Equine-assisted Interventions Research Articles

Bibliometric Analysis on Equine-Assisted Interventions.

Equine Assisted Interventions (EAIs) integrate the active participation of horses in therapeutic or educational interventions. A bibliometric analysis was carried out on this topic, using traditional bibliometric laws and recommendations. For this purpose, a search on the Web of Science (WoS) Core Collection database was carried out, obtaining 333 documents. Annual publications followed an exponentially increasing trend (R2 = 86%), pointing out that this topic is a growing interest among researchers, publishers, and journals. The USA was the most productive country worldwide and Jeong-yi Kwon and Ji Lee were the prolific co-authors. The WoS category with the highest number of papers was Rehabilitation (84 papers). The Journal of Alternative and Complementary Medicine, and Pediatric Physical Therapy were the journals with the highest number of publications. The most cited paper was "State of the Evidence Traffic Lights 2019: Systematic Review of Interventions for Preventing and Treating Children with Cerebral Palsy". The most used author keywords were rehabilitation, balance, and those related to specific populations such as Cerebral Palsy and Autism Spectrum Disorder. These results suggest that EAIs is a topic of increasing interest for researchers, editors, and professionals.

The Behavioral Cost of Care: Changes in Maintenance Behavior during Equine-Assisted Interventions.

This study examined human-animal symbiosis in an animal-assisted intervention through observations of animal maintenance behaviors. The rise of psychotherapy, learning, and recreation incorporating animals warrants exploration of the welfare of the animals involved in these interventions. The analysis of welfare in multispecies engagements can be discussed in terms of symbiosis. Regarding an intervention's animal provider (e.g., therapy horse) and human recipient (psychotherapy client), the balance of cost and benefit is important. Research describing human and animal interactive behavior during interventions is limited, whether focusing on client outcomes or animal welfare. The present study adapted ethological methods to study humans and animals in an equine-assisted intervention, observing equine maintenance behaviors and equid-human interactive behavior. Maintenance behaviors were recorded before, during, and after equine-assisted (psychosocial) learning sessions with youth, providing 1600 observations. Equine alertness, eating behavior, and ambulation varied significantly before, during, and after the equine-assisted sessions. Such interruptions of typical behavior are an important aspect of welfare and unit of analysis when examining symbiotic relationships. A total of 267 sequences of equid-human approach-response behavior were also recorded, indicating that human-animal interaction was predominantly from humans toward equids. Equids' dominant response to human approach was no response, followed by avoidance, while humans' dominant response to equid approach was reciprocation. The findings are discussed in terms of symbiosis and animal welfare.

Experiences of a Therapeutic Equine-Assisted Group Intervention for People with Common Mental Disorders on Sick-Leave

Common mental disorders such as anxiety, depression and stress-related disorders are increasing worldwide, resulting in long-term sick leave and lower quality of life. Traditional treatment is often insufficient to facilitate the recovery process, and the need for holistic interventions that enable successful recovery is evident. Equine-assisted interventions have shown promising results in health promotion among people with mental disorders, and further research is needed to implement them within the range of available care. The aim of the study is therefore to describe experiences of a therapeutic equine-assisted group intervention for people with common mental disorders on sick leave. The study has a descriptive qualitative design with an inductive approach. Ten participants with common mental disorders on sick leave were interviewed after participating in a 12-week equine-assisted intervention and the data were analysed with conventional content analysis. The analysis generated the overall theme “The equine-assisted group intervention facilitates recovery,” which summons the four categories “The environment of the horses contributes to relaxation and an ability to be in the present,” “The presence of the horses facilitates supportive relationships in the group,” “Interplay with the horses entails physical activity and bodily improvements” and “Emotional interactions with the horses strengthen inner power.” In conclusion, equine-assisted interventions have the potential to facilitate recovery for people with common mental disorders by providing relaxation, promoting the ability to be in the present, cultivating supportive relationships and providing physical activity and bodily improvements as well as emotional interactions that strengthen the participants’ inner power.

On the Behaviour-Altering Effect of Horses and Dogs in theTherapy of Attention-Deficit/ Hyperactivity Disorders

The effects of horses and dogs on disorder-specific behavior were examined in amovement-oriented behavioral training for children and adolescents with attention-deficit/hyperactivity disorders. This was done using two behavioral experiments, a two-group experimental plan and a three-group experimental plan, in a within-subject design. In small group settings (3-4 subjects), a total sample of N = 13 was examined in two experiments. In Experiment I, an equineassisted therapy session was compared to a therapy session using an additional person as a control condition (the horse is replaced by a sports student).This experiment was carried out three times in a small group setting with a total of nine subjects (n = 9). In Experiment II, an equineassisted therapy session was compared to a dog-assisted therapy session, using an additional person as a control condition (sports student). Experiment II (n = 4) was carried out once with a small group. In both experiments, symptom-oriented behavior was assessed by Conner's scales and by physical activity measured using accelerometry. As a control variable, the attitudes towards horses, dogs, and sports teachers were recorded by drawings and verbal statements.The results show that in both experiments, the equine-assisted therapy session reduced symptom behavior.The results of accelerometry indicate a superiority of equine-assisted interventions, as physical activity in the equine-assisted setting was lower than in the settings assisted by dog or human, which is considered a desired behavior change in hyperactivity.

Therapeutic Role of Animals: A Comprehensive Literature Review on the Prevalent Forms and Species in Animal-Assisted Interventions

Animals have been valued and used to improve human physical and mental health since ancient times. Animal-assisted therapy (AAT) is a complementary approach to traditional medicine, involving trained animals. AAT can enhance cognition, commitment, character growth, and the learning process. Commonly used species in animal-assisted therapy include cats, dogs, horses, dolphins, and others. Feline-assisted therapy alleviates loneliness and stress, whereas canine-assisted therapy positively impacts emotions and overall well-being. Equine-assisted interventions benefit individuals with cognitive and motor disabilities. Dolphin-assisted therapy shows promise for conditions like autism and cerebral palsy. However, ethical concerns have arisen, particularly in children with behavioral disorders. Safety measures, adult supervision, and proper screening and hygiene practices are crucial in AAT programs. In conclusion, AAIs have a significant potential to enhance well-being and mental health across various contexts, but more research is needed to fully understand their effectiveness and safety in different settings and age groups. The existing literature consists of subjective accounts and inadequate methodologies.

Provision of Outdoor Nature-Based Activity for Older People with Cognitive Impairment: A Scoping Review from the ENLIVEN Project

The health and well-being benefits of outdoor nature-based activity are increasingly recognised, but older people with cognitive impairment face significant barriers to access. The ENLIVEN project aims to promote access by gathering evidence and coproducing guidance for activity providers. As part of this project, we conducted a scoping review to characterise the types of outdoor nature-based activity for older people with dementia and other forms of cognitive impairment for which research evidence is available and the range of outcomes is examined. The protocol is available online. We systematically searched relevant databases from 1st January, 2009, to 20th October, 2022, and screened articles against the following criteria: participants were older people aged 65 and above with cognitive impairment arising from dementia or another health condition. The study described the formal provision of outdoor nature-based activity away from the person’s usual place of residence, and at least one outcome of participation in the activity was evaluated. Twenty-eight articles met inclusion criteria, all focused on people with dementia. In most cases, participants were attending day care or living in residential care, and sample sizes ranged from 4 to 136. Activities fell into three groups: green day care (fifteen articles), equine-assisted interventions (seven articles), and community nature-based activities (six articles). Outcome domains explored were connection with nature, activity engagement, impacts on clinical symptoms, functional ability, physical, psychological and social health,, and quality of life. Outdoor nature-based activity can be offered as an opportunity for meaningful occupation to enrich daily life, as a framework for day care provision, or as an intervention to address clinical needs. The evidence base for green day care is relatively established, but the potential for addressing specific clinical needs remains to be explored. The paucity of evidence regarding community provision, especially for those not attending formal care settings, suggests the need for effective knowledge exchange to stimulate initiatives in this area.

Interpersonal Trust and Self-Confidence as Central Effects of Equine-Assisted Interventions for Children

In this study, 20 qualitative children’s interviews were conducted and evaluated using the grounded theory method to investigate the following research question: What is relevant from the perspective of the surveyed children about equine-assisted interventions? To reconstruct the children’s perspective, drawings painted by the children during each interview had been collected as another means of expression. The consideration of the children’s perspective has received little attention in research so far and this methodological access gave an insight into children’s experiences and thus, into the effects of the interventions. The interviews were analyzed with the qualitative grounded theory methodology and the segment analysis of the drawings offered additional material. The interviewed children took part in the equine-assisted intervention for emotional stabilization, because they had been exposed to increased psychosocial stress, like growing up in residential groups for children and youth welfare and not with their parents. The interviews revealed that, from the children’s point of view, it is of particular importance to the experience that they can trust others and trust themselves as well. Trust in others is supported by the pedagogical riding instructor, who ensured the safety of the animal. The positive experiences with the animal and the resulting trust had a positive effect on the children. If the intervention took place in a group, the children experienced mutual support. The children’s self-confidence was mainly strengthened by learning new things in the equine-assisted setting. At the beginning of the intervention, it was often necessary to overcome fears and in further intervention, there were always new challenges to be conquered with the support of the riding instructor, so that various experiences of success arose and the children felt able to act.

Horses' Tactile Reactivity Differs According to the Type of Work: The Example of Equine-Assisted Intervention.

Tactile perception in humans varies between individuals and could depend on extrinsic factors such as working activity. In animals, there is no study relating the influence of animals' work and their tactile reactivity per se. We investigated horses' tactile reactivity using von Frey filament in different body areas and compared horses working only in equine-assisted interventions (EAI), in riding school (RS) lessons, and in both activities (EAI-RS). We further compared tactile actions by people with or without mental and/or developmental disorders during brushing sessions. The results indicated that EAI horses showed higher tactile reactivity compared to EAI-RS and RS horses, both in terms of number of reactions overall, and especially when the test involved thin filaments. All horses showed high tactile reactivity when tested on the stifle, and this was particularly true for EAI horses. These differences could be related to humans' actions, as participants diagnosed with disorders brushed more the hindquarters and showed more fragmented actions. This study opens new lines of thought on the influence of EAI working activity on horses' tactile reactivity, and hence, on horses' sensory perception. Tactile reactivity outside work, may be directly (via tactile stimulations) or indirectly (via the welfare state), influenced by working conditions.

Measuring heart rate variability using a heart rate monitor in horses (Equus caballus) during groundwork.

Measuring physiological parameters of stress in horses during groundwork, for example when involved in equine-assisted interventions, is important to gain insight into the stress levels of the horses. Heart rate and heart rate variability can be used as physiological indicators of stress in horses. Heart rate monitors could be easily incorporated into practice, as they are not expensive and easy to use. However, it is questionable whether heart rate monitors present accurate heart rate variability results in exercising horses, similar to electrocardiograms. The aim of this study was to determine the accuracy of heart rate monitors for the assessment of heart rate variability in horses during groundwork exercise. Simultaneous telemetric electrocardiograms (Televet) and heart rate monitor (Polar H10 transmitter and M430 receiver, Hylofit electrodes) recordings were performed on 28 horses (15 mares and 13 geldings). Results indicate that the heart rate monitor accurately determined heart rate and time-domain heart rate variability parameters when compared to electrocardiograms during both baseline and groundwork conditions. As expected, heart rate significantly increased and the heart rate variability significantly decreased during groundwork compared to baseline conditions. This indicates that the heart rate monitor can be used to accurately determine heart rate variability during groundwork.

Relatives’ experiences of an equine-assisted intervention for people with psychotic disorders

ABSTRACT Purpose The aim of this study was to describe relatives’ experiences of an equine-assisted intervention for people with psychotic disorders. Methods The study has a qualitative and descriptive design. Ten semi-structured interviews were performed with relatives of people with a psychotic disorder who had participated in an equine-assisted intervention. A conventional content analysis was used to analyse the data. Result The overall category “Being with the horses strengthens health capabilities” summarizes the four identified subcategories “The horses contribute to a context with a common focus”, “Interaction with the horses enhances self-confidence and motivation”, “The interplay with the horses nurtures positive emotions” and “Being with the horses encourages physical activity”. Conclusions The result of this study contributes to the growing body of research about the potential outcomes of equine-assisted interventions. The result also indicates that equine-assisted interventions may improve health capabilities among people with psychotic disorders. The generated knowledge may be useful in mental health services when developing equine-assisted interventions.

A Pilot Observational Study of Implementing an Equine-A ssisted Services Program Within a VA Medical Center Residential Substance Use Disorder Treatment Program.

The aim of this observational pilot study was to assess the safety, feasibility, preliminary outcomes, and predictors of participant response as a result of implementing an equine-assisted intervention within a residential substance abuse treatment program at a large Veterans Administration medical center. A secondary aim was to evaluate psychological instruments for use in future, more rigorous studies. The overarching goal was to complete the necessary work to prepare for a large randomized controlled trial of this intervention for Veterans with addictive disorders. Participants were 33 Veterans, 29 males and 4 females, who participated in one 4-hour session of combined equine-assisted learning and equine-assisted psychotherapy during an admission to a residential substance abuse treatment program. Preintervention and postintervention instruments were utilized to assess changes in affect, anxiety, and craving. Demographic and diagnostic variables were evaluated for the potential to predict outcomes. The intervention was safe and feasible to utilize as there were no adverse outcomes to patients, staff, or equines. The State-Trait Anxiety Inventory, Craving Experience Questionnaire, and Positive and Negative Affect Scale revealed preliminary findings of significant preintervention to postintervention decreases in anxiety, negative affect, and craving, as well as increased positive affect. Lastly, the presence or absence of a history of suicide attempts and/or suicidal ideation were predictive of some postintervention scores. While more rigorous studies are needed, these results indicate that the intervention evaluated in this study is safe and feasible to utilize for Veterans admitted to a residential substance abuse treatment program. Furthermore, preliminary outcomes suggest that this intervention, and perhaps other equine-assisted interventions, has the potential to be beneficial to Veterans with addictive disorders as well as those at risk of suicide. The psychological instruments used in this intervention appear to be appropriate for use in future investigations. Additionally, more rigorous studies are warranted, and this work provides the necessary first steps needed to proceed with those investigations.

Development of an ICF-based assessment tool for equine-assisted therapy: model structure and reliability.

Scientific investigation and documentation of equine-assisted therapy has increased over the past several years. Yet there are no standardized and validated tools for evidence-based measurement of processes and outcomes to assess equine-assisted interventions. The objective of this cross-sectional survey study was to develop a standardized assessment tool for the effective measurement of equine-assisted therapy based on the common language of the International Classification of Functioning, Disability and Health (ICF) framework of the World Health Organization (WHO). Cross-sectional study. Six equine-assisted therapy rehabilitation centers in Germany. Persons with indications for equine-assisted therapy. In a qualitative conceptual portion of the study, four semi-structured focus group interviews were conducted and analyzed with a total of 17 experts and therapists according to the aims, content, and sphere of influence of equine-assisted therapy via structured content analysis. Based on these findings and a linkage to the classification system of ICF, a standardized assessment tool (a general module and three specialized submodules) for equine-assisted therapy was developed. It was field-tested with 116 participants at six locations in a multicenter practical field approach and statistically analyzed via explorative factor analyses and reliability tests. Explorative factor analysis provided support for a three-factor structure for the general module, including psychosocial, motor, and mental functioning scales. For both submodules, i.e., the individual and group settings, a two-factor structure was indicated. Reliability was in the good to excellent range for all modules. A global 80-item assessment tool, divided into a general and three submodules, provides a first step toward a standardized ICF-based assessment of the effects of equine-assisted therapy. A common language in measuring therapy outcomes could increase synchronization and integration of equine-assisted therapy interventions into the international healthcare system. By applying the ICF in multidisciplinary services in rehabilitation management, improved coordination and networking of all necessary services can be provided. The developed assessment tool contributes to evidence-based outcome-measurement and therapy monitoring of equine-assisted interventions. Prospectively, it could enable cost-effectiveness analyses and comparability with other health system interventions.

The Role of the Horse in an Equine-Assisted Group Intervention-as Conceptualized by Persons with Psychotic Conditions

Adopting positive health interventions is necessary to promote self-image, improve well-being, support meaningful social interaction and reduce loneliness, with benefits for psychological and physical health for persons with psychotic conditions. Raised awareness of the potential benefits of involving horses in these kinds of interventions is warranted. Thus, the aim of this study was to explore the role of the horse in equine-assisted interventions (EAI) as conceptualized among persons with psychotic conditions. Interviews were conducted with eight persons with psychotic conditions who had participated in an EAI, and data were analyzed following conventional qualitative content analysis. The results illustrate how the horse united the group and facilitated personal maturity both at a group level and at a personal level. In the group the horse facilitated interaction and became a healthy and normal topic of discussion. The interaction between the horse and others helped the participants to become aware of and reflect on behaviors of oneself and of others. At an individual level, the horse helped to develop participants’ identities and growth by offer mutual friendship. With its size and calming way of being, the horse evoked a healing power among participants who identified characteristics of themselves in the horse. Through its clear body language and communication, the horse facilitated personal maturity and development among the participants that would not have occurred without the horse’s presence.

Interest in Humans: Comparisons between Riding School Lesson Equids and Assisted-Intervention Equids.

Simple SummaryVery little is known about the impact of equine-assisted interventions on equids’ perception of humans. Different factors can influence human–horse relationships: animal characteristics, daily interactions with the caretakers, and working and living conditions. In this study, 172 equids working in equine-assisted interventions, ‘classical’ riding school lessons, or both were submitted to a standardised human–horse relationship test in order to test if EAI had an impact on the equid reactions to humans. The possible influence of intrinsic (age, sex, type) or other extrinsic factors (housing and feeding conditions) was also considered. The results showed that the number (more than the type) of experimenter-directed behaviours varied significantly between individuals and that the activity was the most important factor of influence: Equids working in riding school lessons performed more interactive behaviours than those working in equine-assisted interventions or having mixed activity. Other factors such as daily hay quantity, the horses’ age, and sex also influenced secondarily the horse’s motivation to interact, although no interaction was found between factors. These results suggest that equine-assisted interventions do influence horses’ perception of humans outside work. Further studies are needed in order to understand the processes involved. Little is known about the impact of equine-assisted interventions (EAI) on equids’ perception of humans. In this study 172 equids, living in 12 riding centres, were submitted to a standardised human–horse relationship test: the motionless person test. Age, sex, type (horse/pony), housing, and feeding conditions of subjects were recorded. Overall, 17 equids worked in EAI, 95 in riding school lessons (RS), and 60 in both (EAI-RS). There were high inter-individual variations in the number of interactive behaviours directed towards the experimenter: negative binomial general linear models showed that activity was the most important factor: RS equids performed more interactive behaviours than EAI (p = 0.039) and EAI-RS (p < 0.001) equids. Daily quantity of hay appeared as the second most important factor (equids with more than 3 kg interacted more than equids with less than 3 kg, p = 0.013). Individual characteristics were also important as horses interacted more than ponies (p = 0.009), geldings more than mares (p = 0.032), and 3–15-year-old equids more than equids over 15 years (p = 0.032). However, there was no interaction between factors. The lower number of interactive behaviours of EAI equids leads to different hypotheses—namely, selection on temperament, specific training, or compromised welfare (apathy). In any case, our results raised new lines of questions on EAI.

The Significance of Space: Experiences of Arab Social Work Professionals with EAGALA Equine-Assisted Learning

Abstract The value of equine-assisted interventions that promote growth and learning is increasingly recognised in professional practice. The aim of this study was to examine how equine-assisted intervention enhanced personal and professional growth for social work professionals. Arab social workers from the social service department in the Bedouin city Hura, Israel participated in three workshops based on the Equine Assisted Growth and Learning Association (EAGALA) model. Observations conducted through the workshops, debriefing sessions with participants and fourteen in-depth semi-structured interviews were analysed. Analysis exposed the importance of space in promoting development. Specifically, participants described the value of space for self-reflection, the importance of the space within and between relationships and space as a site for team building. Changes amongst the participants from dependence on external instruction to autonomous decision making, enhanced spontaneous activity with the horses and mutual assistance were identified. This is the first equine-assisted learning workshop and research conducted with social workers in Israel. The results highlight the value of equine-assisted learning as a new avenue to help grow social work professionals as they continue to work with their clientele. Results suggest that there is potential for equine-assisted interventions to support social workers internationally.

Equine-Assisted Interventions (EAIs) for Children with Autism Spectrum Disorders (ASD): Behavioural and Physiological Indices of Stress in Domestic Horses (Equus caballus) during Riding Sessions.

Simple SummaryEquine-assisted interventions (EAIs) are gaining increasing attention as complementary practices in autism spectrum disorders (ASD) as they can provide physical and psychological enrichment to children. However, ASD children could manifest inappropriate behaviours, potentially affecting the welfare of horses. This multicentre study aimed to investigate behavioural and physiological indices of stress in horses involved in EAI standardised sessions with children with ASD compared to sessions involving typically developing (TD) children. It followed a controlled within-subject design with repeated measurements involving 19 horses and 38 children. We compared behavioural and physiological responses of horses between sessions and among session phases. Results indicate a lower sympathetic tone in horses involved in ASD sessions, while in the mounting and dismounting phases, the horses displayed behavioural signs of stress, independently from children’s behaviour. Results from this study indicate that professionals should increase their awareness of horse’s welfare and refine methodologies used in EAIs.Equine-assisted interventions (EAIs) are well-known complementary practices combining physical activity with emotional/cognitive stimulation. They are especially suited for children with autism spectrum disorders (ASD) who need a high degree of physical and psychological enrichment. Even though EAIs have become a common practice, stress responses in horses interacting with individuals that can manifest inappropriate behaviours, such as ASD children, have not been thoroughly investigated. Our multicentre study aimed to investigate behavioural and physiological indices of stress in horses involved in EAI standardised sessions with children with ASD compared to typically developing (TD) children. A controlled within-subject design with repeated measurements involving 19 horses and 38 children was adopted. Stress-related behaviours, heart rate, heart rate variability, and eye temperature were recorded during the riding sessions. Moreover, blood samples were collected from horses before and after each session to monitor changes in blood adrenocorticotropic hormone (ACTH), cortisol, and catecholamines. Results indicate that, in general, stress responses in horses involved in EAIs did not differ as a function of the horse being ridden by children with ASD or TD. A lower sympathetic tone in horses involved in ASD sessions was found, while in the mounting and dismounting phases, horses displayed behavioural signs of stress, independently from children’s behaviour. We conclude that professionals working in EAI should increase their awareness of animal welfare and refine riding practices, taking into account horse’s needs.

Horses and worthwhile causes: Exploring equine-assisted learning at Dune Lakes Horse Inspired Learning Centre in Aotearoa New Zealand

INTRODUCTION: Equine-assisted therapies and trauma-informed interventions have become increasingly popular with a growing literature suggesting that people can deeply relate to experiential work with horses, where silence, emotional growth, reflection and acceptance are prioritised over talking about problems.APPROACH: This research, undertaken at a rural learning and retreat centre near Auckland in Aotearoa New Zealand, examines how practitioners tailor equine-assisted interventions (EAI) and sheds light into values, theories and frameworks that underpin their work. The study is based on personal and professional experiences of four practitioners who engage in equine- assisted learning.FINDINGS AND APPLICATION: Findings are drawn from the thematic analysis of the transcripts of four semi-structured interviews, highlighting the process of facilitating post- traumatic growth in a professional, supportive and client-centred environment involving a facilitator, a horse, and a person keen to improve the quality of their life. Application of this modality, particularly when working with clients with complex trauma, is explored with a special emphasis on the relevance of involvement of animals in social work practice.

A Systematic Review of Equine-Assisted Interventions in Military Veterans Diagnosed with PTSD

Military veterans transitioning from active duty to civilian life often face challenges during the reintegration process. Reintegration can become more difficult when a veteran is coping with posttraumatic stress disorder (PTSD) and its sequelae. Interventions are urgently needed to support veterans during times of transition. Animal-assisted interventions (AAI) show promise in reducing stress, depression, and improving wellbeing in marginalized populations. Equine-assisted interventions (EAI), in particular, are gaining momentum as a treatment option for veterans with PTSD. To synthesize current evidence on the use of EAI as a treatment option in military veterans formally diagnosed with PTSD. A comprehensive, electronic review of the literature was performed. Inclusion criteria were original quantitative or qualitative research, written in English, use of human participants, published through July 2019. The total number of studies included was nine. Main findings were that the efficacy of EAI on PTSD symptoms were equally mixed with both significant and non-significant findings. Data largely trended in the hypothesized direction for improving mental health states, resiliency, social function, quality of life, biological and behavioral measures, however, overall findings did not reach statistical significance. The investigation of EAI as an adjunct treatment for PTSD in military veterans may be effective, however, we cannot make a clear determination based on current evidence. Although findings largely trended in the hypothesized direction, most were not significant (except for PTSD symptoms) and warrant additional research to understand the effectiveness of EAI as an adjunct treatment in military veterans with PTSD.

Equine-assisted interventions for veterans with service-related health conditions: a systematic mapping review

BackgroundEvidence-based treatments for service-related health conditions such as posttraumatic stress disorder (PTSD), depression, and traumatic brain injury (TBI) are not effective for all veterans. Equine-assisted interventions are emerging as an additional treatment modality, but little is known regarding the safe and effective delivery of these interventions. This study aimed to describe the following features of the body of literature concerning equine-assisted interventions among veterans: 1) veterans who have participated in equine-assisted interventions; 2) specific characteristics of equine-assisted interventions in veterans; and 3) the specific characteristics of research on equine-assisted interventions in veterans.MethodsWe conducted a systematic mapping review of peer-reviewed literature reporting on equine-assisted interventions among veterans between 1980 and 2017. Searches of nine databases yielded 3336 unique records, six of which met the inclusion criteria and were reviewed. Data relevant to the study aims were extracted and analyzed.ResultsEquine-assisted interventions among veterans disproportionately targeted psychosocial outcomes and yielded promising results. The detailed methods of EAI varied in the reported studies, ranging from communicating with the horse to mounted exercises. There was also great diversity in outcome measurement. The state of theoretical development regarding the mechanisms by which equine-assisted interventions benefit the veteran population is currently underdeveloped. Studies provided insufficient detail with respect to the description of the intervention, reasons for attrition, and the dose-response relationship.ConclusionsScientific development of equine-assisted interventions targeting psychosocial outcomes among veterans is warranted to establish their efficacy. Targeted outcomes should be expanded, including outcomes more closely aligned with the nature of polytraumatic injuries. Future research must also emphasize the theoretical development of equine-assisted interventions for veterans and thoroughly describe the participants, components of the intervention, factors contributing to attrition, and optimal dose-response relationships.

An Exploration of the Mechanism of Action of an Equine-Assisted Intervention.

Simple SummaryAlthough there is increasing international interest and a growing body of evidence discussing the potential impacts of equine-assisted interventions to assist those with behavioural, mental health, physical health and disability-related issues, there has been little exploration of what “the mechanism of action” may be in causing any potential positive impacts. This paper reports on multi-method research study which considered in detail what was occurring while participants undertook the equine-assisted intervention under study. The intervention was implemented with young people with chronic mental health and behavioural problems for whom talk-based interventions were not working. Previous research has demonstrated long-term health and wellbeing benefits in recipients of the intervention. The three datasets were video data, psycho-physiological data, in this case, skin conductivity response, which is an indicator of emotional arousal, and experiential interview data. Our findings indicated that learning natural horsemanship skills through this intervention caused participants to experience emotional arousal when they asked the horse to perform a task. We would suggest that this process of experiencing a positive outcome following emotional arousal helps participants to achieve the reported behavioural outcomes from this intervention which include increased calmness, assertiveness, focus, empathy, communication skills, taking responsibility for behaviour, planning and confidence as a learner. These changes in behaviour then translate from the intervention to the participants’ everyday lives, thereby achieving the changes in behaviour recorded by those independent practitioners (i.e., social workers and teachers) who refer individuals to this intervention.Though long alluded to, there is now an accumulation of evidence of the vital contribution that emotion makes to learning. Within this broad advance in understanding is a growing body of research emphasising the embodied nature of this emotion-based learning. The study presented here is a pilot study using a mixed-method approach (combining both physiological and experiential methodologies) to give a picture of the “emotional landscape” of people’s learning through the intervention under study. This has allowed researchers to examine mediating pathways that may underlie any effects of an equine-assisted intervention. This study specifically focuses on examining the role of emotion. The intervention under study was used with young people with chronic mental health and behavioural problems for whom talk-based interventions were not working. Nine healthy participants aged 18–24 undertook the equine intervention, with an initial group having emotion-related psycho-physiological changes (skin conductance responses) measured while viewing their experience on video, and a further two participants experiencing a development of the methodology as their physiological responses were captured in real time during the intervention. The sessions were analysed by a group of five cross-disciplinary researchers to determine when significant learning episodes occurred, and the findings were that this learning was associated with powerful skin conductance responses. The qualitative element of the research entailed the participants watching themselves on video undertaking the equine intervention. They were asked to stop the video and share any changes in emotion at any point while watching. All participants experienced a positive temporal change in mood as the intervention progressed. All results supported the findings that emotional arousal occurred in relation to the participants asking the horse to perform a task. This paper will offer two novel contributions: (1) description of a new methodology for investigating the mechanism of action occurring in this type of intervention and (2) findings from the exploration of the intervention via psycho-physiological and experiential mechanisms.