Equine-Assisted Psychotherapy: An Emerging Trauma-Informed Intervention
AbstractEquine-assisted psychotherapy (EAP) has emerged as a promising, evidence-based intervention for the treatment of trauma and stressor-related disorders. This experiential therapy offers an option for clients whose traumatic experiences render traditional talk therapies ineffective. Initial research on the most robust model of EAP, developed by the Equine Assisted Growth and Learning Association (EAGALA), indicates strong, positive effects for children, adolescents and adults who have experienced trauma. EAGALA was designed to allow for rigorous evaluation of efficacy, a clear theoretical base, standardized implementation, and ongoing training for practitioners. As the primary providers of mental and behavioral health services in the United States, social workers are keenly aware of the need for a portfolio of treatment methods to manage the increasing demand for services. EAP has emerged as an important addition to this portfolio, providing options for some the most vulnerable client populations.
American Counseling Association. (2016). Animal-assisted therapy in counseling competencies. Retrieved from: www.counseling.org/knowledge-center/competencies
American Red Cross. (2012). Disaster mental health handbook: Disaster services. Washington DC: Author.
American Veterinary Medical Foundation [AVMA]. (2017). Animal-assisted interventions: Definitions. Retrieved on June 5, 2017, from https://www.avma.org/KB/Policies/Pages/Animal-Assisted-Interventions-Definitions.aspx
Anda, R. F., Felitti, V. J., Bremner, J. D., Walker, J. D., Whitfield, C. H., Perry, B. D., ... Giles, W. H. (2006). The enduring effects of abuse and related adverse experiences in childhood. European Archives of Psychiatry and Clinical Neuroscience, 256(3), 174-186. doi: https://doi.org/10.1007/s00406-005-0624-4
Anda, R., Felitti, V. J., & Corwin, D. L. (2014). Adverse Childhood Experiences and long-term health. ACEs: Informing Best Practice, AVA/NHCVA, Section, 1.
Baker, L. M., Williams, L. M., Korgaonkar, M. S., Cohen, R. A., Heaps, J. M., & Paul, R. H. (2013). Impact of early vs. late childhood early life stress on brain morphometrics. Brain Imaging and Behavior, 7(2), 196-203. doi: https://doi.org/10.1007/s11682-012-9215-y
Bass, M. M., Duchowny, C. A., & Llabre, M. M. (2009). The effect of therapeutic horseback riding on social functioning in children with autism. Journal of Autism and Developmental Disorders, 39, 1261-1267. doi: https://doi.org/10.1007/s10803-009-0734-3
Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond (2nd ed.) New York: Guilford.
Bourne, C., Mackay, C. E., & Holmes, E. A. (2013). The neural basis of flashback formation: The impact of viewing trauma. Psychological medicine, 43(7), 1521-1532. doi: https://doi.org/10.1017/S0033291712002358
Boyd Webb, N. (2015). Play therapy with children and adolescents in crisis (4th ed.). New York: Guilford.
Bray, S. S., Stone, J. P., & Gaskill, R. L. (2017). The impact of trauma on brain development: A neurodevelopmentally appropriate model for play therapists. In R. L. Steen (Ed.), Emerging research in play therapy, child counseling, and consultation (pp. 20-39). Hershey, PA: IGI Global. doi: https://doi.org/10.4018/978-1-5225-2224-9.ch002
Briere, J. N., & Lanktree, C. B. (2013). Treating complex trauma in adolescents and young adults. Thousand Oaks, CA: Sage.
Buckman, R., Kinney, D., & Reese, A. (2008). Narrative therapies. In N. Coady & P. Lehman (Eds.), Theoretical perspectives for direct social work practice, (pp. 369-400). New York: Springer.
Cronholm, P. F., Forke, C. M., Wade, R., Bair-Merritt, M. H., Davis, M., Harkins-Schwarz, M., ...Fein, J. A. (2015). Adverse childhood experiences: Expanding the concept of adversity. American Journal of Preventive Medicine, 49(3), 354-361. doi: https://doi.org/10.1016/j.amepre.2015.02.001
Dannlowski, U., Stuhrmann, A., Beutelmann, V., Zwanzger, P., Lenzen, T., Grotegerd, D., ...Lindner, C. (2012). Limbic scars: Long-term consequences of childhood maltreatment revealed by functional and structural magnetic resonance imaging. Biological Psychiatry, 71(4), 286-293. doi: https://doi.org/10.1016/j.biopsych.2011.10.021
Davis, E., Davies, B., Wolfe, R., Raadsveld, R., Heine, B., Thomason, P., …Graham, H. K. (2009). A randomized controlled trial of the impact of therapeutic horse riding on the quality of life, health, and function of children with cerebral palsy. Developmental Medicine and Child Neurology, 51, 111–119. doi: https://doi.org/10.1111/j.1469-8749.2008.03245.x
Davis, D. M., & Hayes, J. A. (2011). What are the benefits of mindfulness? A practice review of psychotherapy-related research. Psychotherapy, 48(2), 198-208. doi: https://doi.org/10.1037/a0022062
Dominelli, L. (2002). Anti-oppressive social work theory and practice. New York: Palgrave Macmillan. doi: https://doi.org/10.1007/978-1-4039-1400-2
Equine Assisted Growth and Learning Association [EAGALA]. (2010). Welcome. EAGALA Website. Retrieved from www.eagala.org
EAGALA. (2015). Fundamentals of the EAGALA model: Training manual (8th ed.). Santaquin, UT: Author.
Emerson, D., & Hopper, E. (2011). Overcoming trauma through yoga: Reclaiming your body. Berkeley, CA: North Atlantic Books.
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) study. American Journal of Preventative Medicine, 14, 245-258. doi: https://doi.org/10.1016/S0749-3797(98)00017-8
Gateway HorseWorks. (2017). Our mission. Retrieved from http://www.gatewayhorseworks.org
Germer, C. K., Siegel, R. D., & Fulton, P. R. (2013). Mindfulness and psychotherapy (2nd ed.) New York: Guilford.
Getz, L. (2012). Trauma-focused cognitive behavioral therapy: Hope for abused children. Social Work Today, 12, 22-24.
Granvold, D. K. (2008). Constructivist theory. In N. Coady & P. Lehmann (Eds.), Theoretical perspectives for direct social work practice (pp. 401-428). New York: Springer.
Hartman, A. (1992). In search of subjugated knowledge. Social Work, 37, 483-484.
Hayes, T. (2015). Riding home: The power of horses to heal. NY: St. Martin’s Press.
Jalongo, M. R. (2005). What are all these dogs doing at school? Using therapy dogs to promote children’s reading practice. Childhood Education, 81(3), 152-158. doi: https://doi.org/10.1007/s10643-009-0349-5
Kazdin, A. E., & Blaze, S. L. (2011). Rebooting psychotherapy research and practice to reduce the burden of mental illness. Perspectives on Psychological Science, 6(1), 21-37. doi: https://doi.org/10.1177/1745691610393527
Kendall, E., Maujean, A., Pepping, C.A., Downes, M., Lakhani, A., Byrne, J., & Macfarlane, K. (2015). A systematic review of the efficacy of equine-assisted interventions on psychological outcomes. European Journal of Psychotherapy & Counselling, 17, 57-79. doi: https://doi.org/10.1080/13642537.2014.996169
Kliethermes, M., & Wamser, R. (2012). Adolescents with complex trauma. In J. A. Cohen, A. P. Mannarino, & E. Deblinger, E. (Eds.), Trauma-focused CBT for children and adolescents: Treatment applications (pp 175-196). New York: Guilford.
Kross, E., & Ayduk, O. (2011). Making meaning out of negative experiences by self-distancing. Current Directions in Psychological Science, 20, 187-191. doi: https://doi.org/10.1177/0963721411408883
Landreth, G. L. (2002). Therapeutic limit setting in the play therapy relationship. Professional Psychology: Research and Practice, 33(6), 529-535. doi: https://doi.org/10.1037/0735-7028.33.6.529
Larkin, H., Shields, J. J., & Anda, R. F. (2012). The health and social consequences of Adverse Childhood Experiences (ACE) across the lifespan: An introduction to prevention and intervention in the community. Journal of Prevention & Intervention in the Community, 40(4), 263-270. doi: https://doi.org/10.1080/10852352.2012.70743
Ledley, D. R., Marx, B. P., & Heimberg, R. G. (2010). Making cognitive-behavioral therapy work: Clinical process for new practitioners (2nd ed.). New York: Guilford.
Levine, P. A. (2010). In an unspoken voice: How the body releases trauma and restores goodness. Berkeley, CA: North Atlantic Books.
McCormick, A. R., & McCormick, M. D. (1997). Horse sense and the human heart: What horses can teach us about trust, bonding, creativity, and spirituality. Deerfield Beach, FL: Health Communications, Inc.
McCullough, L., Risley-Curtiss, C., & Rorke, J. (2015). Equine facilitated psychotherapy: A pilot study of effect on posttraumatic stress symptoms in maltreated youth. Journal of Infant, Child, and Adolescent Psychotherapy, 14, 158-173. doi: https://doi.org/10.1080/15289168.2015.1021658
Morrison, M. L. (2007). Health benefits of animal-assisted interventions. Complementary Health Practice Review, 12, 51-62. doi: https://doi.org/10.1177/1533210107302397
Murphy, A., Steele, H., Steele, M., Allman, B., Kastner, T., & Dube, S. R. (2016). The clinical Adverse Childhood Experiences (ACEs) questionnaire: Implications for trauma-informed behavioral healthcare. In R. D. Briggs (Ed.), Integrated early childhood behavioral health in primary care (pp. 7-16). Switzerland: Springer International Publishing. doi: https://doi.org/10.1007/978-3-319-31815-8_2
Nurenberg, J. R., Schleifer, S. J., Shaffer, T. M., Yellin, M., Desai, P. J., Amin, R., …Montalvo, C. (2015). Animal-assisted therapy with chronic psychiatric inpatients: Equine-assisted psychotherapy and aggressive behavior. Psychiatric Services, 66(1), 80-86. doi: https://doi.org/10.1176/appi.ps.201300524
O'Haire, M. E., McKenzie, S. J., Beck, A. M., & Slaughter, V. (2015). Animals may act as social buffers: Skin conductance arousal in children with autism spectrum disorder in a social context. Developmental Psychobiology, 57(5), 584-595. doi: https://doi.org/10.1002/dev.21310
Omidi, A. (2013). Towards an integrative approach to trauma study. Archives of Trauma Research, 2(1), 1-2. doi: https://doi.org/10.5812/atr.11288
Pernicano, P. (2014). Using trauma-focused therapy stories: Interventions for therapists, children and their caregivers. New York: Routledge.
Pernicano, P. (2015). Metaphors and stories in play therapy. In C. Schaefer, K. O’Connor, & L. Braverman (Eds.), Handbook of play therapy (2nd ed., pp. 259-275). New York: Wiley. doi: https://doi.org/10.1002/9781119140467.ch12
Pitheckoff, N., McLaughlin, S. J., & de Medeiros, K. (2016). “Calm . . . satisfied. . . comforting”: The experience and meaning of rabbit-assisted activities for older adults. Journal of Applied Gerontology, online, 1-12. doi: https://doi.org/10.1177/0733464816680322
Rhodes, A. M. (2015). Claiming peaceful embodiment through yoga in the aftermath of trauma. Complementary Therapies in Clinical Practice, 21, 247-256. doi: https://doi.org/10.1016/j.ctcp.2015.09.004
Sekiguchi, A., Sugiura, M., Taki, Y., Kotozaki, Y., Nouchi, R., Takeuchi, H., ...Sakuma, A. (2013). Brain structural changes as vulnerability factors and acquired signs of post-earthquake stress. Molecular Psychiatry, 18(5), 618-623. doi: https://doi.org/10.1038/mp.2012.51
Selby, A., & Smith-Osborne, A. (2013). A systematic review of effectiveness of complementary and adjunct therapies and interventions involving equines. Health Psychology, 32, 418-432. doi: https://doi.org/10.1037/a0029188
Substance Abuse and Mental Health Services Administration [SAMSHA]. (2014). SAMHSA’s concept of trauma and guidance for a trauma-informed approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration.
Thomas, L., & Lytle, M. (2016). Transforming therapy through horses. Santaquin, UT: EAGALA.
van der Kolk, B. A. (2002). Beyond the talking cure: Somatic experience and subcortical imprints in the treatment of trauma. In F. Shapiro (Ed.), EMDR as an integrative psychotherapy approach: Experts of diverse orientations explore the paradigm prism (Vol. vii, pp. 57-83). Washington, DC: American Psychological Association. doi: https://doi.org/10.1037/10512-003
van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. London, UK: Penguin Books.
van der Kolk, B. A., & McFarlane, A. C. (Eds.). (2012). Traumatic stress: The effects of overwhelming experience on mind, body, and society. NY: Guilford.
van der Kolk, B. A., Stone, L., West, J., Rhodes, A., Emerson, D., Suvak, M., & Spinazzola, J. (2014). Yoga as an adjunctive treatment for posttraumatic stress disorder: A randomized clinical trial. Journal of Clinical Psychiatry, 75, e1-e7. doi: https://doi.org/10.4088/JCP.13m08561
West, J., Lian, B., & Spinazzola, J. (2016). Trauma sensitive yoga as complementary treatment for posttraumatic stress disorder: A qualitative descriptive analysis. International Journal of Stress Management, 24(2), 173-195. doi: http://dx.doi.org/10.1037/str0000040
Wilkie, K. D., Germain, S., & Theule, J. (2016). Evaluating the efficacy of equine therapy among at-risk youth: A meta-analysis. Anthrozoös, 29(3), 377-393. doi: https://doi.org/10.1080/08927936.2016.1189747
Yorke, J., Adams, C., & Coady, N. (2008). Therapeutic value of equine-human bonding in recovery from trauma. Anthrozoos, 21(1), 17-30. doi: https://doi.org/10.2752/089279308X274038
Zucker, M., Spinazzola, J., Pollack, A. A., Pepe, L., & Barry, S. (2010). Getting teachers in on the act: Evaluation of a theater- and classroom-based youth violence prevention program. Journal of School Violence, 9, 117-135. doi: https://doi.org/10.1080/15388220903479628
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