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BMC psychiatry2024; 24(1); 499; doi: 10.1186/s12888-024-05879-w

Study Protocol: Pegasus: psychotherapy incorporating horses for ‘therapy-resistant’ adolescents with autism spectrum disorders, a study with series of randomised, baseline controlled n-of-1 trials.

Abstract: For people with autism spectrum disorder (ASD), daily life can be highly stressful with many unpredictable events that can evoke emotion dysregulation (ED): a strong difficulty with appropriately negative affect regulation. For some of the patients with ASD, treatment as usual does not prove to be effective for ED. They may be at risk of life-long impairment, development of other disorders and loss of motivation for most regular forms of therapy. A highly promising method that may prove effective for therapy-resistant individuals with ASD is Psychotherapy incorporating horses (PIH). PIH uses the interactions of the horse and the patients on the ground and does not include horseriding. While often met with prejudgment and scepticism, reports from parents and therapists as well as a recent systematic review suggest that PIH may have beneficial effects on youths with ASD. Therefore, we examine clinical outcomes both in the short and in the long terms of PIH offered to adolescents with ASD and severe ED despite regular therapy. Methods: A total of 35 adolescents aged 11-18 years with ASD will receive PIH during 15 sessions once a week with randomization to five different groups differentiating in baseline phase from 2 to 6 weeks. PIH uses horses to promote social awareness and self-awareness as well as relationship management and self-management. The primary outcome is the response to treatment on the Emotion Dysregulation Index (EDI). The secondary outcome measures include ASD symptom severity, quality of life, self-esteem, global and family functioning, and goal attainment. Assessments take place at the baseline (T0), at the end of baseline phase A (T1), after completion of intervention phase B (T2), after the end of post-measurement phase C (T3) and after one year (T4). Qualitative interviews of participants, parents and therapists will be held to reveal facilitators and barriers of PIH and a cost-effectiveness study will be performed. Conclusions: This study aims at contributing to clinical practice for adolescents with ASD and persistent emotion regulation problems despite 1.5 year of treatment by offering Psychotherapy incorporating horses in a study with series of randomised, baseline controlled n-of-1 trials. Background: www. Results: gov NCT05200351, December 10th 2021.
© 2024. The Author(s).
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Publication Date: 2024-07-10 PubMed ID: 38987737PubMed Central: PMC11238395DOI: 10.1186/s12888-024-05879-wGoogle 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.

This research focuses on the effect of a form of therapy, known as “Psychotherapy incorporating horses” (PIH), on therapy-resistant adolescents with Autism Spectrum Disorder (ASD) who are experiencing severe emotional dysregulation. The study will follow 35 patients over a course of 15 weeks, alongside evaluations of their emotional regulation, Autism symptoms, quality of life, self-esteem, familial relationships, and other areas.

Study Overview

  • The research focuses on the evaluation of Psychotherapy incorporating horses (PIH) as a treatment method for therapy-resistant adolescents diagnosed with Autism Spectrum Disorder (ASD), who have severe emotional dysregulation issues. These young people have not responded to standard therapy practices, necessitating the exploration of alternate methods.
  • The study recognizes that life can be stressful for individuals with ASD due to many unpredictable events which often trigger emotional dysregulation, leading to negative impact on their ability to regulate affect. This can result in life-long impairments, development of other disorders and loss of motivation.

Methods of Study

  • The study involves 35 adolescents aged between 11-18 years, who will undergo a total of 15 weekly sessions of PIH. This therapy uses the interactions between the patient and horses to promote self-awareness, relationship management and social awareness.
  • The research uses randomization, dividing the participants into five different groups with baseline phases ranging from 2 to 6 weeks. Notably, the PIH does not involve horse riding, but rather utilizes the interactions between the patient and the horse on the grounds.
  • The research measures the outcomes on two levels: primary and secondary. The primary outcome focuses on the response to treatment on the Emotion Dysregulation Index (EDI). Secondary outcomes include ASD symptom severity, quality of life, self-esteem, global and family functioning, and goal attainment.
  • Assessments occur at the baseline phase (T0), at the end of baseline phase A (T1), after the intervention phase B (T2), the post-measurement phase C (T3), and after one year (T4). The qualitative interviews of participants, parents and therapists are meant to provide further information to understand the facilitators and barriers of PIH.
  • In addition to the qualitative and quantitative assessments, there will also be a cost-effectiveness study.

Conclusions

  • This study aims to contribute to clinical practice for adolescents with ASD experiencing persistent emotional regulation problems despite traditional therapy methods. It seeks to explore the effectiveness of incorporating horses into the therapy routine.
  • Providing new treatment strategies like PIH may help these young people cope better with their daily lives, by improving emotional regulation among other outcomes.

Cite This Article

APA
den Boer JC, Klip H, Blonk A, Lenselink M, Kaijdoe SPT, Tielkes M, van Zandbeek A, Bres G, Herinx M, Staal WG, Rommelse N. (2024). Study Protocol: Pegasus: psychotherapy incorporating horses for ‘therapy-resistant’ adolescents with autism spectrum disorders, a study with series of randomised, baseline controlled n-of-1 trials. BMC Psychiatry, 24(1), 499. https://doi.org/10.1186/s12888-024-05879-w

Publication

BMC psychiatry
ISSN: 1471-244X
NlmUniqueID: 100968559
Country: England
Language: English
Volume: 24
Issue: 1
Pages: 499
PII: 499

Researcher Affiliations

den Boer, Jenny C
  • Karakter, Child and Adolescent Psychiatry, Ede, the Netherlands. J.denboer@karakter.com.
  • Department of Psychiatry, Radboud University Medical Centre, Nijmegen, the Netherlands. J.denboer@karakter.com.
Klip, Helen
  • Karakter, Child and Adolescent Psychiatry, Nijmegen, the Netherlands.
Blonk, Anita
  • Gagelhoeve, Mill, the Netherlands.
Lenselink, Monique
  • Paardenblik, Wageningen, the Netherlands.
Kaijdoe, Shireen P T
  • Karakter, Child and Adolescent Psychiatry, Nijmegen, the Netherlands.
Tielkes, Melanie
  • Karakter, Child and Adolescent Psychiatry, Nijmegen, the Netherlands.
van Zandbeek, Amber
  • Gagelhoeve, Mill, the Netherlands.
Bres, Gerdine
  • Horses en Co, Heerjansdam, the Netherlands.
Herinx, Mandy
  • Horses en Co, Heerjansdam, the Netherlands.
Staal, Wouter G
  • Karakter, Child and Adolescent Psychiatry, Nijmegen, the Netherlands.
  • Department of Psychiatry, Radboud University Medical Centre, Nijmegen, the Netherlands.
  • Institute for Brain and Cognition, Leiden, the Netherlands.
Rommelse, Nanda
  • Department of Developmental Psychology, Utrecht University, Utrecht, the Netherlands.

MeSH Terms

  • Autism Spectrum Disorder / therapy
  • Autism Spectrum Disorder / psychology
  • Adolescent
  • Humans
  • Child
  • Animals
  • Equine-Assisted Therapy / methods
  • Horses
  • Male
  • Female
  • Randomized Controlled Trials as Topic
  • Emotional Regulation
  • Psychotherapy / methods

Grant Funding

  • project 636310020 / ZonMw
  • project 636310020 / ZonMw
  • project 636310020 / ZonMw
  • project 636310020 / ZonMw
  • project 636310020 / ZonMw
  • project 636310020 / ZonMw
  • project 636310020 / ZonMw
  • project 636310020 / ZonMw
  • project 636310020 / ZonMw
  • project 636310020 / ZonMw
  • project 636310020 / ZonMw

Conflict of Interest Statement

The authors declare no competing interests.

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Citations

This article has been cited 1 times.
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