Une approche complémentaire dans le trouble de stress post-traumatique chez l’enfant : la médiation équine thérapeutique

Abstract

BackgroundEquine-Assisted Therapy is a new approach for post-traumatic stress disorder in children, which comes in complementarity with usual therapies and is based on recent scientific studies. Horses and poneys participate more and more often in therapies for people in mental or physical difficulties. The aim is to introduce a horse as an intermediary which intervenes as a mediator for therapy. This care assisted by a horse must be included into the child's global therapeutic program. The horse facilitates development of therapeutic alliance and therapy with the triad child-therapist-horse improves interpersonal adaptation skills, positive attachment and resilience. Some recent studies have shown the interest and benefits for children with post-traumatic stress disorder. AimsA case pilot study is analyzed, starting from an experiment of equine assisted therapy for children with post-traumatic stress disorder symptoms following different psychotraumas (terrorist attack, mistreatment, injury, aggression). MethodTen equine-assisted therapy group sessions have been proposed to three children, aged from 6 to 11 years, addressed by Nice Pediatric Evaluation Psychotraumatism Center, which realizes the follow-up and other therapies. Equine assisted sessions have been carried out by the equine therapist, in presence of the psychomotor therapist, while the psychologist met with the parents. A CPTS-RI questionnaire (index of psychotraumatic stress reaction) was submitted by the psychomotor therapist to each of the three children before the first session of equine assisted therapy and after ten sessions. ResultsAccording to symptoms observed, therapeutic goals, means used and modalities are defined and described. Global results show good joining and participation, and positive evolution. For the three children, equine-assisted therapy has been facilitating for adherence to care, it improved socio-emotional and cognitive functioning, helped regulation in behaviour and emotions, restored confidence and self-esteem, provided wellness. PerspectivesTo understand action of equine assisted therapy for children with posttraumatic stress disorder so as to be able to explain benefits and effectiveness of this complementary therapy. Factors involved are analyzed depending on several approaches: psycho-affective, cognitive, social, neurobiological and therapeutic. This preliminary study must be continued with a larger sample so as to obtain data for evidence based practice and validate equine assisted therapy results in child post-traumatic stress disorder.