Exploring Equine-Assisted Therapy for PTSD in Military Veterans

Posttraumatic stress disorder (PTSD) remains a significant and debilitating condition. It will hit nearly 9 percent of individuals in the United States at some point in their lifetime. Annually, it affects about 3.5 percent of Americans.

Conventional wisdom typically links PTSD to military personnel. And for good reason. Veterans – and active personnel – face higher rates of PTSD, ranging between 10 percent and 30 percent, because of a higher risk of trauma. And, despite advancements in treatment, a substantial portion of PTSD patients – and veterans in particular – fail to ever reach full remission. And they avoid or drop traditional therapy all too often.

Traditional exposure-based therapies, while effective for some, fail to do anything for at least half of the patients who go through it. A lot of patients drop out before ever finishing treatment. And, again, veterans show higher dropout rates and typically avoid starting treatment altogether, whether it’s because of a lack of trust, fear of the stigma associated with treatment, or even simple logistical issues.

Embracing An Alternative PTSD Treatment

Consequently, alternative treatments like equine-assisted therapy (EAT) have soared in popularity.

Advocates for equine-assisted therapy insist that it can help foster emotional awareness and behavioral changes. Horses, known for their particular sensitivity to human emotions and behaviors, provide immediate feedback, helping patients deal with their thoughts and actions. 

But despite the growing enthusiasm, EAT still needs standardized treatment protocols and rigorous scientific validation. To address this, a recent study developed and implemented a group EAT program tailored for PTSD (EAT-PTSD). This program comprised eight 90-minute weekly group sessions.

Researchers then evaluated the program in an open trial that included more the five dozen veterans diagnosed with PTSD. The researchers sought to assess the feasibility, safety, and preliminary efficacy of a standardized EAT-PTSD approach.

The research team recruited participants through multiple channels. Prospective study participants underwent thorough screening and clinical assessments to confirm their PTSD diagnosis and treatment eligibility.

The sessions took place at an equestrian center, with groups of three to five veterans engaging in activities such as grooming, leading the horses, and collaborative tasks.

Promising Results

The results showed promise. Out of the 63 participants, only five dropped out.

Of those who stuck with it, both the clinicians and the participants reported dramatic reductions in PTSD and depressive symptoms from pre-treatment to post-treatment. And the improvements remained at a three-month follow-up.

Clinician-rated symptoms, measured against the Clinician-Administered PTSD Scale (CAPS-5), showed a notable decrease. A little more than half of the participants showed clinically significant change post-treatment, with 46 percent scoring below the PTSD diagnostic threshold. 

Self-reported PTSD symptoms, assessed using the PTSD Checklist for DSM-5 (PCL-5), also dropped significantly.

What’s Next?

Despite this ray of hope, the study also underscored how critical it is for researchers to establish the efficacy and mechanisms of EAT-PTSD. While the open trial design offered valuable insights, a randomized controlled trial would be appropriate to more formally test its effectiveness. 

Additionally, understanding the singular aspects of horse-human interactions and their therapeutic benefits demands a closer examination. Future research should address these aspects and consider the geographical and financial feasibility of implementing EAT on a larger scale.

But as the first standardized EAT intervention, this study lays important groundwork for future research and development in this innovative therapeutic approach.