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Carlsson IM, Bräutigam Ewe M, Nymberg P, Jormfeldt H. Building up bit by bit, parent's experiences of equine-assisted intervention among children and adolescents with mental illness: a grounded theory study. Int J Qual Stud Health Well-being 2024; 19:2354945. [PMID: 38758980 PMCID: PMC11104696 DOI: 10.1080/17482631.2024.2354945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 05/09/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Mental ill health among children and adolescents has increased worldwide. Mental health difficulties from a young age are associated with school absence and educational underachievement. A holistic perspective of treatments besides medical treatment is essential Thus, there is a need for research regarding equine-assisted intervention (EAI). PURPOSE The present study aimed to understand the outcomes of an equine-assisted intervention for children and adolescents with mental ill health from the perspectives of parents and close relatives. METHODS This study used a qualitative research design informed by Charmaz's Grounded Theory, with a purposive sample including six in-depth interviews. RESULTS The theory "building up bit by bit" was constructed, explaining the recognition that their children/adolescents were built up bit by bit and created a stronger self-identity. The participants referred to changes in the child's or adolescent's way of being and emotional regulation, which constituted building blocks leading to the child's or adolescent's 1. increased Harmony. 2. enhanced Self-identity, and 3. improved Capability. CONCLUSION Parents and close relatives experienced that their child or adolescent was built up bit by bit and gained a stronger foundation to stand on. This led to increased harmony in everyday life with stronger self-worth, better performance, and reduced school absenteeism.
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Affiliation(s)
| | | | - Peter Nymberg
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Center for Primary Health Care Research, Region Skåne: Helsingborg/Malmö, Skåne, Sweden
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Doan T, Pennewitt D, Patel R. Animal assisted therapy in pediatric mental health conditions: A review. Curr Probl Pediatr Adolesc Health Care 2023; 53:101506. [PMID: 38040610 DOI: 10.1016/j.cppeds.2023.101506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
Animal assisted therapy (AAT) has been explored as a treatment option for children with mental health disorders and associated symptoms. AAT can be implemented in inpatient, outpatient, and residential care settings. Some studies demonstrate significant improvement in symptom severity while others report only modest results. In this review, we summarize previous studies that have investigated the applications of AAT for pediatric mental health treatment, focusing on management of symptoms related to post-traumatic stress disorder, depression, anxiety, attention-deficit/hyperactivity disorder, and internet gaming disorder. Current studies on AAT and mental health care tend to lack generalizability due to being single-site studies, and comparisons between studies are difficult because studies tend to adopt different definitions of AAT. Future studies examining the effects of AAT on mental health in general and on symptoms for specific conditions are needed before AAT is widely recommended for the pediatric population.
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Affiliation(s)
- Tam Doan
- Western Michigan University Homer Stryker M.D. School of Medicine, USA.
| | - Deanna Pennewitt
- Department of Pediatrics, University of Michigan Medical School, USA
| | - Rohan Patel
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
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Cappelen H, Ivarsson A, Jormfeldt H. The Effects of an Equine-Assisted Therapeutic Intervention on Well-Being in Persons Diagnosed with Schizophrenia. A Pilot Study. Issues Ment Health Nurs 2023; 44:104-111. [PMID: 36649626 DOI: 10.1080/01612840.2022.2158408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The process of personal recovery among persons diagnosed with schizophrenia may be facilitated through innovative health promotion interventions targeting multidimensional aspects of subjective well-being. The current pilot study aims to test the use of self-rated questionnaires as a means of evaluation of the effects of an equine-assisted intervention for persons diagnosed with schizophrenia. Twenty adults diagnosed with schizophrenia were offered a 12-week EAT intervention performed six times once every 14 days by a licensed mental health nurse. Two validated self-rated questionnaires, HSCL-25 and SHIS were used as outcome measurements at baseline and at post-treatment, additionally the self-rated questionnaire PANAS was completed twice a week starting 1 week before the 12 week-EAT intervention. Only six of the 20 participants managed to complete the validated questionnaires. Despite the low response rate of approximately 30%, a significant difference was found between pre and post scores for positive affect and well-being. Effect sizes, ranging from small to large for pre-to-post treatment scores indicated less depression and anxiety, more positive affect, less negative affect, and reinforced well-being. Results suggest that EAT interventions may have beneficial effects among persons diagnosed with schizophrenia and that a varied range of research methods are needed to create a solid evidence base for EAT interventions intended for the target group.
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Affiliation(s)
- H Cappelen
- Institute of Psychology Universiteit Leiden, Leiden, The Netherlands
| | - A Ivarsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - H Jormfeldt
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
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Fridén L, Hultsjö S, Lydell M, Jormfeldt H. Relatives’ experiences of an equine-assisted intervention for people with psychotic disorders. Int J Qual Stud Health Well-being 2022; 17:2087276. [PMID: 35698741 PMCID: PMC9310814 DOI: 10.1080/17482631.2022.2087276] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Purpose The aim of this study was to describe relatives’ experiences of an equine-assisted intervention for people with psychotic disorders. Methods The study has a qualitative and descriptive design. Ten semi-structured interviews were performed with relatives of people with a psychotic disorder who had participated in an equine-assisted intervention. A conventional content analysis was used to analyse the data. Result The overall category “Being with the horses strengthens health capabilities” summarizes the four identified subcategories “The horses contribute to a context with a common focus”, “Interaction with the horses enhances self-confidence and motivation”, “The interplay with the horses nurtures positive emotions” and “Being with the horses encourages physical activity”. Conclusions The result of this study contributes to the growing body of research about the potential outcomes of equine-assisted interventions. The result also indicates that equine-assisted interventions may improve health capabilities among people with psychotic disorders. The generated knowledge may be useful in mental health services when developing equine-assisted interventions.
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Affiliation(s)
- Linda Fridén
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Sally Hultsjö
- Department of Psychiatry, Region Jönköping County, Sweden and Department of Health, Medicine and Caring Sciences, Division of Nursing and Reproductive Health, Linköping University, Linköping, Sweden
| | - Marie Lydell
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
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Punzo K, Skoglund M, Carlsson IM, Jormfeldt H. Experiences of an Equine-Assisted Therapy Intervention among Children and Adolescents with Mental Illness in Sweden - A Nursing Perspective. Issues Ment Health Nurs 2022; 43:1080-1092. [PMID: 36178465 DOI: 10.1080/01612840.2022.2126571] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Mental illness among children and adolescents is increasing globally, and prescription of psychiatric drugs for children and adolescents with mental illness is increasing worldwide, including Sweden. Holistic health-promoting interventions have shown promising long-lasting significant health benefits in young individuals with mental illness, but holistic health-promoting mental health interventions are often disregarded due to a lack of systematic theory-based knowledge. Consequently, the lack of scientific knowledge thwarts implementation of equine-assisted therapy as an established intervention in mental health nursing for children and adolescents with mental illness. The purpose of the study was to better understand experiences of equine-assisted therapy among children and adolescents with mental illness. The study adopted an inductive approach and data was collected using photovoice methodology. Six young persons, 7-18 years of age, referred by a psychologist to the equine-assisted intervention due to mental health issues, were included in the study. Data was analyzed using qualitative content analysis. The results could be summarized by an overarching theme, a physical, emotional, and social milieu for growth, consisting of three subcategories: feeling relief from everyday stress and anxiety; nurturing self-esteem in a mutual friendship; and strengthening self-reliance through synchronized interplay. The results indicate that equine-assisted therapy has essential values closely related to the goals of mental health nursing. Further research should strive to attain even gender distribution in study samples and focus on how equine-assisted therapy could be thoroughly integrated into established nursing intervention for children and adolescents with mental illness.
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Affiliation(s)
- Kim Punzo
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Matilda Skoglund
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
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Equine-Assisted Services: an overview of current scientific contributions on efficacy and outcomes on humans and horses. J Vet Behav 2022. [DOI: 10.1016/j.jveb.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Fynn WI, Runacres J. Dogs at school: a quantitative analysis of parental perceptions of canine-assisted activities in schools mediated by child anxiety score and use case. INTERNATIONAL JOURNAL OF CHILD CARE AND EDUCATION POLICY 2022; 16:4. [PMID: 35300319 PMCID: PMC8897139 DOI: 10.1186/s40723-022-00097-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/07/2022] [Indexed: 06/14/2023]
Abstract
Canine-assisted activities in schools can benefit students' educational, emotional, and social needs. Furthermore, they could be an effective form of non-clinical mental health treatment for children and adolescents. In the United Kingdom, school dogs are growing in popularity, however, little is known about how parents perceive canine-assisted activities as a treatment option. This is important as parental perceptions can influence engagement, whilst lack of awareness can become a barrier to treatment. This study uses a cross-sectional design to quantitatively explore the acceptability of canine-assisted activities amongst UK-based parents (n = 318) of children aged six to 16 (M = 10.12, SD = 3.22). An online survey used a treatment evaluation to determine acceptability across three use-cases. These included a child reading to dogs to improve literacy skills, a child interacting one-to-one to foster greater self-esteem and social skills, and a classroom dog to improve student behaviour and motivation. Additionally, the scale for generalised anxiety disorder was used to rank child anxiety as high or low, where high was a score equal to or above the UK clinical borderline threshold. The results found canine-assisted activities were less acceptable for the behavioural than the reading and social use-cases. Furthermore, parents of children with high anxiety had higher acceptability scores than parents of children with low anxiety for the reading and social use-cases but not for the behavioural use case. These findings suggest that UK parents' acceptability of canine-assisted activities in schools is mediated by child anxiety score. Furthermore, that parents may be less aware of the benefits of classroom dogs than other types of school-based canine-assisted activities.
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Affiliation(s)
- Wendy Irene Fynn
- University of Derby, Enterprise Centre, Bridge Street, Derby, DE1 3LA UK
| | - Jessica Runacres
- University of Derby, Enterprise Centre, Bridge Street, Derby, DE1 3LA UK
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Matarazo JB, Freitas ER. Percepção de profissionais de equoterapia sobre a prática com idosos. FISIOTERAPIA EM MOVIMENTO 2022. [DOI: 10.1590/fm.2022.35147.0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Resumo Introdução A equoterapia é um método terapêutico recentemente regulamentado no Brasil. Não obstante, há anos vem sendo estudado, sobretudo com foco em crianças e adolescentes. Considerando o aumento do número de idosos na população brasileira, investigações com enfoque em pessoas na velhice são cada vez mais necessárias. Objetivo Analisar as percepções de profissionais de equoterapia sobre sua prática com idosos. Métodos Trata-se de uma pesquisa qualitativa e transversal, em que os participantes responderam a um questionário online composto por questões demográficas e relacionadas à equoterapia com idosos. Os dados foram analisados por meio de estatística descritiva e da análise de conteúdo temática. Resultados Participaram 25 profissionais (23-57 anos), graduados, que trabalhavam há pelo menos dois anos com equoterapia (média = 6,64; desvio padrão = 5,39 anos). Essa amostra foi composta majoritariamente por profissionais do sexo feminino (72%) e fisioterapeutas (48%). Do total, 60% relataram já terem atendido pelo menos um praticante idoso. Entre aqueles que nunca trabalharam com esse público, 90% desejam atendê-lo. Todos os profissionais consideram que a equoterapia pode ser benéfica na velhice, reduzindo sintomas depressivos e promovendo variáveis psicossociais (por ex., socialização) e físicas (por ex., equilíbrio). Apesar dos benefícios, os profissionais mencionaram desafios, como dificuldades do praticante (por ex., medo), do local de trabalho (por ex., falta de equipe qualificada) e baixa demanda. Conclusão A equoterapia é considerada pelos participantes um método que contribui para melhorar aspectos biopsicossociais de idosos, porém estes profissionais enfrentam desafios na prática, dificul-tando ou impedindo que atendam pessoas na velhice.
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Matarazo JB, Freitas ER. Perception of hippotherapy professionals about their practice with the elderly. FISIOTERAPIA EM MOVIMENTO 2022. [DOI: 10.1590/fm.2022.35147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Abstract Introduction Riding therapy is a therapeutic method recently regulated in Brazil. Nevertheless, it has been studied for years, especially focusing on children and adolescents. Considering the growing number of elderly in the Brazilian population, investigations focusing on older people are increasingly necessary. Objective To analyze the perceptions of equine therapy professionals about their practice with the elderly. Methods This was a qualitative and cross-sectional research, in which the participants answered an online questionnaire, composed of demographic questions and questions related to horseback riding with the elderly. Data were analyzed using descriptive statistics and thematic content analysis. Results Twenty-five professionals (23-57 years old), graduates, who had worked for at least two years with hippotherapy (mean = 6.64; standard deviation = 5.39 years) participated. This sample was composed mostly of female professionals (72%) and physical therapists (48%). Of the total, 60% reported having already assisted at least one elderly practitioner. Among those who had never worked with this public, 90% wished to do so. All professionals considered that horseback riding can be beneficial in old age, reducing depressive symptoms and promoting psychosocial (e.g., socializing) and physical (e.g., balance) variables. Despite the benefits, professionals mentioned challenges, such as difficulties of the practitioner (e.g., fear), problems with the workplace (e.g., lack of qualified staff), and low demand. Conclusion Hippotherapy professionals consider riding therapy a method that contributes to improving biopsychosocial aspects of the elderly. However, they face challenges in this practice, hindering or preventing them from serving older people.
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Australian Community and Health Professionals Perceptions of Equine-Assisted Psychotherapy. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:2217761. [PMID: 34925526 PMCID: PMC8683167 DOI: 10.1155/2021/2217761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 10/06/2021] [Accepted: 11/03/2021] [Indexed: 11/26/2022]
Abstract
Mental health conditions are increasingly prevalent in the Australian population, and despite the large evidence-based support for contemporary treatments, there are barriers which inhibit their efficacy. Thus, there is a perceived need for therapists to consider other therapeutic options which have potential to enhance treatment outcomes. There is increasing acceptance for complementary and alternative medicines (CAM) among general practitioners and clients/general community. Specifically, more than 70% of Australians utilize CAM. Equine-assisted psychotherapy (EAP) is an underutilized, culturally sensitive, complementary therapy, which has the potential to mitigate barriers of conventional therapy. The present study aimed to determine the level of knowledge about and general acceptance of EAP as a treatment for general psychopathology symptomology within community members and health professionals. The current sample included 144 community members and 55 health professionals, all with Australian citizenship. Data analysis comprised the independent t-test and two hierarchical multiple regressions. Results indicated that community members are significantly more accepting of EAP as a treatment compared to health professionals. Of the predictors tested, higher social support and openness within community members were significant predictors of accepting perceptions, and rural location was the only significant predictor for health professional's accepting perceptions of EAP. This is one of the first studies to investigate perceptions of EAP outside the EAP field and through comparison between community members and health professionals. The current study identifies the need for future research to further investigate perceptions of EAP among Australian health professionals.
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Pérez-Gómez J, Amigo-Gamero H, Collado-Mateo D, Barrios-Fernandez S, Muñoz-Bermejo L, Garcia-Gordillo MÁ, Carlos-Vivas J, Adsuar JC. Equine-assisted activities and therapies in children with attention-deficit/hyperactivity disorder: A systematic review. J Psychiatr Ment Health Nurs 2021; 28:1079-1091. [PMID: 33171006 DOI: 10.1111/jpm.12710] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 09/03/2020] [Accepted: 10/19/2020] [Indexed: 12/26/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Attention-deficit/hyperactivity disorder (ADHD) is characterized by problems of inattention and impulsive hyperactivity in children. Equine-assisted activities and therapies (EAATs) have been used as alternative non-pharmacological intervention option in patients with ADHD. WHAT DOES THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Nowadays, more studies of high methodological quality are needed to determine whether EAAT is an effective intervention for the treatment in children with ADHD. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Between 15 and 40 min of rising horses, 8-32 total sessions, for 4-32 weeks, seem to be beneficial to reduce the symptoms of ADHD. ABSTRACT INTRODUCTION: Attention-deficit/hyperactivity disorder (ADHD) is a disorder characterized by problems of inattention and impulsive hyperactivity. Equine-assisted activities and therapies (EAATs) have become an emerging non-pharmacological intervention option in patients with ADHD. AIM To perform a systematic review of updated literature about EAAT in children with ADHD. METHOD A systematic review was performed until 28 November 2019, in four electronic databases: PubMed, Web of Science, Embase and Google Scholar. The inclusion criteria were as follows: (a) intervention programme, with pre- and post-data, based on EAAT, (b) children with ADHD and (c) articles written in English. RESULTS A total of 9 articles were found that meet the inclusion criteria. The evidence level was C for 7 studies and B for 2 studies. The level of conclusion was 3. DISCUSSION There are few studies with high methodological quality, and there is a high heterogeneity in the variables included, what make that the level of evidence and conclusion are low. CONCLUSION There is no account with enough studies of high methodological quality to determine whether EAAT is an effective intervention for the treatment in children with ADHD.
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Affiliation(s)
- Jorge Pérez-Gómez
- Health, Economy, Motricity and Education (HEME) Research Group, University of Extremadura, Cáceres, Spain
| | - Helena Amigo-Gamero
- Health, Economy, Motricity and Education (HEME) Research Group, University of Extremadura, Cáceres, Spain
| | | | | | | | | | - Jorge Carlos-Vivas
- Health, Economy, Motricity and Education (HEME) Research Group, University of Extremadura, Cáceres, Spain
| | - José Carmelo Adsuar
- Health, Economy, Motricity and Education (HEME) Research Group, University of Extremadura, Cáceres, Spain
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Nieforth LO, Craig EA. Patient-Centered Communication (PCC) in Equine Assisted Mental Health. HEALTH COMMUNICATION 2021; 36:1656-1665. [PMID: 32586134 DOI: 10.1080/10410236.2020.1785376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Experiencing trauma can lead to a variety of chronic and acute symptoms, including post- traumatic stress disorder (PTSD), anxiety, depression, substance abuse, and poor social skills. Given the variety of causes for trauma incorporating individualized treatment options is important for efficacy. Equine assisted mental health (EAMH) - a team approach incorporating equines, clients, and practitioners - has been successful in treating those who have experienced trauma, including veterans and individuals with PTSD, at-risk youth, victims of sexual violence, and children who have been neglected. Although researchers and practitioners understand some about how EAMH treatment results in positive outcomes for these individuals, little is known about the communicative processes that support them. The current study included 19 in-depth interviews with EAMH therapists and practitioners to explore the role of equine communication (i.e., congruence, ongoing positive regard, and empathy) as a communicative process that is integral to the facilitation of EAMH as individualized therapeutic treatment. Using tenets of patient-centered communication (PCC) and principles of client-centered therapy, implications for human-horse communication in therapeutic contexts and client-centered care are discussed.
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Effects of Dog-Assisted Therapy in Adolescents with Eating Disorders: A Study Protocol for a Pilot Controlled Trial. Animals (Basel) 2021; 11:ani11102784. [PMID: 34679805 PMCID: PMC8532616 DOI: 10.3390/ani11102784] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/19/2021] [Accepted: 09/22/2021] [Indexed: 12/02/2022] Open
Abstract
Simple Summary Animal-assisted therapies may lead to benefits in anxiety, depression, low self-esteem, or quality of life. These variables are commonly present among patients with eating disorders. Thus, the current pilot study will aim to evaluate the effects of a dog-assisted therapy on the eating disorders symptoms, mental, psychosocial, and physical health, quality of life, and handgrip strength of adolescents suffering from eating disorders. Thirty-two patients will participate and 16 of them will receive the intervention while the other 16 will be the control group. Both groups will continue with their treatments prescribed at the hospital, but the experimental group will participate in a dog-assisted therapy program involving 7 sessions in 7 weeks. This will be the first study to examine the effects of dog-assisted therapy in this population. Significant improvements, in the primary and secondary outcomes, may be expected based on the known benefits of AAT on self-esteem, stress, and self-control in different populations. Finally, although the program is focused on the improvement of adolescents’ health, animal welfare will be a priority in this study. Abstract Background: Eating disorders are characterized by a persistent disturbance that alters food intake and it is often accompanied by anxiety, depression, low self-esteem, or reduced functional capacity and quality of life. Animal-assisted therapies (AAT) have shown benefits in these variables in children and adult populations. Thus, the present pilot study will aim to evaluate the effects of a dog-assisted therapy on the eating disorders symptoms, mental, psychosocial, and physical health, quality of life, and handgrip strength of adolescents suffering from eating disorders. Methods: The current pilot study will involve 32 patients, who will be assigned to a control or an experimental group. Intervention will be conducted once a week for seven weeks. Neither the experimental nor the control group will discontinue their usual care. The main outcome measures will be the eating disorder symptoms and the health-related quality of life measured with standardized questionnaires, while the secondary variables will be anxiety, depression, character, behavior, strength, and body mass. Conclusions: This pilot-controlled trial will be the first to evaluate the effects of dog-assisted therapy on the physical and mental health of adolescents with eating disorders. Significant improvements, in the primary and secondary outcomes, may be expected based on the known benefits of AAT on self-esteem, stress, and self-control in different populations. Finally, although the program is focused on the improvement of adolescents’ health, animal welfare will be a priority in this study.
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Swank JM, Reese RF. Do Counselors and Other Helping Professionals Use Nature-Based Counseling? JOURNAL OF CREATIVITY IN MENTAL HEALTH 2021. [DOI: 10.1080/15401383.2021.1911725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Maresca G, Portaro S, Naro A, Crisafulli R, Raffa A, Scarcella I, Aliberti B, Gemelli G, Calabrò RS. Hippotherapy in neurodevelopmental disorders: a narrative review focusing on cognitive and behavioral outcomes. APPLIED NEUROPSYCHOLOGY-CHILD 2020; 11:553-560. [PMID: 33949903 DOI: 10.1080/21622965.2020.1852084] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Hippotherapy (HT) is a rehabilitative tool inducing psychological and motor improvements using human-horse interaction. HT provides sensory stimulation to the rider through the rhythmic and repetitive movements of the horse, facilitating communication between patients and healthcare professionals, favoring the establishment of a therapeutic alliance. The purpose of this review is to evaluate the effects of HT treatment on cognitive-behavioral processes in neurodevelopmental disorders. We screened studies published between 2002 and 2020 on PubMed, Scopus, Cochrane, and Web of Sciences databases. The search combined the following terms: "hippotherapy"; "horseback riding"; "equine-assisted therapy"; "developmental disorder"; "autism spectrum disorder"; "dyspraxia"; "infantile cerebral palsy"; and "attention-deficit/hyperactivity disorder". This review shows that HT can be a valuable tool for the treatment of developmental disorders. The psychological, cognitive and relational areas could benefit from the animal-child interaction to promote child autonomy, self-esteem, self-efficacy and openness to others. Physical, motor and psychosocial benefits were found in adolescents with anxiety and/or depression disorders, in autism spectrum disorders, dyspraxia, as well as in infantile cerebral palsy and attention deficit hyperactivity disorder. HT could be considered an alternative therapeutic tool thanks to the relationship between patient-horse-instructor and to the sensory-motor and cognitive stimulation that enforce learning processes.
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Affiliation(s)
| | | | - Antonino Naro
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy
| | | | - Antonio Raffa
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy
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Meola CC, Sias SM, Atherton WL, Leierer SJ, Crowe A, Scroggs LB. The Effects of an Equine Assisted Learning Supervision Intervention on Counselors’-in-training Performance Anxiety and Counseling Self- Efficacy. JOURNAL OF CREATIVITY IN MENTAL HEALTH 2020. [DOI: 10.1080/15401383.2020.1848674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | - Shari M. Sias
- East Carolina University, Greenville, North Carolina, USA
| | | | | | - Allison Crowe
- East Carolina University, Greenville, North Carolina, USA
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The Potential of Human-Horse Attachment in Creating Favorable Settings for Professional Care: A Study of Adolescents' Visit to a Farm. Animals (Basel) 2020; 10:ani10091707. [PMID: 32967140 PMCID: PMC7552679 DOI: 10.3390/ani10091707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/07/2020] [Accepted: 09/15/2020] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Although previous research has shown that the features of an attachment bond are fulfilled in human–dog dyads, it is still unclear if people may have horses as attachment figures. This paper examines whether adolescents’ contact with horses can result in attachment bonds and whether these forms of attachment hold any potential for motivating adolescents in professional care. The paper is based on a time-limited session where six girls and three boys, aged 16–17, were observing and interacting with free-roaming horses at a farm. The results suggest that the presence of horses may activate the development of attachment in adolescents in the same way people do. The four criteria of an attachment bond—proximity maintenance, safe haven, secure base, and separation distress—may be fulfilled in the interaction between a human and a horse. This promotes a therapeutically favorable environment for professional care that is appealing, unique, and accurate. The study provides insights into horses’ therapeutic potential in dealing with adolescents in need of professional therapy or care. Abstract Previous research has shown features of an attachment bond to be fulfilled in, for instance, human–dog dyads; however, there is a considerable lack of research on the potential attachment in human–horse relationships. Employing Bowlby’s criteria of an attachment bond and Pierce’s model of therapeutically powerful activity, this article studies whether short-term exposure to horses brings about elements of emerging attachment for adolescents and if this interaction holds potential in creating a favorable early-stage setting for professional care. It draws from group discussions carried out with nine 16–17-year-old adolescents who participated in an EASEL (Equine-Assisted Social and Emotional Learning) session when visiting a farm with a youth worker. A qualitative content analysis of the discussions revealed that some characteristics of the four principal criteria of an attachment bond—proximity maintenance, safe haven, secure base, and separation distress—were identifiable in the adolescents’ expressed experiences of observing and interacting with horses. Moreover, the three main sources of therapeutic power—appeal, accuracy, and intactness—intersected with the emerging development of the adolescents’ attachment to horses. Additionally, space for self-reflection was enhanced by the presence of the horses. The study offers insights into the potential of human–horse attachment in dealing with adolescents with and without special needs for various therapy and care purposes.
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Portaro S, Cacciola A, Naro A, Cavallaro F, Gemelli G, Aliberti B, De Luca R, Calabrò RS, Milardi D. Can Individuals with Down Syndrome Benefit from Hippotherapy? An Exploratory Study on Gait and Balance. Dev Neurorehabil 2020; 23:337-342. [PMID: 31342817 DOI: 10.1080/17518423.2019.1646830] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Purpose: To evaluate whether a hippotherapy protocol may influence balance and gait in patients with Down Syndrome (DS). Methods: Fifteen male patients affected by DS underwent a 6-month hippotherapy protocol. Stabilometric, baropodometric, and gait assessments were performed at baseline (T0) and at the end of the treatment (T1). Results: At baseline, DS patients showed a low bilateral hind foot pressure percentage at the baropodometric analysis, a high center of pressure area in the closed-eye condition, a high center of pressure sway in open- and closed-eyes recordings, a high medio-lateral and antero-posterior velocity oscillations in the closed eye condition, and a reduced step-length and velocity. After the 6-month, hippotherapy protocol, DS patients had a significant bilateral higher hindfoot pressure percentage. The stabilometric analysis revealed a lower center of pressure area in the closed-eye condition, and a significantly reduced center of pressure sway in open- and closed-eyes recordings. In addition, DS patients showed lower medio-lateral and antero-posterior velocity oscillations in the closed eye condition. Finally, hippotherapy significantly improved step length and velocity. Conclusions: This pilot study demonstrates that hippotherapy determines functional improvement in gait speed, width, bilateral symmetry, and balance in DS.
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Affiliation(s)
| | | | - Antonino Naro
- IRCSS Centro Neurolesi "Bonino Pulejo" , Messina, Italy
| | | | | | | | | | | | - Demetrio Milardi
- IRCSS Centro Neurolesi "Bonino Pulejo" , Messina, Italy.,University of Messina , Messina, Italy
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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. Equine-Assisted Therapy for Veterans with PTSD: Manual Development and Preliminary Findings. Mil Med 2020; 185:e557-e564. [PMID: 32034416 PMCID: PMC7282489 DOI: 10.1093/milmed/usz444] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION 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. MATERIALS AND METHODS 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. RESULTS 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. CONCLUSIONS 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.
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Affiliation(s)
- Shay Arnon
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
| | - Prudence W Fisher
- 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
| | - Alison Pickover
- 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
| | - Ari Lowell
- 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
| | - J Blake Turner
- 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
| | - Anne Hilburn
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
| | - Jody Jacob-McVey
- Bergen Equestrian Center, 40 Fort Lee Road, Leonia, NJ 07605
- EquiSense Solutions LLC, 33 West 93rd Street, 3B, New York, NY 10025
| | | | - Debra G Farber
- Bergen Equestrian Center, 40 Fort Lee Road, Leonia, NJ 07605
| | - Jane F Hamilton
- Rancho Bosque Equestrian Center of Excellence, House Hamilton Business Group, PLC, 8649 E Woodland Road, Tucson, AZ 85749
| | - Allan Hamilton
- Department of Surgery, University of Arizona Health Sciences Center, 1501 N. Campbell Avenue, Tucson, AZ 85724
| | - John C Markowitz
- 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
| | - Yuval Neria
- 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
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The Use of Equine-Assisted Programs for Nontraditional Undergraduate Clinical Pediatric Experiences. TEACHING AND LEARNING IN NURSING 2020. [DOI: 10.1016/j.teln.2020.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Chakales PA, Locklear J, Wharton T. Medicine and Horsemanship: The Effects of Equine-assisted Activities and Therapies on Stress and Depression in Medical Students. Cureus 2020; 12:e6896. [PMID: 32195063 PMCID: PMC7059872 DOI: 10.7759/cureus.6896] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
This study examined the use of an equine-assisted brief course module on stress and depression among medical students (n = 28), a demographic known to experience high pressure. Evidence supports that animal-assisted therapies can lead to the improvement of health and quality of life, particularly in terms of cognitive, psychological, and physical benefits. This study used the seven-session Kane Medicine and Horsemanship program; students completed pre- and post-measures one week before and after the course. Participation in the course significantly reduced perceived stress (p: 0.001), depression (p: <0.001), stress severity (p: 0.014), and stress frequency (p: 0.001) among medical students. This approach should be further investigated as an option for improving well-being among medical students.
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Affiliation(s)
| | - Jacklyn Locklear
- Obstetrics and Gynecology, University of Central Florida, Orlando, USA
| | - Tracy Wharton
- Internal Medicine, University of Central Florida, Orlando, USA
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Gatti F, Walderhaug E, Kern-Godal A, Lysell J, Arnevik EA. Complementary horse-assisted therapy for substance use disorders: a randomized controlled trial. Addict Sci Clin Pract 2020; 15:7. [PMID: 32019584 PMCID: PMC7001193 DOI: 10.1186/s13722-020-0183-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 01/27/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Treatment completion is the greatest challenge for the treatment of substance use disorders (SUDs). A previous investigation showed that complementary horse-assisted therapy (cHAT) was associated with higher retention in treatment and completion than standard treatment alone. This randomized controlled trial further explored the benefits of cHAT for patients with SUDs. METHODS Fifty patients in residential SUD treatment at the Department of Addiction Treatment, Oslo University Hospital, were randomly allocated to either cHAT (cHAT group) or treatment as usual alone (TAU-only group). The primary end-point was treatment completion. Secondary end-points were dropout, transfer to another treatment, and time in treatment. RESULTS The multinomial logistic regression analysis found no statistically significant association between intervention (cHAT) and treatment outcome (completion, dropout, transferred) among the 37 participants who were ultimately recruited to the study. Some unforeseen challenges were encountered in the study: a high number of subjects transferred to another treatment, variable attendance at cHAT sessions, and long temporary exits. Nevertheless, 44% of participants in the cHAT group completed their treatment, compared with 32% in the TAU-only group; this observation encourages further investigation in a larger sample. CONCLUSIONS Though no association was identified between cHAT and treatment retention or completion, our study may have been underpowered. Further work in a larger clinical population is needed; observational studies with repeated measures may also be useful for investigating whether cHAT increases retention in treatment or rates of completion, two important factors for successful SUD treatment. Trial registration The trial was registered and approved on 14 October 2011 by the Regional Committee for Medical and Health Research Ethics with registration number 2011/1642 and registered at ClinicalTrials.gov on 21 February 2013 with registration number NCT01795755.
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Affiliation(s)
- Francesca Gatti
- Department of Addiction Treatment, Oslo University Hospital HF, P.O 4959, 0424, Nydalen, Oslo, Norway
| | - Espen Walderhaug
- Department of Addiction Treatment, Oslo University Hospital HF, P.O 4959, 0424, Nydalen, Oslo, Norway
| | - Ann Kern-Godal
- Department of Addiction Treatment, Oslo University Hospital HF, P.O 4959, 0424, Nydalen, Oslo, Norway
| | - Jeanette Lysell
- Department of Addiction Treatment, Oslo University Hospital HF, P.O 4959, 0424, Nydalen, Oslo, Norway
| | - Espen Ajo Arnevik
- Department of Addiction Treatment, Oslo University Hospital HF, P.O 4959, 0424, Nydalen, Oslo, Norway.
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White‐Lewis S. Equine-assisted therapies using horses as healers: A concept analysis. Nurs Open 2020; 7:58-67. [PMID: 31871691 PMCID: PMC6917924 DOI: 10.1002/nop2.377] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 07/11/2019] [Accepted: 08/28/2019] [Indexed: 11/08/2022] Open
Abstract
Aims A concept analysis was conducted to clarify the attributes, antecedents and meaning of equine-assisted therapy and present an operational definition. Design Concept analysis. Methods Walker and Avant's concept analysis method was used to analyse equine-assisted therapy, using horses as healers by defining and enumerating the attributes, antecedents, consequences and empirical referents. Example cases are presented. Results Defining attributes include the following: a human participant with an equine physically present to assist the human participant, a treatment or intervention as a result of the interactions between an equine and a human participant, a purposeful and regulated interaction and a positive health outcome goal from the interaction. Antecedents include a live horse with a human physically able to interact with the horse, a facilitator and accessibility to an equine-assisted therapy (EAT) programme. Consequences include improved balance, well-being, quality of life, trust, spasticity, self-efficacy, self-esteem, nurse presence, pleasure and a sense of accomplishment.
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Trzmiel T, Purandare B, Michalak M, Zasadzka E, Pawlaczyk M. Equine assisted activities and therapies in children with autism spectrum disorder: A systematic review and a meta-analysis. Complement Ther Med 2018; 42:104-113. [PMID: 30670226 DOI: 10.1016/j.ctim.2018.11.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 11/01/2018] [Accepted: 11/02/2018] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION The multifactorial nature of Autism Spectrum Disorder (ASD) is the reason why complementary and alternative methods of treatment are sought in order to support the classic approach. OBJECTIVES The aim of the study was to assess the effectiveness of Equine-Assisted Activities and Therapies (EAAT) in ASD patients based on a review of the literature. METHODS A review of the literature and a meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PUBMED, Cochrane Library, Web of Science, ClinicalTrials.gov and PEDro databases were searched until July 20, 2017. Only articles published in English, in a journal with a review process, after 1999, with a control group or presentation of comparative pre-/post-therapy results in ASD patients, and clear inclusion/exclusion criteria were considered. The methodological quality of the included studies was assessed using the Quality Assessment Tool for Quantitative Studies (QATQS).The meta-analysis of three studies was conducted. RESULTS A total of 15 studies with 390 participants (aged: 3-16 years) were included. The interaction between psychosocial functioning and EAAT was investigated in most studies. Improvement was reported in the following domains: socialization, engagement, maladaptive behaviors, and shorter reaction time in problem-solving situations after EAAT. The meta-analysis revealed no statistically significant differences for the investigated effects. CONCLUSIONS Despite the need for further, more standardized research, the results of the studies included in this review allow us to conclude that EAAT may be a useful form of therapy in children with ASD.
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Affiliation(s)
- Tomasz Trzmiel
- Department of Geriatric Medicine and Gerontology, Poznan University of Medical Sciences, Poland.
| | - Barbara Purandare
- Department of Geriatric Medicine and Gerontology, Poznan University of Medical Sciences, Poland
| | - Michał Michalak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poland
| | - Ewa Zasadzka
- Department of Geriatric Medicine and Gerontology, Poznan University of Medical Sciences, Poland
| | - Mariola Pawlaczyk
- Department of Geriatric Medicine and Gerontology, Poznan University of Medical Sciences, Poland
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Jormfeldt H, Carlsson IM. Equine-Assisted Therapeutic Interventions Among Individuals Diagnosed With Schizophrenia. A Systematic Review. Issues Ment Health Nurs 2018; 39:647-656. [PMID: 29509053 DOI: 10.1080/01612840.2018.1440450] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Persons diagnosed with schizophrenia are not sufficiently offered health promotion interventions, notwithstanding their increased risk of bodily ill health. Physical activity is found to improve health and decrease psychiatric symptoms although, there is a challenge to motivate and increase physical activity in people with schizophrenia and innovative evidence-based treatment interventions are needed. The aim was to systematically review studies concerning equine assisted interventions among individuals diagnosed with schizophrenia. The findings of the six included articles indicate that therapeutic equine assisted interventions could be beneficial for individuals with severe mental illness such as schizophrenia or schizophrenia like disorders.
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Affiliation(s)
- Henrika Jormfeldt
- a School of Health and welfare , Halmstad University , Halmstad , Sweden
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