Pilot Testing an Ecotherapy Program for Adolescence: Initial Findings and Methodological Reflections.

Children and young people's mental health and well-being has seen a dramatic decline. In the UK, this has been exacerbated by service retrenchment associated with austerity, with evidence of increasing health inequalities. Service innovation that is grounded in practice, has ongoing learning, and is co-designed with children and young people is required now. This can provide creative solutions within the local context and contribute to the fledgling evidence base that explores complex mechanisms of impact. This methodological reflection describes a co-design process of a bespoke, group-based ecotherapy programme: from early piloting using appreciative enquiry before COVID-19 by the mental health, public health, and Street Services team in the port city of Plymouth, to further developing an evaluation framework through an innovative, matched-funded academia-practice partnership. The findings showcase the benefits of a systems-based approach to public, multi-agency and academic collaboration, facilitated by peer and practitioner researchers and embedded researchers-in-residence. They highlight the need to consider nuances of specific (connecting with self, others, animals, nature) and non-specific active ingredients of the emerging and constantly adapting service (therapeutic relationship with practitioners/carers; nature as therapist, and group dynamics), as well as the value of pragmatic and participatory evaluation methods (distance-travelled, goal-based measures; and ethnographic, qualitative observation), to provide rapid, continuous, and real-time learning and improvement.