FREE SHIPPING over $40
OVER 9000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Home / Equine Research Bank / Int J Environ Res Public Health / Psychodynamic Based Equine-Assisted Psychotherapy in Adults ...
International journal of environmental research and public health2020; 17(16); 5661; doi: 10.3390/ijerph17165661

Psychodynamic Based Equine-Assisted Psychotherapy in Adults with Intertwined Personality Problems and Traumatization: A Systematic Review.

Abstract: The growing field of equine-assisted psychotherapy (EAP), a subfield of animal-assisted psychotherapy (AAP), needs theoretically-based clinical studies. This systematic review examines the existing clinical studies in adult populations on psychodynamic psychotherapy combined with equine-assisted psychotherapy. An electronic database search was divided in two studies to identify publications on 1) EAP combined with psychodynamic psychotherapy and 2) EAP combined to personality problems and traumatization in order to compile studies by population, intervention, outcome and therapeutic assets. Study 1 revealed no relevant clinical studies on EAP with a psychodynamic background with an adult population. Study 2 revealed 12 publications to review predominantly addressing veterans with PTSD. The methodological limitations of most of the studies restrain the overall findings on outcome. However, overall positive effects for EAP, specifically on its experiential features and on finding interpersonal trust for patients, can be discerned. There is an apparent need for clinical studies meeting methodological standards on psychodynamic underpinned EAP methodologies in adults with intertwined personality problems and traumatization.
Get Full Text
Publication Date: 2020-08-05 PubMed ID: 32764468PubMed Central: PMC7460234DOI: 10.3390/ijerph17165661Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Journal Article
  • Systematic Review

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.

The research article provides a systematic review of existing clinical studies on the combination of equine-assisted psychotherapy (EAP) and psychodynamic psychotherapy in adults with personality problems and trauma. However, the lack of methodologically robust studies in this field restricts conclusive findings.

Research Methodology

  • The researchers tried to unearth studies focusing on equine-assisted psychotherapy (EAP) combined with psychodynamic psychotherapy in adults. The EAP is a growing subfield in animal-assisted psychotherapy (AAP) where horses are used as a tool for emotional growth and learning. Psychodynamic psychotherapy, on the other hand, is a therapeutic process which helps individuals become aware of their unconscious mind and the influence it has on their behavior.
  • The researchers executed an electronic database search divided into two parts. The first part aimed at finding publications related to EAP in combination with psychodynamic psychotherapy. The second part focused on EAP related to personality problems and traumatization. The goal was to compile the studies based on population, intervention, outcome, and therapeutic assets.

Findings

  • From the first study, the researchers found no relevant clinical studies on EAP with a psychodynamic background that focused on the adult population.
  • The second study revealed 12 publications predominantly addressing veterans with PTSD. These publications implemented EAP as a form of treatment.
  • It was found that despite the overall positive effects of EAP, specifically on its experiential features and in developing interpersonal trust for patients, the methodological limitations of most studies restrained the general conclusions about its outcomes.

Research Limitations and Implications

  • The research brought attention to the lack of clinically vetted studies that meet methodological standards on psychodynamic underpinned EAP methodologies.
  • The researchers emphasized the need for rigorous clinical trials and further studies in EAP paired with psychodynamic psychotherapy, especially in adults who have intertwined personality problems and have experienced trauma.

Cite This Article

APA
Kovács G, van Dijke A, Enders-Slegers MJ. (2020). Psychodynamic Based Equine-Assisted Psychotherapy in Adults with Intertwined Personality Problems and Traumatization: A Systematic Review. Int J Environ Res Public Health, 17(16), 5661. https://doi.org/10.3390/ijerph17165661

Publication

International journal of environmental research and public health
ISSN: 1660-4601
NlmUniqueID: 101238455
Country: Switzerland
Language: English
Volume: 17
Issue: 16
PII: 5661

Researcher Affiliations

Kovács, Géza
  • Faculty of Psychology, Open University, Valkenburgerweg 177, 6419 AT Heerlen, The Netherlands.
  • SPEL Psychologen Putten, Garderenseweg 158, 3881 NE Putten, The Netherlands.
van Dijke, Annemiek
  • Online poli's I-psy psyQ Brijder, Parnassia Group, Schipholpoort 20, 2034 MA Haarlem, The Netherlands.
Enders-Slegers, Marie-Jose
  • Faculty of Psychology, Open University, Valkenburgerweg 177, 6419 AT Heerlen, The Netherlands.

MeSH Terms

  • Adult
  • Animals
  • Equine-Assisted Therapy
  • Horses
  • Humans
  • Mental Disorders
  • Personality
  • Personality Disorders / therapy
  • Psychological Trauma
  • Psychotherapy
  • Psychotherapy, Psychodynamic
  • Treatment Outcome

Conflict of Interest Statement

The authors declare no conflicts of interest.

References

This article includes 55 references
  1. Luyten P, Lowyck B, Blatt S.J. Mechanisms of Change through the Lens of Two-Polarities Models of Personality Development: State of the Art and New Directions. Psychoanal. Inq. 2017;37:179–190.
    doi: 10.1080/07351690.2017.1285187google scholar: lookup
  2. Fonagy P. The effectiveness of psychodynamic psychotherapies: An update.. World Psychiatry 2015 Jun;14(2):137-50.
    doi: 10.1002/wps.20235pmc: PMC4471961pubmed: 26043322google scholar: lookup
  3. Abbass A, Town J, Driessen E. The efficacy of short-term psychodynamic psychotherapy for depressive disorders with comorbid personality disorder.. Psychiatry 2011 Spring;74(1):58-71.
    doi: 10.1521/psyc.2011.74.1.58pubmed: 21463171google scholar: lookup
  4. Hadjipavlou G, Ogrodniczuk JS. Promising psychotherapies for personality disorders.. Can J Psychiatry 2010 Apr;55(4):202-10.
    doi: 10.1177/070674371005500403pubmed: 20416143google scholar: lookup
  5. Gabbard GO, Westen D. Rethinking therapeutic action.. Int J Psychoanal 2003 Aug;84(Pt 4):823-41.
    doi: 10.1516/N4T0-4D5G-NNPL-H7NLpubmed: 13678491google scholar: lookup
  6. Bamelis LL, Evers SM, Spinhoven P, Arntz A. Results of a multicenter randomized controlled trial of the clinical effectiveness of schema therapy for personality disorders.. Am J Psychiatry 2014 Mar;171(3):305-22.
    doi: 10.1176/appi.ajp.2013.12040518pubmed: 24322378google scholar: lookup
  7. Steinert C, Munder T, Rabung S, Hoyer J, Leichsenring F. Psychodynamic Therapy: As Efficacious as Other Empirically Supported Treatments? A Meta-Analysis Testing Equivalence of Outcomes.. Am J Psychiatry 2017 Oct 1;174(10):943-953.
    doi: 10.1176/appi.ajp.2017.17010057pubmed: 28541091google scholar: lookup
  8. Town JM, Abbass A, Hardy G. Short-Term Psychodynamic Psychotherapy for personality disorders: a critical review of randomized controlled trials.. J Pers Disord 2011 Dec;25(6):723-40.
    doi: 10.1521/pedi.2011.25.6.723pubmed: 22217220google scholar: lookup
  9. Parish Plass N. 7. The Therapy Zoo as a Mirror to the Psyche. Purdue University Press; West Lafayette, IN, USA: 2013.
  10. Verheggen T, Enders-Slegers M.-J., Eshuis J. Enactive Anthrozoology: Toward an integrative theoretical model for understanding the therapeutic relationships between humans and animals. Hum.-Anim. Interact. Bull. 2017;5:13–35.
  11. Kovács G. Experiential equine-assisted focal psychodynamic psychotherapy: Addressing personality and attachment in clients with chronic childhood trauma. Routledge; London, UK: 2018.
  12. Siporin S. Talking horses: Equine psychotherapy and intersubjectivity. Psychodyn. Pract. 2012;18:457–464.
    doi: 10.1080/14753634.2012.719744google scholar: lookup
  13. Lundgren K.F. What science says about equine-human interaction in equine-assisted therapy: An outline to a theoretical framework. Routledge; London, UK: 2018.
  14. Porges SW. The polyvagal theory: phylogenetic substrates of a social nervous system.. Int J Psychophysiol 2001 Oct;42(2):123-46.
    doi: 10.1016/S0167-8760(01)00162-3pubmed: 11587772google scholar: lookup
  15. van der Kolk B.A. The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Penguin Books; London, UK: 2014.
  16. Perry B. Applying Principles of Neurodevelopment to Clinical Work with Maltreated and Traumatized Children: The Neurosequential Model of Therapeutics. In: Webb N.B., editor. Working with Traumatized Youth in Child Welfare. The Guilford Press; New York, NY, USA: 2006.
  17. Young C, Horton J. Canine and Equine Therapy for Mental Health: A Review of Clinical Effectiveness. Rapid Response Serv. 2019.
  18. Hoagwood KE, Acri M, Morrissey M, Peth-Pierce R. Animal-Assisted Therapies for Youth with or at risk for Mental Health Problems: A Systematic Review.. Appl Dev Sci 2017;21(1):1-13.
    doi: 10.1080/10888691.2015.1134267pmc: PMC5546745pubmed: 28798541google scholar: lookup
  19. O'Haire ME. Animal-assisted intervention for autism spectrum disorder: a systematic literature review.. J Autism Dev Disord 2013 Jul;43(7):1606-22.
    doi: 10.1007/s10803-012-1707-5pubmed: 23124442google scholar: lookup
  20. Kamioka H, Okada S, Tsutani K, Park H, Okuizumi H, Handa S, Oshio T, Park SJ, Kitayuguchi J, Abe T, Honda T, Mutoh Y. Effectiveness of animal-assisted therapy: A systematic review of randomized controlled trials.. Complement Ther Med 2014 Apr;22(2):371-90.
    doi: 10.1016/j.ctim.2013.12.016pubmed: 24731910google scholar: lookup
  21. Anestis MD, Anestis JC, Zawilinski LL, Hopkins TA, Lilienfeld SO. Equine-related treatments for mental disorders lack empirical support: a systematic review of empirical investigations.. J Clin Psychol 2014 Dec;70(12):1115-32.
    doi: 10.1002/jclp.22113pubmed: 24953870google scholar: lookup
  22. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration.. BMJ 2009 Jul 21;339:b2700.
    doi: 10.1136/bmj.b2700pmc: PMC2714672pubmed: 19622552google scholar: lookup
  23. Bartak A, Soeteman DI, Verheul R, Busschbach JJ. Strengthening the status of psychotherapy for personality disorders: an integrated perspective on effects and costs.. Can J Psychiatry 2007 Dec;52(12):803-10.
    doi: 10.1177/070674370705201208pubmed: 18186181google scholar: lookup
  24. Liotti G. Attachment Disorganization and the Controlling Strategies: An Illustration of the Contributions of Attachment Theory to Developmental Psychopathology and to Psychotherapy Integration. J. Psychother. Integr. 2011;21:232–252.
    doi: 10.1037/a0025422google scholar: lookup
  25. Courtois C.A., Ford J.D. Treating Complex Traumatic Stress Disorders: Scientific Foundations and Therapeutic Models. The Guilford Press; New York, NY, USA: 2009.
  26. Putnam KT, Harris WW, Putnam FW. Synergistic childhood adversities and complex adult psychopathology.. J Trauma Stress 2013 Aug;26(4):435-42.
    doi: 10.1002/jts.21833pubmed: 23893545google scholar: lookup
  27. van Dijke A, Ford JD. Adult attachment and emotion dysregulation in borderline personality and somatoform disorders.. Borderline Personal Disord Emot Dysregul 2015;2:6.
    doi: 10.1186/s40479-015-0026-9pmc: PMC4579502pubmed: 26401308google scholar: lookup
  28. van Dijke A, Hopman JAB, Ford JD. Affect dysregulation, psychoform dissociation, and adult relational fears mediate the relationship between childhood trauma and complex posttraumatic stress disorder independent of the symptoms of borderline personality disorder.. Eur J Psychotraumatol 2018;9(1):1400878.
    doi: 10.1080/20008198.2017.1400878pmc: PMC5795767pubmed: 29410773google scholar: lookup
  29. Comer R.J. Fundamentals of Abnormal Psychology. Worth Publishers; New York, NY, USA: 1985.
  30. Levine P.A. Polyvagal Theory and Trauma. In: Porges S.W., Dana D., editors. Clinical Applications of the Polyvagal Theory: The Emergence of Polyvagal-Informed Therapies. W. W. Norton & Company; New York, NY, USA: 2018.
  31. Schlote S. Integrating Somatic Experiencing® and Attachment into Equine-Assisted Trauma Recovery. Routledge; London, UK: 2018.
  32. Shultz-Jobe B, Naylor K, Jobe T. Natural lifemanship’s trauma- focused EAP for reactive attachment disorder. Routledge; London, UK: 2018.
  33. Johnson RA, Albright DL, Marzolf JR, Bibbo JL, Yaglom HD, Crowder SM, Carlisle GK, Willard A, Russell CL, Grindler K, Osterlind S, Wassman M, Harms N. Effects of therapeutic horseback riding on post-traumatic stress disorder in military veterans.. Mil Med Res 2018 Jan 19;5(1):3.
    doi: 10.1186/s40779-018-0149-6pmc: PMC5774121pubmed: 29502529google scholar: lookup
  34. Bolden L, Bentley D, Adkins S, Jagielski C, Schwebel D. The Effects of Animal Assisted Therapy on Perceived Pain in Patients with Spinal Cord Injury. Arch. Phys. Med. Rehabilit. 2017;98:e117.
    doi: 10.1016/j.apmr.2017.08.377google scholar: lookup
  35. Alfonso SV, Alfonso LA, Llabre MM, Fernandez MI. Project Stride: An Equine-Assisted Intervention to Reduce Symptoms of Social Anxiety in Young Women.. Explore (NY) 2015 Nov-Dec;11(6):461-7.
    doi: 10.1016/j.explore.2015.08.003pubmed: 26386749google scholar: lookup
  36. Kern-Godal A, Arnevik EA, Walderhaug E, Ravndal E. Substance use disorder treatment retention and completion: a prospective study of horse-assisted therapy (HAT) for young adults.. Addict Sci Clin Pract 2015 Oct 14;10:21.
    doi: 10.1186/s13722-015-0043-4pmc: PMC4672500pubmed: 26466788google scholar: lookup
  37. Romaniuk M, Evans J, Kidd C. Evaluation of an equine-assisted therapy program for veterans who identify as 'wounded, injured or ill' and their partners.. PLoS One 2018;13(9):e0203943.
    doi: 10.1371/journal.pone.0203943pmc: PMC6160012pubmed: 30260975google scholar: lookup
  38. Burton LE, Qeadan F, Burge MR. Efficacy of equine-assisted psychotherapy in veterans with posttraumatic stress disorder.. J Integr Med 2019 Jan;17(1):14-19.
    doi: 10.1016/j.joim.2018.11.001pubmed: 30497951google scholar: lookup
  39. Shelef A, Brafman D, Rosing T, Weizman A, Stryjer R, Barak Y. Equine Assisted Therapy for Patients with Post Traumatic Stress Disorder: A Case Series Study.. Mil Med 2019 Oct 1;184(9-10):394-399.
    doi: 10.1093/milmed/usz036pubmed: 30839068google scholar: lookup
  40. Malinowski K, Yee C, Tevlin JM, Birks EK, Durando MM, Pournajafi-Nazarloo H, Cavaiola AA, McKeever KH. The Effects of Equine Assisted Therapy on Plasma Cortisol and Oxytocin Concentrations and Heart Rate Variability in Horses and Measures of Symptoms of Post-Traumatic Stress Disorder in Veterans.. J Equine Vet Sci 2018 May;64:17-26.
    doi: 10.1016/j.jevs.2018.01.011pubmed: 30973147google scholar: lookup
  41. Burton L.E., Burge M.R. Equine assisted therapy reduces symptoms in veterans with post-traumatic stress disorder. J. Investig. Med. 2015;63:165.
  42. Earles JL, Vernon LL, Yetz JP. Equine-assisted therapy for anxiety and posttraumatic stress symptoms.. J Trauma Stress 2015 Apr;28(2):149-52.
    doi: 10.1002/jts.21990pubmed: 25782709google scholar: lookup
  43. Lanning B.A., Wilson A.L., Krenek N., Beaujean A.A. Using Therapeutic Riding as an Intervention for Combat Veterans: An International Classification of Functioning, Disability, and Health (ICF) Approach. Occup. Ther. Ment. Health. 2017;33:259–278.
    doi: 10.1080/0164212X.2017.1283282google scholar: lookup
  44. Balluerka N, Muela A, Amiano N, Caldentey MA. Promoting psychosocial adaptation of youths in residential care through animal-assisted psychotherapy.. Child Abuse Negl 2015 Dec;50:193-205.
    doi: 10.1016/j.chiabu.2015.09.004pubmed: 26443670google scholar: lookup
  45. Luborsky L, Rosenthal R, Diguer L, Andrusyna T.P., Berman J.S., Levitt J.T., Seligman D.A., Krause E.D. The Dodo bird verdict is alive and well—Mostly. Clin. Psychol. Sci. Pract. 2002;9:2–12.
    doi: 10.1093/clipsy/9.1.2google scholar: lookup
  46. Truijens F, Zühlke-van Hulzen L, Vanheule S. To manualize, or not to manualize: Is that still the question? A systematic review of empirical evidence for manual superiority in psychological treatment.. J Clin Psychol 2019 Mar;75(3):329-343.
    doi: 10.1002/jclp.22712pubmed: 30368808google scholar: lookup
  47. Zilcha-Mano S, Barber J.P. Learning from well-trained and experienced dynamic psychotherapists: Research on the efficacy of dynamic psychotherapy and its mechanisms of change. Contemp. Psychoanal. 2014;50:58–88.
    doi: 10.1080/00107530.2014.880309google scholar: lookup
  48. Vanheule S. Psychotherapy and research: A relation that needs to be reinvented. Br. J. Psychother. 2009;25:91–109.
    doi: 10.1111/j.1752-0118.2008.01103.xgoogle scholar: lookup
  49. Greeson JK, Briggs EC, Layne CM, Belcher HM, Ostrowski SA, Kim S, Lee RC, Vivrette RL, Pynoos RS, Fairbank JA. Traumatic childhood experiences in the 21st century: broadening and building on the ACE studies with data from the National Child Traumatic Stress Network.. J Interpers Violence 2014 Feb;29(3):536-56.
    doi: 10.1177/0886260513505217pubmed: 24144720google scholar: lookup
  50. Taylor P, Rietzschel J, Danquah A, Berry K. Changes in attachment representations during psychological therapy.. Psychother Res 2015;25(2):222-38.
    doi: 10.1080/10503307.2014.886791pubmed: 24559454google scholar: lookup
  51. Barlow DH. Negative effects from psychological treatments: a perspective.. Am Psychol 2010 Jan;65(1):13-20.
    doi: 10.1037/a0015643pubmed: 20063906google scholar: lookup
  52. Fonagy P. Attachment Theory and Psychoanalysis. Routledge; London, UK: 2001.
  53. Leichsenring F, Abbass A, Hilsenroth MJ, Luyten P, Munder T, Rabung S, Steinert C. "Gold Standards," Plurality and Monocultures: The Need for Diversity in Psychotherapy.. Front Psychiatry 2018;9:159.
    doi: 10.3389/fpsyt.2018.00159pmc: PMC5928423pubmed: 29740361google scholar: lookup
  54. Solms M. The Feeling Brain: Selected Papers on Neuropsychoanalysis. Routledge; London, UK: 2015.
  55. Kazdin AE, Blase SL. Rebooting Psychotherapy Research and Practice to Reduce the Burden of Mental Illness.. Perspect Psychol Sci 2011 Jan;6(1):21-37.
    doi: 10.1177/1745691610393527pubmed: 26162113google scholar: lookup

Citations

This article has been cited 3 times.
  1. Diaz L, Gormley MA, Coleman A, Sepanski A, Corley H, Perez A, Litwin AH. Equine-assisted services for individuals with substance use disorders: a scoping review. Subst Abuse Treat Prev Policy 2022 Dec 14;17(1):81.
    doi: 10.1186/s13011-022-00506-xpubmed: 36517823google scholar: lookup
  2. Kovács G, van Dijke A, Leontjevas R, Enders-Slegers MJ. The Relevance of Internal Working Models of Self and Others for Equine-Assisted Psychodynamic Psychotherapy. Int J Environ Res Public Health 2022 Aug 30;19(17).
    doi: 10.3390/ijerph191710803pubmed: 36078534google scholar: lookup
  3. Kogstad N, Christiansen SE, Ulberg R, Fiskum C. Therapists' reasons for including horses into psychotherapy, a qualitative study. BMC Complement Med Ther 2025 Nov 27;26(1):20.
    doi: 10.1186/s12906-025-05185-2pubmed: 41310576google scholar: lookup
Subscribe to our newsletter
Join 99,344 horse owners like you who receive our email updates on horse health and nutrition.