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Portfolio: Equine-Assisted Activities and Therapies Definition

Sophie Joan Smith

California State University, Fullerton

English 363: Scientific Writing

Dr. Leslie Bruce

December 9, 2020
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Equine-Assisted Activities and Therapies

Equine-assisted activities and therapies (EAAT) are therapeutic methods which facilitate

patients’ emotional, mental, or physical healing through contact with horses.

Equine-assisted activities and

therapy is commonly abbreviated

as EAAT. Variations of equine

therapies are abbreviated similarly;

Equine-assisted psychotherapy

becomes EAP.

Figure 1. The equine-human bond facilitates patient healing. From

Animalwised.com (2020). [Human equine bond]. Animal Wised.

Etymology

The term equine-assisted therapy can be broken down into two primary parts. “Equine,” from

the Latin word Equus (meaning horse), later evolved into Equinus and finally the modern word

Equine in the 18th century. Similarly, “Therapy,” coming from therapeia, means healing. Equine-

assisted therapy can be roughly translated to horse healing.

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Background

Equine-assisted activities and therapies are gaining popularity for their versatility. EAAT was

formally recognized in the 1950’s and the 1960’s. In 1969 the “North American Riding for

Handicapped Association” was formed and later became “Professional Association of

Therapeutic Horsemanship” or PATH International as it is commonly known today. Recently,

EAAT migrated to the internet which gives a broader audience the chance to discover EAAT.

Popular websites such as www.verywellmind.com now discuss EAAT. In 2020,

www.verywellmind.com offered a comprehensive EAAT description (Clarke, 2020). EAAT tasks

include feeding, brushing (grooming), and walking (leading) the horse under practitioner and

equine specialist supervision. These activities facilitate self-confidence, responsibility, and

emotional regulation (Clarke, 2020). Popular website exposure offers a broader audience

access to EAAT information as more research is conducted determining effectiveness within the

modern behavioral science communities.

Goals

EAAT often builds upon

other more traditional

therapy forms. EAAT goals

include improving

emotional, mental, and

physical health. Some

Figure 2. Goals of equine-assisted therapy. From Verywellmind.com (2020). [Goals of
patients arrive at EAAT equine-assisted therapy]. Very Well Mind.

after having already been

exposed to other forms of therapy, such as Cognitive Behavioral Therapy (CBT). During CBT, a

patient may feel hindered by the formal therapy structure, at which point a practitioner may
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recommend EAAT. EAAT may supplement other therapies. For example, individuals who use

EAAT for physical benefits may also work with physical therapists, and EAAT is part of a

wellness regimen. Overall, EAAT can be used in conjunction with other therapies or on its own

to improve emotional, physical, and mental health.

Principles of Operation

EAAT’s structure depends upon the therapeutic goals and varies from treatment type to

treatment type.

Subfields

Different forms of EAAT are offered to different individuals. Equine therapy is not only

used to treat mental health conditions, but it is also used to treat a variety of physical

and developmental disabilities. In this context, equine therapy is sometimes referred to

as hippotherapy, a form of physical therapy for conditions such as multiple sclerosis,

epilepsy, traumatic injuries, etc. (Koca, & Ataseven, 2016). Researchers are

investigating EAAT as part of treatment for mental health concerns (depression

disorders, anxiety disorders, trauma (Post-Traumatic Stress Disorder)). EAAT

practitioners also treat developmentally disabled patients (Down's Syndrome/ Autism

Spectrum Disorder) because EAAT can facilitate communication, balance, confidence

and physical coordination. In 2013, researchers investigated Autism Spectrum Disorder

(ASD) and therapeutic riding to improve unwanted target behaviors (Holm et al., 2013).

70% of target behaviors improved during therapeutic riding treatment, and 63% were

retained afterwards (Holm et al., 2013). Of all the branches of EAAT, equine-assisted

therapy or therapeutic riding for ASD is perhaps the most widely-studied. Equine-
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assisted therapy differs from equine-assisted psychotherapy, which is loosely based on

talk therapy principles.

Equine-Assisted Psychotherapy

During equine-assisted psychotherapy, a patient may sit with and pet or brush a

horse while talking with a therapist. The horse offers bio-feedback, which

provides live information to the practitioner and the patient regarding state of

mind and mood (Smith, 2020). EAP is a form of talk therapy facilitated by a

practitioner for the improvement of her patient’s mental health. The horse’s

presence can be comforting and empowering for the patient as well as useful to

the practitioner.

Hippotherapy

Hippotherapy focuses on physical therapy and is commonly used to treat

ailments such as Multiple sclerosis, spinal cord injuries, Cerebral palsy,

fibromyalgia, Parkinson’s disease, etc. (Verywellminded.com, 2019). During

these treatments, and depending upon the patient’s physical limitations, a patient

may be placed on the horse’s back (with practitioner and equine-specialist’s help)

and guided through certain tasks such as closing of the eyes, raising of the

hands, sitting backwards on the horse, reaching the arms out horizontally, etc.

The animal’s physical movements facilitate the human’s natural bipedal

balancing motions. This can improve patient’s balance, coordination, strength,

flexibility, and confidence.

Equine-Facilitated Learning
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Equine-facilitated learning (EFL) is a very novel and experimental equine-therapy

branch. EFL focuses on groundwork (involving little to no horse-riding). The

participant carries out certain activities on the ground with the animal to facilitate

learning. In a 2014 Washington State University study, Dr. Patricia Pendry found

that EFL once a week for 11 weeks showed a significant effect on adolescent

social competence (Pendry, 2014). EFL is interesting to behavioral scientists

because horses are prey animals and therefore they are reactive by nature. This

means that the have the ability to help people learn in real-time. As interest in

EFL grows, research studies explore different aspects of the practice and how it

might be useful to learning in a variety of circumstances.

Prominent Research

Equine-assisted therapy is new in the psychology world. To learn more, interested individuals

can find a wide range of peer-reviewed research regarding the uses and effectiveness of

various horse therapies within the PsycInfo database. Formal research began in 1989 and

continues to increase in frequency, scope, and generalizability.

On Autism Spectrum Disorder:

In one previous research study, Ajzenman, Standeven and Shurtleff (2013) supported

the hypothesis that hippotherapy is an effective treatment for Autism Spectrum Disorder

(Ajzenman, Standeven & Shurtleff, 2013). This small-scale study provided 6 autistic

children with 45-minute weekly hippotherapy doses for 12 weeks, after which significant

gains were recorded in a variety of adaptive behaviors such as coping and

communication, self-care, social interaction, and implementation of leisure behaviors

(Ajzenman, Standeven & Shurtleff, 2013). This study’s generalizability is limited by its
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small sample size; however, it should be replicated because initial results are promising

for future implications.

On Cancer:

Both equine-therapy and hippotherapy

have been recently used for patient

emotional and physical health during and

following cancer sickness. Figure 3 depicts

a child receiving EAT in remission from a

rare muscular cancer. She benefits

emotionally and physically (CNN, 2018). In

a previous study involving cancer survivors,

researchers Cerulli et al. (2014)

demonstrated in a true experiment that individuals who had received EAT during a 16-

week period showed significant physical health and quality of life improvements (Cerulli
Figure 3. A child receives benefits from EAT as part of
et al., 2014). The Cerulli et al. (2014) study her healing from cancer. Wpsdlocal6.com (2018).
[Seven-year-old Belle Swersey on her first day of riding
included 20 participants divided evenly into lessons at Friends for Tomorrow in Lincoln,
Massachusetts]. CNN.
a control group and treatment group. While

the treatment group receiving EAT showed significant gains, the control group did not

(Cerulli et al., 2014). Therapies involving equines have a specific advantage: They are

good for both mind and body. This has particularly interesting implications because it

demonstrates the field’s potential healing breadth and scope across ailments. That is,

EAAT’s patient healing properties are unusually far-reaching.

On Post-Traumatic Stress Disorder:

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While the research quantity is still limited, EAAT is promising for individuals experiencing

PTSD and anxiety. In a previous study, Earles et al. (2015) provided EAT for 6 weeks,

reducing PTSD levels including less emotional responses to trauma and less

generalized anxiety, as well as reduced depression symptoms (Earles et al., 2015).

Additionally,

participants

increased

mindfulness and

decreased alcohol

consumption (Earles

et al., 2015).

For PTSD veterans,

EAAT is in its

infancy but its effectiveness has opened up new possibilities to help these individuals

readjust (and thrive)

in civilian life.

Figure 4 displays U.S. Army soldiers conducting Equine Movement Therapy through

Virginia’s Fort Belvoir Community Hospital. The program goal is to rehabilitate active

duty and retired veterans (U.S. Army photos by Sgt. Nicholas T. Holmes) (Flickr, 2019).

Despite the studies’ limitations

Figure 4. A discussed above,
veteran benefits research
from EAT. results are promising.
From "190905-A-KI711-004" by 3d U.S. Infantry
Regiment (The Old Guard) is marked with CC PDM 1.0

Concerns

Novelty

Equine-assisted therapies are experimental; Not enough time has passed, and not

enough data has been gathered to make conclusions about the process’ effectiveness.
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More research is needed. In particular, longitudal studies including follow-ups will be

important in making generalized statements about EAAT effectiveness.

Animal Well-Being

Any time animals are involved in scientific processes, concerns may arise for the

animal’s safety and well-being. Therefore, licensed mental-health professionals are

required to work with a team of PATH certified equine-specialists during sessions. This

practice looks out for not only the safety and well-being of the animals involved, but also

patients’ safety while participating in equine-assisted activities and therapies.

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References

Ajzenman, H. F., Standeven, J. W., & Shurtleff, T. L. (2013). Effect of hippotherapy on motor

control, adaptive behaviors, and participation in children with autism spectrum disorder:

A pilot study. American Journal of Occupational Therapy, 67(6), 653–663. https://doi-

org.lib-proxy.fullerton.edu/10.5014/ajot.2013.008383

Animalwised.com (2020). [Human equine bond]. Animal Wised.

https://www.animalwised.com/what-is-equine-assisted-therapy-1716.html

Cerulli, C., Minganti, C., De Santis, C., Tranchita, E., Quaranta, F., & Parisi, A. (2014).

Therapeutic horseback riding in breast cancer survivors: A pilot study. The Journal of

Alternative and Complementary Medicine, 20(8), 623–629. https://doi-org.lib-

proxy.fullerton.edu/10.1089/acm.2014.0061

Clarke, J. (2020, June 22). Equine Therapy as Mental Health Treatment: How It's Used.

https://www.verywellmind.com/equine-therapy-mental-health-treatment-4177932.

Earles, J. L., Vernon, L. L., & Yetz, J. P. (2015). Equine‐assisted therapy for anxiety and

posttraumatic stress symptoms. Journal of Traumatic Stress, 28(2), 149–152. https://doi-

org.lib-proxy.fullerton.edu/10.1002/jts.21990

Holm, M. B., Baird, J. M., Kim, Y. J., Rajora, K. B., D’Silva, D., Podolinsky, L., Mazefsky, C., &

Minshew, N. (2014). Therapeutic horseback riding outcomes of parent-identified goals

for children with autism spectrum disorder: An ABA’ multiple case design examining

dosing and generalization to the home and community. Journal of Autism and

Developmental Disorders, 44(4), 937–947. https://doi-org.lib-

proxy.fullerton.edu/10.1007/s10803-013-1949-x

Koca, T. T., & Ataseven, H. (2016, January 15). What is hippotherapy? The indications and

effectiveness of hippotherapy. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5175116/.

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Lieber, M. (2018, June 18). Equine-assisted therapy may help autism, PTSD, and pain. WPSD

Local 6. https://www.wpsdlocal6.com/archive/equine-assisted-therapy-may-help-autism-

ptsd-and-pain/article_d5e3a300-feaf-5122-a8cd-9d1ff8812e3e.html.

Pendry, P., Carr, A. M., Smith, A. N., & Roeter, S. M. (2014). Improving adolescent social

competence and behavior: A randomized trial of an 11-week equine facilitated learning

prevention program. The Journal of Primary Prevention, 35(4), 281–293. https://doi-

org.lib-proxy.fullerton.edu/10.1007/s10935-014-0350-7

Smith, C. Learn About EAAT. Equine-Facilitated Psychotherapy.

https://www.pathintl.org/resources-education/resources/eaat/60-resources/efpl/201-

equine-facilitated-psychotherapy.

Verywellmind.com (2020). [Goals of equine-assisted therapy]. Very Well Mind.

https://www.verywellmind.com/equine-therapy-mental-health-treatment-4177932.

Wpsdlocal6.com (2018). [Seven-year-old Belle Swersey on her first day of riding lessons at

Friends for Tomorrow in Lincoln, Massachusetts]. CNN.

https://www.wpsdlocal6.com/archive/equine-assisted-therapy-may-help-autism-ptsd-

and-pain/article_d5e3a300-feaf-5122-a8cd-9d1ff8812e3e.html.

3d U.S. Infantry Regiment "The Old Guard". (2019, September 05). 190905-A-KI711-004.

Retrieved September 27, 2020, from

https://www.flickr.com/photos/63526116@N03/48684741621

Post-Write

This assignment was a really interesting process for me. From feeling overwhelming, to

feeling manageable, the steps along the way have been both challenging and enjoyable. I have

never been asked to do something like this before, and that’s a good thing! One of the most

challenging parts, interestingly, was the actual formatting of the project using Microsoft Word. I
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spent hours shifting things around and sitting back and looking and then shifting everything

around an 8th of an inch again. Anyways, some of the Markel strategies I used were:

Partitioning: The process of partitioning my definition has made the end-result seem much

more attainable. Breaking down the concepts into smaller, more manageable sections not only

feels better for writing, but looks better for reading as well. I partitioned each section using the

green-colored font and then included subsections further indented when I thought the

paragraphs were looking a bit content-heavy (ex: “Prominent Research”).

Graphics: The use of graphics has made concepts which may seem abstract to readers

more tangible. The www.verywellmind.com graphic, which breaks down EAT into its main goals,

was particularly useful to my definition. I thought about my own experiences reading my

textbooks and reflected on the fact that I enjoy visual aids breaking up the content-heavy text.

Principles of Operation: The principles of operation included an overview and the subfields

section of my definition. I broke EAT down into what the practitioner hopes to achieve with his

clients through the use of horses and then included multiple subfields which included

descriptions of the actual processes that occur during equine therapies. Interestingly, even

though I knew I wanted to use the principles of operation convention in my definition, that was

actually the section that I revised the most after receiving my peer-feedback.

Thank you for an interesting and challenging assignment, Professor. I hope you enjoyed

reading about equine-assisted therapy!