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Provan M, Ahmed Z, Stevens AR, Sardeli AV. Are equine-assisted services beneficial for military veterans with post-traumatic stress disorder? A systematic review and meta-analysis. BMC Psychiatry 2024; 24:544. [PMID: 39085783 PMCID: PMC11293092 DOI: 10.1186/s12888-024-05984-w] [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: 10/01/2023] [Accepted: 07/24/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Equine-assisted services (EAS) involves the use of horses within therapy, learning or horsemanship sessions and has been used with military veterans suffering from post-traumatic stress disorder (PTSD). This study systematically reviewed existing research on the use of EAS in the treatment of PTSD in military veterans and evaluated its effectiveness. METHODS A systematic review was performed, in May 2023, with searches and data extraction carried out from three separate databases (PubMed, JSTOR and Science Direct) related to testing the effect of EAS on PTSD outcomes in veterans. A risk of bias assessment of included studies was conducted and meta-analysis of outcomes performed when two or more studies reported the same outcomes. Other effects of EAS on veterans' health were also discussed. RESULTS A total of 13 studies were identified based on our inclusion and exclusion criteria with 11 originating from the US and the remaining two from Australia and Israel. There were 344 participants amongst all of the studies with a mean age of 47 years and a male:female ratio of 19:6. Eight out of the 13 studies reported PTSD scores, as measured by either PTSD Checklist for DSM-5 (PCL-5) or PCL-Veteran/-Military versions (PCL-V/-M), and results suggested a reduction in PTSD score after EAS treatment of 22.6%. A meta-analysis confirmed that EAS favored a significantly lower PTSD score after treatment, with a mean difference of 12.46, 95% CI [9.03,15.88], p < 0.00001. However, only one study had low risk of bias whilst all the rest of the studies had some concerns to high risk of bias. CONCLUSIONS EAS appeared to have a positive influence on PTSD symptoms in military veterans, significantly reducing PTSD severity scores. Other benefits of EAS may be peer support, social integration, learning new skills and bonding. However, the results of this systematic review must be interpreted with caution as almost all of the studies were of low quality. Therefore, further rigorous research is required with larger participants to be able to draw conclusions about the benefits of EAS on PTSD severity.
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Affiliation(s)
- Maisy Provan
- Institute for Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Zubair Ahmed
- Institute for Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
- Centre for Trauma Sciences Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Andrew R Stevens
- Institute for Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Amanda V Sardeli
- Institute for Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
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Sebalj M, Lakhani A, Grindrod A, Stuckey R. Equine-assisted services for people living with dementia: a systematic review. Alzheimers Res Ther 2024; 16:76. [PMID: 38589888 PMCID: PMC11003033 DOI: 10.1186/s13195-024-01453-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 04/04/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Dementia has a significant impact on the social, physical, and psychological wellbeing of people living with dementia, their families and society. Animal-assisted interventions can have positive effects on the health and wellbeing of people living with dementia. Equine-assisted services are animal-assisted non-pharmacological interventions which have improved the health and wellbeing of diverse populations. The impact of participating in equine-assisted services on the health and wellbeing of people with dementia is unclear. A systematic review was conducted to synthesise evidence investigating the effects of participating in equine-assisted services on the health and wellbeing of people living with dementia. DESIGN Systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. METHODS The databases CINAHL, EMBASE, MEDLINE, and Web of Science were searched for any research published prior to 14 June 2023. Peer-reviewed publications in the English language utilizing methods deriving quantitative and/or qualitative data were eligible. Methodological quality of included studies was assessed using the Mixed Methods Appraisal Tool. Findings from studies were synthesised using a deductive approach. RESULTS Of the 223 articles screened, six met the inclusion criteria: four quantitative and two qualitative studies. The six studies represent four separate equine interventions. Studies were of moderate to strong quality. Participants were people living with dementia (n = 44, mean age range 70-83 years), dementia care partners (n = 5, mean age 58), and equine-assisted services providers (n = 5). Interventions varied in duration, activities conducted, outcomes measured, and measurement tools used. Studies found a favourable impact of participating in equine-assisted services on the neuropsychiatric symptoms and quality of life of people living with dementia. Participating in equine-assisted services improved well-being, functional abilities, social participation, and communication, while also having a positive effect on social, emotional, and behavioural outcomes, and physical health. CONCLUSIONS The limited but high-quality literature investigating the impact of equine-assisted services among people living with dementia suggests that equine-assisted services can have a positive impact on the health and wellbeing of people living with dementia. Additional robust studies contributing to the evidence base are warranted; such studies can support the development of programs and further elucidate the impact of participation.
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Affiliation(s)
- Menka Sebalj
- School of Psychology and Public Health, La Trobe University, Kingsbury Drive, Bundoora, Vic, 3086, Australia
| | - Ali Lakhani
- School of Psychology and Public Health, La Trobe University, Kingsbury Drive, Bundoora, Vic, 3086, Australia.
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Logan Campus, University Drive, Meadowbrook, QLD, 4131, Australia.
- Palliative Care Department, Eastern Health, 251 Mountain Highway, Wantirna, VIC, 3152, Australia.
| | - Andrea Grindrod
- School of Psychology and Public Health, La Trobe University, Kingsbury Drive, Bundoora, Vic, 3086, Australia
- Palliative Care Department, Eastern Health, 251 Mountain Highway, Wantirna, VIC, 3152, Australia
| | - Rwth Stuckey
- School of Psychology and Public Health, La Trobe University, Kingsbury Drive, Bundoora, Vic, 3086, Australia
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Marchand WR, Smith J, Nazarenko E, Joubert K, Black H, Osborne M, Andersen S, Bell K, Baldwin S, Klinger W, Connelly H, Sheppard S, Hoopes K. A Pilot Replication Study of Implementing an Equine-Assisted Services Program Within a VA Residential Substance Use Disorder Treatment Program. Mil Med 2024; 189:e220-e226. [PMID: 37522743 DOI: 10.1093/milmed/usad274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/27/2023] [Accepted: 07/10/2023] [Indexed: 08/01/2023] Open
Abstract
INTRODUCTION Veterans have high rates of substance use disorders and other mental health conditions including post-traumatic stress disorder. Effective treatments for these conditions exist; however, high attrition rates and residual symptoms after completing treatment are common. Complementary treatment approaches could enhance treatment engagement and/or response among this population. We previously reported a study of one such intervention, an equine-assisted learning, and psychotherapy incorporating horses intervention provided to veterans admitted to a Veterans Health Care Administration residential substance abuse treatment program. The first aim of this study was to replicate the previous study assessing the safety, feasibility, and preliminary outcomes of this intervention. The second aim was to examine the effect of participants attending multiple intervention sessions. MATERIALS AND METHODS Participants were 94 veterans who participated in one to six sessions of a 3-4-hour program consisting of both equine-assisted learning and psychotherapy incorporating horses. Pre- and post-session administration of the Positive and Negative Affect Scale, State-Trait Anxiety Inventory, and Craving Experience Questionnaire was utilized to assess changes in affect, anxiety, and craving. Wilcoxon signed-rank or paired two-tailed t-tests were utilized for pre- to post-session comparisons of the outcome measures for sessions 1-4. Generalized linear mixed-effects (GLME) models were constructed to determine the impact of dosage. GLME models were constructed to determine the impact of dosage. RESULTS As with our previous study, the intervention was safe and feasible to utilize for this population. There were statistically significant pre- to post-session improvements, with medium-to-large effect sizes, for sessions 1-3 for negative affect and sessions 1 and 2 for positive affect, anxiety, and craving. The GLME models revealed no statistical significance for any of the predictors. CONCLUSIONS Taken together, this study and our previous investigation of this equine-assisted services intervention suggest that it is safe and feasible to utilize for veterans admitted to a residential substance abuse treatment program and we have now found short-term benefits in two separate studies. Thus, a randomized controlled trial of this intervention is warranted to demonstrate cause and effect and determine whether longer-term benefits are associated with the intervention. The finding that there was no additional benefit from attendance at more than two intervention sessions suggests that dose-response relationship studies of equine-assisted services interventions for veterans are needed.
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Affiliation(s)
- William R Marchand
- VISN 19 Whole Health Flagship Site, VA Salt Lake City Health Care System, Salt Lake City, UT 84108, USA
- Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, USA
- Department of Animal, Dairy and Veterinary Sciences, Utah State University, Logan, UT 84322, USA
| | - Judy Smith
- Department of Animal, Dairy and Veterinary Sciences, Utah State University, Logan, UT 84322, USA
| | - Elena Nazarenko
- VISN 19 Whole Health Flagship Site, VA Salt Lake City Health Care System, Salt Lake City, UT 84108, USA
| | - Katryna Joubert
- Mental Health Service, VA Salt Lake City Health Care System, Salt Lake City, UT 84108, USA
| | - Heather Black
- Mental Health Service, VA Salt Lake City Health Care System, Salt Lake City, UT 84108, USA
| | - Makenna Osborne
- Department of Animal, Dairy and Veterinary Sciences, Utah State University, Logan, UT 84322, USA
| | - Sarah Andersen
- Department of Animal, Dairy and Veterinary Sciences, Utah State University, Logan, UT 84322, USA
| | - Kylie Bell
- Department of Animal, Dairy and Veterinary Sciences, Utah State University, Logan, UT 84322, USA
| | - Shannon Baldwin
- Mental Health Service, VA Salt Lake City Health Care System, Salt Lake City, UT 84108, USA
| | - William Klinger
- Mental Health Service, VA Salt Lake City Health Care System, Salt Lake City, UT 84108, USA
| | - Heather Connelly
- Mental Health Service, VA Salt Lake City Health Care System, Salt Lake City, UT 84108, USA
| | - Stephen Sheppard
- Mental Health Service, VA Salt Lake City Health Care System, Salt Lake City, UT 84108, USA
| | - Karl Hoopes
- Department of Animal, Dairy and Veterinary Sciences, Utah State University, Logan, UT 84322, USA
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Seery R, Wells D. An Exploratory Study into the Backgrounds and Perspectives of Equine-Assisted Service Practitioners. Animals (Basel) 2024; 14:347. [PMID: 38275806 PMCID: PMC10812823 DOI: 10.3390/ani14020347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/10/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
Equine-Assisted Services (EASs) are commonplace in today's society, but vary widely in both theoretical and practical applications. Until now, practitioners' experiences and perspectives in relation to these services have received little attention. To address this, a purpose-designed online questionnaire was distributed to EAS practitioners, exploring issues relating to the nature of the service provided, practice patterns, practitioner education, perceived knowledge, challenges faced and the future direction of these services. An analysis revealed a significant association between practitioners' backgrounds and the nature of the service offered, as well as perceived knowledge. Median EAS training received to first practice was 20 days of block release over a year; however, nearly half of the sample (42.4%) reported less training than this. Equine-specific training was more limited, with 41.5% of practitioners having no horse-relevant qualifications. The most important challenges reported by practitioners involved client and equine welfare, financial sustainability and raising awareness of EAS. This research highlights the diverse nature of EAS and also raises important challenges and possible opportunities for development. Findings suggest that more progress is needed to professionalise and legitimise the area to support and help practitioners provide the best service for all concerned.
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Affiliation(s)
- Rita Seery
- Animal Behaviour Centre, School of Psychology, Queen’s University Belfast, Belfast BT7 1NN, UK;
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Li J, Sánchez-García R. Equine-assisted interventions for veterans with posttraumatic stress disorder: a systematic review. Front Psychiatry 2023; 14:1277338. [PMID: 38025432 PMCID: PMC10654975 DOI: 10.3389/fpsyt.2023.1277338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
Equine-assisted intervention therapy has a nearly 60-year history and has been shown to have a significant positive impact on various types of psychotherapy patients. Due to an increase in research on EAT, the number of existing methods of equine-assisted intervention therapy has gradually increased. Based on existing literature on the application of equine-assisted intervention therapy on veterans with post-traumatic stress disorder (PTSD), this study examines the characteristics of several types of equine interventions and includes a systematic review of peer-reviewed literature on equine-assisted interventions for veterans with PTSD published over the past 5 years, from 2018 to the present. Ten articles met the review criteria and served as the primary data for analysis. Several types of equine-assisted interventions were shown to have a beneficial psychological impact on veterans. However, some limitations were also found in the studies, such as that the majority of experiments were constrained by small sample sizes. Equine-assisted intervention therapy has been shown to be effective, but further research is merited, in order to focus on the specific details and theories involved in equine-assisted interventions, and on the welfare of the horses involved in the therapy.
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Affiliation(s)
- Jiaxin Li
- Facultad de Ciencias de la Actividad Física y del Deporte (INEF), Universidad Politécnica de Madrid, Madrid, Spain
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Marchand WR, Sullivan-Sakaeda L, Lackner R, Taplin D, Nazarenko E. A replication study of a psychotherapy incorporating horses resiliency intervention for healthcare workers. Complement Ther Med 2023; 76:102965. [PMID: 37473927 DOI: 10.1016/j.ctim.2023.102965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/16/2023] [Accepted: 07/17/2023] [Indexed: 07/22/2023] Open
Abstract
OBJECTIVES The first aim of this pilot observational study was to replicate a previous study of a resiliency psychotherapy incorporating horses (PIH) intervention for healthcare workers. The second aim was to address some gaps in the literature regarding equine-assisted services more broadly. DESIGN Prospective open trial. SETTING A large healthcare system and a community equine facility INTERVENTION: A single-session four-hour intervention that focused on participants resilience. MAIN OUTCOME MEASURES Safety, feasibility, and utilization were assessed, and psychological instruments were administered. Instruments utilized were the Positive and Negative Affect Scale the Acceptance and Action Questionnaire II, and the Conner-Davidson Resiliency Scale. RESULTS Thirty-eight subjects participated in the study, the majority of which were female (71.1 %). The age group with the most representation included those ranging from age 25-34. The intervention was safe but underutilized. Participation was associated with improved psychological flexibility (PF), and positive affect, as well as reduction in negative affect pre- to post-intervention. There was no change in resiliency and there were no associations between improvements in affect and PF. CONCLUSIONS Resiliency PIH interventions for healthcare workers can be utilized safely and likely result in short-term psychological benefits for participants. Future randomized controlled investigations are warranted, and these studies should implement methods to maximize utilization. Additionally, this study and the literature suggest that enhanced affect and PF are likely important EAS outcomes across a variety of interventions. These constructs should be investigated with more rigorous studies including comparisons of interventions with and without a psychotherapy component.
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Affiliation(s)
- William R Marchand
- VISN 19 Whole Health Flagship site, VA Salt Lake City Health Care System, 500 Foothill Drive, Salt Lake City, UT 84148, USA; Department of Psychiatry, University of Utah, 501 Chipeta Way, Salt Lake City, UT 84108, USA; Department of Animal, Dairy and Veterinary Sciences, Utah State University, 4815 Old Main Hill, Logan, UT 84322, USA.
| | | | - Ryan Lackner
- VISN 19 Whole Health Flagship site, VA Salt Lake City Health Care System, 500 Foothill Drive, Salt Lake City, UT 84148, USA
| | - Dylan Taplin
- VISN 19 Whole Health Flagship site, VA Salt Lake City Health Care System, 500 Foothill Drive, Salt Lake City, UT 84148, USA
| | - Elena Nazarenko
- VISN 19 Whole Health Flagship site, VA Salt Lake City Health Care System, 500 Foothill Drive, Salt Lake City, UT 84148, USA
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Marchand WR. Potential Mechanisms of Action and Outcomes of Equine-Assisted Services for Veterans with a History of Trauma: A Narrative Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6377. [PMID: 37510609 PMCID: PMC10379349 DOI: 10.3390/ijerph20146377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/08/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023]
Abstract
Equine-assisted services (EASs) are being increasingly used as complementary interventions for military veterans who have experienced trauma. However, there is limited evidence of benefit for this population and almost no literature describing the desired potential outcomes and possible mechanisms of action. The aim of this article is to address these gaps by reviewing the extant literature of animal-assisted interventions in general, and equine-assisted services in particular, with the goal of providing guidance for future investigations in the field. Currently, the field is in the early stage of scientific development, but published results are promising. Interventions that enhance treatment compliance and/or outcomes could benefit this population. Preliminary results, reviewed herein, indicate that EAS interventions might benefit the military veteran population by enhancing treatment engagement and therapeutic alliance, as well as by contributing to symptom reduction and resulting in various transdiagnostic benefits. It is recommended that future studies include exploration of potential beneficial outcomes discussed herein, as well as investigate suggested mechanisms of action.
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Affiliation(s)
- William R Marchand
- VISN 19 Whole Health Flagship Site, VA Salt Lake City Health Care System, 500 Foothill, Salt Lake City, UT 84148, USA
- Department of Psychiatry, School of Medicine, University of Utah, 501 Chipeta Way, Salt Lake City, UT 84108, USA
- Animal, Dairy and Veterinary Sciences, Utah State University, 4815 Old Main Hill, Logan, UT 84322, USA
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Marchand WR, Smith J, Hoopes KH, Osborne M, Andersen SJ, Bell K, Nazarenko E, Macneill R, Joubert K. A pilot observational study of horsemanship skills training for veterans with posttraumatic stress disorder. Complement Ther Med 2023; 72:102910. [PMID: 36535458 DOI: 10.1016/j.ctim.2022.102910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES Pilot assessment of an equine-assisted services intervention for Veterans with posttraumatic stress disorder. DESIGN Prospective cohort. SETTING A large Veterans Administration healthcare system. INTERVENTION Two sessions of instruction in horsemanship skills and two sessions of trail rides. MAIN OUTCOME MEASURES Safety and feasibility of recruitment, retention, providing the intervention, and measuring outcomes, as well as acceptability of the intervention to the population studied were the main outcome measures. RESULTS There were no injuries among the 18 participants, 6 staff, or 11 equines over the 3 months of the study. Eleven of 12 (92 %) planned intervention sessions were provided, with one being canceled due to weather. Out of approximately 1800 potential subjects, 21 were enrolled within three months and three dropped out before the first session. The mean number of sessions attended was 3 % and 52 % of participants completed all sessions. The mean PACES score for all sessions together was 109 (SD = 12), with a range of 50-126. Pre- to one-month post-intervention exploratory results indicated increased psychological flexibility (p = 0.008) and positive affect (p = 0.008) as measured by the Acceptance and Action Questionnaire II and the Positive and Negative Affect Scale, respectively as well as decreased PTSD (p = 0.001) and depressive symptoms (p = 0.017) as measured by the PTSD Checklist for DSM 5 and the Beck Depression Inventory, respectively. CONCLUSIONS Results suggest the intervention can be conducted with minimal risk. Further, it was feasible to recruit participants as well as provide the intervention and measure exploratory outcomes. Session attendance and PACES scores indicate acceptability to the Veteran population. The exploratory results will provide sample size estimates for future randomized controlled studies of this intervention Future studies should plan for missed sessions due to weather and consider compensating subjects to enhance retention. Finally, this work provides preliminary evidence that this intervention, without a mental health treatment component, might benefit the mental health of Veterans with PTSD.
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Affiliation(s)
- William R Marchand
- VISN 19 Whole Health Flagship Site, VA Salt Lake City Health Care System, 500 Foothill Drive, Salt Lake City, UT 84148, USA; Department of Psychiatry, University of Utah, 501 Chipeta Way, Salt Lake City, UT 84108, USA; Department of Animal, Dairy and Veterinary Sciences, Utah State University, 4815 Old Main Hill, Logan, UT 84322, USA.
| | - Judy Smith
- Department of Animal, Dairy and Veterinary Sciences, Utah State University, 4815 Old Main Hill, Logan, UT 84322, USA
| | - Karl H Hoopes
- Department of Animal, Dairy and Veterinary Sciences, Utah State University, 4815 Old Main Hill, Logan, UT 84322, USA
| | - Makenna Osborne
- Department of Animal, Dairy and Veterinary Sciences, Utah State University, 4815 Old Main Hill, Logan, UT 84322, USA
| | - Sarah J Andersen
- Department of Animal, Dairy and Veterinary Sciences, Utah State University, 4815 Old Main Hill, Logan, UT 84322, USA
| | - Kylie Bell
- Department of Animal, Dairy and Veterinary Sciences, Utah State University, 4815 Old Main Hill, Logan, UT 84322, USA
| | - Elena Nazarenko
- VISN 19 Whole Health Flagship Site, VA Salt Lake City Health Care System, 500 Foothill Drive, Salt Lake City, UT 84148, USA
| | - Rachel Macneill
- Mental Health Service, VA Salt Lake City Health Care System, 500 Foothill Drive, Salt Lake City, UT 84148, USA
| | - Katryna Joubert
- Mental Health Service, VA Salt Lake City Health Care System, 500 Foothill Drive, Salt Lake City, UT 84148, USA
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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; 17:81. [PMID: 36517823 PMCID: PMC9749232 DOI: 10.1186/s13011-022-00506-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 11/14/2022] [Indexed: 12/15/2022] Open
Abstract
The implementation of equine-assisted services (EAS) during treatment for psychological disorders has been frequently documented; however, little is known about the effect of EAS on outcomes for populations with substance use disorder (SUD). The purpose of this scoping review was to synthesize existing literature reporting the effects of EAS when incorporated into SUD treatment. This review followed guidelines in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist for scoping reviews. A search of four databases (MEDLINE/PubMed, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Academic OneFile) identified studies reporting quantitative and/or qualitative data for an EAS intervention that was implemented among a population receiving treatment for and/or diagnosed with SUD. Of 188 titles, 71 underwent full-text assessment and six met inclusion criteria. Three additional articles were identified through other sources. Quantitative data suggested a potential positive effect of EAS on SUD treatment retention and completion as well as participants' mental health; however, studies were limited by small sample sizes. Qualitative data indicated that in addition to participants developing bonds with the horses and perceiving EAS as welcomed breaks from traditional treatment, they experienced increased self-efficacy, positive emotional affect, and SUD treatment motivation. Due to methodological limitations and an overall dearth of available studies, the effectiveness of EAS as adjuncts to SUD treatment is inconclusive. Additional research is necessary before supporting broad implementation of EAS as adjuncts to SUD treatment.
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Affiliation(s)
- Liam Diaz
- grid.413319.d0000 0004 0406 7499Addiction Medicine Center, Prisma Health, 876 W Faris Rd, Greenville, SC 29605 USA
| | - Mirinda Ann Gormley
- grid.413319.d0000 0004 0406 7499Addiction Medicine Center, Prisma Health, 876 W Faris Rd, Greenville, SC 29605 USA ,grid.413319.d0000 0004 0406 7499Department of Emergency Medicine, Prisma Health, 701 Grove Rd, Greenville, SC 29605 USA ,grid.26090.3d0000 0001 0665 0280Department of Public Health Sciences, Clemson University College of Behavioral, Social, and Health Science, 503 Edwards Hall, Clemson, SC 29631 USA ,grid.254567.70000 0000 9075 106XDepartment of Emergency Medicine, University of South Carolina School of Medicine- Greenville, 701 Grove Rd, Greenville, SC 29605 USA
| | - Ashley Coleman
- grid.413319.d0000 0004 0406 7499Addiction Medicine Center, Prisma Health, 876 W Faris Rd, Greenville, SC 29605 USA
| | - Abby Sepanski
- grid.413319.d0000 0004 0406 7499Addiction Medicine Center, Prisma Health, 876 W Faris Rd, Greenville, SC 29605 USA
| | | | - Angelica Perez
- grid.413319.d0000 0004 0406 7499Addiction Medicine Center, Prisma Health, 876 W Faris Rd, Greenville, SC 29605 USA ,grid.26090.3d0000 0001 0665 0280Clemson University School of Health Research, 605 Grove Rd., Suite 301, Greenville, SC 29605 USA
| | - Alain H. Litwin
- grid.413319.d0000 0004 0406 7499Addiction Medicine Center, Prisma Health, 876 W Faris Rd, Greenville, SC 29605 USA ,grid.26090.3d0000 0001 0665 0280Clemson University School of Health Research, 605 Grove Rd., Suite 301, Greenville, SC 29605 USA ,grid.254567.70000 0000 9075 106XDepartment of Medicine, University of South Carolina School of Medicine- Greenville, 701 Grove Rd, Greenville, SC 29605 USA ,grid.413319.d0000 0004 0406 7499Department of Internal Medicine, Prisma Health, 876 W Faris Rd, Greenville, SC 29605 USA
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Marchand WR, Sullivan-Sakaeda L. A pilot observational study of a psychotherapy incorporating equines resiliency intervention for staff at a large medical center. Complement Ther Clin Pract 2022; 49:101660. [PMID: 35988323 DOI: 10.1016/j.ctcp.2022.101660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 06/12/2022] [Accepted: 08/10/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND and purpose: Stress and burnout among healthcare workers are significant public health concerns. The primary aim of this pilot study was to conduct preliminary assessments of safety, feasibility, and participant satisfaction with a psychotherapy incorporating equines (PIE)-based resiliency intervention for healthcare workers. The overarching goal was to lay the groundwork for future, more rigorous investigations. Lastly, a very preliminary assessment of using the Acceptance and Action Questionnaire II (AAQII) to assess for changes in psychological flexibility (PF) associated with PIE was conducted. MATERIALS AND METHODS Thirty-seven staff members from a medical center participated in a 4-h PIE-based resiliency retreat. Pre- and post-intervention instruments were utilized to assess participants' self-perception of physical and psychological health (PROMIS Global Short Form) and enjoyment of (Physical Activity Enjoyment Scale) and satisfaction with (Client Satisfaction Questionnaire) the intervention, as well as changes in PF (AAQII). RESULTS There were no adverse effects on participants, staff, or equines. Preliminary results suggested that the intervention was perceived as enjoyable by participants. However, the intervention was not fully utilized. Finally, there was a significant (p = 0.02) pre-to post-intervention change in AAQII scores. CONCLUSION This study provides a foundation for future rigorous studies of PIE-based resiliency interventions for medical staff. Given the limitations of this pilot work, firm conclusions cannot be drawn regarding safety and feasibility. However, the preliminary results suggest that future studies of this intervention are warranted and that the AAQII may be a useful instrument to assess for possible changes in PF.
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Affiliation(s)
- William R Marchand
- VISN 19 Whole Health Flagship Site, Located at VA Salt Lake City Health Care System, 500 Foothill Drive, Salt Lake City, UT, 84148, USA; Department of Psychiatry, University of Utah, 501 Chipeta Way, Salt Lake City, UT, 84108, USA; Department of Animal, Dairy and Veterinary Sciences, Utah State University, 0500 Old Main Hill, Logan, UT, 84322, USA.
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Hultsjö S, Jormfeldt H. The Role of the Horse in an Equine-Assisted Group Intervention-as Conceptualized by Persons with Psychotic Conditions. Issues Ment Health Nurs 2022; 43:201-208. [PMID: 34543163 DOI: 10.1080/01612840.2021.1975332] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Adopting positive health interventions is necessary to promote self-image, improve well-being, support meaningful social interaction and reduce loneliness, with benefits for psychological and physical health for persons with psychotic conditions. Raised awareness of the potential benefits of involving horses in these kinds of interventions is warranted. Thus, the aim of this study was to explore the role of the horse in equine-assisted interventions (EAI) as conceptualized among persons with psychotic conditions. Interviews were conducted with eight persons with psychotic conditions who had participated in an EAI, and data were analyzed following conventional qualitative content analysis. The results illustrate how the horse united the group and facilitated personal maturity both at a group level and at a personal level. In the group the horse facilitated interaction and became a healthy and normal topic of discussion. The interaction between the horse and others helped the participants to become aware of and reflect on behaviors of oneself and of others. At an individual level, the horse helped to develop participants' identities and growth by offer mutual friendship. With its size and calming way of being, the horse evoked a healing power among participants who identified characteristics of themselves in the horse. Through its clear body language and communication, the horse facilitated personal maturity and development among the participants that would not have occurred without the horse's presence.
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Affiliation(s)
- Sally Hultsjö
- Department of Psychiatry, Region Jönköping County, Sweden.,Department of Health, Medicine and Caring Sciences, Division of Nursing and Reproductive Health, Linköping University, Linköping, Sweden
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Hoopes KH, Osborne M, Marchand WR, Joubert K, Nazarenko E, Black H, Klinger W, Sheppard S. A pilot observational study of recreational trail riding for Veterans with addictive disorders. Complement Ther Med 2022; 65:102813. [DOI: 10.1016/j.ctim.2022.102813] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 02/01/2022] [Accepted: 02/02/2022] [Indexed: 11/03/2022] Open
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Impact of Equine-Assisted Interventions on Heart Rate Variability in Two Participants with 22q11.2 Deletion Syndrome: A Pilot Study. CHILDREN 2021; 8:children8111073. [PMID: 34828786 PMCID: PMC8617898 DOI: 10.3390/children8111073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/12/2021] [Accepted: 11/18/2021] [Indexed: 11/23/2022]
Abstract
People with disabilities due to genetic origin often present high levels of stress: non-pharmacological interventions such as Equine-Assisted Interventions (EAI) may be a useful strategy. The objective of this pilot study was to evaluate stress levels in two participants with 22q11.2 deletion syndrome diagnosis, immediately after carrying out the EAI. A single case experimental design methodology was chosen due to the small sample size. Two participants with 22q11.2 Deletion Syndrome, a rare disease, with different comorbidities were included. The present study considered the EAI as the independent variable while the Heart Rate Variability (HRV) represented the dependent one, as HRV is considered an indicator of stress level. Measurements were performed before and after carrying out the interventions. The results showed an HRV increase in one of the participants and an increase in the arousal level evidenced by a decrease in his HRV. After having carried out the program, EAI seems to cause an impact on the activation level of the participants depending on the typology and nature of the intervention. However, these results should be treated with caution due to the small sample size. This study is a pilot to test the feasibility of the proposed interventions on the variable under study.
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