The Effects of Equine-Assisted Psychotherapy on Mindfulness, Self-Reflection, Insight, and Psychological Well-Being in Veterans

Abstract

The purpose of this quasi-experimental study was to investigate the effects of equine-assisted psychotherapy (EAP) on mindfulness, self-reflection, insight, and psychological well-being in an adult veteran population with mental health concerns. Specific aims were (1) to determine the effect of EAP on mindfulness, self-reflection, insight, and psychological well-being in veterans with psychiatric diagnoses or mental health concerns; and (2) to describe the relationship of the sociodemographic characteristics (age, ethnicity, gender, education level, income, and deployment history) to mindfulness, self-reflection, insight, and psychological well-being of adult veterans with mental health concerns engaged in EAP. Smith’s (1999) theory of unitary caring provided the guiding theoretical and conceptual framework for the study.

A convenience sampling design was used to recruit 18 participants from a South Florida therapeutic riding center and an online veterans’ forum. The sample consisted of adult veterans ages 18 years and older who had mental health concerns and/or diagnoses. Assignment to the EAP group (n = 9) was determined by the therapy center director based on session days and times and participant availability. The comparison group (n = 9) received their treatment as usual.

Paired t-tests for the EAP group showed a statistically significant increase for engaging in self-reflection. Mean scores for all variables except insight demonstrated an increase from pre to post, but did not reach statistical significance; however, the test was underpowered. The main ANCOVA analysis results supported significantly greater increases in mindfulness, the awareness subscale for mindfulness, self-reflection, the engaging in self-reflection subscale, and psychological well-being for the treatment group, compared to the comparison group. There were no significant demographic predictors of mindfulness, self-reflection, insight, and well-being. Additional analysis supported that mindfulness and insight were correlated with well-being in this study, whereas self-reflection was not. Neither deployment history, years since discharge, nor age were found to be moderators of the relationship between self-reflection and wellbeing. Future studies using larger veteran and other populations, non-English speaking participants, biomarkers, and measures of PTSD and dissociation could offer further insight into the efficacy of EAP as a therapeutic modality. Examination of whether increased mindfulness as a result of EAP mediates well-being is also indicated.