Journal of integrative medicine2018; 17(1); 14-19; doi: 10.1016/j.joim.2018.11.001

Efficacy of equine-assisted psychotherapy in veterans with posttraumatic stress disorder.

Burton, LE
·
Qeadan, F
·
Burge, MR

Abstract: Posttraumatic stress disorder (PTSD) is a common and debilitating disorder among war veterans. Although complementary and alternative therapies are gaining acceptance in the treatment of PTSD, the efficacy of animal-based therapies in this disorder is unknown. The goal of equine-assisted psychotherapy (EAP) is to improve the social, emotional, and/or cognitive functions of individuals with PTSD. Objective: This study aims to explore the effects of EAP on PTSD symptoms. We hypothesized that veterans with PTSD who participate in a standardized EAP program for 1 h per week for 6 weeks would experience decreased PTSD symptoms and would demonstrate increased resilience as compared with individuals who do not receive EAP intervention. Methods: We conducted a sequentially assigned, two-arm parallel group trial comparing 6 weeks of EAP with standard, previously established, ongoing PTSD therapy. Therapy was conducted at a community EAP facility in conjunction with an academic University Hospital. Twenty adult veterans with symptomatic PTSD completed the study. Ten adult veterans with previously diagnosed PTSD were assigned to EAP and received directed interaction with trained horses for one hour a week in groups of 3 or 4 individuals, while also continuing their previously established therapies. A certified therapist supervised the sessions, and a professional horse handler was also present. Results were compared with those from 10 adult veterans who only received their standard previously established PTSD care as prescribed by their provider. Methods: Changes in salivary cortisol, scores for the PTSD Check List-Military Version (PCL-M) and the Connor-Davidson Resilience Scale (CD-RISC) after 6 weeks of study were measured. Results: Of the 20 enrolled patients, 10 served in Afghanistan, 5 served in Iraq, and 3 served in Vietnam. Subjects were (47 ± 14) years old, were predominantly male, and had a body mass index of (29 ± 7) kg/m. They had (9.2 ± 6.1) years of military service and carried 66% ± 37% service-connected disability. PCL-M scores declined significantly in both groups and CD-RISC scores increased significantly in the EAP group. There was no difference between the groups with respect to the magnitude of change. Conclusions: As compared to the control group, a 6-week EAP program did not produce a statistically significant difference with respect to PCL-M and CD-RISC scores, or salivary cortisol. However, our results suggest that EAP may work as well as standard therapy with respect to these parameters. This study supports further inquiry into EAP as a potentially efficacious alternative for veterans suffering from PTSD. Background: ClinicalTrials.gov NCT #03039361.

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Publication Date: 2018-11-16 PubMed ID: 30497951DOI: 10.1016/j.joim.2018.11.001Google Scholar: Lookup

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Summary

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This study investigates the effect of equine-assisted psychotherapy, where patients interact with horses, on the symptoms of posttraumatic stress disorder (PTSD) in military veterans. For six weeks, a group of veterans participated in horse therapy sessions and their PTSD symptoms, resilience, and stress levels were compared to a control group receiving standard PTSD care. The results showed no significant difference between the two groups, suggesting horse therapy may be as effective as standard therapy for PTSD.

Study Objective and Hypothesis

The research sought to determine the impact of equine-assisted psychotherapy (EAP) on the symptoms of PTSD in military veterans. The therapy aimed to improve the affected individuals’ social, emotional, and/or cognitive functions.
The researchers hypothesized that veterans who participate in a weekly 1-hour EAP program for six weeks would experience a decrease in their PTSD symptoms and show increased resilience compared to those who do not.

Methods

A sequentially assigned, two-arm parallel group trial was carried out, comparing six weeks of EAP with the standard, previously established therapy for PTSD. It took place at a community EAP facility in partnership with an academic University Hospital.
The study involved twenty adult veterans with symptomatic PTSD. Ten were assigned to EAP, where they received directed interaction with trained horses for one hour a week in groups of three or four, while also continuing their previously established therapies. The other ten served as a control group, receiving only their standard care for PTSD.
Changes in PTSD symptoms, resilience, and salivary cortisol, an indicator of stress levels, were measured after the six weeks of therapy.

Results

The PCL-M (PTSD Check List-Military Version) scores, which measure PTSD symptoms, declined significantly in both groups. CD-RISC (Connor-Davidson Resilience Scale) scores, showing resilience levels, increased significantly in the EAP group.
There was no significant difference between the EAP group and the control group in terms of the magnitude of change.
The study did not find a significant change in the salivary cortisol level, suggesting that EAP does not have a strong impact on stress levels as measured by this indicator.

Conclusions

While there was no significant difference in PTSD symptom reduction or increasing resilience between the group practicing EAP and the control group, evidence suggested that EAP might be equally effective as conventional therapy.
As such, the study supports further exploration of EAP as a potentially effective alternative treatment for individuals experiencing PTSD, particularly veterans.

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APA

Burton LE, Qeadan F, Burge MR. (2018). Efficacy of equine-assisted psychotherapy in veterans with posttraumatic stress disorder. J Integr Med, 17(1), 14-19. https://doi.org/10.1016/j.joim.2018.11.001

Publication

Journal of integrative medicine

ISSN: 2095-4964

NlmUniqueID: 101603118

Country: Netherlands

Language: English

Volume: 17

Issue: 1

Pages: 14-19

PII: S2095-4964(18)30115-8

Researcher Affiliations

Burton, L Elisabeth

College of Nursing, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA.

Qeadan, Fares

Department of Internal Medicine/Epidemiology, Biostatistics & Preventive Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA.

Burge, Mark R

Department of Internal Medicine/Endocrinology, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA. Electronic address: mburge@salud.unm.edu.