Equine Assisted Therapy for Patients with Post Traumatic Stress Disorder: A Case Series Study.
Abstract: Equine assisted therapy (EAT) which includes therapeutic horseback riding (THR), grooming, horsemanship and ground level work with horses, has been studied as treatment for children with special needs and/or autistic spectrum disorder. Preliminary evidence indicates that EAT is also effective for improving self-efficacy and self-esteem in adults with psychiatric disorders. Empowerment, bonding and building trust with the horses, may promote functioning of patients struggling with post traumatic stress disorder (PTSD).The authors performed a prospective, pilot open case series study to assess the effect of EAT on patients with PTSD in terms of symptoms and functioning in work, family and social interaction. Patients with PTSD received EAT once a week for 3 consecutive hours for 6 months. The Short Post Traumatic Stress Disorder Rating Interview (SPRINT) and the Sheehan Disability Scale (SDS) were assessed at baseline, the SDS after 1 and 6 months, and the SPRINT after 6 months. Thirteen of 23 participants completed the study. Ten participants withdrew from the study for various reasons including discomfort from horses. Total SPRINT scores showed a statistically significant improvement in PTSD symptoms (baseline vs. 6 months: 24.38 ± 6.4 vs. 21.54 ± 7.94 points; p < 0.05). SPRINT scores indicated improvement in the ability to work and perform daily tasks (p < 0.05). A statistically significant improvement in the total SDS score was revealed following 1 month (p < 0.03) and after 6 months (p < 0.02) of EAT. There was also a significant decline in the days of inefficiency (baseline vs. 6 months: 4.15 ± 2.73 vs, 1.88 ± 2.18 days per week, p < 0.02). This preliminary pilot open case series study suggests that EAT may be a beneficial treatment for patients suffering from PTSD. The study demonstrated improved ability to work and perform daily tasks and reduction in the number of days of inefficiency. Further large-scale long-term studies are warranted to substantiate our observation.
© Association of Military Surgeons of the United States 2019. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Publication Date: 2019-03-07 PubMed ID: 30839068DOI: 10.1093/milmed/usz036Google Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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The research article investigates the potential of Equine Assisted Therapy (EAT) as a treatment method for adults suffering from Post Traumatic Stress Disorder (PTSD). The study confirms that EAT notably improved the functionality and reduced the symptoms of PTSD in patients.
Introduction to the Study
- The research focuses on using Equine Assisted Therapy (EAT), that encompasses therapeutic horseback riding, grooming, horsemanship and ground level work with horses, as a treatment method for adults with Post Traumatic Stress Disorder (PTSD).
- EAT has been demonstrated previously as being effective in boosting self-efficacy and self-esteem among children with special needs or autism spectrum disorders, and adults with psychiatric disorders.
Study Approach and Methodology
- The researchers conducted a prospective, pilot open case series study.
- They worked with adult PTSD patients, who underwent EAT once a week for about three consecutive hours over a period of six months.
- The researchers used the Short Post Traumatic Stress Disorder Rating Interview (SPRINT) and the Sheehan Disability Scale (SDS) to assess the symptoms and functionality of the participants at various intervals.
Results and Findings
- Ten participants withdrew from the study, primarily due to discomfort with the horses, resulting in 13 of the initial 23 participants completing the study.
- The participating patients showed significant improvement in PTSD symptoms and in their ability to fulfil work duties and perform daily tasks.
- The SPRINT scores after six months and the total SDS scores after one month and again after six months confirmed these improvements.
- A significant drop was also observed in the number of days of inefficiency.
Conclusions and Future Recommendations
- This study indicates that EAT could be a potent treatment choice for adults suffering from PTSD, marked by improved functionality and diminished PTSD symptoms.
- The researchers strongly recommend larger-scale, long-term studies to validate further and strengthen these observations.
Cite This Article
APA
Shelef A, Brafman D, Rosing T, Weizman A, Stryjer R, Barak Y.
(2019).
Equine Assisted Therapy for Patients with Post Traumatic Stress Disorder: A Case Series Study.
Mil Med, 184(9-10), 394-399.
https://doi.org/10.1093/milmed/usz036 Publication
Researcher Affiliations
- Abarbanel Mental Health Center, Bat-Yam, Israel.
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
- Therapy, Research & Care Institute, Tel-Mond, Israel.
- Therapy, Research & Care Institute, Tel-Mond, Israel.
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
- Geha Mental Health Center and Felsenstein Medical Research Center, Petah Tiqva, Israel.
- Abarbanel Mental Health Center, Bat-Yam, Israel.
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
- Dunedin School of Medicine, Otago University, New Zealand.
MeSH Terms
- Adult
- Animals
- Case-Control Studies
- Equine-Assisted Therapy / methods
- Equine-Assisted Therapy / statistics & numerical data
- Female
- Horses / psychology
- Humans
- Israel
- Male
- Middle Aged
- Psychometrics / instrumentation
- Psychometrics / methods
- Psychometrics / statistics & numerical data
- Stress Disorders, Post-Traumatic / psychology
- Stress Disorders, Post-Traumatic / therapy
- Treatment Outcome
Citations
This article has been cited 15 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).
- Kapteijn CM, Frippiat T, van Beckhoven C, van Lith HA, Endenburg N, Vermetten E, Rodenburg TB. Measuring heart rate variability using a heart rate monitor in horses (Equus caballus) during groundwork. Front Vet Sci 2022;9:939534.
- 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.
- Kovács G, van Dijke A, Enders-Slegers MJ. Psychodynamic Based Equine-Assisted Psychotherapy in Adults with Intertwined Personality Problems and Traumatization: A Systematic Review. Int J Environ Res Public Health 2020 Aug 5;17(16).
- Duerr R, Gorny MK. V2-Specific Antibodies in HIV-1 Vaccine Research and Natural Infection: Controllers or Surrogate Markers. Animals (Basel) 2019 Aug 3;9(8).
- Held A, Hubbard K, Nazarenko E, Marchand W. A Pilot Observational Study in Ohio, USA of the Healing of Our Veterans Equine Services Intensive Intervention for Veterans with Trauma Histories. Healthcare (Basel) 2025 Nov 28;13(23).
- Rodríguez-Sobrino N, Melguizo-Garín A. Effects of Equine Coaching on Psychoemotional Wellbeing: A Pilot Study in Women with and Without Fibromyalgia. Healthcare (Basel) 2025 Oct 25;13(21).
- 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.
- McCrea CE, Tibbets G, Smith LW, Campbell CG. At-risk youth receive similar benefits from equine- assisted psychotherapy and traditional psychotherapy; an applied analysis. Front Psychiatry 2025;16:1518783.
- Rankins EM, Quinn A, McKeever KH, Malinowski K. Ground-based adaptive horsemanship lessons for veterans with post-traumatic stress disorder: a randomized controlled pilot study. Front Psychiatry 2024;15:1390212.
- Potier JF, Louzier V. Evaluation of stress markers in horses during hippotherapy sessions in comparison to being ridden by beginners. Anim Welf 2023;32:e10.
- 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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