A pilot observational study of horsemanship skills training for veterans with posttraumatic stress disorder

Marchand, William R.; Smith, Judy; Hoopes, Karl H; Osborne, Makenna; Andersen, Sarah; Bell, Kylie; Nazarenko, Elena; Macneill, Rachel; Joubert, Katryna

doi:10.1016/j.ctim.2022.102910

Cited by 7 publications

(20 citation statements)

References 76 publications

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“…( 22 , 26 ), and Marchand et al. ( 24 ) have reported data from follow-up times points ranging from 30 days to 3 months after the intervention. Except for Arnon et al.…”

Section: Discussionmentioning

confidence: 99%

Ground-based adaptive horsemanship lessons for veterans with post-traumatic stress disorder: a randomized controlled pilot study

Rankins,

Quinn,

McKeever

et al. 2024

Front. Psychiatry

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IntroductionEquine-assisted services (EAS) has received attention as a potential treatment strategy for post-traumatic stress disorder (PTSD), as existing literature indicates that symptoms may decrease following EAS. Relatively little is known about the mechanisms at play during lessons and if physiological measures are impacted. The objectives of this pilot study were to 1) explore the effects of adaptive horsemanship (AH) lessons on symptoms of PTSD, hormone concentrations, and social motor synchrony; 2) determine if physiological changes occur as veterans interact with horses; and 3) explore if the interaction between veteran and horse changes over the 8-week session.MethodsVeterans with PTSD were randomly assigned to control (CON, n = 3) or AH (n = 6) groups for an 8-week period (clinical trial; NCT04850573; clinicaltrials.gov). Veterans completed the PTSD Checklist (PCL-5) and Brief Symptom Inventory (BSI) at pre-, post-, and 2- and 6-month follow-up time points. They also completed a social motor synchrony test (pendulum swinging) and blood draw at pre- and post-time points. In weeks 1, 4, and 8, blood samples were drawn at 0 min, 3 min, 5 min, 25 min, and 30 min during the 30-min AH lessons. Veterans completed the Human–Animal Interaction Scale (HAIS) after each lesson. Blood samples were assayed for plasma cortisol, epinephrine, norepinephrine, and oxytocin. Data were analyzed with repeated measure ANOVAs. Changes in PTSD symptoms from pre- to post-time point were analyzed with paired t-tests.ResultsChanges in PCL-5 scores tended to differ (p = 0.0989), and global BSI scores differed (p = 0.0266) between AH (−11.5 ± 5.5, mean ± SE; −0.5 ± 0.2) and CON (5.3 ± 5.4; 0.4 ± 0.2) groups. Social motor synchrony and hormone concentrations did not differ between groups or time points (p > 0.05). Cortisol, norepinephrine, and oxytocin concentrations did not differ across sessions (p > 0.05). Epinephrine concentrations tended (p = 0.0744) to decrease from week 1 to 4 of sessions. HAIS scores increased (p ≥ 0.0437) in week 3 and remained elevated as compared to week 1.DiscussionParticipant recruitment was the greatest challenge. These preliminary results agree with the literature suggesting that EAS can reduce symptoms of PTSD.

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“…( 22 , 26 ), and Marchand et al. ( 24 ) have reported data from follow-up times points ranging from 30 days to 3 months after the intervention. Except for Arnon et al.…”

Section: Discussionmentioning

confidence: 99%

Ground-based adaptive horsemanship lessons for veterans with post-traumatic stress disorder: a randomized controlled pilot study

Rankins,

Quinn,

McKeever

et al. 2024

Front. Psychiatry

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show abstract

“…In recognition of all the above, animal-assisted interventions (AAIs) are being frequently used as complementary interventions for trauma survivors in general [43][44][45], specifically among veterans [26,33,[46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64]. AAIs might benefit trauma survivors by facilitating enhanced engagement with conventional interventions and/or, after rigorous studies demonstrating benefit, serve as stand-alone evidence-based treatments.…”

Section: Conventional Interventions For Trauma Exposurementioning

confidence: 99%

“…There is now emerging literature reporting investigations of EAS interventions for veterans with trauma histories. This review identified 23 studies [26,33,[46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][108][109][110][111] in the literature (Table 1). However, of these, only three [47,52,53] had a control group and only one [52] was a randomized trial.…”

Section: Overview Of the Extant Literaturementioning

confidence: 99%

“…Four studies [47,55,63,110] report physiologic outcome measures (discussed in more detail below). Lastly, several studies [26,46,53,57,58,63] report interventions that are manualized or structured to facilitate manual development. All the studies suggest benefit for veterans, as is reviewed in a subsequent section of this paper; however, the lack of rigorous research indicates that the field is still in the early stage of scientific development.…”

Section: Overview Of the Extant Literaturementioning

confidence: 99%

“…Regarding studies of EASs for veterans, there is evidence that participants find EAS interventions to be enjoyable [57,58], which may enhance treatment engagement. One study [58] found that among participants in a six-session intervention, 58% completed four or more sessions and 24.2% completed all sessions.…”

Section: Treatment Engagement and Therapeutic Alliancementioning

confidence: 99%

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Potential Mechanisms of Action and Outcomes of Equine-Assisted Services for Veterans with a History of Trauma: A Narrative Review of the Literature

Marchand

2023

IJERPH

Self Cite

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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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A Pilot Replication Study of Implementing an Equine-Assisted Services Program Within a VA Residential Substance Use Disorder Treatment Program

et al. 2023

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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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A pilot observational study of horsemanship skills training for veterans with posttraumatic stress disorder

Cited by 7 publications

References 76 publications

Ground-based adaptive horsemanship lessons for veterans with post-traumatic stress disorder: a randomized controlled pilot study

Ground-based adaptive horsemanship lessons for veterans with post-traumatic stress disorder: a randomized controlled pilot study

Potential Mechanisms of Action and Outcomes of Equine-Assisted Services for Veterans with a History of Trauma: A Narrative Review of the Literature

A Pilot Replication Study of Implementing an Equine-Assisted Services Program Within a VA Residential Substance Use Disorder Treatment Program

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