Horses prove worth in getting patients to complete substance abuse treatment

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stock-nose-fence_1490People seeking help for substance misuse through a Norwegian hospital were far more likely to complete their treatment if they opted to take part in additional horse-assisted therapy.

Researchers, writing in the journal, Addiction Science & Clinical Practice, said keeping those with substance-use disorders actively engaged in treatment was a challenge.

Horse-assisted therapy, they noted, was increasingly used as a complementary therapy, with claimed motivational and other benefits to physical and psychological health.

The study involved 108 substance users at Oslo University Hospital who were admitted to its addiction treatment facility during an 18-month period from the start of 2011 . Patient participation in the study was voluntary.

They compised 78 men and 30 women, ranging from the age of 17 to 33. None of the patients had any legal requirement to remain in treatment.

The 108 – a mix of inpatients and outpatients – were all enrolled in the same treatment regime, but were given the option of adding horse-assisted therapy.

In all, 65 opted to undertake horse-assisted therapy and 43 decided against it.

Ann Kern-Godal and her colleagues said the baseline characteristics of the two groups were similar.

They found that 56.9% of those who took part in the horse-assisted therapy completed their treatment (37 patients), compared to 14% of those who opted against it (six patients). Those who took the horse program also remained in treatment for longer – an average of 141 days – as opposed to an average of 70 days for those who did not involve horses.

The research team said the findings did not prove that the horse therapy was responsible for the differences. “However, it adds supporting evidence for the development of an innovative therapy, and warrants investment in further research in relation to its inclusion in substance-use disorder treatment.”

The equine program used the hospital’s resident herd of five therapy horses. It comprised 12 90-minute sessions of body-orientated psychotherapy with horses.

Patients were encouraged to attend and participate fully, but had the option not to undertake an activity, such as mounted work.

The researchers said 90 days was often identified as the minimum period for effective treatment. The patients undertaking the equine therapy were significantly more likely to remain in treatment for 90 days or more and complete their treatment than those who opted out of the horse program.

However, because there was no information on why patients joined or did not join the horse program, it was not possible to form an opinion on whether the participants stayed in treatment longer because they participated in the program or because of some other positive factor which led them to take part.

“Our findings are consistent with claims that horse-assisted therapy has a positive effect on psychosocial illness,” they wrote.

“However, we acknowledge this could be due, in whole or in part, to a variety of possible confounding factors that were not examined (such as, for example the ‘honeymoon’ effect of a new program, the outdoor environment or the ambience around the stables).

“It is possible that a similar effect might be obtained more economically with another animal, such as a dog.

“Inclusion of dogs in substance misuse therapy has been found to improve therapeutic relationships. However, we have found no studies which compare the use of horses with other animals as an adjunct therapy for substance misuse.”

The researchers said it was a continuous struggle to find what motivated substance-use disorder patients to remain healthy. Rigorous evidence of safety and effectiveness was required before horse-assisted therapy can become a conventionally accepted treatment, they said.

However, the positive findings to date warranted further investigation of both the underlying therapeutic processes and the longer-term impact of horse therapy on substance-use disorder treatment.

“Investment is needed in larger controlled studies,” they said.

Kern-Godal was joined in the study by Espen Ajo Arnevik, Espen Walderhaug and Edle Ravndal.

Substance use disorder treatment retention and completion: a prospective study of horse-assisted therapy (HAT) for young adults
Ann Kern-Godal, Espen Ajo Arnevik, Espen Walderhaug and Edle Ravndal.
Addiction Science & Clinical Practice 2015, 10:21 doi:10.1186/s13722-015-0043-4
The full study can be read here

The full study was published under a Creative Commons License

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