A SYSTEMATIC REVIEW OF THE EFFECTS OF PSYCHOTHERAPY ...

develop skills that can be applied to cross-cultural communication, so important in an everincreasing
global economy.
Theories of attachment (Bowers & McDonald, 2001; Sable, 1995) and neurodevelopment
(Perry, 2002; Perry & Hambrick, 2008) have been suggested as applicable to the theoretical
framework of equine-assisted psychotherapy. It is an established principle in psychotherapy that
the strength of attachment in the helping relationship, characterized by warmth, empathy, trust,
acceptance and collaboration is the most powerful predictor of positive client outcome (Lambert &
Bergin, 1994; see also Fine, 2000; Schultz, Remick-Barlow & Robbins, 2007;Yorke, 1997). A
successful alliance requires a connection and the mobilization of hope, and is facilitated by
encouraging a client’s sense of well-being and offering insights in a nurturing environment while
encouraging the development of mastery. Horses involved in the therapeutic process can be a
useful adjunct in the establishment of the therapeutic relationship and to enhance the
development of the alliance.
Horses provide warm and accepting companionship, which provides essential comfort
and an unconditional support system to individuals in turmoil (Fine, 2000).
Psychotherapy
involving horses has the singular advantage of therapeutic touch in a manner not possible with
smaller companion animals, or for obvious ethical reasons, with the therapist. Because the horse
can be ridden it is possible that neural circuits can be re-wired in an adaptive manner, although
care must be exercised with certain populations, for example, clients with a history of trauma or
abuse (see Appendix C).
Recent research on the therapeutic effects of exercise, particularly with depressed
clients is intriguing in its applicability to the theoretical base of this treatment strategy (Brosse,
Sheets, Lett & Blumenthal, 2002; Cripps, 2008; Johnson, 2009; Penedo & Dahn, 2005; Tsang,
Chan & Cheung, 2008). The barn as milieu (Hallberg, 2008; Pressly & Heesacker, 2001) has also
been put forth as an avenue for investigation, as has risk behavior application (Bailey, 2007; see
also Biery, 1985; Mayberry, 1978; Roberts, 1994) All of these areas hold promise as the
theoretical underpinnings of equine-facilitated psychotherapy continue to be constructed.
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