A SYSTEMATIC REVIEW OF THE EFFECTS OF PSYCHOTHERAPY ...

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3.1.6 Long-term Effects Two studies reported follow-up data on the long-term effects of equine-involved interventions (Klontz et al, 2007; Shambo et al, 2007). Klontz et al. found no significant changes in any of the measures from posttest to six-month follow-up. Shambo et al. found a statistically significant decrease in levels of depression from posttest to four-month follow-up, and also noted a statistically significant improvement in symptoms as measured on the Dissociative Experience Scale from pre-test to follow-up. 3.1.7 Study Quality The studies included in this review utilized a broad range of equine-facilitated/assisted therapeutic techniques and measurement instruments to address a wide variety of psychosocial outcomes in vastly different clinical populations, making comparison difficult. Two studies used the Rosenberg Self-Esteem Scale (Greenwald, 2001; Iannone, 2003). Three studies used the Nowicki-Strickland Locus of Control Scale (Bowers & MacDonald, 2004; Ewing et al, 2007; Iannone, 2003). Three studies used the Self-Perception Profile for Children (Ewing et al, 2007; Kaiser et al, 2006; Kaiser et al, 2004) and one used the Self-Perception Profile for Adolescents (Bowers & MacDonald). The Children’s Depression Inventory and the Children’s Loneliness Questionnaire were both used in two studies (Bowers & MacDonald; Ewing et al). Ten of the studies reported reliability and validity for the instruments used (Bowers & MacDonald; Ewing et al; Graham, 2007; Greenwald; Iannone; Kaiser et al, 2006; Kaiser et al, 2004; Russell-Martin, 2006; Schultz et al, 2007; Trotter et al, 2008). 3.1.7.1 Sample The majority of the studies in this review were conducted with small convenience samples, ranging from n=6 (Shambo et al, 2007) to the largest of n=63 (Schultz et al, 2007). However, two studies employed random sample comparison design (Graham, 2007; Trotter et al, 2008). Three of the studies employed non-equivalent comparison groups (Iannone, 2003; Shultz, 2005; Trotter). Attrition was not addressed in several studies (Kaiser et al, 2006; Kaiser et al, 2004; Shultz; Tetreault, 2006; Trotter, 2008). 37
3.1.7.2 GRADE The results of the application of GRADE criteria to the studies included for review are summarized in Table 3.1. The application of GRADE criteria to the aggregate of selected studies yielded a mostly low to very low level of quality, with two exceptions: Graham’s (2007) study achieved a moderate result according to GRADE criteria, as did Trotter et al.’s (2008) study. Attaining a moderate level of quality is significant, since this is the highest level that can be achieved for observational studies using GRADE criteria. An appreciation for the stringency of GRADE requirements explains how the results of this review can be considered promising, despite the seemingly inconsistent level of evidence in the aggregate. 38
Page 1 and 2: A SYSTEMATIC REVIEW OF THE EFFECTS
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 and 10: LIST OF TABLES Table Page 2.1 GRADE
Page 11 and 12: The purpose of this systematic revi
Page 13 and 14: movement manifested in some neurolo
Page 15 and 16: Animals have been used for therapeu
Page 17 and 18: traumatic brain injury, attention d
Page 19 and 20: vendor (Borzo, 2002). Interestingly
Page 21 and 22: therapists address a variety of men
Page 23 and 24: interest in nature-based therapies
Page 25 and 26: their perceptions of the world. Man
Page 27 and 28: CHAPTER 2 METHODS 2.1 Literature Se
Page 29 and 30: Retrieved potentially relevant publ
Page 31 and 32: were achieved in regard to desired
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Page 37 and 38: Table 2.4 Pre-Posttest Studies with
Page 39 and 40: Table 2.5--Continued 30 Study Ianno
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Page 43 and 44: used to compute outcomes. In the re
Page 45: that participants with increased le
Page 49 and 50: CHAPTER 4 DISCUSSION To date, there
Page 51 and 52: generalizability (Shambo et al), or
Page 53 and 54: CHAPTER 5 IMPLICATIONS FOR SOCIAL W
Page 55 and 56: 5.1.1 Adjunctive Uses Interventions
Page 57 and 58: CHAPTER 6 FUTURE DIRECTIONS Despite
Page 59 and 60: effects of this application on the
Page 61 and 62: Beckman-Devik, L. & Ansin, C, (Wint
Page 63 and 64: (http://www.horsesandhumans.org/Res
Page 65 and 66: handling, grooming, longeing, ridin
Page 67 and 68: APPENDIX C PRECAUTIONS AND CONTRAIN
Page 69 and 70: An acute episode of “reactive air
Page 71 and 72: REFERENCES Acampora, T. (2008). Not
Page 73 and 74: Birch, A. & Hong, C. S. (2007). A l
Page 75 and 76: Cornelius, S. (2002). An explorator
Page 77 and 78: Fine, A., H. (2000). Animals and th
Page 79 and 80: Hansen, K., Messinger, C., Baun, M.
Page 81 and 82: *Kaiser, L. K., Spence, L. J., Lave
Page 83 and 84: Levinson, B. M. (1972). Man, animal
Page 85 and 86: National Association of Social Work
Page 87 and 88: Root, A. (2000). Equine-assisted th
Page 89 and 90: Tedeschi, P. (1992). Guidelines for
Page 91 and 92: Yorke, J. (2008). The significance

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