Stressed first-responders benefit from horse-related therapy – study

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Many of the participants who met the threshold for depression and PTSD before the program no longer met the criteria after participation.
As one participant shared: “Connecting to the horses, they seem to be able to look directly into your soul, they see and feel your pain and emotions.” File image by Rodnei Reis Fotografia Sacramento/MG/BR

Horse-assisted therapy benefits first responders dealing with the effects of post-traumatic stress disorder (PTSD), a Canadian study has found.

The PTSD Association of Canada has released the findings of a pilot study, which shows the benefits of equine-assisted therapy as an adjunct therapy for the treatment of PTSD. The study revealed remarkable results for first responders affected by stress.

“In my career-spanning work with psychological trauma amongst first-responders, I have always been curious as to why some individuals respond well to conventional therapy and recovery, while others do not,” said Dr Charles Nelson, principal investigator for the study.

“Adjunctive equine therapy shows promising support in shoring the gap in recovery for those first responders who do not recover using psychological and/or pharmacological treatment alone.”

Nelson said the findings of the pilot study underline the therapeutic value of equine therapy. The study outcomes support its use among first-responders affected by the disorder, he said.

PTSD is an increasingly urgent area of concern around the world, affecting a wide range of people including police, firefighters, paramedics, rescue workers, military personnel, journalists, healthcare workers and the public at large. Its effects have been alarmingly amplified by the Covid-19 epidemic.

First responders have always been on the front lines of emergencies, but the last few years have increasingly demonstrated just how critical they are to the public’s health and safety. Many face tragedy, violence, disasters, heartache and trauma in their working lives.

As one participant shared: “Connecting to the horses, they seem to be able to look directly into your soul, they see and feel your pain and emotions.”

The study, carried out by Nelson with Ph.D. candidates Kimberly Dossett and Deanna Walker, involved seven first responders who took part in eight weekly 90-minute equine-assisted therapy sessions. The program involved groundwork only.

The responders were assessed for anxiety, depression, trauma, inflexibility and avoidance behaviours before and after the program. The study team also examined their feelings toward the program.

Findings showed symptom reduction, particularly for depressive and trauma-related symptoms. Feedback from the participants pointed to significant benefits, including an increased sense of peace, reduced anxiety, mindfulness, and increased trust in the self and others.

“To our knowledge, this is the first study to directly examine clinical outcomes of first responders with PTSD participating in equine-assisted therapy and presents a promising adjunct to care in first responders moving forward,” the researchers said.

All components of the program were rated at least 6.3 out of 7 following participants’ completion of the sessions, suggesting overall satisfaction with the program.

“Participants rated time with the horses as the most helpful, followed by staff. Notably, participants consistently mentioned that time with the horses brought them feelings of calm and helped them to be present and mindful in the moment.”

They also reported experiencing increased trust in themselves and in others, and a more positive outlook on life.

“Most participants reported feeling a sense of belonging and understanding in participating in the program with other first responders experiencing PTSD; however, one first responder noted that this was also a difficult component of the program.” Overall, participants noted that staff were knowledgeable, friendly, and understanding.

Comments from participants were favourable toward the involvement of horses. One said: “Had a feeling of calm during and immediately after spending time with the horses; also a feeling of having a clear mind and a better outlook on life in general.”

Another said: “Being present with the horses allowed me to focus on leading and being present with the horses. Allowed me to not think about the issues of the day.”

From the first session, participants were observed encouraging one another and cheering each other’s successes. Over the course of the program, participants were observed speaking more openly during group check-ins about their reactions to sessions and emotional experiences both in-session and during the time between sessions.

Participants’ responses to the open-ended questionnaire supported this observation, with numerous participants noting the importance of companionship and understanding from other participants.

Discussing their findings, the study team said the overall results supported the use of equine-assisted therapy as an adjunct to evidence-informed trauma exposure psychological treatment. The program had clearly provided benefits to first responders with PTSD in terms of symptoms of the disorder.

“In line with our predictions, participants experienced significantly lower levels of depression and trauma-related symptoms following completion of the program.

“Notably, numerous participants who had met the threshold for depression and PTSD prior to the beginning of the program no longer met criteria following their participation in the program.”

There was some preliminary evidence to suggest decreases in anxiety and inflexibility/avoidance over the course of the program, but more work is needed in this area.

The self-reported improvements were equally important. “The program was consistently associated with a sense of calm, peace, grounding, and sense of being able to trust self and others. This is particularly meaningful given primary concerns associated with PTSD symptoms relating to reduced sense of trust in others and the self.”

Connecting with oneself, as well as with others who have shared experiences, appeared to greatly benefit first responders, the authors said.

“Our hope is that the benefits experienced by first responders in this pilot project prompt larger-scale research in this domain, whereby this program could be offered to a wider group of Canadian first responders who are experiencing mental distress, including anxiety, depression, and PTSD.”

The pilot study, titled “Equine-assisted therapy for post-traumatic stress disorder among first responders,” can be read here.

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