Research Studies in Equine Therapy

2016 EAAT Literature Review
By Leif Hallberg

When contemplating the foundation for The Clinical Practice of Equine-Assisted Therapy: Including Horses in Human Healthcare (Routledge, 2018), it was clear an approach was needed that would help bridge the gap between scientific research and the personal beliefs, opinions, and practices prevalent in mainstream literature or promoted by membership or training organizations.

Many providers of equine-assisted therapy report inadequate access to peer-reviewed journals (Stroud & Hallberg, 2016), which are the primary source for documenting current research and practice trends. This phenomenon is called the “science to service gap” (National Implementation Science Research Network, 2016). Common across most healthcare disciplines, the results of scientific study are not always accessible to those in clinical practice. When professionals do not have access to current research, healthcare strategies may be provided that are ineffective, outdated, or lack conclusive research results (International Council of Nurses, 2012).

To achieve this goal, a comprehensive review of research articles on equine-assisted therapy published between 1985-2016 was conducted using fourteen databases including PsycINFO, PsycARTICLES, PubMed, CAB Abstracts, Psychiatric Online, Psychological and Behavioral Sciences Collection, the Social Sciences Citation Index, Nursing & Allied Health Collection, Physical Therapy and Sports Medicine Collection, EBSCO Academic Search, EBSCO SPORTDiscus, EBSCO Educational Research Complete, EBSCO HealthSource, and VetMed.

Inclusion Criteria

  • Peer-reviewed (refereed) papers
  • Primary source
  • Written in English
  • Published between 1985-2016
  • Directly relevant to equine-assisted therapy, but includes papers on the following related topics:
  • Robo (or mechanical horse simulator use as it relates to equine-assisted interventions)
  • Practice patterns, reviews, and perspectives related to equine-assisted interventions
  • Horse care and welfare, ethics, and selection criteria related to equine-assisted interventions
  • Horse ethology (including communication, behavior, psychology)
  • Safety and accident data related to working with horses

Key Words and Search Terms

The following key words were used: Equine-assisted therapy, hippotherapy, therapeutic riding, adaptive riding, equine-assisted psychotherapy, equine-facilitated psychotherapy, equine-assisted counseling, equine-assisted learning, and equine-facilitated learning.

Additional search terms were used in conjunction with the above key words including:

  • Autism
  • Addictions or chemical dependency
  • Amputations
  • Anxiety
  • At-risk youth
  • ADD/ADHD
  • Cancer
  • Cerebral palsy
  • Chemical dependency
  • Children and adolescents
  • Combat PTSD
  • Depression
  • Down syndrome
  • Eating disorders
  • Elderly
  • Intellectual disability
  • Learning disability
  • Muscular dystrophy
  • Multiple sclerosis
  • Neurological conditions
  • Physical abuse
  • Psychiatric conditions
  • PTSD
  • Self-harming behaviors
  • Severe mental illness
  • Sexual assault or abuse
  • Spina bifida
  • Stroke
  • Spine injury
  • Trauma
  • Traumatic brain injury
  • Veterans

A total of 354 papers were identified that met the inclusion criteria. These articles were coded and sorted into categories by population or condition addressed by an equine intervention, or by the topic of research inquiry.

An asterisk indicates a regulated type of therapy (physical, occupation, speech, or mental health) provided by a licensed healthcare professional was utilized as the treatment intervention. Only live-horse studies were included in this distinction.

Articles without asterisks indicate a non-therapy service like adaptive riding or equine-assisted learning was used, or that the article was not clear as to if therapy was used or if the intervention was provided by a licensed healthcare professional.

Literature or Systematic Reviews

Anestis, M.D., Anestis, J.C., Zawilinski, L.L., Hopkins, T.A., & Lilienfeld, S.O. (2014). Equine-related treatments for mental disorders lack empirical support: A systematic review of empirical investigations. Journal of Clinical Psychology, 0(0), 1-18.

Angoules, A., Koukoulas, D., Balakatounis, K., Kapari, I., & Matsouki, E. (2015). A review of efficacy of hippotherapy for the treatment of musculoskeletal disorders. British Journal of Medicine and Medical Research, 8(4), 289–297.

Bachi, K. (2012). Equine-facilitated psychotherapy: The gap between practice and knowledge. Society & Animals20, 364–380.

Bachi, K. (2013). Equine-facilitated prison-based programs within the context of prison-based animal programs: State of the science review. Journal of Offender Rehabilitation, 52(1), 46–74.

Bond, M. (2007). Horseback riding as therapy for children with cerebral palsy: Is there evidence of its effectiveness? Physical & Occupational Therapy in Pediatrics, 27(2), 5–23.

Bronson, C., Brewerton, K., Ong, J., Palanca, C., & Sullivan, S. J. (2010). Does hippotherapy improve balance in persons with multiple sclerosis: A systematic review. European Journal of Physical and Rehabilitation Medicine, 46(3), 347-353.

Cantin, A, & Marshall-Lucette, S. (2011). Examining the literature on the efficacy of equine assisted therapy for people with mental health and behavioural disorders. Mental Health and Learning Disabilities Research and Practice, 51–61.

Carlsson, C. (2016). A narrative review of qualitative and quantitative research in equine-assisted social work or therapy – Addressing gaps and contradictory results. Animalia An Anthrozoology Journal, (February 14).

Frewin, K., & Gardiner, B. (2005). New age or old sage? A review of equine assisted psychotherapy. The Australian Journal of Counselling Psychology, 6, 13–17.

Kendall, E., Maujean, A., Pepping, C.A., Downes, M., Lakhani, A., Byrne, J., & Macfarlanea, K. (2015). A systematic review of the efficacy of equine- assisted interventions on psychological outcomes. European Journal of Psychotherapy & Counselling, 2537(17), 57–79.

Lee, P. T., Dakin, E., & Mclure, M. (2016). Narrative synthesis of equine-assisted psychotherapy literature: Current knowledge and future research directions. Health and Social Care in the Community, 24(3), 225–246.

Lentini, J. A., & Knox, M. (2009). A Qualitative and quantitative review of equine facilitated psychotherapy (EFP) with children and adolescents. The Open Complementary Medicine Journal, 1, 51–57.

Lentini, J. A., & Knox, M. S. (2015). Equine-facilitated psychotherapy with children and adolescents: An update and literature review. Journal of Creativity in Mental Health, 10(3), 278–305.

MacKinnon, J.R., Noh, S., Laliberte, D., Allan, D.E., & Lariviere, J. (1995). Therapeutic horseback riding: A review of literature. Physical & Occupational Therapy in Pediatrics, 15(1), 1–15.

Selby, A., & Smith-Osborne, A. (2013). A systematic review of effectiveness of complementary and adjunct therapies and interventions involving equines. Health Psychology, 32(4), 418–432.

Smith-Osborne, A., & Selby, A. (2010). Implications of the literature on equine-assisted activities for use as a complementary intervention in social work practice with children and adolescents. Child and Adolescent Social Work Journal, 27, 291–307.

Snider, L, Korner-Bitensky, N., Kammann, C., Warner, S., & Saleh, M. (2007). Horseback riding as therapy for children with cerebral palsy: Is there evidence of its effectiveness? Physical & Occupational Therapy in Pediatrics, 27(2), 5–23.

Sterba, J. A. (2007). Does horseback riding therapy or therapist-directed hippotherapy rehabilitate children with cerebral palsy? Developmental Medicine and Child Neurology, 49(1), 68–73.

Thompson, J. R., Iacobucci, V., & Varney, R. (2012). Giddyup! or whoa nelly! Making sense of benefit claims on websites of equine programs for children with disabilities. Journal of Developmental and Physical Disabilities, 24, 373–390.

Tseng, S.-H., Chen, H.-C., & Tam, K.-W. (2012). Systematic review and meta-analysis of the effect of equine assisted activities and therapies on gross motor outcome in children with cerebral palsy. Disability and Rehabilitation, 35, 1–11.

Wang, G., Ma, R., Qiao, G., Wada, K., Aizawa, Y., & Satoh, T. (2015). The effect of riding as an alternative treatment for children with cerebral palsy: A systematic review and meta-analysis. Integrative Medicine International, 1(4), 211–222.

Whalen, N.C., & Case-Smith, J. (2012). Therapeutic effects of horseback riding therapy on gross motor function in children with cerebral palsy: A systematic review. Physical & Occupational Therapy in Pediatrics, 32(3), 229–242.

Zadnikar, M., & Kastrin, A. (2011). Effects of hippotherapy and therapeutic horseback riding on postural control or balance in children with cerebral palsy: A meta-analysis. Developmental Medicine and Child Neurology, 53(8), 684-691.

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