Equine Facilitated Mental Health Services and Social Adjustment in Adolescents on Probation

Little quantitative research has been done to verify claims that the use of horses in Equine Facilitated Mental Health and Education Services has an impact on the clients’ emotional and mental wellbeing. This study was created to determine if participation in six months of weekly involvement in an equine facilitated mental health program would lead to lower scores in an adjustment inventory, indicating greater social adjustment. The differences between pre-treatment and post-treatment scores on an adjustment inventory were measured as a function of participation in six months of weekly equine facilitated mental health sessions. Four participants were involved in the study. Two served as a control group and participated in traditional probation therapies and two served as the experimental group and were additionally enrolled in an equine facilitated mental health program. Based on test scores in an inventory of adolescent adjustment, the participants in the equine services show a decline in general adjustment as well as on subscales of Antisocial Behavior, Anger Control, Emotional Distress, and Positive Self. Discussion focuses on the implications of these data on the field of Equine Facilitated Mental Health Services, possible explanations for “acting out” behavior in adolescents and considerations for future studies. Horses and Adjustment 7 Literature Review Introduction Before recorded history human and horse have shared an intertwined pathway. Changes in the skeleton of the prehistoric horse evidence that horses were ridden and used as transportation as early as 3000 to 3500 B.C. (Olsen, 2003). The domestication of this majestic animal shaped history as its influence molded the world’s transportation, inspired culture, revolutionized warfare and facilitated long-distance trade. Using the horse, humans could travel farther, travel faster, and carry more. The horse became fearful weapon as well as transportation; a well-trained mount could inflict as much damage as its warrior rider. With the fall of the Roman Empire, the horse returned from its place in the cavalry to a position before a plow; working farmland and guiding cattle. Horses again became symbols of wealth and power as the Renaissance swept through Europe and a New World was colonized. The role of the horse changed little until the 1960’s when the horse began to be employed in physical therapy treatment, now known as hippotherapy. In more recent history, horses are being utilized in a field of psychology called Equine Facilitated Mental Health and Education Services (EFMH/ES). Equine Facilitated Mental Health and Education Services EFMH/ES is a burgeoning field of psychological therapy using horses to stimulate emotional and mental processes. These services are used by people with emotional or mental health issues, as well as individuals without these afflictions, to encourage mental, emotional, or spiritual growth. Equine Facilitated Mental Health Association (EFMHA) is a guiding organization for equine facilitated mental health Horses and Adjustment 8 practices. According to EFMHA, equine facilitated mental health and education services strive to teach human clients to “instill a sense of order, to create an understanding of boundaries, to improve focus, and to instill trust” (Equine-Facilitated Mental Health Association, 2003). An Equine Facilitated Mental Health and Education Service combines typical therapeutic tasks with equine activities. Clients of these services participate in activities such as selecting a horse “partner,” observing the interactions of the horse with the herd, grooming or cleaning the horse, leading the horse through obstacle courses, and riding the horse. Emotions and conflicts that arise during the activities are discussed and processed with the facilitating therapist and/or used as learning experiences. In this type of service the horse serves as either a catalyst for change or a metaphor for an aspect of the participant’s life. For example, the unruly horse may begin to symbolize a mother’s relationship with her unruly child. Through these equine activities the mother can confront her unconscious emotions toward her child’s behavior and practice with the horse new ways of handling the behavior at home. Equine Facilitated Mental Health and Education is also used to further education for “well” people. At Stanford University Medical School, equine facilitated education is used to teach medical students how to communicate with their patients and improve their non-verbal communication skills. According to Dr. Beverly Kane, instructor of the Medicine and Horses class, One of the things we ask the horses to do is an analogy for informed consent for a surgical operation. [. ] The way the horse signs the form is to walk across a tarp on the ground if consenting to the surgery and to resist if the surgery is a no-go. Horses and Adjustment 9 The idea is that the horse is going to let you know whether he likes the way that you touch him or he doesn’t, and you need to keep focused on the parts of the body that the horse uses to signal his displeasure (Whiting, 2007, p. 4). Animal Assisted Therapy As early as ancient Greece and Rome, dogs were kept in temples and close to the owner to promote healing and ensure mental stability (Rennie, 1997). By the 1700s, York Retreat began using animals for companions for psychiatric patients. The retreat is still in existence and continues to use animals in treatment. In the 1960’s Boris Levinson, a psychiatrist in New York, began bringing his pet dog, Jingles, into therapeutic sessions. He noted that children were more likely to respond in a positive manner when the dog was present than if only Levinson was in the room. In his observations and research, Levinson proposed that the dog acted as a catalyst; for the children Jingles was a safe subject for discussion through which their unconscious fears and anxieties were allowed to play out (Wells, 2007). Levinson’s work spurred research into realm of human-canine interactions and their role in human health. Research has noted that a relationship with a dog promotes physical and psychological wellbeing. In Well’s review of research in the relationship between canines and humans, she notes that dogs have been shown to be predictors and preventers of ill health, facilitators of recovery from poor health, and therapists (2007). For example, stroking or talking to a dog has been shown to reduce blood pressure and heart rate. In several experiments, the mere presence of a dog in the room reduced participants’ reactions to stress (Beck, 1983). Horses and Adjustment 10 Due to these research findings animals have increasingly been utilized in a therapeutic capacity, guided by organizations such as the Delta Society, the Society for Companion Animal Studies (SCAS) in the United Kingdom, and the International Association of Human-Animal Interaction Organization, which advises the United Nations (UN) and the World Health Organization (WHO). Animals in this position, including dogs, cats, and birds, work in nursing homes, prisons, psychiatric facilities, hospitals, and private homes providing owners with a relationship which has been proven physically and psychologically valuable. Despite the wellspring of research into the psychosocial effects of canines on humans, the use of horses in a mental or psychological therapeutic setting did not arise out of this newly established field of animal assisted therapy. Instead, EFMH/ES has its roots in physical therapy. Hippotherapy Humans have long recognized the ability of the horse to provide physical therapeutic support. Both hippotherapy and therapeutic riding are based on the belief that the natural movement of the horse’s gait provided a mechanism for healing the physical disabilities. In the 18th century, doctors in Europe began to recommend horseback riding as a method of improving flexibility, stability, muscle control, and posture. The world began to take notice of the healing power of hippotherapy when Liz Hartel, a young woman paralyzed with polio, won the silver medal for dressage in the 1952 Helsinki Olympic Games. Hartel acknowledged that, with the help of a physical therapist, she began intense horseback riding lessons to improve her muscle strength and coordination (Strides, 2007). Horses and Adjustment 11 Hartel’s international success introduced hippotherapy and therapeutic riding to the United States in the 1960’s. Hundreds of hippotherapy and therapeutic riding centers cropped up throughout the U.S., bringing about the formation of the North American Riding for the Handicapped Association (NARHA). NARHA provided ethical guidelines, certification, guidelines for care of working horses, and education for those interested in providing and receiving hippotherapy or therapeutic riding services. They also outlined and prescribed stringent operating and safety standards to be met at all NARHA facilities. NARHA also encouraged its members to look into other ways in which the relationship with a horse was beneficial for humans. The organization endeavored to support all equine activities that include “all the various offerings of NARHA centers and all the equine activities and therapies designed for people with disabilities and diverse needs” (North American Riding for the Handicapped Association, 2008). This methodology of branching into all aspects of the horse-human relationship led NARHA to begin to foster the small sample of clients who “may have needed less of the physical benefits derived from interaction with horses, and more of the psychosocial benefits” (Hallberg, 2007, p. 43-44). Principle Founders A grassroots movement in hippotherapy and therapeutic riding led to the formations of two guiding organizations: Equine Facilitated Mental Health Association (EFMHA), and Equine Assisted Growth and Learning Association (EAGALA). A pioneer in the field of EFMH/ES is Barbara Rector, a therapeutic ri