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 * Equine-Facilitated Psychotherapy

EFP is a type of Psychotherapy “that involves horses and takes place in and around the natural surroundings of the stables”. EFP is conducted with a licensed, credentialed mental health professional that works alongside a credentialed equine professional and a patient or groups of patients. EFP is unique because of the qualities of the horse, including (but not limited to) the horse as a mirror. This mirror gives patients instant feedback about how their emotions, behavior and physical movement are being conveyed, which is then analyzed by the group.

Studies have shown that EFP improves:


 * Sense of empowerment.
 * Ability to manage emotion.
 * Creating and maintaining healthy relationships.
 * Communication skills.
 * Recovering from physical, sexual and verbal trauma and abuse.
 * Self-confidence and self-esteem.
 * Feelings of trust.
 * Greater feeling of control.

Studies have shown that EFP decreases:


 * Recreational drug use and new police records (refer to graphs)
 * Psychological distresses such as major depressive disorder and fear and anxiety.

Unique Role of Horse
This list includes characteristics of horses that make them unique for therapy.


 * Non-judgmental and unbiased: Horses react only to the patient’s behavior and emotions and are not biased by the patient’s physical appearance or past mistakes.


 * Feedback and mirroring: Their nature as a prey and herd animal makes them hyper vigilant and sensitive, thus making them keen observers. This means that their feedback is provided earlier and more consistently than with a human therapist. The horse has an innate tendency to mirror the patient’s behavior, physical movements and emotions, which help the participant be more aware of him or herself. It allows patients to “feel felt”. This feedback can then be translated by the equine specialist and analyzed by the group.


 * Metaphor for real life: The ability of a psychotherapist to use the horse as a metaphor for other issues. This helps make the equine treatment applicable to real life problems.   An example of how a therapist can help the patient work out issues in their own lives through the use of the horse as a metaphor: “One child was having great difficulty discussing an upcoming move to a different foster home. She was, however, able to offer many suggestions for how to help a horse that was being sold feel more comfortable in his new environment”. Using the horse as a metaphor for his own move, the child better understood and could cope with his own move.

Good candidates for EFP

 * Adolescents – One researcher explains that EFP is an alternative for young adolescents because going to the barn and spending time with horses seems less daunting for children but can be just as effective. Additionally, “going to the barn” reduces the stigma associated with “going to the psychologist” which could be particularly beneficial for teenage clients.


 * Victims of abuse – One study interviewed five past sexual abuse survivors who participated in EFP during their recovery. Based on interview results, the participants:
 * 1) felt that they had regained control of their bodies and no longer felt powerless to their victimizers
 * 2) enjoyed that the hands-on nature of EFP as opposed to talk sessions
 * 3) benefited from the instant feedback from horses as non-judgmental mirrors
 * 4) found EFP to be more intense, focused and intimate than traditional talk therapy. One participant argued that EFP was a faster way of doing psychotherapy.

Another study found the teens of both genders that had been sexually abused displayed more positive touch behaviors after EFP. Using horses, the participants replicated healthy and unhealthy touches and received instant and unbiased feedback from the horse, thus helping them recognize the difference between unsafe and safe touches.

An added benefit to the use of touch with horses is that this sort of unsafe and safe touch practice is      not possible in the normal scope of talk psychotherapy, which allows for the exploration of important issues that would normally be off limits.


 * Physical trauma survivors – Severely injured participants interviewed explained that their human-equine bond helped them regain the trust, self-esteem and self-efficacy that they had lost after their accidents.


 * Cancer patients – One study showed that in interviews, participants said that a six week EFP program helped them take charge, overcome fear and obstacles, let go of cancer, increase self confidence and joy, and improve their communication.

Limitations
The main limitation of EFP is the lack of research. The research there is lacks statistical power because of small convenience sampling, lack of control groups and being largely interview based studies.

A prominent researcher in the field of EFP, Keren Bachi, calls for an EFP theory and protocol that will help unify the therapy. Additionally, some researchers worry that the lack of quantitative research may limit the acceptance of EFP in the medical community and may limit accessibility.