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Healthcare (Basel, Switzerland)2025; 13(23); 3111; doi: 10.3390/healthcare13233111

A Pilot Observational Study in Ohio, USA of the Healing of Our Veterans Equine Services Intensive Intervention for Veterans with Trauma Histories.

Abstract: : Equine-assisted services are being increasingly utilized as complementary interventions for military veterans who have experienced trauma. However, rigorous research is lacking, and randomized controlled trials are needed. The H.O.O.V.E.S. Intensive intervention was developed for this population. This intensive program is an equine-assisted learning approach developed for veteran and active-duty military trauma survivors. The program integrates equine-assisted learning, peer mentorship and experiential learning in a residential retreat format. The primary aim of this pilot study was to determine if more rigorous studies of this intervention are warranted. Secondary aims were to assess preliminary outcomes and explore possible relationships between changes in outcome measures. : This was a pilot prospective study. Inclusion criteria for the program included veteran or active-duty military status and a history of trauma exposure. Data were collected from April-October of 2024 in Ohio, USA. Six psychological instruments were administered to participants before, immediately after and 90 days and 120 days after the intervention. These were the PTSD Checklist for DSM-5 (PCL-5), the Acceptance and Action Questionnaire II (AAQII), the Positive and Negative Affect Scale (PANAS), the State-Trait Anxiety Inventory (STAI), the Beck Depression Inventory (BDI) and the Posttraumatic Growth Inventory (PTGI). Analyses were conducted to assess for significant changes across the study timeframe and for relationships among the changes in psychological instrument scores. : Study participants were 32 veterans with trauma histories ranging in age from 30 to 67 years old. There were statistically significant pre- to post-intervention improvements for all instruments except the PTGI, suggesting short-term increased psychological flexibility (AAQII) and positive affect (PANAS-positive) as well as decreased anxiety (STAI), negative affect (PANAS-negative), depression (BDI) and PTSD symptoms (PCL-5). Changes in BDI and PCL-5 scores persisted at 120 days post-intervention whereas changes in the AAQII, PANAS and STAI did not persist. Increased psychological flexibility was correlated with reductions in negative affect, PTSD symptoms and anxiety, as well as with increases in positive affect. : Preliminary results reported herein suggest participation is associated with psychological benefits. Further, decreased experiential avoidance/increased psychological flexibility should be explored as an underlying mechanism potentially contributing to the benefits of participation in EAS. A randomized controlled trial of the H.O.O.V.E.S. Intensive program is warranted.
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Publication Date: 2025-11-28 PubMed ID: 41373328PubMed Central: PMC12692443DOI: 10.3390/healthcare13233111Google Scholar: Lookup
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  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

Overview

  • This study investigated the effects of the Healing of Our Veterans Equine Services (H.O.O.V.E.S.) Intensive intervention, an equine-assisted learning program designed for veterans and active-duty military personnel with trauma histories.
  • The research aimed to determine if further rigorous studies are justified by evaluating psychological outcomes before and after participation in the program.

Background and Purpose

  • Equine-assisted services (EAS) are increasingly used as complementary therapies for veterans who have experienced trauma, but there is a lack of rigorous evidence supporting their effectiveness.
  • The H.O.O.V.E.S. Intensive intervention combines equine-assisted learning, peer mentorship, and experiential learning delivered in a residential retreat format tailored for military trauma survivors.
  • The primary purpose was to pilot the intervention and assess preliminary psychological outcomes, with the goal of determining if more robust randomized controlled trials (RCTs) are needed.

Study Design and Methods

  • A pilot prospective observational study conducted in Ohio, USA from April to October 2024.
  • Participants consisted of 32 veterans, aged 30 to 67, all with a history of trauma exposure.
  • Eligibility required current or past military service and trauma history.
  • Assessment instruments administered at four time points: before intervention, immediately after, and at 90 and 120 days post-intervention included:
    • PTSD Checklist for DSM-5 (PCL-5) – measures PTSD symptoms
    • Acceptance and Action Questionnaire II (AAQII) – measures psychological flexibility
    • Positive and Negative Affect Scale (PANAS) – measures positive and negative emotions
    • State-Trait Anxiety Inventory (STAI) – measures anxiety
    • Beck Depression Inventory (BDI) – measures depression severity
    • Posttraumatic Growth Inventory (PTGI) – measures positive psychological change after trauma
  • Data analyses focused on identifying statistically significant changes over time and exploring correlations among changes in psychological measures.

Key Findings

  • Significant improvements were observed from pre- to post-intervention on all measures except PTGI, indicating:
    • Increased psychological flexibility as measured by AAQII.
    • Increased positive affect (PANAS-positive).
    • Decreased anxiety (STAI).
    • Decreased negative affect (PANAS-negative).
    • Decreased depression (BDI).
    • Reduced PTSD symptoms (PCL-5).
  • Improvements in depression and PTSD symptoms were sustained at 120 days post-intervention.
  • Improvements in psychological flexibility, affect, and anxiety did not persist at 120 days.
  • Correlations revealed that increased psychological flexibility related closely to:
    • Decreases in negative affect, PTSD symptoms, and anxiety.
    • Increases in positive affect.

Interpretations and Implications

  • The findings suggest participation in the H.O.O.V.E.S. Intensive equine-assisted program is associated with meaningful psychological benefits in veterans with trauma histories.
  • The sustained reductions in depression and PTSD symptoms are particularly promising for longer-term mental health improvements.
  • The role of psychological flexibility (reduced experiential avoidance) appears to be a key underlying mechanism mediating benefits from the intervention.
  • The lack of significant improvement in posttraumatic growth may indicate either a need for longer follow-up or specific program enhancements to foster this outcome.
  • The pilot results support conducting larger, randomized controlled trials to rigorously evaluate efficacy and better understand mechanisms of the H.O.O.V.E.S. Intensive intervention.

Summary

  • This pilot observational study provides preliminary evidence that the H.O.O.V.E.S. Intensive equine-assisted learning program offers psychological improvements in veterans with trauma histories.
  • Improvements in symptoms of PTSD and depression were observed and maintained up to four months after the program.
  • Psychological flexibility emerged as a potentially important factor in achieving these benefits.
  • Future randomized controlled trials are necessary to confirm these findings and optimize this therapeutic approach for trauma-affected veterans.

Cite This Article

APA
Held A, Hubbard K, Nazarenko E, Marchand W. (2025). A Pilot Observational Study in Ohio, USA of the Healing of Our Veterans Equine Services Intensive Intervention for Veterans with Trauma Histories. Healthcare (Basel), 13(23), 3111. https://doi.org/10.3390/healthcare13233111

Publication

Healthcare (Basel, Switzerland)
ISSN: 2227-9032
NlmUniqueID: 101666525
Country: Switzerland
Language: English
Volume: 13
Issue: 23
PII: 3111

Researcher Affiliations

Held, Amanda
  • H.O.O.V.E.S. (Healing of Our Veterans Equine Services), 4055 Wilkins Rd., Swanton, OH 43558, USA.
Hubbard, Katy
  • H.O.O.V.E.S. (Healing of Our Veterans Equine Services), 4055 Wilkins Rd., Swanton, OH 43558, USA.
Nazarenko, Elena
  • Whole Health Service, VA Salt Lake City Health Care System, 500 Foothill Drive, Salt Lake City, UT 84148, USA.
Marchand, William
  • Whole Health Service, VA Salt Lake City Health Care System, 500 Foothill Drive, Salt Lake City, UT 84148, USA.
  • Department of Psychiatry, University of Utah, 501 Chipeta Way, Salt Lake City, UT 84108, USA.
  • Department of Animal, Dairy and Veterinary Sciences, Utah State University, 4815 Old Main Hill, Logan, UT 84322, USA.

Conflict of Interest Statement

The authors declare no conflicts of interest.

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