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Running head: EAP FOR VETERANS 1 Equine-Assisted Psychotherapy for Veterans


Melissa R. Amos


ENG122: English Composition II


Dr. William Carpenter


May 10, 2016 EAP FOR VETERANS 2 Although traditional medicine is used to a larger extent in the Western world, EquineAssisted Psychotherapy (EAP) provides hands-on exposure therapy which helps the Veteran


make significant progress in treatments, significantly more than the progress which is done


through conventional therapies and medication alone. ?There is something about the outside of a


horse that is good for the inside of man? is a quote by Winston Churchill. Emotional bonds have


been forged with horses, from times past, reaching from Ancient Greece, heroic tales of knights,


and cowboys riding into the sunset. Horses have come to represent freedom, spirit, adventure,


perseverance and drive (Sheehan, 2014).


Interaction with nature and animals helps many people rejuvenate their mind-body


connection. Due to the unique characteristics of the personality of a horse, they have the ability


to reflect human emotion (Brandt, 2013). The world has evolved into an excessively technical


and high demand environment, allowing individuals to separate themselves from authentic


experiences and feelings. Horses show a willingness to express emotion, as such, the use of


horses in a therapeutic setting, creates an effective medium for people to reconnect with their


authentic selves. In contrast, humans have become accustomed to rigidly controlling their


emotional expressions, especially within the military and Veteran population, which has


developed the incongruence between verbal and nonverbal communication. Unlike cats or dogs,


horses are prey animals and must be constantly attuned to their environment to ensure survival.


Horses are highly social heard animals, which depend on continuous communication between


members for safety, by which requires them to remain present in the moment as well as


accurately interpreting their environmental cues (Brandt, 2013). Through interaction and


observation between a human and horse, there are opportunities for a therapist to teach and


develop social and relational skills for a Veteran. Horses rely heavily on nonverbal EAP FOR VETERANS 3 communication and body language. When a human shows incongruence, horses instinctively


react, thereby, reflecting the person?s internal emotional state, regardless of outward expression.


The horse provides instant and direct feedback when they become confused and agitated, which


is non-judgmental, when the person presents unclear intentions or mixed verbal and non-verbal


cues (Brandt, 2013; Kuropatkin, 2013). The lesson that is learned through any equine assisted


learning (EAL) allows the therapist to see physical manifestations of any inner conflicts,


reflected outwardly by the horse?s ability to read and understand human body language. This


provides a learning tool as a pathway to change the ?inside? by changing the ?outside?


(Kuropatkin, 2013). The horse will respond exactly as the human body is communicating, and


will respond and react differently once the lesson of mindfulness has been learned.


EAP may be more readily accepted by those who are resistant to traditional therapeutic


interventions because it is held in a non-traditional setting. The stigma associated with receiving


treatment at a mental health clinic is removed, as the setting requires the Veteran to meet the


horse in its environment, conducting lessons in natural, outdoor settings, which provide more


relaxing and safe environment over a traditional office setting. Conducting therapy in a natural


and interactive environment alleviates some of the stigma related to attending therapy. Clients


often have fewer preconceptions attached to working with horses. This allows the client to


connect emotionally with the horse while their initial negative concepts of therapy are reframed


into an engaging, interactive, and positive experiences allow for deeper participation in the


therapeutic process, which facilitates change within the client (Brandt, 2013; Kelly, 2015).


Experiential learning is frequently more active than traditional ?talk therapy?. Mindfulness of the


body language of both themselves and the horse, being present in the moment, validation of the


non-verbal cues of the horse, all allow the client to gain a better awareness and understanding of EAP FOR VETERANS 4 their own bodies (Brandt, 2013; Kelly, 2015). A unique opportunity to elaborate on this


relationship takes place at a horse rescue, Dream Catcher. At this facility, abused and neglected


horses are rescued, bringing them to a facility which provides care, shelter, and nurturing. This


agency, in partnership with the local Veterans Center, assist Veterans who struggle with PTSD,


depression, anxiety, and issues with readjustment to civilian life. When incorporating with


treatment by a skilled and qualified mental health professional, equines bring qualities into


treatment which enhance this therapeutic modality. Helping rescued horses helps the horse to


?rescue? the person through therapy in a reciprocal relationship (Brandt, 2013; Kelly, 2015). The


Dream Catcher horse rescue provides this unique opportunity through no cost to those receiving


treatment or to taxpayers. Their program is self-funded, charging for boarding, riding lessons and


other services (McGhee, 2016).


Equine assisted psychotherapy is used along with a variety of therapeutic modalities, with


practitioners treating with a wide variety of theoretical practices. It is easily adaptable to


individual, group or family therapy sessions, in which the activities are tailored to the unique


treatment plans and goals of the client (Brandt, 2013; Mansini, 2010). EAAT programs are


diverse and offer concentrations in several different areas of need. All areas encompass specific


goals and techniques, which may be appropriate for certain individuals, which require different


professional personnel to facilitate. All areas complement and overlap, and the client receives


valuable physical and psychological benefits. Regardless of the area of concentration the client,


the horse (chosen for size and temperament), volunteers (trained as side walkers and horse


leaders), a certified therapeutic riding instructor and a licensed therapist work together as a team


to achieve individual goals (Kuropatkin, 2013). Ecopsychology and nature have allowed many


Veterans who otherwise would not have sought treatment through conventional means, due to the EAP FOR VETERANS 5 stigma in the military regarding post-traumatic stress, seek an alternative means for therapy.


Commonality between Veterans with PTSD and how their experiences through nature allow


them to feel as if they have regained their humanity following traumatic military experiences


(Westlund, 2015). Accreditation and certification of staff and establishments offering EAP


require control measures to establish consistency within future programs (Masini, 2010). Those


who have participated in studies report at the end of the session, significantly reduced posttraumatic stress symptoms, less severe emotional responses to trauma, less generalized anxiety,


and fewer symptoms of depression. Increased mindfulness strategies and decreased alcohol use


were all reported (Earles, Vernon & Yetz 2015). Results of those who participated in a residential


equine-assisted therapy program were maintained through a 6-month follow-up.


Clients and horses must be carefully evaluated prior to participation in any EAP sessions.


It is the responsibility of the therapist to establish if a client is fearful or has a history of animal


abuse or arson. This demographic is not an appropriate group for EAP. Those who have a


potential medical condition which may be a safety hazard to the client or horse, must notify the




Clients meet with a therapist in a traditional office setting to complete an initial


evaluation, establish a treatment plan and goals, and discuss the format for future sessions,


discuss with clients their past experiences and comfort level with animals. Brief check-ins prior


to and following each session, in addition to an occasional full session within a traditional


therapeutic setting. Safety considerations are discussed prior to EAP session and throughout the


treatment process. Therapists are also advised to frequently discuss their dual role during equine


activities. Protocols regarding safety and physical touch must all be implemented prior to any


sessions (Brandt, 2013). PATH has identified that social workers are the demographic which puts EAP FOR VETERANS 6 EAP into practice more than any other group of mental health professionals. PATH has stringent


standards to become an approved EAP facility. In these facilities, therapists must play multiple


roles, often being directive and firm with clients because of safety rules. They must occasionally


step in and act quickly to ensure that the horse and client are safe, including physically removing


one or the other from and area, or providing first aid. Credibility within the medical community


and general public, if more postsecondary and advanced degree institutions provided education,


training and certification (Brandt, 2013). Horses that are used for this modality are both


physically and mentally sound. Therapy cannot be effective and will potentially lead to setbacks


if the horse is not safe (Brandt, 2013). Each horse which is utilized in EAP must not be


overworked, and they must also be provided with ample down time with the heard, which helps


to re-cooperate and de-stresses the horse following an EAP session.


There are those who would refute the validity of EAP, stating that there are limited


continuity through the studies. There have been several research limitations identified, as EAP is


a newly studied therapeutic intervention. Equine facilitated and assisted psychotherapies have


only started to establish clinical trials and set standard criteria to compare results. Pilot studies


had small participation and have been limited to measured anger, depression, quality of life and


perceived self-confidence, in addition to mental health, age-related, cognitive-neurological,


behavioral, and other health risks and conditions (Selby & Smith-Osborne, 2013). Studies have


been initiated by the equine community and have not maintained the consistency within the


clinical community to become a valid therapy.


Clinical and equine communities have begun to work collaboratively to address the


deficit in research, as previous research has been conducted stemming from the equine rather


than the academic or clinical mental health communities. This developing therapeutic EAP FOR VETERANS 7 intervention must have more stringent reporting procedures to ensure the growth of this effective


technique in conjunction with various clinical populations. Isolating the effects of EAP through


multiple clinical diagnosis populations is time consuming and expensive and has yet to occur


(Brandt, 2013; Earles, Vernon & Yetz, 2015; Selby & Smith-Osborne, 2013). Future research in


equine assisted psychotherapy would greatly benefit from larger sample sizes and randomized


controlled trials, as they lacked a control group (Brandt, 2013; Earles, Vernon & Yetz 2015).


There are four primary organizations, and numerous minor organizations, which provide training


and certifications for equine and mental health professionals who incorporate horses into their


practices. EAP is an experiential therapeutic technique that is brief and solution-oriented. The


collaborative effort between a licensed therapist and a horse professional working along with the


client and horse help to foster emotional growth and healing. Equine assisted psychotherapy


sessions are an effective modality for engaging in enjoyable activities while helping them to


develop social skills, coping mechanisms, and distress tolerance. Skills that are learned during


EAP sessions allow them to transfer skills over to other areas of their lives, fostering long-term


change and prevents relapse. Meta-analytic studies indicate that clients suffer from a wide range


of mental illnesses report psychological symptoms improve following participation (Brandt,


2013). Implementing control measures will respond to those who question the validity and depth


of study. Establishing a review board, comprised of members in an academic setting, such as


from a University, would ensure continuity within EAP programs. A research assistant, who


plays no role in the therapy, must administer all consent forms and questionnaires. A baseline


questionnaire must be administered within a few weeks before the first session, and the


posttreatment questionnaire must be administered immediately following the final session while


participants remain at the facility. A schedule must be established, which includes size of class EAP FOR VETERANS 8 participation (i.e. participants attend a program in three groups, ranging from five to six


participants; each attending once a week for six weeks; each session is 2-hours long and


conducted by the same Therapist) (Earles, Vernon & Yetz, 2015). All tasks that are completed,


must be individual, with the rest of the class mindfully observing and occasionally discussing the


process of the task with personal insights each gained (Earles, Vernon & Yetz, 2015).


A natural bond occurs between a person and a horse when traditional psychotherapy


techniques are combined with equine assisted psychotherapy. This helps to enhance the healing


process. The equine-human bond, in conjunction with the client-therapist relationship, allows for


the processing of painful emotions and experiences while developing intimacy, identity and


partnership. This dual process creates a successful and efficient therapeutic program. Traditional


medicine and therapies have been used for decades with Service Members and Veterans returning


from war. Alternative medicine has become more mainstream and accepted within the medical


community. Conjunctive use of both traditional medicine and alternative ideas, using this form of


animal assisted therapy (AAT), have been found to increase adherence to treatment, develop


coping resources, social skills and problem solving strategies for those who have special needs.


These Equine Assisted Activities and Therapies (EAAT) assist to improve quality of life and help


to influence the whole person (Brandt, 2013; Kuropatkin, 2013). Participants with PTSD


symptoms, emotional distress, anxiety, depression, and alcohol use significantly decreased


following program participation. Mindfulness also increased following treatments (Earles,


Vernon & Yetz, 2015). Mutual trust, affection, patience, assertiveness and responsibility are some


of the abilities which horses bring out in people. Increased mindfulness, being less burdened by


guilt and fear, in addition to becoming more independent and self-supportive are some of the


many attributes which benefit Veterans report as a side effect of completing EAP. This broadens EAP FOR VETERANS 9 the narrow use of cognitive-behavioral therapies, here-and-now therapies, and limited stages of


personality development to a more complete psychotherapeutic experience and involvement?


(Brandt, 2013). EAP FOR VETERANS 10


References Anestis, M. D., Anestis, J. C., Zawilinski, L. L., Hopkins, T. A., & Lilienfeld, S. O. (2014).


Equine-Related Treatments For Mental Disorders Lack Empirical Support: A Systematic


Review of Empirical Investigations. Journal Of Clinical Psychology, 70(12), 1115.




Brandt, C. (2013). Equine-Facilitated Psychotherapy as a Complementary Treatment


Intervention. Practitioner Scholar: Journal Of Counseling & Professional


Psychology, 2(1), 23.


Boatwright, A. (2013). The Outside of a Horse. Horse & Rider, 52(4), 74-83


Earles, J. L., Vernon, L. L., & Yetz, J. P. (2015). Equine-Assisted Therapy for Anxiety and


Posttraumatic Stress Symptoms. Journal of Traumatic Stress. doi:10.1002/jts.21990


Kelly, S. (2015). A Second-Chance for Horses. Countryside & Small Stock Journal, 99(4),68-69


Kuropatkin, L. (2013). The Benefits of Equine Assisted Activities and Therapies. Exceptional


Parent, 43(3), 32-34 3p


Lanning, B. A., & Krenek, N. (2013). Examining effects of equine-assisted activities to help


combat veterans improve quality of life. Journal Of Rehabilitation Research &


Development, 50(8), vii-xiii 7p. doi:10.1682/JRRD.2013.07.0159


MacLean, B. (2011). Guest Editorial. Equine-assisted therapy. Journal Of Rehabilitation


Research & Development, 48(7), ix-xii 4p. doi:10.1682/JRRD.2011.05.0085


Masini, A. (2010). Equine-Assisted Psychotherapy in Clinical Practice. Journal Of Psychosocial


Nursing & Mental Health Services, 48(10), 30. doi:10.3928/02793695-20100831-08


McGhee, Tom - The Denver, P. (2016). Horse therapy helps veterans, soldiers. AP Regional State


Report - Montana, McClatchy Tribune Collection. EAP FOR VETERANS 11 Notgrass, C. G., & Pettinelli, J. D. (2015). Equine Assisted Psychotherapy: The Equine Assisted


Growth and Learning Association?s Model Overview of Equine-Based


Modalities. Journal Of Experiential Education, 38(2), 162.




O?Brien, B. (2014). Impacts & Innovations. Nonprofit Charity Impacts Wounded Combat


Veterans And Children Facing Adversity. Nursing Economic$, 32(5), 270-274 5p


Selby, A., & Smith-Osborne, A. (2013). A systematic review of effectiveness of complementary


and adjunct therapies and interventions involving equines. Health Psychology, 32(4),


418-432. doi:10.1037/a0029188


Sheehan, E. M. (2014). Equine-Assisted Therapies in Rehabilitation: an overview. Journal Of


Nurse Life Care Planning, 14(2), 603-607 5p


Westlund, S. (2015). `Becoming human again': Exploring connections between nature and


recovery from stress and post-traumatic distress. Work, 50(1), 161-174 14p.


doi:10.3233/WOR-141934 . . EAP FOR VETERANS


Intro & Thesis


Idea 1


Idea 2


Idea 3


Negative 1


Refute 1


Negative 2


Refute 2


Conclusion 12


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