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Animals : an open access journal from MDPI2022; 12(19); 2491; doi: 10.3390/ani12192491

Reducing Anxiety and Stress among Youth in a CBT-Based Equine-Assisted Adaptive Riding Program.

Abstract: Reining in Anxiety (RiA) is a therapeutic program for youth with mild to moderate anxiety delivered in a therapeutic riding setting by Certified Therapeutic Riding Instructors. RiA was developed after a review of the evidence base for youth anxiety, is manualized, and includes five core CBT components: in vivo exposure, cognitive restructuring, youth psychoeducation, relaxation, and caregiver psychoeducation about anxiety. This study extended findings from a prior RCT that examined (1) the feasibility of collecting saliva samples from horses and children to measure stress (cortisol) and relaxation (oxytocin); (2) whether changes in stress and relaxation occurred both during each lesson and over the course of the 10-week intervention for horses and youth; (3) whether changes in anxiety symptoms, emotional regulation, and self-efficacy found in the first trial were comparable; and (4) if fidelity to the program was reliable. Youth participants ( = 39) ages 6-17 with caregiver-identified mild-to-moderate anxiety participated in a ten-week therapeutic intervention (RiA), which combined adaptive riding and components of CBT. Physiological data and self-report measures were taken at weeks one, four, seven, and ten for the youth and horses. Saliva assays assessed cortisol as a physiological marker of stress and anxiety, and oxytocin as a measure of relaxation. Fidelity data were recorded per session. Anxiety, as measured by caregiver self-reporting, significantly decreased from pre- to post-test, while emotional regulation scores increased. No significant changes in self-efficacy from pre- to post-test were observed. Saliva samples obtained from participants before and after riding sessions showed a consistent decrease in cortisol and a significant increase in oxytocin at two of the four timepoints (Week 1 and Week 7), but no overall pre- to post-test changes. Horse saliva data were collected using a modified bit; there were no significant changes in oxytocin or cortisol, suggesting that the horses did not have an increase in stress from the intervention. RiA may be a promising approach for reducing anxiety and stress among youth, as measured both by self-reported and by physiological measures. Collection of salivary assays for both youth and horses is feasible, and the intervention does not increase stress in the horses. Importantly, RiA can be delivered by adaptive/therapeutic horseback riding instructors in naturalistic (e.g., non-clinic-based) settings. As youth anxiety is a growing public health problem, novel interventions, such as RiA, that can be delivered naturalistically may have the potential to reach more youth and thus improve their quality of life. Further research is needed to examine the comparative value of RiA with other animal-assisted interventions and to assess its cost-effectiveness.
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Publication Date: 2022-09-20 PubMed ID: 36230232PubMed Central: PMC9558534DOI: 10.3390/ani12192491Google Scholar: Lookup
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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 paper discusses a treatment program, Reining in Anxiety (RiA), designed for young individuals with mild to moderate anxiety levels. It focuses on whether the program is effective in reducing stress and anxiety as well as increasing emotional regulation and self-efficacy.

Overview of the RiA Program

  • The RiA was created based on evidence-based practices for treating youth anxiety.
  • It’s comprised of five key cognitive therapy components: practical exposure, cognitive restructuring, youth education, relaxation techniques, and educating caregivers on anxiety.
  • The program was administered by Certified Therapeutic Riding Instructors who offered a ten-week course that combines adaptive riding and cognitive therapy.

Purpose of the Study

  • The research aimed to test RiA’s efficacy, emulating a previous Randomized Control Trial. This included measuring stress and relaxation levels in both children and horses during the therapy course.
  • Other objectives of the study were to confirm if any changes in anxiety symptoms and self-efficacy matched those of the initial experiment.
  • Ultimately, the researchers aimed to establish whether RiA can be delivered consistently and reliably.

Study Design and Results

  • 39 youths aged 6-17, all with caregiver-identified mild-to-moderate anxiety, took part in the ten-week RiA intervention.
  • Data such as physiological information and self-reported measures were collected at three-week intervals over the ten-week course for both children and horses.
  • Saliva samples revealed a decrease in cortisol (stress hormone) and an increase in oxytocin (relaxation hormone) in children, but these changes were not significant on a pre to post-test basis.
  • The study also found that there were no stress fluctuations in the horses, indicating that the therapy program did not cause them distress.
  • Anxiety as reported by caregivers significantly decreased after the ten-week course, while emotional regulation scores increased substantially.
  • However, there were no noticeable changes in self-efficacy.

Conclusions and Future Research Needs

  • The study concluded that RiA could potentially reduce anxiety in youths.
  • It also established the feasibility of collecting salivary assays from both participants and horses, thereby validating such procedures in analyzing stress and relaxation.
  • The study props the potential of RiA within natural, non-clinical settings under the guidance of qualified riding instructors.
  • Given the increasing prevalence of youth anxiety, the study emphasizes the importance of further research to compare RiA’s effectiveness with other animal-assisted therapies and its cost-effectiveness.

Cite This Article

APA
Hoagwood K, Vincent A, Acri M, Morrissey M, Seibel L, Guo F, Flores C, Seag D, Peth Pierce R, Horwitz S. (2022). Reducing Anxiety and Stress among Youth in a CBT-Based Equine-Assisted Adaptive Riding Program. Animals (Basel), 12(19), 2491. https://doi.org/10.3390/ani12192491

Publication

Animals : an open access journal from MDPI
ISSN: 2076-2615
NlmUniqueID: 101635614
Country: Switzerland
Language: English
Volume: 12
Issue: 19
PII: 2491

Researcher Affiliations

Hoagwood, Kimberly
  • Department of Child and Adolescent Psychiatry, New York University, New York, NY 10012, USA.
Vincent, Aviva
  • Falk School, Syracuse University, Syracuse, NY 13244, USA.
Acri, Mary
  • Department of Child and Adolescent Psychiatry, New York University, New York, NY 10012, USA.
Morrissey, Meghan
  • Department of Child and Adolescent Psychiatry, New York University, New York, NY 10012, USA.
Seibel, Lauren
  • Department of Child and Adolescent Psychiatry, New York University, New York, NY 10012, USA.
Guo, Fei
  • Department of Child and Adolescent Psychiatry, New York University, New York, NY 10012, USA.
Flores, Chelsea
  • Department of Child and Adolescent Psychiatry, New York University, New York, NY 10012, USA.
Seag, Dana
  • Department of Child and Adolescent Psychiatry, New York University, New York, NY 10012, USA.
Peth Pierce, Robin
  • Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH 44106, USA.
Horwitz, Sarah
  • Department of Child and Adolescent Psychiatry, New York University, New York, NY 10012, USA.

Grant Funding

  • None / anonymous

Conflict of Interest Statement

The authors declare that they have no conflict of interest. The research study was held at Fieldstone Farm Therapeutic Riding Center where author A.V. is employed at the Director of Program Quality; the co-author R.P.P. is a current employee of the company Public Health Communications Consulting; both of these roles did not interfere with intervention delivery as they were not an instructor, nor was access to the study’s data, the analysis and interpretation of the data, and the preparing and publishing of the manuscripts impacted in any way. All authors declare no conflict of interest.

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