The Impact of Equine Assisted Interventions on Measures of Social and Emotional Wellbeing in Adolescents by Shreyasi Brodhecker June 2020

Introduction

There is limited empiric understanding of the emotional and social benefits of equine assisted interventions. This literature review asks, “What is the impact of equine assisted interventions on measures of social and emotional wellbeing in adolescents?”

The rationale for selecting this topic lies in the intention of the author to partner with equines, in a nature based setting, to provide life skills and psychoeducation to young adults from disadvantaged backgrounds or otherwise considered to be “at risk”.

For the purpose of this review, equine assisted interventions (EAI) may encompass the following;

Equine Facilitated Psychotherapy (EFP), Equine Assisted Psychotherapy (EAP), Equine Facilitated Learning (EFL), Equine Assisted Learning (EAL).

Study Summaries and Analysis

Frederick et al.’s (2015) study, EAL’s impact on the levels of hope and depression in a population of at-risk youth was explored by recruiting middle and high school-aged participants from a Texas school. The children participated in a five week curriculum based EAL program called L.A.S.S.O. (Leading Adolescents In Successful School Outcomes). Self-report measures were collected from students at the start and end of L.A.S.S.O. In the results, students attending EAL had significantly higher levels of hope at the end of the study. Hope is thought to be inversely related to depression and has been associated with optimism, self-esteem and academic achievement in school-aged children; hope is therefore understood to influence both social and emotional wellbeing.

A similar EAL intervention was attempted in a group of at-risk Australian Aboriginal youth in Coffin’s (2019) pilot study. This unique EAL was provided by Aboriginal educators in the context of a culturally approved program by elders in the local communities. Students completed a six to 10 week program in EAL, with weekly 45-60 minute sessions. These sessions included individual, paired and group activities for non-riding equine interactions, discussion of topics such as coping skills and self-regulation, and leadership-focused activities. Quantitative data was derived from measurements on a modified Strength and Difficulties Questionnaire at the start and end of EAL. This study extended data collection beyond the quantitative findings of Frederick et al.’s (2015) work to include qualitative data. Findings of this study also showed EAL’s benefits – namely, that youth attending the EAL showed improved social and emotional wellbeing, self-regulation, socialization and self-awareness ratings and behaviors.

There have been a number of studies highlighting the benefits of EAL on healthy social functioning in teens. For example, Hauge et al. (2014) investigated the impact of EAL on levels of perceived social support among Norwegian teens aged 12 to15 years old without diagnosed mental health conditions. Students from ten local schools voluntarily participated in a four month intervention at select local farms, where they attended two-hour weekly sessions with a peer who was new to them at the study start. The participants worked with the same horses and instructor over the weeks of intervention and had the opportunity to learn and perform groundwork, riding, communication with the horses and general farm skills. Self-report measures of self-esteem, self-efficacy and perceived social support were collected at the start and end of the intervention and a questionnaire was provided to assess the degree to which participants thought they had mastered task-based and relationship skills with the horses as a result of EAL. There was significant improvement in the level of perceived social support at the end of EAL compared to the start, although there were no changes seen in either self-esteem or self-efficacy ratings. As well, those teens with lower levels of perceived social support at the study start showed the strongest correlation with experienced mastery of horse skills. In other words, although the participant demographic had similar psychological variable scores at the start of the study, those with slightly lower levels of social support showed the most improvement in mastery of skills with horses.

Social competence, related to social wellbeing, is also impacted by EAL/EFL (Pendry, Carr, Smith, & Roeter, 2014). The effects of an 11 week EFL program on the social competence and behaviors of Grade five to eight children were explored by the random assignment of 131 children to an EFL group or to waitlist control. The EFL group provided participants with weekly, 90-minute sessions of individual and group activities. Study measures included parent-rated social competence scores, pre and post-EFL and checklist scores from three independent raters at each EFL session. Results of this study were that EFL participation (vs. waitlist) had a moderate treatment effect on social competence regardless of pre-test ratings, age or gender. As may be expected, higher levels of program attendance predicted more observed positive behaviors in the children.

Other studies exploring the impact of EFL on prosocial behaviors in children included those by Perkins (2018), Maujean et al. (2013), and Fo et al. (2017). EAL’s association with significant improvement in prosocial behaviors related to social and emotional wellbeing, such as communication, confidence, and impulse control, in at risk youth was demonstrated. Perkins (2018) described a quantitative pilot study of six adolescent females, from the foster care system, who attended an eight week psychoeducational/EAL program called Cowboy Trails, or eight weeks of group therapy (group therapy served as the control in this study). Weekly EAL sessions included a 15 minute discussion of a life skill taught that week, 45 minutes to complete a task with a horse and then final group debrief. Questionnaires on prosocial behaviors were completed by the participants at the start and end of the intervention. Questionnaires were also collected from members of the EAL team. On the participant’s pre and post intervention questionnaires, measures of emotional regulation increased significantly at the end of the Cowboy Trails intervention. Further, on the team reports pre and post-test comparisons, other prosocial skills such as communication, confidence and respect also showed improvement. Although this study was limited by the small sample size and generalizability of the results, it showed that EFL may be a worthwhile avenue to improve prosocial behaviors in at risk youth.

Similar findings of improved emotional and social wellbeing in teens were found by Maujean et al. (2013) who conducted a qualitative pilot study of 16 disenfranchised youth in Queensland, Australia, to assess the impact of an equine-assisted intervention on measures of self-esteem, self-efficacy, engagement and prosocial behaviors. Participants completed a ten week, hourly intervention called Horse Play, which incorporated Parelli natural horsemanship, life skills teaching and applying character traits such as kindness outside of sessions. Qualitative themes from interviews of the participants and case managers were; 1. enjoyment (of the program); 2. social and psychological benefits (including improved social skills and self-esteem); 3. engagement (improved school attendance and participation in non-horse activities); and 4. transferable skills (e.g. improved motivation and self-awareness).

These prosocial behaviour findings are in alignment with those from Fo et al. (2017) who tested an equine assisted intervention’s impact on the Habits of Mind program, a prosocial, skills-based curriculum in the at risk youth’s school. Known as EQUAL (Equine Assisted Learning), the intervention included EAP, EAL, therapeutic riding, and hippotherapy provided for weekly, three-hour sessions over a total of 16 weeks. There were two cohorts, in 2013 and 2014, of students between the ages of 11 and 15 years of age (who entered this school after failing their elementary school exams). Scores on a rating scale for dimensions of the Habits of Mind curriculum, including Persistence, Thinking Flexibly, Taking Responsible Risks, Managing Impulsivity and Understanding/Empathy and were measured at the start and end of EQUAL in treatment and control groups. There were significant improvements in the Habits of Mind factors in the EQUAL group versus control; this finding was seen in the 2013 and 2014 cohorts. As well, measures of change correlated positively with student grade point average at the end of semester.

Conclusion

This literature review facilitated the following considerations for future practice. Firstly, various forms of EAL can be helpful for improving measures of social and emotional wellbeing in at risk youth. On average, EAL interventions consisted of at least eight weekly sessions, each session being at least one hour in duration. The studies’ EALs included riding and non-riding related equine activities, implying that both are beneficial modalities. Secondly, although one study (Hauge et al. 2014) cited equine assisted interventions being applied in normotypic teens, the majority of studies showed benefit for at risk youth of both genders. Finally, factors hypothesized to positively contribute to study results and that can be integrated into future practice include; 1. a program blend of structured equine activities and group discussion about life skills and themes from the sessions; 2. consistent and intentional pairing of horse and participant where possible; 3. a nature-based setting and ; 4. a non-judgmental and supportive learning environment.

In conclusion, this literature review indicated that there is significant improvement in measures of social and emotional wellbeing such as; perceived social support, enjoyment, mastery of skills, improved engagement at school and improved ratings on prosocial behavior scales, associated with administering equine assisted interventions in adolescents.

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