Eleanor Harrison The Effects of Equine-Assisted Activities on Physical, Cognitive and Socioemotional Development

The Effects of Equine-Assisted Activities on Physical, Cognitive and Socioemotional Development Eleanor Harrison

Over the past few decades, alternative therapies have been used to treat individuals with a variety of disorders and diseases (Malchiodi, 2013). One of these forms of treatments is equine-assisted activities, which includes therapeutic horseback riding and equine-facilitated psychotherapy (Professional Association of Therapeutic Horsemanship [PATH], 2018). Therapeutic horseback riding (TR) teaches horsemanship skills to improve motor skills, as well as help the rider create an empathetic bond with the horse (All, Loving, & Crane, 1999; Bracher, 2000; Drnach, O’Brien, & Kreger, 2010). Similarly, equine-facilitated psychotherapy (EFP), involves a mental health professional working in collaboration with an equine professional and a client to address the client’s psychotherapy goals (PATH, 2018). Since both equine-assisted activities focus on many areas of development (e.g., physical, cognitive, and socioemotional), they are effective in improving a wide variety of emotions, skills, and behaviors, including mood, focus, posture, motor skills, sedentary behavior, and reactions to sensory input — all of which are notably difficult for individuals with different disorders (e.g., schizophrenia, cerebral palsy, autism spectrum disorder, and mood disorders; Bass, Duchowny, & Llabre, 2009; Corring, Lundberg, & Rudnick, 2013; Gabriels et al., 2012; Zadnikar & Kastrin, 2011). To better understand the specific ways in which these equine-assisted activities work, this literature review sought to explore the question: how do equineassisted activities influence an individual’s physical, cognitive, and socioemotional development?

Therapeutic Horseback Riding

Therapeutic horseback riding (TR), one of the many equine-assisted activities, primarily focuses on the didactic teaching of horsemanship skills (e.g., steering, grooming, posting, etc.), with the purpose of positively contributing to the rider’s cognitive, physical, emotional, and social wellbeing (PATH, 2018). Of the physical changes seen in individuals following therapeutic riding interventions, the most positive are improved posture and motor skills (Bass et al., 2009). During TR, individuals are taught the correct riding posture, which subsequently contributes to better overall posture (Bass et al., 2009; Bracher, 2000). When horseback riding, individuals must maintain a strong upright posture to effectively stay on the horse; sitting up straight with one’s shoulders back and chest out exerts effort on the shoulder, back, and core muscles, and allows the rider to balance better than when slouched or slumped over (Bertoti, 1988; Biery & Kauffman, 1989; Zadnikar & Kastrin, 2011). This improved posture has, in turn, been shown to reduce joint and muscle pain over time, especially as the individual ages, leading to improved health outcomes (Kitazaki & Griffin, 1997). Moreover, TR has been particularly effective in improving the motor skills of those with cerebral palsy, autism spectrum disorder, or multiple sclerosis (Bass et al., 2009; Gabriels et al., 2012). These individuals often have difficulties with activities requiring fine motor skills that include small muscle movements, and gross motor skills that include large muscle movements (Matson, Matson, & Beighley, 2011). By engaging in behaviors such as pulling on the reins and standing up on the saddle, therapeutic riding allows riders to practice both sets of motor skills (Bass et al., 2009; Hawkins, Ryan, Cory & Donaldson, 2014). In addition to the physical benefits of therapeutic horseback riding, completion of therapeutic horseback riding sessions is also correlated with decreased irritability and hyperactivity, as well as an overall increase in positive mood (Gabriels et al., 2012; Gabriels et al., 2015). This may be related to the decrease in sedentary behavior and physical activation associated with horseback riding, since physical activity is associated with decreased negative affect (Bass et al., 2009; Gapin, Labban, & Etnier, 2011). Furthermore, TR has been shown to improve riders’ attention, focus, and reactions to sensory input (Bass et al., 2009; Gabriels et al., 2012; Gabriels et al., 2015). In particular, therapeutic horseback riding benefits individuals with sensory sensitivities, by improving their reactions to sensory input (Bass et al., 2009; Gabriels et al., 2015). This is because therapeutic horseback riding provides opportunities for highly sensitive individuals to practice tolerance, as there are a lot of new sounds, sights, smells, and textures associated with horseback riding (Gabriels et al., 2012; Ward, Whalon, Rusnak, Wendell, & Paschall, 2013). While being exposed to these new stimuli, riders are simultaneously expected to pay attention to and focus on the TR instructor to learn riding skills (Lanning, Baier, Ivey-Hatz, Krenek, & Tubbs, 2014). This improved attention and focus has also been shown to transfer to school and home settings (Lanning et al., 2014; Ward et al., 2013). Teachers and parents perceive children who participate in therapeutic horseback riding as having improved social communication, greater tolerance to new experiences, and improved reactions to sensory input, compared to their counterparts who did not receive this intervention (Bass et al., 2009; Lanning et al., 2014; Ward et al., 2013). This shows that therapeutic horseback riding generates positive outcomes

outside of the therapeutic horseback riding setting. Additionally, for individuals with socioemotional difficulties, TR can aid in the development of key skills such as self-confidence and self-esteem (Burgon, 2003; Corring et al., 2013; Fox et al., 1984). For example, children with attention deficit hyperactivity disorder (ADHD) who undergo TR experience increases in self-confidence and self-esteem (Burgon, 2003; Corring et al., 2013; Cuypers, De Ridder, & Strandheim, 2011; Fox et al., 1984). It is also linked with increased selfconfidence, self-efficacy, motivation, and volition in children, which can appear in this context as increased eagerness to mount the horse (Burgon, 2003; Corring et al., 2013; Cuypers et al., 2011; Fox et al., 1984). Research demonstrates that, as riders interact with the horse during TR sessions (e.g., through caretaking practices such as grooming the horse), they develop greater empathy, both towards horses and humans, which is, in turn, associated with improved affective understanding and perspective taking (Cuypers et al., 2011). As such, individuals who traditionally have difficulty with social skills, such as those with schizophrenia and ASD, learn to begin initiating and maintaining social interactions by working with their horse, and thus develop socioemotional skills which they can transfer into their interpersonal relationships (Burgon, 2003; Corring et al., 2013).

Equine-Facilitated Psychotherapy

While TR uses horseback riding as the primary therapeutic modality, equine-facilitated psychotherapy (EFP), which is another form of equine-assisted activity, primarily focuses on the use of the horse as a metaphor within mental health treatment (PATH, 2018). In EFP, the horse is used as a guide within the therapeutic interaction, and participants use interactions between different horses (e.g., two horses fighting) or between a horse and a human (e.g., a horse approaching a human seemingly spontaneously) as to portray how people interact with each other in the real world (Rothe, Vega, Torres, Soler, & Pazos, 2004). Since horses are social and prey animals, they look to other beings as well as cues within their environment to assist them in navigating their reactions to different stimuli (Lentini & Knox, 2009). As a result, equine-facilitated psychotherapy uses these reactions as the basis for the therapy sessions, wherein clients apply these as metaphors of stimuli in their own lives that they may be consciously or subconsciously reacting to (Karol, 2007). Moreover, as horses are intuitive animals that use minute expressions and body language to communicate with each other and with humans, within the context of equine-facilitated psychotherapy, their interactions are described in parallel to human interactions in order to develop emotional growth and encourage deeper understanding of the self and relationships with others (Brandt, 2004; Carpenter, 1997). As such, this type of therapy can be used to address behavioral issues, uplift mood, and improve communication needs (Rothe et al., 2004). Equine-facilitated psychotherapeutic interventions have been developed to specifically address behavioral, social and communicative challenges (Ewing, MacDonald, Taylor, & Bowers, 2007; Vidrine, Owen-Smith, & Faulkner, 2002). Following completion of equine-facilitated psychotherapy interventions, children and adolescents display improvement in mood, and report being happier and overall more content than they were prior to completion of the sessions (Kern et al., 2011; Lentini & Knox, 2015). Equine-facilitated psychotherapy is also related to increases in positive behaviors (e.g., petting the horse in a kind way), decreases in negative behaviors (e.g., physical aggression), as well as improvements in general problem behavior areas (e.g., repetitive or stereotyped behavior patterns; Nelson et al., 2011; Trotter, Chandler, Goodwin-Bond, & Casey, 2008). Furthermore, equine-facilitated psychotherapy has been helpful in reducing the severity of symptoms of different psychopathologies, such as challenges with communication and social interaction (Kern et al., 2011). When clients participate in equine-facilitated psychotherapy, the horse’s behavior provides a reason and means for communication between the client and clinician (Lentini & Knox, 2015). As such, clients tend to perceive higher levels of social support and have increased levels of social interaction following their participation in EFP (Hauge, Kvalem, Berget, Enders-Slegers, & Braastad, 2014; Nelson et al., 2011).

Conclusion

Equine assisted activities have many known benefits for the individuals that they serve, particularly in relation to socioemotional, physical, and cognitive development (Burgon, 2003; Hauge et al., 2014; Lentini & Knox, 2015). Therapeutic horseback riding supports the individual’s physical and cognitive development, with both the clients themselves as well as participants’ parents and teachers reporting positive effects (Bass et al., 2009; Gabriels et al., 2012; Lanning et al., 2014). Conversely, equine-facilitated psychotherapy focuses more on the individual’s socioemotional development, with clients reporting emotional growth as well as higher levels of socialization (Brandt, 2004; Nelson et al., 2011). However, equine-assisted activities are a relatively new field of study. As such, there is limited research surrounding the efficacy of these activities with any specific population, and the small sample sizes for the studies that have been conducted limit their generalizability. Future research should examine how different factors in equine-assisted activities (e.g., the horse used and the quality of the instructor) influence the physical, cognitive and socioemotional changes mentioned in this paper. While this is a burgeoning field with limited research, it is quickly gaining in popularity, and more research will help to cement the legitimacy and efficacy of both therapeutic horseback riding and equinefacilitated psychotherapy.

References

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