~/caro/portfolio/2026
Orange confetti streamers

Gaps and Opportunities
in ADHD Therapy Processes

brand

Cog ADHD logoCOG ADHD

role

Research
Strategy
UX/UI

time

2 months

tools

Figma
Miro
Notion
Asana

summary

As the Founding Designer at a pre-seed mental health startup, I led product discovery, uncovered key user needs, and turned insights into tested, shipped solutions. This resulted in an increase in therapy session bookings and growth in user engagement.

setting the stage

Cog is a mobile app designed to support people with ADHD. A significant part of its offering is online therapy delivered through Cog Clinic. My goal was to understand ADHD therapy from multiple perspectives to identify problems and uncover focused design opportunities.

Cog app phone - check-in history bar chartCog app phone - check-in history listCog Clinic dashboard - Katherine Bell overview

MY ROLE

Magnifying glass on a green diagonal card

research >

I interviewed customers, therapists, and clinic staff, carried out a competitive analysis, and analysed findings with the team.

Lightbulb on a green diagonal card

synthesis >

I identified friction points and improvement opportunities through affinity mapping, personas, and user journey analysis.

Upward arrows on a green diagonal card

strategy >

The number of opportunities identified was striking and helped me shape the long-term vision for Cog Clinic.

Orange burst on a green diagonal card

design >

I was responsible for designing a feasible solution to address the most urgent issue within the existing resource constraints.

INTERVIEWS

HOLISTIC INSIGHTS
THROUGH 360° INTERVIEWS WITH…

Mascot representing therapy clients

Therapy clients

Cog Clinic customers who had prior experience with therapy

Mascot representing therapists

Therapists

Specialists experienced in providing therapy for individuals with ADHD

Mascot representing clinic staff

Clinic staff

Professionals at mental health clinics familiar with operational systems

My goal was to gain a deeper understanding of the ADHD therapy landscape so I could address our users' needs better.

Purple thought bubble
What processes in mental healthcare clinics influence the therapy experience?
Green thought bubble
What factors contribute to a successful therapy?
Green thought bubble
What challenges do therapists face?
Purple thought bubble
What are our customers' needs when starting ADHD therapy?
Green thought bubble
Which parts of the current process are challenging, and what aspects work well?

Competitive Analysis

SPACE FOR OPPORTUNITY
IN THE THERAPY AIDING TOOLS

I identified a variety of solutions for ADHD support, generally divided into two categories: self-help apps and therapy platforms.

Agave Health logoinflow logoHelloSelf logoshimmer logobloom logo
Self-help app screen with a daily mood and emotion pickerSelf-help app screen for picking guided journeys

Self-help apps are typically designed to be engaging and fun, offering tools like mood check-ins, educational videos, and AI chatbots.

Therapy platforms generally offer access to coaches through monthly subscriptions but lack tools that directly support the therapy process. Only a few, including our key competitors Inflow and Agave Health, included features like emotion or symptom check-ins.

Inflow therapy platform screen matching a client with a coachShimmer therapy platform screen showing 1:1 coaching sessions

This gap in therapy-support tools indicated a unique opportunity to develop features that actively support the therapeutic journey.

Key research findings

Gaps in connection,
lack of structure and resources

Affinity map grouping research observations into themes such as establishing core needs, accountability, measuring progress, admin work, and risk assessment
“Each week, I'm asked how my week's been, but all I remember is the last meeting I've had that day so we end up chatting about the first thing that comes to my mind”
@Cog clinic customer
“Biggest challenge I face is a lack of engagement from my clients.”
@Cog clinic therapist
“I wish that I had a good sense of what day of the week I struggled with. I tried tracking it, especially when on medication, so then I know how things are going for me”
@Cog clinic customer

Insight #01

Defining needs and goals is crucial yet challenging

Effective therapy relies on clients understanding their emotions and goals, but many struggle to express them, often giving vague responses like “I want to complete tasks more easily” because their needs aren’t fully clear.

Insight #02

session structure leads to unfocused therapy

Sessions often start with “How’s your week been?”, often leading clients to recall recent events instead of key issues. This impacts the focus and outcomes of therapy.

Insight #03

clients' motivation dips
without visible progress

Clients are driven by visible progress, but therapists lack structured tools to track it. Without consistent tracking, clients struggle to see improvements, leading to a lack of motivation.

Insight #04

therapists are drowning in administrative work

Therapists handle extensive admin tasks including session summaries and risk assessments that can take 15–40 minutes per session, often unpaid. This extra workload contributes to burnout.

Session Booking Drop-off

Beyond the core insights, I identified a high-impact friction: users valued individual and flexible session booking but often forgot to rebook, even when they wanted to continue. This presented a clear opportunity for a quick, valuable fix.

CURRENT THERAPY PROCESS -
CLIENT JOURNEY MAP

Portrait of Katherine Bell, the persona for the journey map

Katherine Bell

“I need therapy with continuity, clear progress, and actionable insights readily available.”

scenario

Katherine is successful at work but struggles to balance it with her personal life and mental health, often feeling burnout. She wants to understand and manage her ADHD to feel less exhausted and anxious. Previous therapy felt chaotic and unexpected, leaving her unmotivated and uncertain about any progress.

expectations

  • ·She wants to manage her ADHD effectively and work with a therapist she can build rapport with.
  • ·She seeks structured therapy with clear progress tracking to stay motivated.
  • ·She hopes her therapist will help identify key focus areas, reducing the burden of recall.
Cog Clinic current therapy process journey map: stages, actions, thoughts, touchpoints, emotions and opportunities across choose, prepare, introduce, remember, recall and analyse phases

Strategy

Transforming therapy
with AI and data-driven solutions

The issues I uncovered revealed many opportunities for improvement. I began to imagine, what could a big picture product vision for Cog clinic look like?

Cog allows users to track symptoms, emotions, wins and add daily journal entries for context.

Why not use these tools to give users a clear, insightful view of their progress and overall well-being?

Cog home screen - Hi Katherine, your daily practiceCog check-in - How is your focus?Cog check-in - How is your punctuality?
Cog journal - What went well today?Cog journal - What's been happening?

This would also give therapists a better understanding of their patient’s health and areas to focus on.

With structured data available before sessions, patients wouldn’t have to rely on memory, and seeing their progress could be a huge motivation boost.

Additionally, a centralised hub would keep therapy organised; session summaries, homework, communication, reminders, and an archive all in one place, so nothing ever gets lost.

design ideaCog Clinic dashboard concept - Katherine Bell progress view with symptom-progress line chart and symptom-control donut charts

Automating some of the admin work could further reduce clinician burnout. For example, after each session, AI could draft a session summary and risk assessment based on the user’s data, allowing therapists to simply review it.

design ideaCog Clinic dashboard concept - Katherine Bell session view with an AI-drafted session summary

METHODOLOGY

INVITING ENGINEERS
TO DISCUSSIONS EARLY ON

With this big vision in place, I focused on prioritising ideas. Transforming check in entries (symptoms, emotions, wins, and daily journals) into actionable insights would address key issues identified in the research.

Problem #01

Defining needs and goals is crucial yet challenging

Access to symptoms history would allow users to identify patterns enabling more targeted goals.

Problem #02

session structure leads to unfocused therapy

Users could use their check in data to share relevant information each week, streamlining session focus.

Problem #03

clients' motivation dips Without Visible Progress

Check in analytics could help users monitor symptoms and see their progress more clearly.

Early on, I worked with engineers to figure out what was realistic. Our backend setup in Firebase couldn't support complex data aggregation without a major restructure, so we went with a lightweight weekly check-in history to launch fast and learn quickly.

exploratory sketches

Exploratory wireframe sketches 1Exploratory wireframe sketches 2Exploratory wireframe sketches 3

Challenges

Testing Shows
Information Overload

I started with a day-by-day layout and colour-coded progress bars to help users review their week and spot patterns. But, user testing showed that this layout was overwhelming.

“I’m finding it hard to make sense of all the symptoms and analyse them day by day to see where my low points are.”

Early version of the Cog tracker history screen showing a dense day-by-day list of colour-coded symptom progress bars

Solution

User Journey Shaping Clarity

I focused my redesign on improving the user’s journey when reviewing their check in data. The goal was to help users move seamlessly from identifying key pain points to diving deeper into specific insights.

Portrait of Katherine Bell, the therapy-client persona

Katherine Bell

Therapy Client

How has this week been overall?

Which days were the hardest for me?

What made those days so challenging?

What should I talk to my therapist about?

Weekly overview screen plotting ADHD scores over the last 7 days as a bar chartDaily check-in detail for Wednesday 11th Dec showing 'Your Highs' with mood and restlessness ratings

weekly overview graph >

I designed a visual representation of the week to help users quickly understand key patterns. At a glance, users can spot the worst days and identify areas to explore further.

two-tab view >

To make navigation easier, I introduced a two-tab system that enables users to switch between a high-level weekly summary and detailed check-in data.

symptom ranking >

To make the data more digestible, I grouped symptoms into categories: highs, lows, and neutrals. This provided clarity and allowed users to focus on what mattered most.

journal and wins entries >

Journals add valuable context by capturing what was happening on specific days, while “wins” serve as positive reinforcement, helping users stay motivated.

Journal entries screen with your journal comments, wins, and a 'You practiced self-help!' noteSymptom ranking screen grouping the week into Your Highs, Your Lows, and Your Neutral Zone

In parallel, I also addressed session booking drop-off by introducing a batch booking feature, allowing users to schedule multiple therapy sessions at once.

Results

Small changes, measurable results

The history feature helped both users and therapists find value in reviewing past check-ins, contributing to a noticeable increase in DAU and average time spent.

Separately, after implementing batch session booking, we saw an increase in therapy bookings.

“It's a great starting point, and I'm excited to use it with my clients.”

@Cog clinic therapist

“Being able to spot key highs and lows of the week helps focus therapy sessions on the most relevant issues.”

@Cog clinic therapist

“In the past, I struggled to see the point of checking in, but using it to look back at my week is great.”

@Cog clinic customer

“This motivates me to check in more often, as I can use the entries as a conversation starter in therapy.”

@Cog clinic customer

KEY TAKEAWAYS

DESIGN IS COMPLEX
AND CONTEXT-DRIVEN

prioritisation

Business goals, budgets, and timelines shape decisions. We prioritised feasible solutions with the highest user value.

communication

Clear communication and early engineer involvement ensured smooth implementation and prevented wasted effort.

iteration

A big vision serves as a north star, but progress comes from iterating in small steps and tracking feedback.

View next project

Designing an AI brain
for a support call centre

CHECK IT OUT