Interview with Beth Lanning

Interview with Beth Lanning 

HHRF Grant Recipient, November 2016

Beth Lanning, PhD, MCHES, is principal investigator on the 2014 HHRF-funded project “Examination of the Effects of Equine Assisted Activities on PTSD Symptoms, Quality of Life and Participation in Combat Veterans.” The purpose of the project was to assess changes in PTSD symptoms, quality of life and participation of combat veterans who participate in equine assisted activities. The study utilized a mixed-methods, waitlist-controlled, repeated measures trial of a standardized 8-week therapeutic riding intervention for combat veterans with PTSD. Behavioral changes were assessed four times during the study.

Director of the Public Health Undergraduate Program at Baylor University Robbins College of Health and Human Services in Waco, Texas, her research interests include health literacy, sexual violence prevention, quality of life in vulnerable populations in addition to human-animal interaction. 

How did you come to be a researcher in this field?

I was looking for a way to combine my professional research with my personal involvement with animals.  Animals, especially horses have played a huge role in my life. I knew that animals can improve a person’s quality of life, but when I started to look in the professional literature for research to support that idea, I found very little.  I reached out to several people who were involved in equine programs and in the process was told about the PATH (then NARHA) organization and annual conference.    I decided to attend one of the PATH (then NARHA) conferences. Once there, I looked for practitioners to collaborate with, and that’s when I met Nancy Krenek from Ride On Center for Kids in Georgetown TX. She started one of the first veteran equine programs in the country, and we collaborated on research after that.  

I first conducted a pilot study using therapeutic riding as an intervention for veterans and we saw that both depression and PTSD symptoms decreased as a result of the program. . After publishing the results of the pilot study, I thought we needed to go the next step and develop this study and look for funding. My home institution supported the beginning of the study and HHRF funded the second application I submitted. 
Please provide an update on the status of your project. 
The project is now complete. I presented part of the results at the PATH conference in Virginia and now it’s just a matter of submitting manuscripts from this study for possible publication in peer reviewed journals. 

How did the concept for your HHRF funded research project come to be?

What do you feel is the most important aspect of your finding?

We saw a clinically and statistically significant improvement in PTSD symptoms over time. . We are also excited about the other positive changes that were documented duringthe 8 weeks of intervention. Plus, some of the changes were sustained even two months after the intervention ended, though they were somewhat diminished. The control group actually reported an increase in some depression and PTSD symptoms over the 8 weeks while the intervention group reported an improvement in the same symptoms Also, families and loved ones reported similar mental health improvements of the participants. This observational assessment (proxy report) by a family member was an important addition to this study.   

How does your research and/or other research findings inform the work of EAA practitioners?

It provides empirical data to support the work of others. The findings of the research also raise additional questions such as the impact of the environment on the participants.   The horse is definitely a part of this environment, but there are other parts that are also important. The barn itself, and being in a more rural area. And veterans working with the veteran participantshelps them feel physically safe which then helps them feel emotionally safe. My other research projects have included working with children on the autism spectrum.  The environmental component is important with that population as well.    

What do you feel should be the next steps from this project to advance EAA/EAT research?

Next steps depend on the population. With veterans, quasi experimental studies and randomized control trials need to be conducted with a larger number of veterans. . Research in the area of EAA and children with autism is more developed than research with veterans. Dr. Robin Gabriels’ work added important empirical data to the growing body of evidence in EAA and autism research Next steps for this area of research should include examining the effects of equine movement on the participant, length of the program needed to achieve benefits, and critical components of the program.  We’ve found that with both populations, the most dramatic changes appear to occur within the first 4 weeks, but we don’t really know if 8 weeks is enough, or if the program should be much longer to achieve maximum results.

Another next step is to learn how to separate TBI from PTSD - or if it can or should be separated for research and practical purposes. 

Also, investigating programs that include only women veterans and/or women who have experienced military sexual trauma. Some therapeutic riding facilities have EAAT programs designed especially for women and the instructors of those programs have reported unique, positive effects related to these programs.  We included both men and women veterans in our study.  We did not ask specifically if the women were survivors of military sexual trauma.  Both the men and women reported improvement in PTSD symptoms as result of the program. 

We also need to look at the importance of involving the family. Some programs include a family component and the instructors believe it is effective. Comparing a veteran only program to a veteran plus family program would be an interesting study. 

What areas of research needs are most urgently surfacing in the EAA fields?

We need studies with larger sample sizes and a standardized intervention acrossprograms. We used a standardized curriculum in our study and all the riding centers were PATH premier accredited centers.  This element was important to ensure fidelity of the intervention. 

What are you working on now? And where do anticipate it will take you?

I am currently waiting to hear back on an NIH grant application that I submitted in collaboration with Dr. Rebecca Johnson and Dr. Gretchen Carlisle from the University of Missouri.  Our project is related to the mechanisms of change in therapeutic riding and children with autism spectrum disorder.  I have conducted several pilot studies related this area and I am looking forward to building on what I have learned. 

What is the most exciting EAA research happening today?

We are seeing more people become involved in EAAT research and better quality research coming forward. I think there is nice collaboration between researchers and practitioners and we are seeing more consistency and improved quality because of it.  

What are the reasons we need to continue to invest in research? 

If EAA facilities want to be reimbursed for their services and the programs recognized as valid therapeutic programs, research is very important. But I think it’s going to take the next level of actually lobbying for changes within insurance companies. It has to go that far. Until someone can knock down those political doors it will be difficult. It might take getting government health care programs to cover it first then pushing for coverage by private insurance companies. 

The HHRF BOARD is considering focusing research in specific areas of our field. What would you suggest to them? 

I really want to commend the board for their work in this area. Without their support a lot of these pilot studies would not have been possible. I also support the board’s decision to increase the funding amount, which will allow researchers to expand their projects and include larger sample sizes. Expanding research with the veteran population is important. My suggestion is to make sure funding efforts support randomized control trials or quasi experimental research designs so the results will add to the growing body of empirical data.   Also, I think the HHRF has a proven track record of successfully funding EAAT research and now may be the time to explore collaborative partnerships with other foundations to increase funding streams needed to support larger research projects.  

janet w.