Equine-Assisted Psychotherapy for Childhood Trauma: A Randomized Controlled Trial of the EAGALA Model

Abstract

Childhood trauma is a widespread problem that impacts millions of children, yet effectively engaging children in treatment post-trauma is challenging. Research on animal-assisted therapies and, specifically, equine-assisted psychotherapy (EAP), an animal-assisted form of treatment that partners with horses in the therapeutic process, suggests that it may be an efficacious treatment for children and adolescents with trauma-related mental health symptoms and diagnoses. However, the vast majority of this research consists of small, nonrandomized groups. This study is a longitudinal, randomized controlled trial of adolescents initially screened for trauma symptoms, who then received either EAGALA Model (EAP) (n = 55) or treatment as usual (TAU) (n = 49), with 10 sessions of active treatment, followed by a 10-week post-intervention follow-up assessment. Although both interventions demonstrated significant declines in anxiety, depression, and posttraumatic stress symptoms, it was the EAP group that demonstrated a significantly greater decrease in overall trauma symptoms that continued to decline longitudinally at 10-weeks post-intervention. The EAP group showed an improvement in emotion awareness from baseline to Week 5, although gains on emotional awareness were not maintained at Week 10 or at post-intervention follow-up. Attachment was only a significant predictor of therapeutic alliance at Week 1 but not at Week 5 or 10. Treatment group did not moderate the relationship between attachment and therapeutic alliance. Contrary to prediction, TAU had higher scores on therapeutic alliance but results did not reach statistical significance. Overall, these findings provide evidence for EAP as an effective form of treatment for trauma-impacted adolescents, but identifies caveats to be considered in future interventions and research.