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Home / Equine Research Bank / Mil Med / Equine-Assisted Therapy for Veterans with PTSD: Manual Devel...
Military medicine2020; 185(5-6); e557-e564; doi: 10.1093/milmed/usz444

Equine-Assisted Therapy for Veterans with PTSD: Manual Development and Preliminary Findings.

Abstract: 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. 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. 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. 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.
Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2019. This work is written by (a) US Government employee(s) and is in the public domain in the US.
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Publication Date: 2020-02-09 PubMed ID: 32034416PubMed Central: PMC7282489DOI: 10.1093/milmed/usz444Google Scholar: Lookup
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  • Journal Article
  • Research Support
  • Non-U.S. Gov't

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.

This study developed a standardized, eight-session equine-assisted therapy (EAT) protocol to treat post-traumatic stress disorder (PTSD) for veterans. Preliminary results suggest that the protocol is safe and effective in reducing PTSD, depressive, and anxiety symptoms.

Development of the Standardized Protocol

  • The researchers undertook the creation of an eight-session equine-assisted therapy (EAT) protocol specifically designed for veterans suffering from post-traumatic stress disorder (PTSD).
  • This step was critical as EAT treatments have gained popularity despite the lack of empirical support, a comprehensive manual, or a standardized methodology.
  • The protocol was developed by a team of experts in both EAT and PTSD, reflecting best practices from both fields.

Administration of the Protocol and Assessment Method

  • The proposed treatment protocol was administered to two pilot groups of military veterans to assess its initial efficacy and safety.
  • Data on PTSD, depressive, and anxiety symptoms, and quality of life were collected at various stages -before treatment, halfway through the treatment, after the treatment, and during a 3-month follow-up phase.
  • Apart from the subjective data, protocol safety, feasibility, and acceptability were also evaluated through the occurrence of any adverse events, completion rates of the treatment, and self-rated patient satisfaction.

Preliminary Findings

  • No adverse events were recorded during the implementation of the protocol, indicating it was safe.
  • All the patients were able to complete the sessions, pointing to the feasibility of the new method.
  • Also, high patient satisfaction was reported, suggesting the treatment was well-attended and well-received by patients.
  • Preliminary data showed notable decreases in PTSD and depressive symptoms from the beginning to the end of treatment and at follow-up.
  • All patients showed some benefit post-treatment, but the gains did not persist at the follow-up stage, suggesting the need for further research on the longevity of the treatment benefits.

Conclusions

  • This study presented the first standardized EAT protocol for treating PTSD in veterans.
  • While the study is only preliminary and sample size small, the results suggest that the newly developed EAT protocol appears to be safe and well-regarded, offering short-term benefits in reduced symptomatology and improved quality of life.
  • However, the researchers acknowledge the need for continued research to test this alternative PTSD treatment more rigorously due to the observed variations in treatment response and remission, and the unclear longevity of the benefits.

Cite This Article

APA
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. (2020). Equine-Assisted Therapy for Veterans with PTSD: Manual Development and Preliminary Findings. Mil Med, 185(5-6), e557-e564. https://doi.org/10.1093/milmed/usz444

Publication

Military medicine
ISSN: 1930-613X
NlmUniqueID: 2984771R
Country: England
Language: English
Volume: 185
Issue: 5-6
Pages: e557-e564

Researcher Affiliations

Arnon, Shay
  • New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032.
Fisher, Prudence W
  • 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.
Pickover, Alison
  • 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.
Lowell, Ari
  • 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.
Turner, J Blake
  • 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.
Hilburn, Anne
  • New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032.
Jacob-McVey, Jody
  • Bergen Equestrian Center, 40 Fort Lee Road, Leonia, NJ 07605.
  • EquiSense Solutions LLC, 33 West 93rd Street, 3B, New York, NY 10025.
Malajian, Bonnie E
  • Bergen Equestrian Center, 40 Fort Lee Road, Leonia, NJ 07605.
Farber, Debra G
  • Bergen Equestrian Center, 40 Fort Lee Road, Leonia, NJ 07605.
Hamilton, Jane F
  • Rancho Bosque Equestrian Center of Excellence, House Hamilton Business Group, PLC, 8649 E Woodland Road, Tucson, AZ 85749.
Hamilton, Allan
  • Department of Surgery, University of Arizona Health Sciences Center, 1501 N. Campbell Avenue, Tucson, AZ 85724.
Markowitz, John C
  • 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.
Neria, Yuval
  • 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.

MeSH Terms

  • Animals
  • Anxiety
  • Equine-Assisted Therapy
  • Female
  • Horses
  • Humans
  • Male
  • Quality of Life
  • Stress Disorders, Post-Traumatic / therapy
  • Treatment Outcome
  • Veterans

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Citations

This article has been cited 3 times.
  1. 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).
    doi: 10.3390/ijerph20146377pubmed: 37510609google scholar: lookup
  2. 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.
    doi: 10.1177/2470547021991556pubmed: 33644617google scholar: lookup
  3. 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 Apr 15;42(6):1930-1939.
    doi: 10.1002/hbm.25360pubmed: 33547694google scholar: lookup
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