Acceptability of an adjunct equine-assisted activities and therapies program for veterans with posttraumatic stress disorder and/or traumatic brain injury.
Abstract: 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. Conclusions: These data offer preliminary evidence that an adjunct EAAT program is acceptable for veterans with PTSD and/or TBI participating in an IOP.
Copyright © 2020 Shanghai Changhai Hospital. Published by Elsevier B.V. All rights reserved.
Publication Date: 2020-01-21 PubMed ID: 31996299DOI: 10.1016/j.joim.2020.01.005Google Scholar: Lookup
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Summary
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The research article investigates the impact and acceptance of equine-assisted activities and therapies (EAATs) in treating veterans with posttraumatic stress disorder (PTSD) or traumatic brain injury (TBI) as part of an intensive outpatient program.
Methodology
- The study involved administeration of EAATs to veterans with PTSD and/or TBI. The treatment process also allowed for a family member or support person to accompany the veterans, thereby encouraging a supportive environment.
- A total of 106 participants, which included 62 veterans and 44 family members, were taken from an urban environment and made to participate in a two-day EAAT program in rural New Hampshire.
- At the end of the two-week intensive clinical program, satisfaction surveys were conducted, the results of which were then studied using thematic analysis to draw insights and observations.
Results
- The survey responses suggested that horses played a significant role in facilitating emotional rehabilitation. This was found to be one of the positive aspects of the EAAT program,
- Participants found the intensive immersion in equine-assisted activities to be effective.
- Another positive outcome was the program’s ability to promote interpersonal relationships.
- The need for staff to be educated about PTSD was also indicated in the survey responses.
- The vets and their family members provided largely positive feedback about the program, with high scores on the satisfaction survey. On a 10-point visual analog scale, veterans scored an average of 9.76, while family members scored an average of 9.91, indicating a favourable overall experience.
Conclusions
- The study data provides preliminary evidence that EAAT is an acceptable supplemental treatment for veterans with PTSD and/or TBI undergoing an intensive outpatient program
- However, more rigorous and long-term studies would likely be required to further validate these findings and to understand the lasting impacts of EAATs on PTSD/TBI treatment.
Cite This Article
APA
Sylvia L, West E, Blackburn AM, Gupta C, Bui E, Mahoney T, Duncan G, Wright EC, Lejeune S, Spencer TJ.
(2020).
Acceptability of an adjunct equine-assisted activities and therapies program for veterans with posttraumatic stress disorder and/or traumatic brain injury.
J Integr Med, 18(2), 169-173.
https://doi.org/10.1016/j.joim.2020.01.005 Publication
Researcher Affiliations
- 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. Electronic address: lsylvia2@mgh.harvard.edu.
- Home Base: A Red Sox Foundation and Massachusetts General Hospital Program, Massachusetts General Hospital, Charlestown, MA 02129, USA.
- Home Base: A Red Sox Foundation and Massachusetts General Hospital Program, Massachusetts General Hospital, Charlestown, MA 02129, USA.
- Home Base: A Red Sox Foundation and Massachusetts General Hospital Program, Massachusetts General Hospital, Charlestown, MA 02129, USA.
- 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.
- Equine Immersion Programs™, USA.
- Equine Immersion Programs™, USA.
- 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.
- 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.
- 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.
MeSH Terms
- Adult
- Animals
- Brain Injuries, Traumatic / therapy
- Emotions
- Equine-Assisted Therapy
- Female
- Horses
- Humans
- Interpersonal Relations
- Male
- Middle Aged
- Mindfulness
- New Hampshire
- Patient Satisfaction
- Program Evaluation
- Self Concept
- Stress Disorders, Post-Traumatic / therapy
- Surveys and Questionnaires
- Veterans / psychology
Citations
This article has been cited 11 times.- Marchand WR. Potential Mechanisms of Action and Outcomes of Equine-Assisted Services for Veterans with a History of Trauma: A Narrative Review of the Literature. Int J Environ Res Public Health 2023 Jul 16;20(14).
- Wanqing DU, Liuding W, Min J, Xiao L, Bo LI, Yunling Z, Xing L. Mixed methods research in complementary and alternative medicine: a scoping review. J Tradit Chin Med 2022 Aug;42(4):652-666.
- Marchand WR, Andersen SJ, Smith JE, Hoopes KH, Carlson JK. Equine-Assisted Activities and Therapies for Veterans With Posttraumatic Stress Disorder: Current State, Challenges and Future Directions. Chronic Stress (Thousand Oaks) 2021 Jan-Dec;5:2470547021991556.
- de Mello EC, Regalo SCH, Diniz LH, Lage JB, Ribeiro MF, Bevilacqua Junior DE, Rosa RC, Ferreira AA, Ferraz MLF, Teixeira VPA, Espindula AP. Electromyographic analysis of stomatognathic muscles in elderly after hippotherapy. PLoS One 2020;15(8):e0238036.
- Kowalski H, Van Buiten H, Hopkins P, Baldwin C, Nazarenko E, Marchand WR. A Multi-Site Observational Evaluation of the Equine Assisted Growth and Learning Association Model of Equine-Assisted Psychotherapy for Veteran Trauma Survivors. Int J Environ Res Public Health 2025 Oct 13;22(10).
- Lanning BA, Smith CM, Ugale C, Nazarenko E, Marchand WR. Using Functional Near-Infrared Spectroscopy to Elucidate Neurophysiological Mechanism of Action of Equine-Assisted Services: Proof-of-Concept Study. Int J Environ Res Public Health 2025 Aug 19;22(8).
- Kapteijn C, Reinders N, Hueting M, Van Huffelen RA, Vermetten E, Rodenburg B, Endenburg N. Are Equine Assisted Interactions (EAI) a Dark Horse Bet? A Systematic Review on Measuring the Psychological and Physiological Effects of EAI on PTSD, Anxiety and/or Mood Disorders. Psychiatry Clin Psychopharmacol 2025 Aug 11;35(Suppl 1):S90-S112.
- Provan M, Ahmed Z, Stevens AR, Sardeli AV. Are equine-assisted services beneficial for military veterans with post-traumatic stress disorder? A systematic review and meta-analysis. BMC Psychiatry 2024 Aug 1;24(1):544.
- Nieforth LO, Leighton SC. Animal-assisted interventions for military families: a systematic review. Front Public Health 2024;12:1372189.
- Li J, Sánchez-García R. Equine-assisted interventions for veterans with posttraumatic stress disorder: a systematic review. Front Psychiatry 2023;14:1277338.
- Nelson C, Dossett K, Walker DL. Equine-Assisted Therapy for Posttraumatic Stress Disorder Among First Responders. Psychol Rep 2024 Oct;127(5):2203-2219.
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