Potential Mechanisms of Action and Outcomes of Equine-Assisted Services for Veterans with a History of Trauma: A Narrative Review of the Literature

Abstract

Equine-assisted services (EASs) are being increasingly used as complementary interventions for military veterans who have experienced trauma. However, there is limited evidence of benefit for this population and almost no literature describing the desired potential outcomes and possible mechanisms of action. The aim of this article is to address these gaps by reviewing the extant literature of animal-assisted interventions in general, and equine-assisted services in particular, with the goal of providing guidance for future investigations in the field. Currently, the field is in the early stage of scientific development, but published results are promising. Interventions that enhance treatment compliance and/or outcomes could benefit this population. Preliminary results, reviewed herein, indicate that EAS interventions might benefit the military veteran population by enhancing treatment engagement and therapeutic alliance, as well as by contributing to symptom reduction and resulting in various transdiagnostic benefits. It is recommended that future studies include exploration of potential beneficial outcomes discussed herein, as well as investigate suggested mechanisms of action.

Psychotherapy Incorporating Equine Interaction as a Complementary Therapeutic Intervention for Young Adults in a Residential Treatment Program during the COVID-19 Pandemic

“…Nevertheless, withdrawal symptoms did not limit participation in these equine interactive activities in the current study, and this may be due to the fact that somatic symptoms associated with withdrawal are less intense for younger adults [47], allowing for the safe implementation of physical activities to an addiction treatment program designed for a younger population. Further, the mere presence of the animal within the therapeutic environment facilitates the release of oxytocin, which is a stress-modulating hormone [48,49]. This increase in oxytocin during animal interaction decreases stress, anxiety, and even pain.…”

Ground-based adaptive horsemanship lessons for veterans with post-traumatic stress disorder: a randomized controlled pilot study

“…A recent review on equine-assisted services for veterans with a history of trauma reported that the existing literature indicates veterans can benefit from this type of programming ( 7 ). The author also concluded that the field is in the early stages of scientific development with more studies needed.…”

“…Currently, there are several proposed theories and ideas for why equine-assisted services can be beneficial to individuals who have experienced trauma. These include self-determination theory, the horse–human relationship and the bonding that can occur between the two, enhanced engagement and therapeutic alliance during sessions, emotional and physiological mirroring, self-distancing through metaphor, and an opportunity for biophilia and mindfulness ( 7 , 27 ).…”

Bibliometric Analysis on Equine-Assisted Interventions

“…These programs are carefully designed to address a wide range of needs and goals in areas such as physical health, rehabilitation, emotional development, and personal growth [ 7 , 8 ]. These services have demonstrated benefits at a physical level with improved trunk control, balance, strength, and gross motor function [ 9 , 10 , 11 ]; mental health and cognitive aspects [ 12 , 13 , 14 , 15 , 16 ]; and learning-positive effects in behavior and learning and daily living skills [ 17 , 18 , 19 ]. Due to the diversity of terminology used, there is a large number of terms that have been used as synonyms.…”