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Equine Assisted Treatment, Part 2

Helping at-risk youths

by Joseph Nowinski, Ph.D. and Abigail Jeffries

Adolescence can be a tumultuous time of life for many young people, but it can be especially challenging for those with risk factors associated with dropping out of school. These risk factors can include low-income status, membership in certain minority groups, inadequate role models, limited knowledge of English, learning or emotional disabilities, living in a single-parent family, having a mother or older siblings who dropped out, becoming pregnant or having to work to support the family, low grades and high absenteeism in school, and a history of poor classroom behavior.

At-risk students face serious long-term consequences. Dropping out can lead to “a lifetime of economic hardship,” according to the Center for Public Education, which observes that dropouts “are far more likely to become unemployed, receive public assistance, commit crimes, and become incarcerated."

In this second in our series of posts about equine-assisted therapy, we’ll take a look at how equine assisted counseling (EAC) -- a treatment method that incorporates work with horses into the counseling process -- can be used as an effective, perhaps superior, alternative to traditional, classroom-based treatment.

An equine-assisted treatment for at-risk youth

Research has demonstrated EAC can help to reduce undesirable behaviors and increase positive behaviors such as courage, stress management, improved communication, self-esteem, self-confidence, and collaboration with others. In a study led by Dr. Kay Sudekum Trotter, an EAC program designed for at-risk youth was compared to an award-winning traditional, school-based intervention program. [Trotter, Kay Sudekum; Chandler, Cynthia K.; Goodwin-Bond, Deborah; Casey, Janie Journal of Creativity in Mental Health, v3 n3 p254-284 Oct 2008]

The study group consisted of 164 third through eighth grade students who were identified by their school counselors as being at-risk for academic and/or social failure. One hundred two were male, 62 were female. Most of the students were Caucasian; however, 12 were African American, 11 were Hispanic, and five belonged to other ethnic groups.

The students were invited to participate in a group-counseling program, subject to parental permission, and those who accepted were offered the choice of participating in either EAC or a comparison treatment program called “Kids Connection” offered by Rainbow Days, Incorporated (RD). Kids Connection, which aims at developing coping skills for a variety of issues, has received the Exemplary Substance Abuse Prevention Award from the Center for Substance Abuse Prevention. Thirty-eight students chose RD, and 126 chose EAC.

Participants in both EAC and RD met once a week for 12 weeks. The EAC groups met at a ranch and were led by a masters level mental health counselor and an equine professional, both of whom were experienced in EAC intervention. The RD groups met in an office or classroom in their respective schools and were led by a specially trained school counselor.

EAC consisted of traditional talk therapy, group processing, equine-based therapy activities, and complementary adventure-based therapy activities. Each of the EAC activities built upon the previous one, such that each group had to successfully complete an activity in order to progress to the next, with the culminating activities involving actually riding a horse. Regardless of the pace of progress through the activities, each EAC participant received treatment for the same total number of hours over the 12-week period. At the end of each session, whether the activity had been successfully completed or would continue into the following session, the therapy team facilitated discussion of what had happened, how the horse had acted and reacted to the participants, and how this insight could be related to human relationship building.

Pre- and posttreatment data were collected using these established measures: Behavioral Assessment System for Children (BASC), Self Rating Scale (SRS) and Parent Rating Scale (PRS). In addition, the EAC therapy team used the Psychosocial Session Form (PSF) to track patient progress at the end of each treatment session.

New environment, new rules, new relationships

EAC treatment began with an introduction to the ranch setting and horse safety instruction. Participants selected a ranch name, which personalized their experience and helped establish the ranch world as a place where life was different from what they were used to. Group expectations were established. Throughout the sessions, participants learned about the horse’s world, horse behavioral dynamics, and horse body language and communication.

After spending some unstructured time with the group of therapy horses, participants chose a particular horse they wanted to build a relationship with throughout the sessions. This was the start of relying on reading their horse’s nonverbal cues, a skill they would later transfer to human interactions.

Throughout the sessions, participants were asked to perform tasks that relied on their growing understanding of how to read and anticipate the horses’ behavior so that their own actions and strategies for completing the tasks would succeed. After each session, the facilitated discussion related that session’s experiences to concepts such as active listening, correct reading of nonverbal cues, how to communicate so that you are deemed “safe” to be with, how to work as a team on a common goal, active versus passive, leader versus follower, productive versus counterproductive behavior, development of self-control and control of one’s environment, and respect.

Tapping the power of courage and collaboration

Most of the activities with horses took place with participants working from the ground rather than mounted. These groundwork activities included learning to tie a horse’s lead rope to a rail using a safety knot, learning how to move safely around a horse, catching and releasing a horse, and grooming a horse. As working closely with a large horse means risking being kicked, bitten, or stepped on, even the most basic ground exercises required participants to tap their courage in a way that was therapeutic. As Trotter observes, “courage to stay positively engaged with a powerful horse can generalize into courage to stay positively engaged with another person.”

One activity required a team of participants to collaborate to get a horse to walk over a low jump (a metaphor for life’s challenges) without touching or bribing the horse or using a lead rope, and without any verbal communication between teammates except during strategy planning sessions. Some teams were able to complete this activity within an hour, but others took longer and struggled through more than one session before eventually succeeding. Because they could not progress to an activity that involved actually riding a horse until they had completed the prerequisite tasks, the teams were motivated to develop a solution to the problem of how to get the horse to step over the jump. The activity was designed to make participants struggle and become frustrated before achieving success. This meant applying some of the communication and problem-solving skills they had been working on, as well as their growing understanding of how the horse was likely to react. During the post-activity discussion, facilitators related this process to daily struggles faced by participants at home or in school.

In the last phase of the EAC treatment program, participants were able to ride bareback and later with a saddle and reins. The riding activities focused on concepts such as leadership, assertiveness, confidence, teamwork, responsibility, and communication.

A mirror that reflects internalizing behavior

At the conclusion of the study, Trotter observed, “The horse-human relationship was strengthened during several interactive equine activities that took place during the 12-week treatment period, and the relationship flourished in an environment of support and honesty that benefitted both the individual and the group.” She noted that, because participants tended to choose a horse that had traits similar to their own, “the horse often dramatized the participants’ inner struggles and relationship issues by magnifying and mirroring what a participant needed to recognize in him- or herself.”

When measured against the comparison RD treatment group, the EAC treatment group demonstrated a greater decrease in five negative behaviors and greater increase in two positive behaviors. Improvements were seen in social stress, self-esteem, behavioral symptoms index, externalizing problems composite, hyperactivity, aggression, and conduct problems. The data indicated EAC is especially promising with respect to helping participants to “internally cope with problems, seem less lonely, less nervous and less anxious.” Trotter notes the importance of addressing internalizing behavior problems, which “often go unidentified and untreated in children and adolescents until they become serious, or even deadly.”

Because EAC was effective in more and different areas than RD, Trotter concluded the equine-assisted program was superior for treating at-risk students. The study also noted EAC is a structured program that can be replicated and therefore has the potential to help a large number of at-risk children and adolescents.

The horse as a uniquely effective therapeutic tool

Is it worth it to seek out equine-assisted counseling? What does a horse offer therapeutically that other animals such as dogs do not? In her study, Trotter cites research that offers some clues as to what makes horses particularly helpful in a therapy setting. The empowerment that can come from interacting with and controlling a large and powerful animal; the positive social environment of the barn/farm setting; the ability to form a partnership with the horse, which has no expectations or prejudices; the horse’s ability to provide instant, honest feedback in response to human actions; the risk-taking that is part of working with horses – all of these help patients build self-esteem and self-confidence, improve self-control, reveal true feelings, and improve communication, conflict resolution, and problem-solving skills while also enjoying the physical experience of working with the horse.

Ask just about anyone who has enjoyed spending time with horses what makes them special, and you are likely to get an earful, possibly with a tear or two. Winston Churchill put it simply: “There is something about the outside of a horse that is good for the inside of a man.” For some at-risk youth, that “something” may turn out to be everything.

Want to know more about equine-assisted therapy?

The Equine Assisted Growth and Learning Association (EAGALA) establishes and monitors standards and practices for equine-assisted psychotherapy. EAGALA is the leading international nonprofit association for professionals incorporating horses to address mental health and personal development needs. To date, EAGALA members are located in every U.S. state, as well as in Australia, Belgium, Canada, England, Germany, Mexico, New Zealand, Scotland, and Sweden (EAGALA, 2005). For more information or to find a program, visit

Joseph Nowinski, Ph.D. is a clinical psychologist and author.

Abigail Jeffries is a freelance writer with a special interest in health and mental health issues.