Promoting mental health in military veterans. Methodology and evaluation tools in a pilot study involving an Equine-Assisted Intervention.

Overview

• This study developed and evaluated a standardized Equine-Assisted Therapy (EAT) intervention aimed at promoting mental health among military veterans experiencing post-deployment adjustment difficulties.
• Using both quantitative and qualitative methods, the research investigated the effects of a 9-month EAT program on veterans’ mental well-being, coping strategies, and interpersonal skills.

Background and Purpose

• Military veterans often encounter stressful or traumatic experiences during deployment that may lead to mental health challenges post-deployment.
• Equine-Assisted Therapy is an emerging complementary therapeutic practice that involves interactions with horses to support mental health, but lacks standardized protocols.
• The study’s goal was to create a standardized EAT intervention specifically for veterans and to evaluate its effectiveness through diverse assessment tools.

Methodology

• Participants: 16 veterans participated, with 11 assigned to the EAT group and 5 to a control group.
• Intervention duration: The EAT program lasted for 9 months.
• Data collection: The study employed mixed methods:
  • Quantitative evaluation: Used standardized instruments including the State-Trait Anxiety Inventory Scale, Hamilton Depression Rating Scale, Symptom Checklist 90, and Warwick Edinburgh Mental Well-Being Scale to assess anxiety, depression, symptoms, and general well-being.
  • Qualitative evaluation: Conducted through observations and guided group discussions to capture behavioral and attitudinal changes.

Findings

• Quantitative results: The standardized scales did not show statistically significant changes in measured mental health outcomes.
• Qualitative results:
  • Participants displayed positive transformations in attitudes and behaviors, notably increased autonomy, self-confidence, and a strengthened sense of agency.
  • Improvement in coping strategies was observed, with better management of anxiety symptoms.
  • Participants reported gradual overcoming of interpersonal difficulties, suggesting enhanced social skills.
  • The empathetic connection with the horses facilitated the building of positive relationships within the participant group.
  • A process of self-awareness developed during guided discussions, helping veterans rediscover or create a new sense of group identity.
• Adherence: The intervention had high participant adherence, indicating acceptability and feasibility.

Strengths and Limitations

• Strengths:
  • Successful development and implementation of a standardized EAT intervention for veterans.
  • Use of a mixed-methods approach provided rich data capturing both measurable and experiential outcomes.
  • High adherence rates and positive participant feedback demonstrated the intervention’s acceptability.
• Limitations:
  • Small sample size (only 16 participants) limited generalizability and statistical power, affecting quantitative findings.
  • Absence of female veterans restricted understanding of how EAT might affect women differently.
  • Geographical distance between participants’ residences and the equestrian rehabilitation center posed logistical challenges.

Conclusions and Implications

• The study highlights the potential benefits of Equine-Assisted Therapy in supporting veterans’ mental health, particularly through strengthened interpersonal skills and coping strategies.
• The empathetic human-horse relationship emerged as a key therapeutic factor fostering group cohesion and personal growth.
• While standardized quantitative tools did not detect statistical improvements, qualitative findings suggest meaningful personal and social development among participants.
• Future research should include larger and more diverse samples, refine protocols to overcome logistical barriers, and explore gender-specific responses to EAT.
• The pilot study lays groundwork for using animal-assisted interventions as a complementary approach in veteran mental health services.