Patient-Centered Communication (PCC) in Equine Assisted Mental Health

ABSTRACT

Experiencing trauma can lead to a variety of chronic and acute symptoms, including post- traumatic stress disorder (PTSD), anxiety, depression, substance abuse, and poor social skills. Given the variety of causes for trauma incorporating individualized treatment options is important for efficacy. Equine assisted mental health (EAMH) – a team approach incorporating equines, clients, and practitioners – has been successful in treating those who have experienced trauma, including veterans and individuals with PTSD, at-risk youth, victims of sexual violence, and children who have been neglected. Although researchers and practitioners understand some about how EAMH treatment results in positive outcomes for these individuals, little is known about the communicative processes that support them. The current study included 19 in-depth interviews with EAMH therapists and practitioners to explore the role of equine communication (i.e., congruence, ongoing positive regard, and empathy) as a communicative process that is integral to the facilitation of EAMH as individualized therapeutic treatment. Using tenets of patient-centered communication (PCC) and principles of client-centered therapy, implications for human-horse communication in therapeutic contexts and client-centered care are discussed.

Notes

1. The EAGALA model is a team approach (i.e., mental health professional, equine specialist, horses and clients) focused on horses as large, powerful, prey animals that live in herds and have distinct personalities for solution focused treatment (EAGALA, 2018). OK Corral centers on principles of pressure/pain, attention/at-ease, reciprocal process, and the nonverbal zones of horses as a way to focus on “natural horse and herd behavior as a model for human mental and emotional health” (OK Corral, 2019). Natural Lifemanship’s Trauma-Focused Equine Assisted Psychotherapy (TF-EAP) combines the neurobiology of trauma, and how equines assist in the identification of relationship patterns, reformation of new behaviors, and formation of new relationships to accomplish therapeutic outcomes (Natural Lifemanship, 2019). Finally, Eponaquest integrates interaction with horses and other tools (e.g., an emotional message chart, the false self/authentic self-paradigm, the body scan, and a boundary handout) to teach leadership, assertiveness, empowerment, intuition, and emotional fitness skills (Eponaquest, 2019).

2. The first author is a PATH certified Equine Specialist in Mental Health and Learning, has an OK Corral Certification and training in Trauma-Focused Equine Assisted Psychotherapy with 7 years of experience as a practitioner in EAMH. As part of a larger ethnographic study, the second author logged over 120 hours of on-site observations at a local EAMH facility where they employed trauma-focused equine assisted psychotherapy to treat trauma in adolescents.