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Elliott TR. Editor's vale dictum: Activities, challenges and reflections from the line in between 2011 and 2023, Journal of Clinical Psychology. J Clin Psychol 2023; 79:2721-2735. [PMID: 37791998 DOI: 10.1002/jclp.23597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 10/05/2023]
Affiliation(s)
- Timothy R Elliott
- Department of Educational Psychology, Texas A&M University, College Station, Texas, USA
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2
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Li J, Sánchez-García R. Equine-assisted interventions for veterans with posttraumatic stress disorder: a systematic review. Front Psychiatry 2023; 14:1277338. [PMID: 38025432 PMCID: PMC10654975 DOI: 10.3389/fpsyt.2023.1277338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
Equine-assisted intervention therapy has a nearly 60-year history and has been shown to have a significant positive impact on various types of psychotherapy patients. Due to an increase in research on EAT, the number of existing methods of equine-assisted intervention therapy has gradually increased. Based on existing literature on the application of equine-assisted intervention therapy on veterans with post-traumatic stress disorder (PTSD), this study examines the characteristics of several types of equine interventions and includes a systematic review of peer-reviewed literature on equine-assisted interventions for veterans with PTSD published over the past 5 years, from 2018 to the present. Ten articles met the review criteria and served as the primary data for analysis. Several types of equine-assisted interventions were shown to have a beneficial psychological impact on veterans. However, some limitations were also found in the studies, such as that the majority of experiments were constrained by small sample sizes. Equine-assisted intervention therapy has been shown to be effective, but further research is merited, in order to focus on the specific details and theories involved in equine-assisted interventions, and on the welfare of the horses involved in the therapy.
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Affiliation(s)
- Jiaxin Li
- Facultad de Ciencias de la Actividad Física y del Deporte (INEF), Universidad Politécnica de Madrid, Madrid, Spain
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3
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Palomar-Ciria N, Bello HJ. Equine-Assisted Therapy in Post-Traumatic-Stress Disorder: A Systematic Review and Meta-Analysis. J Equine Vet Sci 2023; 128:104871. [PMID: 37355148 DOI: 10.1016/j.jevs.2023.104871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 06/13/2023] [Accepted: 06/19/2023] [Indexed: 06/26/2023]
Abstract
Alternative treatments for Post-traumatic-Stress Disorder (PTSD) have attracted attention, especially Equine-Assisted Services (EAS) including psychotherapy and occupational therapy involving horses. In this work, we measured the effectiveness of EAS in PTSD through a meta-analysis. An intensive bibliography search focusing in EAS and PTSD was conducted following the PRISMA recommendations. The search was not restricted by date. For the quantitative analyses, 5 works were selected. They were chosen based on the instrument utilized for the assessment of PTSD symptoms: the PTSD Checklist for DSM-5 (PCL-5). A random effects model was carried out, showing significant results in the reduction of PTSD symptoms. In the qualitative synthesis, 10 studies were included which showed interesting results in the improvement of PTSD symptoms and other variables. In conclusion, EAS are beneficial for post-traumatic symptoms in the short term follow-up period. However, EAS require further research and major standardization.
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Affiliation(s)
- Nora Palomar-Ciria
- Psychiatry Service, Complejo Asistencial Universitario de Soria, Soria, Spain.
| | - Hugo J Bello
- Department of Applied Mathematics, University of Valladolid (Campus Duques de Soria), Soria, Spain
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4
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Rankins EM, McKeever KH, Malinowski K. Equids in Equine Assisted Services: A Scoping Review. J Equine Vet Sci 2023:104825. [PMID: 37244632 DOI: 10.1016/j.jevs.2023.104825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/22/2023] [Accepted: 05/22/2023] [Indexed: 05/29/2023]
Abstract
Equid welfare in equine assisted services (EAS) is an area that has received attention, but less attention than the documentation of human outcomes in response to EAS. To safeguard the well-being of equids and minimize human risk of injury, continued research on the effects of EAS programming and participants on equids needs to occur. The aims of this systematic scoping review were to identify the approaches taken for describing and understanding equids in EAS and the methods employed in evaluating equids' responses to EAS programming, participants, or both. Literature searches were performed in relevant databases to identify titles and abstracts for screening. Fifty-three articles were identified for full-text review. Fifty-one articles met the inclusion criteria and were retained for information and data extraction. The qualitative grouping of articles by study aim resulted in four categories: 1) characterization and description of equids in EAS; 2) the acute responses of equids to EAS programming, participants, or both; 3) the effects of management practices; and 4) the chronic responses of equids to EAS programming and participants. The latter three areas are in need of more research, especially as it relates to differentiating acute and chronic effects of EAS on the equids involved. Detailed reporting of information on study design, programming and participant characteristics, equid demographics, and workload are needed to facilitate comparison among studies and permit eventual meta-analysis of studies. Multi-faceted approaches including an array of measurements as well as relevant and informative control groups or conditions are required to identify the complex effects of EAS work on equids, their welfare, well-being, and affective states.
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Affiliation(s)
- Ellen M Rankins
- Rutgers Equine Science Center, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.
| | - Kenneth H McKeever
- Rutgers Equine Science Center, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Karyn Malinowski
- Rutgers Equine Science Center, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
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5
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Cappelen H, Ivarsson A, Jormfeldt H. The Effects of an Equine-Assisted Therapeutic Intervention on Well-Being in Persons Diagnosed with Schizophrenia. A Pilot Study. Issues Ment Health Nurs 2023; 44:104-111. [PMID: 36649626 DOI: 10.1080/01612840.2022.2158408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The process of personal recovery among persons diagnosed with schizophrenia may be facilitated through innovative health promotion interventions targeting multidimensional aspects of subjective well-being. The current pilot study aims to test the use of self-rated questionnaires as a means of evaluation of the effects of an equine-assisted intervention for persons diagnosed with schizophrenia. Twenty adults diagnosed with schizophrenia were offered a 12-week EAT intervention performed six times once every 14 days by a licensed mental health nurse. Two validated self-rated questionnaires, HSCL-25 and SHIS were used as outcome measurements at baseline and at post-treatment, additionally the self-rated questionnaire PANAS was completed twice a week starting 1 week before the 12 week-EAT intervention. Only six of the 20 participants managed to complete the validated questionnaires. Despite the low response rate of approximately 30%, a significant difference was found between pre and post scores for positive affect and well-being. Effect sizes, ranging from small to large for pre-to-post treatment scores indicated less depression and anxiety, more positive affect, less negative affect, and reinforced well-being. Results suggest that EAT interventions may have beneficial effects among persons diagnosed with schizophrenia and that a varied range of research methods are needed to create a solid evidence base for EAT interventions intended for the target group.
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Affiliation(s)
- H Cappelen
- Institute of Psychology Universiteit Leiden, Leiden, The Netherlands
| | - A Ivarsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - H Jormfeldt
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
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6
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Potier JFN, Louzier V. Evaluation of stress markers in horses during hippotherapy sessions in comparison to being ridden by beginners. Anim Welf 2023; 32:e10. [PMID: 38487430 PMCID: PMC10936384 DOI: 10.1017/awf.2023.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 08/24/2022] [Accepted: 08/30/2022] [Indexed: 02/03/2023]
Abstract
Hippotherapy has been used for decades and its benefits to human patients have largely been proven, whether being applied to those with physical or mental disabilities. There have been a plethora of animal welfare studies recently, pertaining especially to ridden horses. This study aimed to investigate stress markers in horses during hippotherapy sessions to address the ethical considerations raised by using horses for therapy. A ridden stress ethogram was established and validated specifically for this study via subjective observation and video recording of a ridden session involving intermediate-level riders. The experiment entailed eight healthy horses undergoing two ridden sessions on separate days, one with disabled riders and one with beginners. Several parameters associated with physiological responses to stress were evaluated at rest, such as heart rate, plasma adrenocorticotropic hormone [ACTH], serum and salivary cortisol. These parameters as well as the behavioural stress score from the ethogram scale were measured during both sessions. No significant differences were found between heart rate, plasma ACTH, and stress scores. Serum and salivary cortisol were significantly lower during the hippotherapy session than during the session with beginners. The current study found no evidence of compromised welfare when horses were used as a therapeutic aid during hippotherapy sessions compared to their usual ridden activity. Although these results indicate that hippotherapy may be ethically justified as it benefits humans without causing harm to the horses, the present study was small, and the results should be interpreted with caution.
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Affiliation(s)
| | - Vanessa Louzier
- APCSe Agressions Pulmonaires et Circulatoires dans le Sepsis, Université de Lyon, VetAgro Sup – Campus Vétérinaire de Lyon, 1 Avenue Bourgelat, 69280, Marcy-l’Étoile, France
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7
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Fridén L, Hultsjö S, Lydell M, Jormfeldt H. Relatives’ experiences of an equine-assisted intervention for people with psychotic disorders. Int J Qual Stud Health Well-being 2022; 17:2087276. [PMID: 35698741 PMCID: PMC9310814 DOI: 10.1080/17482631.2022.2087276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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.
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Affiliation(s)
- Linda Fridén
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Sally Hultsjö
- Department of Psychiatry, Region Jönköping County, Sweden and Department of Health, Medicine and Caring Sciences, Division of Nursing and Reproductive Health, Linköping University, Linköping, Sweden
| | - Marie Lydell
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
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8
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Diaz L, Gormley MA, Coleman A, Sepanski A, Corley H, Perez A, Litwin AH. Equine-assisted services for individuals with substance use disorders: a scoping review. Subst Abuse Treat Prev Policy 2022; 17:81. [PMID: 36517823 PMCID: PMC9749232 DOI: 10.1186/s13011-022-00506-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 11/14/2022] [Indexed: 12/15/2022] Open
Abstract
The implementation of equine-assisted services (EAS) during treatment for psychological disorders has been frequently documented; however, little is known about the effect of EAS on outcomes for populations with substance use disorder (SUD). The purpose of this scoping review was to synthesize existing literature reporting the effects of EAS when incorporated into SUD treatment. This review followed guidelines in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist for scoping reviews. A search of four databases (MEDLINE/PubMed, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Academic OneFile) identified studies reporting quantitative and/or qualitative data for an EAS intervention that was implemented among a population receiving treatment for and/or diagnosed with SUD. Of 188 titles, 71 underwent full-text assessment and six met inclusion criteria. Three additional articles were identified through other sources. Quantitative data suggested a potential positive effect of EAS on SUD treatment retention and completion as well as participants' mental health; however, studies were limited by small sample sizes. Qualitative data indicated that in addition to participants developing bonds with the horses and perceiving EAS as welcomed breaks from traditional treatment, they experienced increased self-efficacy, positive emotional affect, and SUD treatment motivation. Due to methodological limitations and an overall dearth of available studies, the effectiveness of EAS as adjuncts to SUD treatment is inconclusive. Additional research is necessary before supporting broad implementation of EAS as adjuncts to SUD treatment.
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Affiliation(s)
- Liam Diaz
- grid.413319.d0000 0004 0406 7499Addiction Medicine Center, Prisma Health, 876 W Faris Rd, Greenville, SC 29605 USA
| | - Mirinda Ann Gormley
- grid.413319.d0000 0004 0406 7499Addiction Medicine Center, Prisma Health, 876 W Faris Rd, Greenville, SC 29605 USA ,grid.413319.d0000 0004 0406 7499Department of Emergency Medicine, Prisma Health, 701 Grove Rd, Greenville, SC 29605 USA ,grid.26090.3d0000 0001 0665 0280Department of Public Health Sciences, Clemson University College of Behavioral, Social, and Health Science, 503 Edwards Hall, Clemson, SC 29631 USA ,grid.254567.70000 0000 9075 106XDepartment of Emergency Medicine, University of South Carolina School of Medicine- Greenville, 701 Grove Rd, Greenville, SC 29605 USA
| | - Ashley Coleman
- grid.413319.d0000 0004 0406 7499Addiction Medicine Center, Prisma Health, 876 W Faris Rd, Greenville, SC 29605 USA
| | - Abby Sepanski
- grid.413319.d0000 0004 0406 7499Addiction Medicine Center, Prisma Health, 876 W Faris Rd, Greenville, SC 29605 USA
| | | | - Angelica Perez
- grid.413319.d0000 0004 0406 7499Addiction Medicine Center, Prisma Health, 876 W Faris Rd, Greenville, SC 29605 USA ,grid.26090.3d0000 0001 0665 0280Clemson University School of Health Research, 605 Grove Rd., Suite 301, Greenville, SC 29605 USA
| | - Alain H. Litwin
- grid.413319.d0000 0004 0406 7499Addiction Medicine Center, Prisma Health, 876 W Faris Rd, Greenville, SC 29605 USA ,grid.26090.3d0000 0001 0665 0280Clemson University School of Health Research, 605 Grove Rd., Suite 301, Greenville, SC 29605 USA ,grid.254567.70000 0000 9075 106XDepartment of Medicine, University of South Carolina School of Medicine- Greenville, 701 Grove Rd, Greenville, SC 29605 USA ,grid.413319.d0000 0004 0406 7499Department of Internal Medicine, Prisma Health, 876 W Faris Rd, Greenville, SC 29605 USA
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9
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Kovács G, van Dijke A, Leontjevas R, Enders-Slegers MJ. The Relevance of Internal Working Models of Self and Others for Equine-Assisted Psychodynamic Psychotherapy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10803. [PMID: 36078534 PMCID: PMC9518159 DOI: 10.3390/ijerph191710803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 06/15/2023]
Abstract
Attachment characteristics play a key role in mental health and in understanding mental disorders. The aim of this study was to gain insight into the role the attachment characteristics can play in treatment effects in adult patients with intrapsychic and interpersonal problems who underwent Equine-assisted Short-term Psychodynamic Psychotherapy (ESTPP). In the first part of the study, we compared the effects of ESTPP to treatment-as-usual from a previous dataset regarding psychological dysfunction. For this, an explorative experimental non-randomized pre-treatment and 1-year post-treatment design was used. A mixed model revealed a significant decline in psychological dysfunction for both conditions, with no significant difference between the two. In the second part of the study, we examined the course of ESTPP effects over the period of 1 year when controlled for attachment styles and, subsequently, for internal working models of self and others. To this end, measurements were taken at baseline, 2 months waiting time, one-week intensive module, 6 months, and one year after the start of the treatment. Mixed models accounted for repeated measures showed significant improvements in psychological dysfunction, remoralization, and depression for ESTPP patients over time. The study implies that models of self and others may be used to predict the course of effects, which is relevant in determining what works for whom. In particularly, duration and intensity of therapy and a focus on the Model of Self seem relevant for shaping a more personalized treatment. ESTPP seems beneficial for patients with low pre-treatment attachment security.
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Affiliation(s)
- Géza Kovács
- Department of Psychology, Open University of the Netherlands, 6419 AT Heerlen, The Netherlands
- SPEL Psychologen Putten, 3881 NE Putten, The Netherlands
| | - Annemiek van Dijke
- PsyQ I-Psy Brijder The Netherlands, Leiden University Medical Centre, 2333 ZA Leiden, The Netherlands
| | - Roeslan Leontjevas
- Department of Psychology, Open University of the Netherlands, 6419 AT Heerlen, The Netherlands
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10
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Allen B, Shenk CE, Dreschel NE, Wang M, Bucher AM, Desir MP, Chen MJ, Grabowski SR. Integrating Animal-Assisted Therapy Into TF-CBT for Abused Youth With PTSD: A Randomized Controlled Feasibility Trial. CHILD MALTREATMENT 2022; 27:466-477. [PMID: 33499659 PMCID: PMC9215110 DOI: 10.1177/1077559520988790] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This clinical trial examined animal-assisted therapy (AAT) as an adjunct to Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) for abused youth with posttraumatic stress disorder (PTSD). Youth between the ages of 6 and 17 (M = 11.79, SD = 3.08) were randomized to receive standard TF-CBT or TF-CBT with adjunctive AAT (TF-CBT+AAT) employing retired service dogs. Feasibility metrics evaluating the addition of AAT were collected in addition to common clinical outcomes evaluated in TF-CBT trials. The inclusion of AAT increased the number of potential participants who declined participation and there were no noted benefits for treatment retention or satisfaction with services. Analyses showed that the inclusion of AAT did not enhance improvement of PTSD symptom severity (β = .90, t = .94, p = .351) or a number of other outcomes. On the contrary, there were indications from analyses and clinician feedback that AAT may have attenuated improvement in many cases. This study identified a number of important feasibility considerations in the design of studies testing AAT. However, the results examining clinical outcomes suggest that the inclusion of AAT with TF-CBT in the treatment of maltreated youth with PTSD is not warranted at this time.
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Affiliation(s)
- Brian Allen
- Department of Pediatrics, Penn State College of Medicine, Hershey, PA, USA
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA, USA
- Center for the Protection of Children, Penn State Children's Hospital, Hershey, PA, USA
| | - Chad E Shenk
- Department of Pediatrics, Penn State College of Medicine, Hershey, PA, USA
- Department of Human Development and Family Studies, 8082Penn State University, State College, PA, USA
| | - Nancy E Dreschel
- Department of Animal Science, 8082Penn State University, State College, PA, USA
| | - Ming Wang
- Department of Public Health Sciences, 12310Penn State College of Medicine, Hershey, PA, USA
| | - Ashley M Bucher
- Department of Pediatrics, Penn State College of Medicine, Hershey, PA, USA
| | - Michelle P Desir
- Center for the Protection of Children, Penn State Children's Hospital, Hershey, PA, USA
| | - Michelle J Chen
- Department of Psychology, 14727University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Simonie R Grabowski
- Department of Psychology, 4052Indiana University of Pennsylvania, Indiana, PA, USA
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11
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Stolz I, Tillmann V, Anneken V, Froboese I. Development of an ICF-based assessment tool for equine-assisted therapy: model structure and reliability. Eur J Phys Rehabil Med 2022; 58:60-67. [PMID: 34747578 PMCID: PMC9980525 DOI: 10.23736/s1973-9087.21.06816-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND 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. AIM 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). DESIGN Cross-sectional study. SETTING Six equine-assisted therapy rehabilitation centers in Germany. POPULATION Persons with indications for equine-assisted therapy. METHODS 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. RESULTS 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. CONCLUSIONS 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. CLINICAL REHABILITATION IMPACT 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.
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Affiliation(s)
- Isabel Stolz
- Research Institute for Inclusion through Physical Activity and Sport at the German Sport University, Cologne, Germany - .,Institute of Movement and Neurosciences, German Sport University, Cologne, Germany -
| | - Vera Tillmann
- Research Institute for Inclusion through Physical Activity and Sport at the German Sport University, Cologne, Germany
| | - Volker Anneken
- Research Institute for Inclusion through Physical Activity and Sport at the German Sport University, Cologne, Germany
| | - Ingo Froboese
- Research Institute for Institute of Health Promotion and Clinical Movement Science, German Sport University, Cologne, Germany
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12
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Vincent A, Ballard I, Farkas KJ. Mind Full or Mindful? A Cohort Study of Equine-Facilitated Therapy for Women Veterans. JOURNAL OF CREATIVITY IN MENTAL HEALTH 2021. [DOI: 10.1080/15401383.2021.1984353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Aviva Vincent
- University of Tenness, Veterinary Social Work Certificate Program, USA
| | - Isabel Ballard
- Mandel School of Applied Social Sciences, Case Western Reserve University, USA
| | - Kathleen J. Farkas
- Mandel School of Applied Social Sciences, Case Western Reserve University, USA
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13
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Zhu X, Suarez-Jimenez B, Zilcha-Mano S, Lazarov A, Arnon S, Lowell AL, Bergman M, Ryba M, Hamilton AJ, Hamilton JF, Turner JB, Markowitz JC, Fisher PW, Neria Y. Neural changes following equine-assisted therapy for posttraumatic stress disorder: A longitudinal multimodal imaging study. Hum Brain Mapp 2021; 42:1930-1939. [PMID: 33547694 PMCID: PMC7978114 DOI: 10.1002/hbm.25360] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/09/2021] [Accepted: 01/21/2021] [Indexed: 12/17/2022] Open
Abstract
Background While effective treatments for posttraumatic stress disorder (PTSD) exist, many individuals, including military personnel and veterans fail to respond to them. Equine‐assisted therapy (EAT), a novel PTSD treatment, may complement existing PTSD interventions. This study employs longitudinal neuro‐imaging, including structural magnetic resonance imaging (sMRI), resting state‐fMRI (rs‐fMRI), and diffusion tensor imaging (DTI), to determine mechanisms and predictors of EAT outcomes for PTSD. Method Nineteen veterans with PTSD completed eight weekly group sessions of EAT undergoing multimodal MRI assessments before and after treatment. Clinical assessments were conducted at baseline, post‐treatment and at 3‐month follow‐up. Results At post‐treatment patients showed a significant increase in caudate functional connectivity (FC) and reduction in the gray matter density of the thalamus and the caudate. The increase of caudate FC was positively associated with clinical improvement seen immediately at post‐treatment and at 3‐month follow‐up. In addition, higher baseline caudate FC was associated with greater PTSD symptom reduction post‐treatment. Conclusions This exploratory study is the first to demonstrate that EAT can affect functional and structural changes in the brains of patients with PTSD. The findings suggest that EAT may target reward circuitry responsiveness and produce a caudate pruning effect from pre‐ to post‐treatment.
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Affiliation(s)
- Xi Zhu
- Department of Psychiatry, Columbia University, New York, New York, USA.,New York State Psychiatric Institute, New York, New York, USA
| | - Benjamin Suarez-Jimenez
- Department of Psychiatry, Columbia University, New York, New York, USA.,New York State Psychiatric Institute, New York, New York, USA.,Neuroscience Department, University of Rochester, Rochester, New York, USA
| | | | - Amit Lazarov
- Department of Psychiatry, Columbia University, New York, New York, USA.,School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Shay Arnon
- New York State Psychiatric Institute, New York, New York, USA
| | - Ari L Lowell
- Department of Psychiatry, Columbia University, New York, New York, USA.,New York State Psychiatric Institute, New York, New York, USA.,Memphis Veterans Administration Medical Center, Memphis, Tennessee, USA
| | - Maja Bergman
- New York State Psychiatric Institute, New York, New York, USA
| | - Matthew Ryba
- New York State Psychiatric Institute, New York, New York, USA
| | | | - Jane F Hamilton
- Rancho Bosque Equestrian Center of Excellence, House Hamilton Business Group, PLC, Tucson, Arizona, USA
| | - J Blake Turner
- Department of Psychiatry, Columbia University, New York, New York, USA.,New York State Psychiatric Institute, New York, New York, USA
| | - John C Markowitz
- Department of Psychiatry, Columbia University, New York, New York, USA.,New York State Psychiatric Institute, New York, New York, USA
| | - Prudence W Fisher
- Department of Psychiatry, Columbia University, New York, New York, USA.,New York State Psychiatric Institute, New York, New York, USA
| | - Yuval Neria
- Department of Psychiatry, Columbia University, New York, New York, USA.,New York State Psychiatric Institute, New York, New York, USA.,Department of Epidemiology, Columbia University Irving Medical Center, New York, New York, USA
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Marino L, Lilienfeld SO. Third time's the charm or three strikes you're out? An updated review of the efficacy of dolphin-assisted therapy for autism and developmental disabilities. J Clin Psychol 2021; 77:1265-1279. [PMID: 33482038 DOI: 10.1002/jclp.23110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 12/11/2020] [Accepted: 12/20/2020] [Indexed: 12/17/2022]
Abstract
CONTEXT Dolphin-assisted therapy (DAT) is a popular form of animal-assisted therapy for autism spectrum disorders and other psychological conditions. OBJECTIVE In this review, our third, we analyze the most recent DAT studies in terms of construct and internal validity criteria to determine if there is empirical support for DAT. METHOD To ensure a systematic review, we searched for peer-reviewed studies on DAT by submitting relevant search terms to Google Scholar from 2007 to 2020, conducted a further search of all DAT papers in several peer-reviewed journals, and reviewed reference sections of DAT articles to ensure a thorough review of the literature between 2007 and the present. RESULTS The DAT literature continues to be marked by several weaknesses in both internal and construct validity that preclude confident inferences regarding the intervention's efficacy. CONCLUSION There is still insufficient evidence that DAT has therapeutic value.
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Affiliation(s)
- Lori Marino
- Whale Sanctuary Project, Kimmela Center for Animal Advocacy, Kanab, Utah, USA
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15
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Stern C, Chur‐hansen A. An umbrella review of the evidence for equine‐assisted interventions. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.1111/ajpy.12246] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Cindy Stern
- The Joanna Briggs Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia,
| | - Anna Chur‐hansen
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia,
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16
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Kovács G, van Dijke A, Enders-Slegers MJ. Psychodynamic Based Equine-Assisted Psychotherapy in Adults with Intertwined Personality Problems and Traumatization: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165661. [PMID: 32764468 PMCID: PMC7460234 DOI: 10.3390/ijerph17165661] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/01/2020] [Accepted: 07/31/2020] [Indexed: 06/01/2023]
Abstract
The growing field of equine-assisted psychotherapy (EAP), a subfield of animal-assisted psychotherapy (AAP), needs theoretically-based clinical studies. This systematic review examines the existing clinical studies in adult populations on psychodynamic psychotherapy combined with equine-assisted psychotherapy. An electronic database search was divided in two studies to identify publications on 1) EAP combined with psychodynamic psychotherapy and 2) EAP combined to personality problems and traumatization in order to compile studies by population, intervention, outcome and therapeutic assets. Study 1 revealed no relevant clinical studies on EAP with a psychodynamic background with an adult population. Study 2 revealed 12 publications to review predominantly addressing veterans with PTSD. The methodological limitations of most of the studies restrain the overall findings on outcome. However, overall positive effects for EAP, specifically on its experiential features and on finding interpersonal trust for patients, can be discerned. There is an apparent need for clinical studies meeting methodological standards on psychodynamic underpinned EAP methodologies in adults with intertwined personality problems and traumatization.
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Affiliation(s)
- Géza Kovács
- Faculty of Psychology, Open University, Valkenburgerweg 177, 6419 AT Heerlen, The Netherlands;
- SPEL Psychologen Putten, Garderenseweg 158, 3881 NE Putten, The Netherlands
| | - Annemiek van Dijke
- Online poli’s I-psy psyQ Brijder, Parnassia Group, Schipholpoort 20, 2034 MA Haarlem, The Netherlands;
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Arnon S, Fisher PW, Pickover A, Lowell A, Turner JB, Hilburn A, Jacob-McVey J, Malajian BE, Farber DG, Hamilton JF, Hamilton A, Markowitz JC, Neria Y. Equine-Assisted Therapy for Veterans with PTSD: Manual Development and Preliminary Findings. Mil Med 2020; 185:e557-e564. [PMID: 32034416 PMCID: PMC7282489 DOI: 10.1093/milmed/usz444] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Equine-assisted therapy (EAT) for post-traumatic stress disorder (PTSD) has attracted great interest despite lacking empirical support, a manual, and a standardized protocol. Our team of experts in EAT and PTSD developed an eight-session group EAT treatment protocol for PTSD (EAT-PTSD) and administered it to two pilot groups of military veterans to assess initial effects. MATERIALS AND METHODS We describe the development of the treatment manual, which was used with two pilot groups of veterans. Protocol safety, feasibility, and acceptability were assessed by reported adverse events, treatment completion rates, and self-rated patient satisfaction. Preliminary data on PTSD, depressive, and anxiety symptoms and quality of life were collected pretreatment, midpoint, post-treatment, and at 3-month follow up. RESULTS No adverse events were recorded. All patients completed treatment, reporting high satisfaction. Preliminary data showed decreases in clinician-assessed PTSD and depressive symptoms from pre to post-treatment and follow-up (medium to large effect sizes, d = .54-1.8), with similar trends across self-report measures (d = 0.72-1.6). In our pilot sample, treatment response and remission varied; all patients showed some benefit post-treatment, but gains did not persist at follow-up. CONCLUSIONS This article presents the first standardized EAT protocol. Highly preliminary results suggest our new manualized group EAT-PTSD appears safe, well-regarded, and well-attended, yielding short-term benefits in symptomatology and quality of life if unclear length of effect. Future research should test this alternative treatment for PTSD more rigorously.
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Affiliation(s)
- Shay Arnon
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
| | - Prudence W Fisher
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032
| | - Alison Pickover
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032
| | - Ari Lowell
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032
| | - J Blake Turner
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032
| | - Anne Hilburn
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
| | - Jody Jacob-McVey
- Bergen Equestrian Center, 40 Fort Lee Road, Leonia, NJ 07605
- EquiSense Solutions LLC, 33 West 93rd Street, 3B, New York, NY 10025
| | | | - Debra G Farber
- Bergen Equestrian Center, 40 Fort Lee Road, Leonia, NJ 07605
| | - Jane F Hamilton
- Rancho Bosque Equestrian Center of Excellence, House Hamilton Business Group, PLC, 8649 E Woodland Road, Tucson, AZ 85749
| | - Allan Hamilton
- Department of Surgery, University of Arizona Health Sciences Center, 1501 N. Campbell Avenue, Tucson, AZ 85724
| | - John C Markowitz
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032
| | - Yuval Neria
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032
- Department of Epidemiology, Columbia University Irving Medical Center, 722 West 168th Street, New York, NY 10032
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18
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García-Gómez A, Guerrero-Barona E, García-Peña I, Rodríguez-Jiménez M, Moreno-Manso JM. Equine-assisted therapeutic activities and their influence on the heart rate variability: A systematic review. Complement Ther Clin Pract 2020; 39:101167. [PMID: 32379693 DOI: 10.1016/j.ctcp.2020.101167] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 03/27/2020] [Accepted: 03/31/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To examine the effect of equine-assisted therapeutic interventions on users' heart rate variability, using this said variability as an objective biological variable related to stress levels. METHOD A systematic review has been carried out using the methodology suggested in the PRISMA declaration following systematic searches in academic databases. RESULTS 432 registers were initially identified; however, in the screening and suitability process, nine papers were included in the review. With one exception, all of them reported that equine-assisted therapeutic activities had a favourable effect on users' heart rate variability as such activities favour a state of relaxation by activating the Parasympathetic Nervous System. The analysis of the quality of the evidence and the confirmation of the bias in the works indicate that these results must be considered with caution. DISCUSSION Although these preliminary results are promising, more rigorous clinical trials are necessary to overcome the methodological limitations of the works.
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Affiliation(s)
| | | | - Inés García-Peña
- Department of Psychology and Anthropology, University of Extremadura, Spain
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Pálsdóttir AM, Gudmundsson M, Grahn P. Equine-Assisted Intervention to Improve Perceived Value of Everyday Occupations and Quality of Life in People with Lifelong Neurological Disorders: A Prospective Controlled Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072431. [PMID: 32260047 PMCID: PMC7177295 DOI: 10.3390/ijerph17072431] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 03/29/2020] [Accepted: 03/31/2020] [Indexed: 12/03/2022]
Abstract
People with neurological disorders suffer from poor mobility, poor balance, fatigue, isolation and monotonous everyday activities. Studies show that equine-assisted interventions can improve their mobility and balance, but could these kinds of interventions also increase participants’ activity repertoire and self-assessed health, and reduce their fatigue? The study was conducted as a prospective, controlled study with three cohorts followed for one year: intervention group (n = 14), control group Passive (n = 29), and control group Active (n = 147). Participants in the study were affected by neurological disease or injury that limited their opportunities for an active everyday life. The intervention group lacked regular activities outside the home before the intervention, which consisted of riding once a week, led by a certified therapist. Control group Passive lacked regular activities outside the home, while control group Active had several activities outside the home per week. Primary outcome measures were activity repertoire measured with Occupational Value Assessment questionnaire. Secondary outcome measures were global self-assessed health measured with EuroQol-VAS and fatigue measured with Shirom-Melamed Burnout Questionnaire. The intervention group’s activity repertoire and self-assessed health increased significantly compared to both baseline and the control groups. Equine-assisted interventions could help to improve the perceived value of everyday occupations and quality of life, as well as break isolation and increase the activity repertoire of people with neurological disorders.
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Affiliation(s)
- Anna María Pálsdóttir
- The Department of Work Science, Business Economics and Environmental Psychology, Swedish University of Agricultural Sciences, P.O. Box 88, SE-230 53 Alnarp, Sweden;
- Correspondence: ; Tel.: +46-40-415-425; Fax: +46-40-415-010
| | - Marie Gudmundsson
- Nature and Health, Region Dalarna, P.O. Box 712, SE-791 29 Falun, Sweden;
| | - Patrik Grahn
- The Department of Work Science, Business Economics and Environmental Psychology, Swedish University of Agricultural Sciences, P.O. Box 88, SE-230 53 Alnarp, Sweden;
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20
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Gatti F, Walderhaug E, Kern-Godal A, Lysell J, Arnevik EA. Complementary horse-assisted therapy for substance use disorders: a randomized controlled trial. Addict Sci Clin Pract 2020; 15:7. [PMID: 32019584 PMCID: PMC7001193 DOI: 10.1186/s13722-020-0183-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 01/27/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Treatment completion is the greatest challenge for the treatment of substance use disorders (SUDs). A previous investigation showed that complementary horse-assisted therapy (cHAT) was associated with higher retention in treatment and completion than standard treatment alone. This randomized controlled trial further explored the benefits of cHAT for patients with SUDs. METHODS Fifty patients in residential SUD treatment at the Department of Addiction Treatment, Oslo University Hospital, were randomly allocated to either cHAT (cHAT group) or treatment as usual alone (TAU-only group). The primary end-point was treatment completion. Secondary end-points were dropout, transfer to another treatment, and time in treatment. RESULTS The multinomial logistic regression analysis found no statistically significant association between intervention (cHAT) and treatment outcome (completion, dropout, transferred) among the 37 participants who were ultimately recruited to the study. Some unforeseen challenges were encountered in the study: a high number of subjects transferred to another treatment, variable attendance at cHAT sessions, and long temporary exits. Nevertheless, 44% of participants in the cHAT group completed their treatment, compared with 32% in the TAU-only group; this observation encourages further investigation in a larger sample. CONCLUSIONS Though no association was identified between cHAT and treatment retention or completion, our study may have been underpowered. Further work in a larger clinical population is needed; observational studies with repeated measures may also be useful for investigating whether cHAT increases retention in treatment or rates of completion, two important factors for successful SUD treatment. Trial registration The trial was registered and approved on 14 October 2011 by the Regional Committee for Medical and Health Research Ethics with registration number 2011/1642 and registered at ClinicalTrials.gov on 21 February 2013 with registration number NCT01795755.
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Affiliation(s)
- Francesca Gatti
- Department of Addiction Treatment, Oslo University Hospital HF, P.O 4959, 0424, Nydalen, Oslo, Norway
| | - Espen Walderhaug
- Department of Addiction Treatment, Oslo University Hospital HF, P.O 4959, 0424, Nydalen, Oslo, Norway
| | - Ann Kern-Godal
- Department of Addiction Treatment, Oslo University Hospital HF, P.O 4959, 0424, Nydalen, Oslo, Norway
| | - Jeanette Lysell
- Department of Addiction Treatment, Oslo University Hospital HF, P.O 4959, 0424, Nydalen, Oslo, Norway
| | - Espen Ajo Arnevik
- Department of Addiction Treatment, Oslo University Hospital HF, P.O 4959, 0424, Nydalen, Oslo, Norway.
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21
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Sylvia L, West E, Blackburn AM, Gupta C, Bui E, Mahoney T, Duncan G, Wright EC, Lejeune S, Spencer TJ. Acceptability of an adjunct equine-assisted activities and therapies program for veterans with posttraumatic stress disorder and/or traumatic brain injury. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2020; 18:169-173. [PMID: 31996299 DOI: 10.1016/j.joim.2020.01.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 08/29/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Equine-assisted activities and therapies (EAATs) have been a growing adjunctive integrative health modality, as they allow participants to practice mindfulness, emotional regulation, and self-mastery or self-esteem building skills. Preliminary evidence suggests that these programs may be helpful in reducing posttraumatic stress disorder (PTSD), anxiety, and depressive symptoms. The current study examines the acceptability of integrating an EAAT program as part of a two-week, intensive clinical program for veterans with PTSD and/or traumatic brain injury (TBI). METHODS A family member or support person could accompany veterans and participate in the program. One hundred and six participants (veteran n = 62, family n = 44) left the urban environment in an intensive outpatient program (IOP) to attend a two-day, weekend EAAT in rural New Hampshire. Satisfaction surveys were conducted on the last day of the program and examined using thematic analysis. RESULTS The following themes were reported in the surveys: ability of horses to catalyze emotional rehabilitation, effectiveness of immersion in equine-assisted activities, program's ability to foster interpersonal relationships and necessity of education about PTSD for staff. Participants also reported enjoying the program as highlighted by qualitative feedback, a mean score of 9.76 (standard deviation [SD] = 0.61) as reported by veterans and a mean score of 9.91 (SD = 0.29) as reported by family members on a 10-point visual analog scale with higher scores indicating a greater overall experience. CONCLUSION These data offer preliminary evidence that an adjunct EAAT program is acceptable for veterans with PTSD and/or TBI participating in an IOP.
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Affiliation(s)
- Louisa Sylvia
- Home Base: A Red Sox Foundation and Massachusetts General Hospital Program, Massachusetts General Hospital, Charlestown, MA 02129, USA; Harvard Medical School, Boston, MA 02115, USA; Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, MA 02114, USA.
| | - Emerson West
- Home Base: A Red Sox Foundation and Massachusetts General Hospital Program, Massachusetts General Hospital, Charlestown, MA 02129, USA
| | - Allyson M Blackburn
- Home Base: A Red Sox Foundation and Massachusetts General Hospital Program, Massachusetts General Hospital, Charlestown, MA 02129, USA
| | - Carina Gupta
- Home Base: A Red Sox Foundation and Massachusetts General Hospital Program, Massachusetts General Hospital, Charlestown, MA 02129, USA
| | - Eric Bui
- Home Base: A Red Sox Foundation and Massachusetts General Hospital Program, Massachusetts General Hospital, Charlestown, MA 02129, USA; Harvard Medical School, Boston, MA 02115, USA
| | | | | | - Edward C Wright
- Home Base: A Red Sox Foundation and Massachusetts General Hospital Program, Massachusetts General Hospital, Charlestown, MA 02129, USA; Harvard Medical School, Boston, MA 02115, USA
| | - Simon Lejeune
- Home Base: A Red Sox Foundation and Massachusetts General Hospital Program, Massachusetts General Hospital, Charlestown, MA 02129, USA; Harvard Medical School, Boston, MA 02115, USA
| | - Thomas J Spencer
- Home Base: A Red Sox Foundation and Massachusetts General Hospital Program, Massachusetts General Hospital, Charlestown, MA 02129, USA; Harvard Medical School, Boston, MA 02115, USA; Pediatric Psychopharmacology and Adult ADHD Program, Massachusetts General Hospital, Boston, MA 02114, USA
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22
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Whitworth JD, Scotland-Coogan D, Wharton T. Service dog training programs for veterans with PTSD: results of a pilot controlled study. SOCIAL WORK IN HEALTH CARE 2019; 58:412-430. [PMID: 30875483 DOI: 10.1080/00981389.2019.1580238] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 01/25/2019] [Accepted: 02/01/2019] [Indexed: 06/09/2023]
Abstract
Service dog programs are increasingly being explored as complementary or alternative interventions for military veterans with posttraumatic stress disorder (PTSD). This paper details the results of a control group, pre-and-post pilot investigation evaluating the use of a 14-week service dog training program for veterans in central Florida. Thirty veterans diagnosed with PTSD, 15 in the intervention group and 15 in the waitlist controlled group, completed all pretests and posttests measures, consisting of the 136-item Trauma Symptom Inventory-2 and the 36-item World Health Organization-Disability Assessment Schedule 2.0. Compared to demographically similar veterans in the control group, participants who completed the service dog training program demonstrated significant decreases in posttraumatic symptomatology, intra/interpersonal difficulties associated with psychological trauma, and in disabilities secondary to their PTSD. Study findings, in combination with results from two other recently published controlled investigations, provide evidence supporting the endorsement and use of service dog programs as helpful complementary or alternative treatment options for some veterans. Social work practitioners may want to consider referring their veteran clients with PTSD to qualified service dog programs for adjunctive support when they are having difficulty engaging with or benefiting from office-based traditional therapy approaches.
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Affiliation(s)
- James D Whitworth
- a School of Social Work, College of Health Professions and Science , University of Central Florida , Orlando , Florida , USA
| | - Diane Scotland-Coogan
- b School of Education and Social Services , University Campus-MC 2067 , Saint Leo , Florida , USA
| | - Tracy Wharton
- a School of Social Work, College of Health Professions and Science , University of Central Florida , Orlando , Florida , USA
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Jones MG, Rice SM, Cotton SM. Incorporating animal-assisted therapy in mental health treatments for adolescents: A systematic review of canine assisted psychotherapy. PLoS One 2019; 14:e0210761. [PMID: 30653587 PMCID: PMC6336278 DOI: 10.1371/journal.pone.0210761] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 01/01/2019] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION As interest in Animal-Assisted Interventions (AAI) grows, there is increasing need to differentiate informal activities from formal and professionally directed therapies, including mental health focussed Canine-Assisted Psychotherapy (CAP). There have been no reviews focusing exclusively on CAP and the distinct developmental period of adolescence. The aims of this study were to identify the characteristics of CAP interventions, their impacts and their acceptability, tolerability and feasibility for adolescents with mental health disorders. METHOD A systematic review identified studies incorporating canines into mental health treatments for adolescents aged 10-19 years. Studies reporting qualitative or quantitative psychological or psychosocial outcomes were included. RESULTS Seven studies were scrutinised. Intervention characteristics varied, including a range of formats, settings, locations, doses, and facilitators. Information on the role of the canines in sessions was sparse. CAP had a positive impact on primary diagnoses and symptomatology, conferring additional benefits to standard treatments for internalising disorders, post-traumatic stress disorder, and equivalent effects for anxiety, anger and externalising disorders. CAP was associated with positive impacts on secondary factors including increased engagement and socialisation behaviours, and reductions in disruptive behaviours within treatment sessions. Global functioning also improved. There was insufficient evidence that CAP improved factors associated with self-esteem, subjective wellbeing, or coping. Good attendance and retention rates indicated high levels of acceptability. Moderate to high tolerability was also indicated. Feasibility may be limited by additional training and logistical requirements. RECOMMENDATIONS We recommend the development of theoretically informed, standardised (manualised) intervention protocols that may subsequently form the basis of efficacy and effectiveness testing. Such protocols should clearly describe canine-participant-facilitator interactions via a formalised nomenclature; spontaneous (animal-led), adjunctive (facilitator-led), and experiential (participant-led). CONCLUSIONS There is emerging evidence to suggest that CAP improves the efficacy of mental health treatments in self-selected adolescent populations via reductions in primary symptomatology, and via secondary factors that improve therapeutic processes and quality, such as engagement and retention.
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Affiliation(s)
- Melanie G. Jones
- Orygen The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia
- The University of Melbourne, Parkville, Victoria, Australia
- Lead The Way Institute, Boronia, Victoria, Australia
| | - Simon M. Rice
- Orygen The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia
- The University of Melbourne, Parkville, Victoria, Australia
| | - Susan M. Cotton
- Orygen The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia
- The University of Melbourne, Parkville, Victoria, Australia
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Pan Z, Granger DA, Guérin NA, Shoffner A, Gabriels RL. Replication Pilot Trial of Therapeutic Horseback Riding and Cortisol Collection With Children on the Autism Spectrum. Front Vet Sci 2019; 5:312. [PMID: 30693284 PMCID: PMC6339889 DOI: 10.3389/fvets.2018.00312] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 11/26/2018] [Indexed: 12/28/2022] Open
Abstract
We aimed to determine whether results of our prior randomized control trial [RCT; NCT02301195, (1)] of Therapeutic Horseback Riding (THR) for children and adolescents with autism spectrum disorder (ASD) could be replicated at a different riding center and if treatment effects also included differences in the expression of associations between problem behavior and the activity of the hypothalamic-pituitary-adrenal (HPA) axis. Participants with ASD (N = 16) ages 6-16 years were randomized by nonverbal intelligence quotient to either a 10-week THR group (n = 8) or no horse interaction barn activity (BA) control group (n = 8). Outcome measures were a standard speech-language sample and caregiver-report of aberrant and social behaviors. Participants' saliva was sampled weekly at a consistent afternoon time immediately pre- and 20 min' post-condition (later assayed for cortisol). Intent-to-treat analysis revealed that compared to controls, THR participants had significant improvements in hyperactivity, and social awareness, and significant improvements at the 0.1 significance level in irritability and social communication behaviors. There were no significant improvements in number of words or new words spoken during the standard language sample. Linear mixed effects model analysis indicated that greater weekly pre-lesson irritability levels were associated with smaller post-lesson reduction in salivary cortisol levels, and greater weekly pre-lesson hyperactivity levels were associated with smaller cortisol reduction in the THR group, but not in the BA control group. The findings represent a partial replication of prior results (1), extend prior observations to include THR effects on biobehavioral relationships and suggest that cortisol could be a target mediator for THR effects on irritability and hyperactivity behaviors in youth with ASD. Clinical Trial Registration: Trial of Therapeutic Horseback Riding in Children and Adolescents with Autism Spectrum Disorder; http://clinicaltrials.gov, identifier: NCT02301195.
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Affiliation(s)
- Zhaoxing Pan
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- Children's Hospital Colorado, Aurora, CO, United States
| | - Douglas A. Granger
- Institute for Interdisciplinary Salivary Bioscience Research, University of California, Irvine, Irvine, CA, United States
- Bloomberg School of Public Health and School of Nursing, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Noémie A. Guérin
- Center for the Human-Animal Bond of Purdue, College of Veterinary Medicine, Purdue University, West Lafayette, IN, United States
| | - Amy Shoffner
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Robin L. Gabriels
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- Children's Hospital Colorado, Aurora, CO, United States
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Hartwig EK, Binfet JT. What is important in canine-assisted intervention teams? An investigation of canine-assisted intervention program online screening tools. J Vet Behav 2019. [DOI: 10.1016/j.jveb.2018.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Trzmiel T, Purandare B, Michalak M, Zasadzka E, Pawlaczyk M. Equine assisted activities and therapies in children with autism spectrum disorder: A systematic review and a meta-analysis. Complement Ther Med 2018; 42:104-113. [PMID: 30670226 DOI: 10.1016/j.ctim.2018.11.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 11/01/2018] [Accepted: 11/02/2018] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION The multifactorial nature of Autism Spectrum Disorder (ASD) is the reason why complementary and alternative methods of treatment are sought in order to support the classic approach. OBJECTIVES The aim of the study was to assess the effectiveness of Equine-Assisted Activities and Therapies (EAAT) in ASD patients based on a review of the literature. METHODS A review of the literature and a meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PUBMED, Cochrane Library, Web of Science, ClinicalTrials.gov and PEDro databases were searched until July 20, 2017. Only articles published in English, in a journal with a review process, after 1999, with a control group or presentation of comparative pre-/post-therapy results in ASD patients, and clear inclusion/exclusion criteria were considered. The methodological quality of the included studies was assessed using the Quality Assessment Tool for Quantitative Studies (QATQS).The meta-analysis of three studies was conducted. RESULTS A total of 15 studies with 390 participants (aged: 3-16 years) were included. The interaction between psychosocial functioning and EAAT was investigated in most studies. Improvement was reported in the following domains: socialization, engagement, maladaptive behaviors, and shorter reaction time in problem-solving situations after EAAT. The meta-analysis revealed no statistically significant differences for the investigated effects. CONCLUSIONS Despite the need for further, more standardized research, the results of the studies included in this review allow us to conclude that EAAT may be a useful form of therapy in children with ASD.
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Affiliation(s)
- Tomasz Trzmiel
- Department of Geriatric Medicine and Gerontology, Poznan University of Medical Sciences, Poland.
| | - Barbara Purandare
- Department of Geriatric Medicine and Gerontology, Poznan University of Medical Sciences, Poland
| | - Michał Michalak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poland
| | - Ewa Zasadzka
- Department of Geriatric Medicine and Gerontology, Poznan University of Medical Sciences, Poland
| | - Mariola Pawlaczyk
- Department of Geriatric Medicine and Gerontology, Poznan University of Medical Sciences, Poland
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Schroeder K, Stroud D, Sherwood DM, Udell MAR. Therapeutic Factors in Equine-Facilitated Group Psychotherapy for Women Survivors of Interpersonal Violence. JOURNAL FOR SPECIALISTS IN GROUP WORK 2018. [DOI: 10.1080/01933922.2018.1516707] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Jormfeldt H, Carlsson IM. Equine-Assisted Therapeutic Interventions Among Individuals Diagnosed With Schizophrenia. A Systematic Review. Issues Ment Health Nurs 2018; 39:647-656. [PMID: 29509053 DOI: 10.1080/01612840.2018.1440450] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Persons diagnosed with schizophrenia are not sufficiently offered health promotion interventions, notwithstanding their increased risk of bodily ill health. Physical activity is found to improve health and decrease psychiatric symptoms although, there is a challenge to motivate and increase physical activity in people with schizophrenia and innovative evidence-based treatment interventions are needed. The aim was to systematically review studies concerning equine assisted interventions among individuals diagnosed with schizophrenia. The findings of the six included articles indicate that therapeutic equine assisted interventions could be beneficial for individuals with severe mental illness such as schizophrenia or schizophrenia like disorders.
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Affiliation(s)
- Henrika Jormfeldt
- a School of Health and welfare , Halmstad University , Halmstad , Sweden
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29
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Voelpel P, Escallier L, Fullerton J, Abitbol L. Interaction Between Veterans and Horses: Perceptions of Benefits. J Psychosoc Nurs Ment Health Serv 2018. [DOI: 10.3928/02793695-20180305-05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
| | - Lori Escallier
- State University of New York, Downstate Medical Center, College of Nursing Brooklyn, New York
| | - Judith Fullerton
- University of California San Diego, School of Medicine, San Diego, California
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Benefits of Hippotherapy and Horse Riding Simulation Exercise on Healthy Older Adults: A Systematic Review. PM R 2018; 10:1062-1072. [PMID: 29626616 DOI: 10.1016/j.pmrj.2018.03.019] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 03/12/2018] [Accepted: 03/18/2018] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To provide an up-to-date research analysis on equine-assisted therapies and horse riding simulation exercise in older adults, and to suggest future directions in clinical practice and research. TYPE: Systematic review. LITERATURE SURVEY A comprehensive search of studies was performed in 4 electronic databases (Cochrane, PubMed, PEDro, and Web of Science) regarding the effects of equine-assisted therapies and horse riding simulation exercise in older adults. Eight articles were selected, 5 of them focused on hippotherapy, 2 on horse riding simulation, and a single article that used the 2 types of therapy. METHODOLOGY PRISMA guidelines were followed for the data extraction process. SYNTHESIS The studies were all randomized controlled trials, but not double-blind, so they were classified as level of evidence B. Duration of hippotherapy programs ranged from 8-12 weeks. Sessions lasted between 15 and 60 minutes and were performed 2-5 times per week. Interventions using a horse simulator spanned 8 weeks and were conducted for 20 minutes 5 times per week. CONCLUSIONS Results indicate that hippotherapy might improve balance, mobility, gait ability, and muscle strength, as well as could induce hormonal and cerebral activity changes in healthy older adults. Benefits of horse riding simulation could be limited to physical fitness and muscular activity. LEVEL OF EVIDENCE I.
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O'Haire ME, Rodriguez KE. Preliminary efficacy of service dogs as a complementary treatment for posttraumatic stress disorder in military members and veterans. J Consult Clin Psychol 2018; 86:179-188. [PMID: 29369663 PMCID: PMC5788288 DOI: 10.1037/ccp0000267] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Psychiatric service dogs are an emerging complementary treatment for military members and veterans with posttraumatic stress disorder (PTSD). Yet despite anecdotal accounts of their value, there is a lack of empirical research on their efficacy. The current proof-of-concept study assessed the effects of this practice. METHOD A nonrandomized efficacy trial was conducted with 141 post-9/11 military members and veterans with PTSD to compare usual care alone (n = 66) with usual care plus a trained service dog (n = 75). The primary outcome was longitudinal change on The PTSD Checklist (PCL; Weathers, Litz, Herman, Huska, & Keane, 1993), including data points from a cross-sectional assessment and a longitudinal record review. Secondary outcomes included cross-sectional differences in depression, quality of life, and social and work functioning. RESULTS Mixed-model analyses revealed clinically significant reductions in PTSD symptoms from baseline following the receipt of a service dog, but not while receiving usual care alone. Though clinically meaningful, average reductions were not below the diagnostic cutoff on the PCL. Regression analyses revealed significant differences with medium to large effect sizes among those with service dogs compared with those on the waitlist, including lower depression, higher quality of life, and higher social functioning. There were no differences in employment status, but there was lower absenteeism because of health among those who were employed. CONCLUSION The addition of trained service dogs to usual care may confer clinically meaningful improvements in PTSD symptomology for military members and veterans with PTSD, though it does not appear to be associated with a loss of diagnosis. (PsycINFO Database Record
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Affiliation(s)
- Marguerite E O'Haire
- Center for the Human-Animal Bond, Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University
| | - Kerri E Rodriguez
- Center for the Human-Animal Bond, Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University
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Crossman MK, Kazdin AE. Perceptions of animal-assisted interventions: The influence of attitudes toward companion animals. J Clin Psychol 2017; 74:566-578. [PMID: 29023782 DOI: 10.1002/jclp.22548] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 07/02/2017] [Accepted: 09/01/2017] [Indexed: 11/07/2022]
Abstract
OBJECTIVE We tested whether people are prone toward positive perceptions of Animal-Assisted Interventions (AAIs). We additionally evaluated whether this effect is stronger for people who have positive attitudes toward companion animals. METHOD We presented 210 participants with fictitious news reports, each describing a study of an AAI or a control intervention. Participants rated the news reports on their credibility, acceptability, and general appeal and completed a measure of attitudes toward companion animals. RESULTS Individuals with positive attitudes toward companion animals evaluated AAIs as more credible, acceptable, and positive than did individuals with negative attitudes toward companion animals. There was no difference in how people with positive and negative attitudes toward companion animals evaluated control treatments. CONCLUSION We found that individuals with positive attitudes toward companion animals perceived AAIs as more credible, acceptable, and positive, relative to individuals with more negative attitudes toward companion animals.
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De Santis M, Contalbrigo L, Borgi M, Cirulli F, Luzi F, Redaelli V, Stefani A, Toson M, Odore R, Vercelli C, Valle E, Farina L. Equine Assisted Interventions (EAIs): Methodological Considerations for Stress Assessment in Horses. Vet Sci 2017; 4:E44. [PMID: 29056702 PMCID: PMC5644660 DOI: 10.3390/vetsci4030044] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 08/30/2017] [Accepted: 09/05/2017] [Indexed: 11/23/2022] Open
Abstract
Equine assisted interventions (EAIs) are recently facing an increasing popularity, and are characterized by a wide diversity of practices. However, information on the welfare of animals involved in this kind of activity is often lacking. Horses are highly susceptible to work stressors related to physical constraints and/or to the need to control emotions while interacting with humans. Considerations of the emotional state of horses involved in EAIs have multiple valences: for the safety of humans and animals involved, for the quality and efficacy of interventions, as well as for ethical reasons. The aim of this unsystematic narrative review is to summarize the different approaches used for the evaluation of horses' stress responses, investigate their application in the context of EAIs, and discuss some methodological considerations for researchers and practitioners involved in EAI. The sources of information are mostly based on electronic databases (i.e., Medline, Scopus and Google scholar), as well as on hand searches of the references of retrieved literature, and discussions with experts in the field. At present, a few studies have investigated horses' stress responses during EAIs, and further studies are recommended, with the final aim to derive a reliable multidimensional method for assessing a horse's reaction during therapeutic programs, ultimately helping professionals to better develop interventions by taking into consideration the animal's perspective.
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Affiliation(s)
- Marta De Santis
- Italian National Reference Centre for Animal Assisted Interventions, Istituto Zooprofilattico Sperimentale delle Venezie, 35020 Legnaro, Italy.
| | - Laura Contalbrigo
- Italian National Reference Centre for Animal Assisted Interventions, Istituto Zooprofilattico Sperimentale delle Venezie, 35020 Legnaro, Italy.
| | - Marta Borgi
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, 00161 Rome, Italy.
| | - Francesca Cirulli
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, 00161 Rome, Italy.
| | - Fabio Luzi
- Department of Veterinary Medicine, University of Milan, 20133 Milan, Italy.
| | - Veronica Redaelli
- Department of Veterinary Medicine, University of Milan, 20133 Milan, Italy.
| | - Annalisa Stefani
- Istituto Zooprofilattico Sperimentale delle Venezie, 35020 Legnaro, Italy.
| | - Marica Toson
- Istituto Zooprofilattico Sperimentale delle Venezie, 35020 Legnaro, Italy.
| | - Rosangela Odore
- Department of Veterinary Science, University of Turin, 10095 Grugliasco, Italy.
| | - Cristina Vercelli
- Department of Veterinary Science, University of Turin, 10095 Grugliasco, Italy.
| | - Emanuela Valle
- Department of Veterinary Science, University of Turin, 10095 Grugliasco, Italy.
| | - Luca Farina
- Italian National Reference Centre for Animal Assisted Interventions, Istituto Zooprofilattico Sperimentale delle Venezie, 35020 Legnaro, Italy.
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McNamara J. Equine Facilitated Therapy for Children and Adolescents: A Qualitative Pilot Study. JOURNAL OF CREATIVITY IN MENTAL HEALTH 2017. [DOI: 10.1080/15401383.2017.1340215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kazdin AE. Strategies to improve the evidence base of animal-assisted interventions. APPLIED DEVELOPMENTAL SCIENCE 2017. [DOI: 10.1080/10888691.2016.1191952] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Serpell J, McCune S, Gee N, Griffin JA. Current challenges to research on animal-assisted interventions. APPLIED DEVELOPMENTAL SCIENCE 2017. [DOI: 10.1080/10888691.2016.1262775] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | | | | | - James A. Griffin
- The National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development
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Carlsson C. Triads in Equine-Assisted Social Work Enhance Therapeutic Relationships with Self-Harming Adolescents. CLINICAL SOCIAL WORK JOURNAL 2016; 45:320-331. [PMID: 29187767 PMCID: PMC5684297 DOI: 10.1007/s10615-016-0613-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Despite an increasing number of studies, there is still a lack of knowledge about the unique features that underlie the process in equine assisted social work (EASW). This study aimed to reveal, through qualitative methods, the dyads within the triad that become stronger during the process of EASW, as well as the effect of the participation of the horse on the relationship between the counselor and client. Data were collected through in-depth interviews with nine female self-harming clients aged 15-21 years and eight staff members. The interviews, together with video-recorded human-horse interactions with three staff members and four clients were analyzed, resulting in additional issues answered by these three staff members and four clients in a second interview. Critical dialogues between patterns and fragmentations in the narratives and video-recordings, as well as a dialogue with the participants while they were viewing videos of their own EASW sessions, led to the conclusion that adding a horse qualitatively changes therapeutic relationships in EASW. The different triads consist of different liaisons between actors in the triad, giving rise to unique combinations. The quality of the relationships depends on both the staff and the clients' attachment orientations. Further research is needed to investigate how the degree of emotional connection to the horse affects the impact that horses have on triads in EASW.
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Crossman MK. Effects of Interactions With Animals On Human Psychological Distress. J Clin Psychol 2016; 73:761-784. [PMID: 27809353 DOI: 10.1002/jclp.22410] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 08/22/2016] [Accepted: 09/29/2016] [Indexed: 01/04/2023]
Abstract
CONTEXT Human-animal interaction (HAI) is widely used as a method of reducing psychological distress. However, research findings in support of HAI have not kept pace with the widespread prevalence in practice. OBJECTIVE I review and synthesize the quantitative evidence for the influence of HAI on psychological distress and outline future directions for research. RESULTS The evidence suggests that HAI has a small-to-medium effect on distress but does not clarify whether animals account for the treatment effects. Research also has not determined whether positive effects observed in circumscribed HAI programs extend to companion animal ownership. CONCLUSION HAI research needs to address methodological limitations and expand the focus beyond treatment outcome studies. By increasing our understanding of the processes through which HAI reduces distress, the circumstances under which it is most effective at doing so, and the influence HAI has on the animals, we can enhance the impact of HAI.
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Kern-Godal A, Brenna IH, Arnevik EA, Ravndal E. More Than Just a Break from Treatment: How Substance Use Disorder Patients Experience the Stable Environment in Horse-Assisted Therapy. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2016; 10:99-108. [PMID: 27746677 PMCID: PMC5054942 DOI: 10.4137/sart.s40475] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 08/29/2016] [Accepted: 09/04/2016] [Indexed: 11/06/2022]
Abstract
Inclusion of horse-assisted therapy (HAT) in substance use disorder (SUD) treatment is rarely reported. Our previous studies show improved treatment retention and the importance of the patient–horse relationship. This qualitative study used thematic analysis, within a social constructionist framework, to explore how eight patients experienced contextual aspects of HAT’s contribution to their SUD treatment. Participants described HAT as a “break from usual treatment”. However, four interrelated aspects of this experience, namely “change of focus”, “activity”, “identity”, and “motivation,” suggest HAT is more than just a break from usual SUD treatment. The stable environment is portrayed as a context where participants could construct a positive self: one which is useful, responsible, and accepted; more fundamentally, a different self from the “patient/self” receiving treatment for a problem. The implications extend well beyond animal-assisted or other adjunct therapies. Their relevance to broader SUD policy and treatment practices warrants further study.
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Affiliation(s)
- Ann Kern-Godal
- Department of Addiction Treatment, Oslo University Hospital, Oslo, Norway.; Norwegian Centre for Addiction Research (SERAF), University of Oslo, Oslo, Norway
| | | | - Espen Ajo Arnevik
- Department of Addiction Treatment, Oslo University Hospital, Oslo, Norway.; Department of Psychology, University of Oslo, Oslo, Norway
| | - Edle Ravndal
- Norwegian Centre for Addiction Research (SERAF), University of Oslo, Oslo, Norway
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Additional Evidence is Needed to Recommend Acquiring a Dog to Families of Children with Autism Spectrum Disorder: A Response to Wright and Colleagues. J Autism Dev Disord 2016; 46:332-335. [PMID: 26231204 DOI: 10.1007/s10803-015-2542-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Caregivers of children with autism spectrum disorder are vulnerable to overstated benefits of interventions, and such overstatements are common with interventions involving animals. This response to Wright, Hall, Hames, Hardmin, Mills, the Paws Team, and Mills' (2015) article, "Acquiring a Pet Dog Significantly Reduces Stress of Primary Careers for Children with Autism Spectrum Disorder: A Prospective Case Control Study," details why that study's conclusions are premature. Specific limitations of the study are detailed, including overstatements of the supportive literature, problems with the design, and mismatch between the findings and conclusions. The purpose is not to challenge the benefits of pet ownership, but to point out that those benefits have not yet been established.
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Gibbons JL, Cunningham CA, Paiz L, Poelker KE, Chajón A. ‘Now, he will be the leader of the house’: An equine intervention with at-risk Guatemalan youth. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2016. [DOI: 10.1080/02673843.2016.1202844] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Judith L. Gibbons
- Department of Psychology, Saint Louis University, St. Louis, MO, USA
| | | | - Leslie Paiz
- Lead-Up International, Jocotenango, Guatemala
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Kern-Godal A, Brenna IH, Kogstad N, Arnevik EA, Ravndal E. Contribution of the patient-horse relationship to substance use disorder treatment: Patients' experiences. Int J Qual Stud Health Well-being 2016; 11:31636. [PMID: 27291162 PMCID: PMC4904069 DOI: 10.3402/qhw.v11.31636] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/18/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND A good therapeutic relationship is a strong predictor of successful treatment in addiction and other psychological illness. Recent studies of horse-assisted therapy (HAT) have drawn attention to the importance of the client's relationship to the horse in psychotherapy. Few have reported on the patient's own perspective and none have reported specifically on the human-horse relationship in substance use disorder (SUD) treatment and its implications for health and well-being. AIM This article explores SUD patients' own experience of their relationship with the horse and their perceptions of its contribution to their therapy. METHODS As part of a large mixed-method study of HAT in SUD treatment, we used semi-structured interviews of eight patients to gather information about their experiences of HAT. From the data obtained, the relationship with the horse was found to be a significant part of participants' HAT experience. It is therefore the subject of the current phenomenological study, in which thematic analysis was used to investigate how the participants constructed the reality of their relationship with the horse(s) and their perceptions of the consequences of that reality in SUD treatment. RESULTS Participants' own descriptions suggest that the horses were facilitators of a positive self-construct and provided important emotional support during treatment. Analysis found relationship with the horse, emotional effect, and mastery to be important and interrelated themes. The findings were interpreted within an attachment theory context. CONCLUSION The results appear to be consistent with key addiction treatment theories and with findings in HAT theoretical and empirical studies. They add to our understanding of the impact of HAT on SUD treatment. However, further research is needed into both the construct validity of the patient-horse therapeutic relationship and the possible variance within and between different populations.
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Affiliation(s)
- Ann Kern-Godal
- Department of Addiction Treatment, Oslo University Hospital, Oslo, Norway.,Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway;
| | - Ida H Brenna
- Department of Addiction Treatment, Oslo University Hospital, Oslo, Norway
| | - Norunn Kogstad
- Reinsvoll Psychiatric Hospital, Sykehuset Innlandet, Reinsvoll, Norway
| | - Espen A Arnevik
- Department of Addiction Treatment, Oslo University Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Edle Ravndal
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
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Signal T, Taylor N, Prentice K, McDade M, Burke KJ. Going to the dogs: A quasi-experimental assessment of animal assisted therapy for children who have experienced abuse. APPLIED DEVELOPMENTAL SCIENCE 2016. [DOI: 10.1080/10888691.2016.1165098] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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45
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Hoagwood KE, Acri M, Morrissey M, Peth-Pierce R. Animal-Assisted Therapies for Youth with or at risk for Mental Health Problems: A Systematic Review. APPLIED DEVELOPMENTAL SCIENCE 2016; 21:1-13. [PMID: 28798541 DOI: 10.1080/10888691.2015.1134267] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
To systematically review experimental evidence about animal-assisted therapies (AAT) for children or adolescents with or at risk for mental health conditions, we reviewed all experimental AAT studies published between 2000-2015, and compared studies by animal type, intervention, and outcomes. METHODS Studies were included if used therapeutically for children and adolescents (≤21 years) with or at risk for a mental health problem; used random assignment or a waitlist comparison/control group; and included child-specific outcome data. Of 1,535 studies, 24 met inclusion criteria. RESULTS Of 24 studies identified, almost half were randomized controlled trials, with 9 of 11 published in the past two years. The largest group addresses equine therapies for autism. CONCLUSION Findings are generally promising for positive effects associated with equine therapies for autism and canine therapies for childhood trauma. The AAT research base is slim; a more focused research agenda is outlined.
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Affiliation(s)
- Kimberly Eaton Hoagwood
- New York University, Child Study Center, Department of Child and Adolescent Psychiatry, New York University School of Medicine. One Park Avenue, 7th Floor, New York, NY 10016
| | - Mary Acri
- New York University, Child Study Center, Department of Child and Adolescent Psychiatry, New York University School of Medicine. One Park Avenue, 7th Floor, New York, NY 10016
| | - Meghan Morrissey
- New York University, Child Study Center, Department of Child and Adolescent Psychiatry, New York University School of Medicine. One Park Avenue, 7th Floor, New York, NY 10016
| | - Robin Peth-Pierce
- Public Health Communications Consulting, LLC, 900 Mission Hills Lane, Columbus, OH 43235
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Rigby BR, Grandjean PW. The Efficacy of Equine-Assisted Activities and Therapies on Improving Physical Function. J Altern Complement Med 2016; 22:9-24. [DOI: 10.1089/acm.2015.0171] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- B. Rhett Rigby
- Department of Kinesiology, Texas Woman's University, Denton, TX
| | - Peter W. Grandjean
- Baylor Laboratories for Exercise Science & Technology, Department of Health, Human Performance, and Recreation, Baylor University, Waco, TX
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Kern-Godal A, Arnevik EA, Walderhaug E, Ravndal E. Substance use disorder treatment retention and completion: a prospective study of horse-assisted therapy (HAT) for young adults. Addict Sci Clin Pract 2015; 10:21. [PMID: 26466788 PMCID: PMC4672500 DOI: 10.1186/s13722-015-0043-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 10/01/2015] [Indexed: 11/10/2022] Open
Abstract
Background Keeping substance use disorder patients actively engaged in treatment is a challenge. Horse-assisted therapy (HAT) is increasingly used as a complementary therapy, with claimed motivational and other benefits to physical and psychological health. This naturalistic study aimed to assess HAT’s impact on the duration and completion of treatment for young substance users at Oslo University Hospital. Methods Discharge and other data were derived from the Youth Addiction Treatment Evaluation Project (YATEP) database for patients (n = 108) admitted during an 18-month period. An intention-to-treat design, and univariate and multivariate analyses were used to compare those receiving treatment as usual (n = 43) with
those who received treatment as usual plus HAT (n = 65). Results Despite a lack of randomization, the baseline characteristics of the two groups were similar. However, more HAT participants completed treatment (56.9 vs 14 %, p < 0.001), remained in treatment for longer (mean 141 vs 70 days, p < 0.001) and had a significantly higher chance of completing their treatment than those not given the HAT program. Excluding time in treatment, and after controlling for the potentially confounding influence of age, sex, education, number and severity of substances used, psychological distress and number of temporary exits, the adjusted odds ratio for treatment completion was 8.4 in the HAT group compared with those not participating in HAT (95 % CI 2.7–26.4, p < 0.001). Conclusion The study found a statistically significant association between HAT participation and time in treatment, and between HAT participation and completion of treatment. This association does not infer causality. However, it adds supporting evidence for the development of an innovative therapy, and warrants investment in further research in relation to its inclusion in substance use disorder treatment.
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Affiliation(s)
- Ann Kern-Godal
- Department of Addiction Treatment, Oslo University Hospital, Sognsvannsveien 21, Building 22, 0424, Oslo, Norway.
| | - Espen Ajo Arnevik
- Department of Addiction Treatment, Oslo University Hospital, Sognsvannsveien 21, Building 22, 0424, Oslo, Norway. .,Department of Psychology, University of Oslo, Oslo, Norway.
| | - Espen Walderhaug
- Department of Addiction Treatment, Oslo University Hospital, Sognsvannsveien 21, Building 22, 0424, Oslo, Norway.
| | - Edle Ravndal
- Norwegian Centre for Addiction Research (SERAF), University of Oslo, Oslo, Norway.
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Schroeder K, Stroud D. Equine-Facilitated Group Work for Women Survivors of Interpersonal Violence. JOURNAL FOR SPECIALISTS IN GROUP WORK 2015. [DOI: 10.1080/01933922.2015.1082684] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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