Contribution of the patient–horse relationship to substance use disorder treatment: Patients’ experiences

Abstract

BackgroundA good therapeutic relationship is a strong predictor of successful treatment in addiction and other psychological illness. Recent studies of horse-assisted therapy (HAT) have drawn attention to the importance of the client's relationship to the horse in psychotherapy. Few have reported on the patient's own perspective and none have reported specifically on the human–horse relationship in substance use disorder (SUD) treatment and its implications for health and well-being.AimThis article explores SUD patients’ own experience of their relationship with the horse and their perceptions of its contribution to their therapy.MethodsAs part of a large mixed-method study of HAT in SUD treatment, we used semi-structured interviews of eight patients to gather information about their experiences of HAT. From the data obtained, the relationship with the horse was found to be a significant part of participants’ HAT experience. It is therefore the subject of the current phenomenological study, in which thematic analysis was used to investigate how the participants constructed the reality of their relationship with the horse(s) and their perceptions of the consequences of that reality in SUD treatment.ResultsParticipants’ own descriptions suggest that the horses were facilitators of a positive self-construct and provided important emotional support during treatment. Analysis found relationship with the horse, emotional effect, and mastery to be important and interrelated themes. The findings were interpreted within an attachment theory context.ConclusionThe results appear to be consistent with key addiction treatment theories and with findings in HAT theoretical and empirical studies. They add to our understanding of the impact of HAT on SUD treatment. However, further research is needed into both the construct validity of the patient–horse therapeutic relationship and the possible variance within and between different populations.

The Efficacy of Dog Assisted Therapy in Detained Drug Users: A Pilot Study in an Italian Attenuated Custody Institute

“…mechanisms. Indeed, the human-animal relationship improves both the perceived social support [ 68 , 69 , 70 , 71 , 72 , 73 , 74 ] and the learning of active coping strategies [ 75 , 76 ], which are protective factors against psychological distress whose well-known related outcomes are anxiety and depression [ 77 , 78 , 79 , 80 ]. Moreover, the SCL-90-R Global Severity Index confirmed a significant positive change in the psychological distress level of inmates, which could take advantage from the D.A.T.…”

Complementary horse-assisted therapy for substance use disorders: a randomized controlled trial

“…We used treatment completion as the outcome variable, but future research should include additional outcome variables specifically related to HAT. In a qualitative study, the participants reported that HAT facilitated positive attachment, reflective functioning, self-efficacy and emotional regulation [44]. All of these, or other outcome variables theoretically associated with HAT, should be investigated.…”

“…Since 2011, our group has undertaken a series of parallel research projects to investigate the effects of integrating HAT into the standard treatment of patients with SUDs and comorbidities [19,43,44]. We designed a non-randomized intention-to-treat study enrolling 108 patients voluntarily upon referral by their treating clinician and performed univariate and multivariate analyses to compare those receiving treatment as usual (TAU; n = 43) with those receiving HAT in addition to TAU (HAT; n = 65) [19].…”

“…The results from this preliminary study showed that HAT is a promising complementary therapy associated with higher retention in treatment and completion than standard psychotherapeutic treatment alone: (1) more HAT participants completed treatment (56.9 vs. 14%, P < 0.001), (2) remained in treatment for longer (means of 141 vs. 70 days, P < 0.001) and 3had a greater chance of completing their treatment than those not given the HAT treatment (odds ratio (OR) 8.4, 95% confidence interval (CI) 2.7-26.4, P < 0.001) [19]. In a parallel study, we investigated the patients' perspectives on complementary HAT in their therapeutic process and identified the nature of the relationship, their emotional engagement and their sense of mastery as the main aspects perceived by the patients to be motivational during therapy [44].…”

Manipulating practices: A critical physiotherapy reader

“…mucking out, preparing fodder, grooming, tacking up, (Håkanson, 2008), and partly as a result of rhythmical movements shared between rider and horse to facilitate body awareness, mobilisation, balance or coordination (Angsupaisal et al, 2015;Håkanson, Möller, Lindström, & Mattsson, 2009;Von Dietze, 2011). Horses are used in substance abuse and mental health therapy at several Norwegian hospitals, increasing treatment retention and learning (Kern-Godal, Brenna, Kogstad, Arnevik, & Ravndal, 2016;Thelle, 2010). Adapted riding for disabled children is offered at two hospitals and in local municipalities (Traetteberg, 2006), and horses are shown to contribute to development of self-esteem (Hauge, Kvalem, Berget, EndersSlegers, & Braastad, 2014;Traeen & Koren, 2003).…”