-army

Listen to the STA Podcast: You can find out more by listening to the STA Podcast where Kirsty McIntosh chats with Luke Pritchard-Woollett, STA, and Tanya Anderson, CrossReach about how the team have been getting on. The Podcast will be published on Tuesday 15th September and can be found @ https://www.scottishtecharmy.org/podcasts

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Design • UX • Product • Content • Wellness

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Ciara Carroll

Ciara Carroll

Design • UX • Product • Content • Wellness

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