A SYSTEMATIC REVIEW OF THE EFFECTS OF PSYCHOTHERAPY ...

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CHAPTER 1 INTRODUCTION Horses are powerful, and therapeutic interventions involving horses for people with various disabilities and difficulties are not recent phenomena: History is rich with accounts of the extraordinary curative effects associated with interaction with equines. However, significant scholarly attention was not directed toward animal-assisted therapeutic interventions in general until the 1960’s (Christian, 2005; Eggiman, 2006; Fine, 2000; Levinson, 1962), and only relatively recently has the literature regarding specific equine-facilitated therapeutic techniques begun to emerge. Since the 1950’s, worldwide attention to the potential therapeutic effects of interactions with horses has increased exponentially, with an attendant increase in the number of therapeutic horsemanship facilities available to the public. In the decades since then, the literature on the beneficial effects of horsemanship has grown substantially, particularly regarding the positive physical results of therapeutic interventions utilizing horses. In the past ten years, building upon this accumulating body of anecdotal and other evidence, interest in this therapeutic modality has virtually exploded. Sentimental public campaigns and widespread media attention invoke awareness of the favorable outcomes reported from involving horses in the therapeutic process; however, there is a dearth of rigorous evidence to support such claims. Despite a call for research dating back at least to the 1970’s (Mayberry, 1978; Potter, Evans & Nolt, 1994), only a handful of studies on the positive physical effects of horsemanship as therapy exist that are considered methodologically sound, and even fewer that demonstrate empirical support for psychosocial improvements. 1
The purpose of this systematic review is to examine the evidence for the psychosocial benefits resulting from involving horses in the therapeutic process. This inquiry attempts to provoke thoughtfulness in answering questions raised in the application of evidence-based practice and in conforming to principles of best practice: Does it work? For whom? And why? Specifically, the following questions will be examined: 1. Does involving horses in the therapeutic process result in psychosocial benefits for participants? 2. What is the strength of the research that has examined the above question? 3. Does the research support recommendations for equine-assisted activities integrated into the course of psychotherapy? 4. What are future research needs and recommendations? Further, horsemanship as a therapeutic intervention is discussed in historical context, and the theoretical underpinnings are examined. A framework upon which to base an understanding of this treatment approach is constructed, with the overarching aim of enhancing the credibility of this unique intervention, and thereby to increase consideration and scholarly attention to this treatment strategy, leading to sorely needed research funding and, consequently, a recognition of whether the methods described herein are a viable approach to treatment for mental health difficulties, ultimately leading to third-party reimbursement. Most importantly, this review is intended as a critical appraisal of the evidence for the effectiveness of this treatment approach in order to protect the consumer’s right to informed consent and to encourage further development of the field. 1.1 Historical Context Seemingly embedded within our genetic code, the sound of hoofbeats across the landscape is immediately recognizable and unmistakable to the human ear. According to a recent exhibition mounted by the American Museum of Natural History, horses have been evolving for an estimated 50 million years—a far longer time than humans have inhabited the earth. Perhaps more than any other animal, images of horses appear in prehistoric European cave art. At least 2
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Page 3 and 4: ACKNOWLEDGEMENTS Some time ago I ca
Page 5 and 6: TABLE OF CONTENTS ACKNOWLEDGEMENTS
Page 7 and 8: APPENDIX 6. FUTURE DIRECTIONS .....
Page 9: LIST OF TABLES Table Page 2.1 GRADE
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Page 19 and 20: vendor (Borzo, 2002). Interestingly
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Beckman-Devik, L. & Ansin, C, (Wint
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(http://www.horsesandhumans.org/Res
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handling, grooming, longeing, ridin
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APPENDIX C PRECAUTIONS AND CONTRAIN
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An acute episode of “reactive air
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REFERENCES Acampora, T. (2008). Not
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Birch, A. & Hong, C. S. (2007). A l
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Cornelius, S. (2002). An explorator
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Fine, A., H. (2000). Animals and th
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Hansen, K., Messinger, C., Baun, M.
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*Kaiser, L. K., Spence, L. J., Lave
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Levinson, B. M. (1972). Man, animal
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National Association of Social Work
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Root, A. (2000). Equine-assisted th
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Tedeschi, P. (1992). Guidelines for
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Yorke, J. (2008). The significance
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