An Alternative Therapy: Equine-Facilitated Psychotherapy

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An Alternative TherapyEquine-Facilitated
Psychotherapy

• Nadia Moheisen
• Roya Leavitt

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Description

• Equine-Facilitated Psychotherapy Experiential
  psychotherapy that includes equines.  It may
  include, but is not limited to, a number of
  mutually respectful equine activities such as
  handling, grooming, lunging, riding, driving, and
  vaulting. This must be accompanied by a licensed
  mental health professional and an equine
  professional.
• Equine Assisted Learning/Therapy Includes
  equine activities incorporating the experience of
  equine/human interaction in an environment of
  learning or self-discovery.
• Goals usually related to self-improvement,
  social interaction and/or education.  
• Often used in group team building exercises

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Uses

• Equine Facilitate Psychotherapy (EFP) can be used
  to alleviate the effects of psycho-social issues
  and mental health needs such as
• Posttraumatic Stress Disorder
• Eating Disorders
• Trauma due to Sexual or Physical Abuse
• Mood disorders such as Depression and Mania

• Attention Deficit Hyperactivity Disorder, Autism,
  Personality Disorders
• Anxiety Disorders
• Environmental trauma (natural disasters),
  divorce, grief, and loss.

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How/Why it works

• Horses are large and powerful animals, which can
  incite fear or intimidation. Accomplishing a task
  involving the horse, despite their fears, creates
  confidence, and a sense of self-efficacy in the
  client
• Horses mirror the emotions and read the body
  language of the people around them
• Horses dont lie they will convey to you
  exactly whats going on
• Use these as metaphors for understanding the
  emotions the client is experiencing or avoiding.
  Working with horses provides the therapist with
  an object in the space (other than self) on which
  to promote projection and identification.
  Disclosure of abuse and expression of feelings
  can be integrated into story-telling. Children
  will tell stories from the animals point of view
  which are metaphorical or are actual details of
  the childs life (Reichert, 1998).
• Congruency Allow therapist to discover
  unacknowledged emotions or get to issues faster
• Develop problem-solving skills

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• Can address fear and empowerment issues (example
  For dependant personality disorder can help
  discover how to establish boundaries and respect
  through self-empowerment)
• Example (person hiding emotions, horse picks up
  on that)
• Creates a more nurturing and comforting setting
  for client and therapist
• Riding rhythm and beat can help get through
  highly charged moments (adults usually revert to
  fetal position or a rocking back motion when
  overwhelmed with emotions or fear)

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History

• 5th century Greek soldiers used horses to
  rehabilitate their injured
• 1969 North American Riding for the Handicapped
  Association (NARHA) started
• Some believe the theoretical underpinnings of EFP
  originate from Gestalt Therapy (1950s) which is
  an existential and experiential psychotherapy
  that focuses on the individual's experience in
  the present moment, the therapist-client
  relationship and the environmental and social
  contexts in which these things take place
• Not until 1996 that Equine Facilitated Mental
  Health Associated started as a branch of NARHA
• Last four years become more widely recognized

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Case Study

• Children Cross-study analysis (Schultz N.P.,
  Remick-Barlow G. A., 2007)
• Main Measurement GAF ( Children's global
  assessment of Functioning)
• Secondary info demographic information, physical
  health history, medication history, mental health
  history, mental examination, and Diagnostic and
  Statistical Manual of Mental Disorders, Fourth
  Edition (DSM-IV) diagnosis.
• Participants 63 total, half Hispanic, age range
  4-16, disorders family abuse, PSTD at-risk for
  mental disorders, ADHD, and mood disturbance
  diagnosis
• Found significant improvement in GAF, did not
  test against other therapies

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Case Study (Karol 2007) 

• Case study approach one example mood disorder
  (manic and depressive episodes)
• She was able to close her eyes and imagine the
  horses rhythm as her own when she felt herself
  either out of control or falling toward
  depression. This did not cure her of these
  states, but lessened the severity of them, she
  was able to calm her body and her thoughts which
  helped prevent most of her manic outbursts from
  getting out of control. (example use of metaphor
  and effect of stable rhythm)
• The horse is a potent object for the child to
  join with. The child can borrow the power and
  grace of the horse while he or she is riding and
  so experience his or her body and, thus, self
  differently. Also the child can join his or her
  experience of powerlessness and vulnerability
  with the vulnerable nature of the horse, because
  of the unique and disparate characteristics of
  the horse the child can find a friend in both his
  or her need for an enhanced sense of self and a
  companion in the lonely and painful experience of
  limitation and helplessness.
• Helps facilitate trust and communication between
  client and therapist

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Organizations

• Equine Facilitated Mental Health Association
  (EFMHA) which is a newly established (1996)
  branch of the North American Riding for the
  Handicapped Association, Inc. (NARHA),(est.1969)
• Provides workshops, network, guidelines, ethics,
  certification if eligible to take exam
• A growing field (2003-2006)
• EAGALA
• Horses and Humans
• Foundation (HHF)

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Certification

• Eligibility for examination to get certification
  (EFMHA)
• A copy of a current license to practice mental
  health services (counseling, social work,
  substance abuse counseling, pastoral counseling,
  psychology, etc.) in the state where you will be
  providing services. (In some states a Masters is
  required, in others a bachelors degree with
  proper training will qualify)
• At least 1,000 hours must be in equine
  facilitated mental health or learning (EFMH/L)
• i. At least 550 hours of the 1,000 hours must be
  in delivery of mental health services that
  incorporates equines and would include all face
  to face work with clients, supervision, planning,
  meetings, and evaluation, etc.
• ii. As many as 450 of the hours could be in
  seminars, coursework, workshops, academic
  courses, etc.

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Organizations (cont.)

• EAGALA (founded 1999) certifies team of
• Mental Health Practitioner must be under a
  governing board/association that can hold him/her
  accountable for any practice violations relating
  to mental health practice.
• Equine Specialist/Professional
• The person we interviewed (Susan Hice) had become
  certified in this way and is currently working
  towards establishing a non-profit status for
  their practice.

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In this area

• There are a number of organizations in Virginia
  which focus on psychotherapy, team-building, and
  physical therapy
• Horses Healing Hearts in Suffolk, VA
• Susan Hice, Equine Specialist in Warrenton, VA
  (EAGALA Certified Instructor)
• Horse as Teach Programs Charlottesville, VA

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Sources

• http//www.naropa.edu
• http//www.narha.org
• http//www.eagala.org
• http//www.blackwell-synergy.com
  Equine-assisted psychotherapy a mental health
  promotion/intervention modality for children who
  have experience intra-family violence
• http//ccp.sagepub.com - Applying a Traditional
  Individual Psychotherapy Model to
  Equine-Facilitated Psychotherapy (EFP)Theory and
  Model