For Immediate Release

Contact: KC Henry, Executive Director - Horses and Humans Research Foundation PO Box 480
Chagrin Falls, OH 44022
440-840-2402

Email: info@horsesandhumans.org Web: http://www.horsesandhumans.org

Effects of Equine-Assisted Activities on PTSD Symptoms: Coping, Self-Efficacy, Emotion Regulation, and Social Engagement in Military Veterans
Principal Investigator: Rebecca A. Johnson, PhD, RN, FAAN, FNAP

Chagrin Falls, Ohio, March 23, 2016 - University of Missouri-Columbia, College of Veterinary Medicine recently reported on findings from their research related to military veterans with symptoms of Post-Traumatic Stress Disorder (PTSD). The study investigated if participation in a structured, six-week therapeutic horseback riding (THR) program decreased PTSD symptoms, as well as improved coping, self-efficacy, emotion regulation, and social engagement among veterans. The project was funded through a grant from the Horses and Humans Research Foundation and was led by Principal Investigator Rebecca A. Johnson, PhD, RN, FAAN, FNAP.

Thirty-eight veterans were randomly assigned to participate in the six-week THR program, either without a wait control period or assigned to a six-week wait control period prior to the six weeks of riding. As predicted, no significant changes were found for any outcome measure during the wait control period, indicating that changes in outcome measures were due to the THR rather than other extraneous factors.

Results of this study provide clear evidence that the THR program contributed to a decrease in PTSD symptoms. Veterans participating in THR had statistically significant decreases in their PTSD symptoms throughout the study period; and the benefit increased the longer an individual was in the riding program. Veterans also expressed great enjoyment when interacting with the

horses and learning to ride. They also enjoyed the camaraderie with other veterans and the research and riding center staff. These positive interactions were an enormous advantage in engaging the veterans – especially as compared to frequent resistance found with clinical counseling sessions. It is also worth noting that several of the participants from this study have continued on with THR and others are now doing volunteer work as side walkers or leaders at the center where the study was conducted.

There are more than 6000 instructors, therapists and facilitators providing equine-assisted activities across the USA. The majority of these programs are not scientifically evaluated. Without scientific evidence demonstrating the impact of equine assisted activities and without established evidenced based practices, progress and support is often constrained. Strong research findings, like this University of Missouri project, significantly impact the future of equine-assisted programs and their ability to grow to serve more people.

Dr Johnson said that “Further investigation is needed to learn more about the changes we saw in self-efficacy and emotional regulation. We continue to analyze the extensive and very rich array of qualitative data from the participants’ weekly riding diaries, which we think may help shed light on the trends we found in these outcome variables.”

Mission: Through investment in rigorous research, Horses and Humans Research Foundation will serve as a catalyst to advance knowledge of horses and their potential to impact the health and wellness of people.

Horses and Humans Research Foundation (HHRF) is dedicated to funding research to investigate the equine-assisted activities and therapies field. Since its founding, HHRF has awarded $460,000 in professional research efforts led by ten research teams in the United

States, Canada and Germany. HHRF is a non-endowed foundation dependent solely on donations. To make a donation and/or learn more about this and other Horses and Humans Research Foundation projects visit http://www.HorsesandHumans.org. http://www.horsesandhumans.org/

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FOR IMMEDIATE RELEASE

Contact: KC Henry, HHRF Executive Director Address: P.O. Box 480 Chagrin Falls, Ohio 44022 Email: KCHenry@horsesandhumans.org Website: horsesandhumans.org

$100,000 campaign to support EAA research has been completed! Generous donors make significant research opportunism possible.

Chagrin Falls, OH – January 28, 2016 – Horses and Humans Research Foundation (HHRF) announced that their 10th year anniversary campaign surpassed its goal in 2015. This new campaign fund of $120,900, will be invested in a research project to investigate the therapeutic effects of horses on humans. Up to $100,000 will be given to fund an awarded grant and the remainder will offset assessment, administration and management expenses. The Foundation's broad research agenda includes basic research that will ultimately impact physical/mental health and quality of life for those engaged in equine-assisted activities/therapies.

In HHRF’s first decade the foundation awarded ten investigative grants averaging $50,000/project. The HHRF board feels that this larger grant will result in an increasingly robust research project with increased analytical capacity and the potential for additional data collection cycles, more stringent sampling procedures and greater statistical significance. The equine assisted activity and therapy field has a significant need for research that will move it toward evidenced based practices.

Campaign chairman Alison Zack Darrell (Stoningham, CT) and honorary campaign chairman, Molly Sweeney (Hockley, TX) provided leadership for the campaign. Ms. Sweeney stated

“Thanks to the generosity of our Anniversary Campaign donors, HHRF will now be able to offer more rigorous research resulting in a greater relevance on the field of horse-centered and equine assisted programs of all types. There are exciting new developments on the horizon that I believe will get us closer and closer to understanding how the horse manages to have such a profound impact on the well-being of people.”

Interested research teams should watch the HHRF website for the call for proposals which will be posted in coming weeks.

Make a contribution to HHRF today and help ensure that this important research continues. For more information on the foundation, or on becoming a donor, contact KC Henry, Executive Director, KCHenry@horsesandhumans.org.

Horses and Humans Research Foundation (HHRF) is dedicated to funding research to support the equine-assisted activities and therapies field. Since its founding, HHRF has awarded $410,000 in professional research efforts led by nine research teams in the United States, Canada and Germany. HHRF is a non-endowed foundation dependent solely on donations. To make a donation and/or learn more about this and other Horses and Humans Research Foundation projects visit http://www.HorsesandHumans.org. Through investment in rigorous research, Horses and Humans Research Foundation will serve as a catalyst to advance knowledge of horses and their potential to impact the health and wellness of people.

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Interview with Molly Sweeney, HHRF Founder, November 2015

-Will you talk a little bit about your background that led you to spend your time and energy helping HHRF come to existence and develop to where it is today?  

My grandfather was a professional horseman so I was lucky enough to grow up with horses. Our home in Chagrin Falls, OH, was connected to the barn, which was very nice on cold winter days. I have owned, cared for and ridden horses all my life. I discovered Therapeutic Horsemanship in 1990 when I donated a saddle to SIRE, our local program in the Houston, TX, area. They didn’t take the saddle, but took me instead as a volunteer and I have been with them ever since, in every capacity from mucking stalls to Board President. Then and now, I travel a lot and like to visit centers to learn what other programs are doing. I was asked
to join the NARHA, now PATH, board in 1997 and gained a
broader national and international perspective

-Do you remember the moment when you realized that HHRF should exist? 

In the 1990s, national and international horse-centered organizations seemed to be talking a lot about how the field needed research, as practically none existed then. I found a sponsor willing to fund getting people together to brainstorm what was needed to jump start research. Barbara Rector and Nancy McGibbon found a location in Arizona and helped organize the logistics. We brought together fundraisers, researchers and administrative people to lay out a plan for a Foundation to grant research grant awards related exclusively to Equine Assisted Activities and Therapies. The biggest problem was choosing a name! 

-Why did HHRF evolve to a model of funding competitive research instead of just conducting the research on its own? 

It is cheaper to fund other people’s research then our own and we wanted the competition to bring out the most talented researchers. As HHRF grows financially, an Institute to fund our own research is a possibility.

-What are you most proud of from the last 10 years of the organization's existence? 

Attitudes are changing. When we started HHRF, many individuals would say, “What do we need research for?” At last year’s PATH Conference, every session either mentioned existing research or areas where we needed more research. So “research” has finally become a household word.

More and more people in the horse world know about therapeutic horsemanship and have come to appreciate the value of the horse’s role as therapist. More countries are legally declaring animals as sentient beings, most recently Australia and Quebec, Canada.

-You are building not just a research base - but you also have the challenge of building a sustainable organization - what has been the most challenging part of that?  the most helpful?  success, failures

The most helpful person in building a sustainable organization has been KC Henry who stepped up and offered to administratively start HHRF as the Executive Director and has guided us for all 10 years.  She has been supported by hard working board members who not only govern effectively but have put in a lot of time, talent and treasure in building HHRF. The Scientific Advisory Council has gathered expert researchers to evaluate the grant proposals, and regularly review and strengthen the grant making process.

The challenge has come from convincing those in the therapeutic horsemanship field as well as the broader equestrian world that their financial investment in research is not only critical but that it will come back ten fold in support of all horse activities.  We know that many in the medical community have a very hard time accepting even the possibility of the healing power of horse.  But a few inroads have been made, even into the Veterans community. The light is dawning! It just takes time.

-What are key factors to success of HHRF? For example, how has input from the Sci Advisory Council shaped foundation work/direction?  (see above for Scientific committee contribution)

Key factors for measuring success for HHRF for me, are: 1) An ever broadening acceptance of and appreciation for the ability of horse to make us better people on many different levels; 2) Develop evidence based best practices in the field of EAAT; 3) Raise money to give more and larger grants; 4) Convincing the medical community and insurance companies of the intrinsic medical value of the many forms of EAA/T

-Looking back on the research that's come to light in the last 10 years, would you maintain that EAA/T as a method of therapy or rehab is superlative to other forms of therapy? How do you compare it to them? 

EAA/T is unique in that horse recognizes what we most need now, even if we don’t, and then chooses to help us connect with and meet that need, be it mental, physical, emotional, psychological, intellectual or even spiritual. In effect, horse can diagnose and holistically treat humans at the same time. This concept is rarely accepted in the field of medical treatments so comparison to other treatments is difficult. However my own and observed experiences would say that horse heals humans faster, gets to the deepest cause and works better than other treatments with zero side effects.

-Has the foundation arrived at it first decade anniversary looking like you expected - what has changed/been a surprise/different than your original vision? 

Funding has been a bigger challenge than we thought it would be.  Several grants didn’t quite measure up to what we expected in the execution of the process, not in the value of the results. We started with the idea of funding the best EAA/T research we could find, no matter the client base being investigated or what was being measured. For financial reasons we may now have to follow the money and fund what we can get donations for and who we can partner with.  The educational piece about understanding what the research means to the client is going to be more critical than originally thought. It’s all part of growth and all good in the long run. 

-What is your hope for the next 10 years at HHRF? 

Awesome financial growth. 

More corporate, government and nonprofit organization partnerships, nationally and internationally.  

The scientific world will develop testing methods that can begin to tell us exactly what is happening in the mind, heart, body and soul in the horse/human interaction. Heart rate variability measurements from Heart Math are looking very promising as well as some new types of electro-magnetic discharge imaging out of Russia that films auras.

An International symposium on “How/Why the Horse?” to gain expanded media attention as we look deeper into horse human partnership.
 

Interview with

Clare Thomas-Pino, HHRF Scientific Advisory Council Member

September 2, 2015

Clare is a former Equine Facilitated Mental Health Association (EFMHA) board member, former chair of the EFMHA research committee, and a member of The Professional Association of Therapeutic Horsemanship International equine advocacy task force. Clare is an Interdisciplinary PhD candidate at the University of Maine, researching eco-therapies, equine facilitated psychotherapy and the human equine bond as well as obtaining clinical licensure in counseling.

She has a strong educational and research background in animal behavior, psychology, women’s health and counseling. She has over 30 years of equine experience, practicing and encouraging mutual respect-based equine handling practices. Clare teaches research methods courses, as well as courses in Livestock and Companion Animal Behavior, Equine Behavior, and Medical Issues for Counselors at the University of Maine. She is currently developing a primarily online certificate program in Animal Assisted Activities and Therapies (including Equine) and Anthrozoology for the UMaine System. She strongly encourages students to increase their awareness of how their behavior influences the behavior of the animals.

HHRF: What is your research background or interest area?

CT: As an undergrad when I was studying psychology, animal behavior and biomedicine and it was then that I became interested in attachment theory. An article I read in 1996 by Judith Tyler (published in ’94) called “EFP: Worth More Than Just a Horse Laugh” inspired me to finish my undergrad degree and really focus on the human-equine bond. Reading that article made me feel like I wasn’t alone. I’d been working with horses since age four, they were an important part of my life and I was always amazed how my and others’ behavior was dramatically influenced by our time with equines.

I started a job in women’s health and epidemiology which led to a Masters in social and developmental psychology. I studied how people formulate ideas and communicate, and how that impacts their health. My interest in attachment theory came into play with that too. I met Molly Sweeney at the Horses and Healing Conference at Touchstone Farms in 2004 and it is then that I decided I really wanted to incorporate my various interests into a doctorate, so I approached the University of Maine about an interdisciplinary PhD degree. I am primarily trained to be therapist, but I have found I love the teaching piece more and thoroughly enjoy helping people pursue their interests in animal-assisted activities. 

Having come from the field of epidemiology, where there is good evidence-based practice, to this field that was lacking it, good research quickly became very important to me. Making sure that these therapies are available for all is also very important to me. Through the courses I took for my doctorate I learned a lot about adventure and wilderness therapy and horticultural therapy in addition to animal-assisted. Every one of those different therapies, provided they are following an approved protocol, should be available to all and supported by insurance. My personal mission is to support research to prove the efficacy and cost effectiveness of these alternative therapies. 

HHRF: How would you explain your connection to HHRF or its mission?
CT: I am drawn to HHRF because of the wonderful people who share a common goal of seeing the industry succeed, and do well and serve as many people as possible. Everyone strongly believes in solid research.
HHRF: What broad observations or trends have your observed from your time on the Scientific Advisory - regarding applications, review process, types of research proposed, types of research funded, or anything else.

CT: The biggest thing is improvement in the quality of proposals. I advise capstone (4th year undergrads) students who have to do a mock grant application, and when I was first reviewing HHRF proposals, I would literally look at proposals and cry. Improvement in quality and caliber of applicants and facilities they are working with has really improved. I don’t think there are any major universities at this point that haven’t participated in this type of research. The international participation is also growing, we regularly receive applications now from Europe, Asia and South America. The other change I’ve observed is the research projects used to focus on hippotherapy and therapeutic riding and now we are seeing many more that are dealing with mental health, including working with military veterans. 

HHRF: What is the most exciting EAA research happening today (within our outside of HHRF)? 

CT: All of it! I see a tremendous amount of pure equine behavior research happening right now that is focused on the human-equine bond, which dovetails beautifully with the work we are doing in equine-assisted activities research. 

HHRF: What are flaws you see in research projects that you do NOT recommend for funding?

CT: The most important thing for an applicant to do is to read the recommendations on the website about what we are funding and what we want included in the proposals. The majority of ‘no’s have not provided information we need, like full details their budget or literature review. I am aware of the majority of what is out there in terms of articles, so if someone says there is nothing out there when I know that there is, I am not going to be impressed. It’s a lot easier to do that research now with the internet, too. The other thing is methodology. It must be replicable. You have to be absolutely clear in what you are doing, and if you are not, it’s a red flag to me. Realistic time limits also matter. For example, giving yourself 2 weeks to write a final report is not long enough. And lastly, pilot studies. There is no excuse for not having pilot studies. At Universities there are undergrads who will be happy to help conduct one for you. Also you can expand on existing research in the field, and that basically gives you a pilot study to reference.

HHRF: What do you hope to see in future research applications/projects?

CT: I’d really like to see more randomized control trials, particularly in mental health. Just using a wait list control and EFP rather than comparing conventional therapy with EAAT and having a true control, doesn’t provide the evidence we need to convince insurance companies to fund this type of therapy. So for newer areas of research, showing that that the treatment is as effective or more effective than conventional therapy, and is as cost effective too, is very important. The equine facilitated psychotherapy field, for example, is not even 25 years old, so it’s not surprising that the good research has only started to come out in the last 5 years.

I would also love to see some truly randomized control trials that compare equine assisted psychotherapy, animal-assisted therapy, wilderness therapy and conventional therapy. We may need to find funding sources outside of HHRF to do this. If these alternative therapy fields come together in research we have a stronger case with insurance. And it helps clients too, to decide what to do and what is best at a given time. 

HHRF: Any advice for future applicants?

CT: Be clear and if you’re unfortunate to get me, know that I will cross check your reference list with your literature review. So let your undergrads do that extra work for you!

HHRF: What are the emerging trends in the field of EAA research?

CT: We are seeing more quantitative work on things like cortisol and the heart math. Also people researching the influence of equine-assisted therapies for returning military veterans with PTSD. A lot of research is happening with kids with development disorders. Even a little bit is being done with Native Americans and kids who are incarcerated. In every aspect there seems to be an increase in research, as if everyone is trying to get research to fit whatever their interest and client populations are. I think this is a great thing. 

The biggest shift at HHRF was by far Tim Shurtleff’s first research application. It was literally a joy for me to review that first grant application from him. It was so far beyond what anyone has done in terms of the caliber of the proposal. What he has done for hippotherapy as a result of that research is unbelievable. It would be great to see something of that caliber happen with the equine-facilitated mental health and education realms. 

HHRF: What will research do for the EAA field?

CT: The biggest thing is to legitimize it. I don’t mind being on the fringes. But making a decent living as a practitioner or as a facility is important, and this work must be legitimized by someone other than yourself or your clients to achieve that. What we’re trying to do with this research is show that these treatment options are available, they do work, and they can transform people in ways that nothing else can. All of those alternative therapies – equine- and animal-assisted, wilderness and horticultural therapies - the change you see in people in a short period when it is practiced right is amazing. A brief encounter can make a phenomenal difference. 

HHRF:  Why is Horses and Humans Research Foundation's work and mission important?

I love the group of people. I think that everything is thought out and reasoned in terms of funding excellent research that is going to support the field worldwide. That creates a huge benefit to clients, practitioners and communities. With the military, it is a massively important social piece as well.

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Interview with
Heather Ajzenman OTD,OTR/L, HHRF Scientific Advisory Council Member

June 3, 2015

Heather Ajzenman received her doctorate in occupational therapy from Washington University in St. Louis in December of 2012. She piloted a study on “The Effect of Hippotherapy on Motor Control, Adaptive Behaviors, and Participation in Children with Autism Spectrum Disorders,” which was published in 2013 in The American Journal of Occupational Therapy. As part of her doctoral apprenticeship, she worked with a variety of American Hippotherapy Association faculty members learning different research, business, and treatment approaches, and developing a hippotherapy toolbox and practice model that she employs in her current practice.

She currently lives in Hillsborough, North Carolina working full time as an occupational therapist with children from birth to 21 years old in the community setting, including using hippotherapy as a treatment strategy. Heather incorporates a variety of other evidence-based interventions into her practice such as DIR/Floortime, NDT/motor learning principles, sensory processing intervention, self-care, and executive functioning approaches. She is an active dressage rider with experience riding at the FEI level, now focusing on starting young dressage horses. 

HHRF: What is your research background or interest area?

HA: My research focus was primarily in graduate school where I completed my doctorate at Washington University in St. Louis. As the primary investigator, I conducted a pilot study examining utilizing hippotherapy as an occupational therapy intervention for children with autism spectrum disorders (read about it). It was published in the American Journal of Occupational Therapy in 2013, which was used for the basis of Dr. Timothy Shurtleff’s HHRF grant. I continue to engage in research reviews in the academic setting, assisting and collaborating with professors and graduate students on research projects. My main role now though is working full time as an occupational therapist with children in the community setting. 

HHRF: How would you explain your connection to HHRF or its mission?

HA: Though engaging in research is not my main focus at the time, I continue to rely on the literature to implement evidence-based practices into my clinical work. It is so important that we continue to get the best evidence out there to support the work of the equine-assisted fields, whether as a therapist, educator, mental health provider, or riding instructor.

HHRF: What broad observations or trends have your observed from your time on Scientific Advisory - regarding applications, review process, types of research proposed, types of research funded, or anything else.

HA: When I first joined the scientific advisory council, a large majority of the applications were for adaptive riding and therapy-based interventions. For the past year or so, applications have had a heavy focus on mental health, especially for veterans. It is amazing to see the role we have and how we are beginning to explore best practice related to integrating equine-assisted activities and therapies (EAA/T) for these individuals.

HHRF: What is the most exciting EAA/T research happening today (within or outside of HHRF)? 

HA: There are a variety of solid research studies that support the benefits of EEA/T for children and adults with disabilities including studies on utilizing hippotherapy with children with autism and cerebral palsy. A recently published study, on “A Comparison of Equine-Assisted Intervention and Conventional Play-Based Early Intervention for Mother–Child Dyads with Insecure Attachment” by Beetz, et al. (read about it) highlights the importance of utilizing equine-assisted therapy (in this case the term interventions is used to include all early intervention specialists) for children under the age of 3 as an intervention approach for mother-child relationships. Two interesting aspects of this study were how the research compared EAT to a play-based intervention and explored EAT beyond Neuro-motor development. EAT is a wonderful treatment approach and makes a great impact to a large range of clients, however, it reminds therapists that there are a number of other treatment approaches to use in conjunction with hippotherapy for improving child/family outcomes.

HHRF: What are flaws you see in research projects that you do not recommend for funding?

HA: The biggest flaw is related to terminology, with researchers confusing, not defining, or switching terminology related to equine-assisted therapy - EAT (hippotherapy, mental health practices) and equine-assisted activities - EAA (adaptive riding/therapeutic riding, equine learning experiences). This issue goes beyond grant applications, as there is confusion throughout the industry regarding what is EAT and EAA. It is important to be clear what equine-assisted therapy or activity is used if we are to gain increased acceptance from the medical field and the community as a whole. As a result it is important for researchers to define if therapy (including mental health providers), recreational, or educational approaches are the focus of their study to increase the likelihood of funding.

HHRF: What do you hope to see in future research applications/projects or do you see any emerging trends? Any advice for future applicants?

HA: The recent mother-child dyad study (see above) that compared early intervention using the horse versus play-based approaches is a wonderful example for the direction of future studies. We need to start comparing various therapy approaches to EAT or various recreational activities to EAA to better understand when EAA/T is beneficial or not beneficial over various approaches and/or can be used in conjunction with other approaches. It is exciting that more research is beginning to focus on a combination of factors (e.g. socio-emotional well-being, motor control, child-family interactions, cognition) and how EAA/T can play a dynamic role in this development.

HHRF: What will research do for the EAA/T fields?

HA: Research is important as it provides individuals in the field with evidence-based approaches to apply in their settings as well as provide ideals for what best approaches or practice may look like. Research is key, as evidence encourages “support” from the community including families, future investors in research, medical providers, and policy makers.

HHRF: Why is Horses and Humans Research Foundation's work and mission important?

HA: HHRF provides an essential place to bring together a huge interdisciplinary team (the scientific advisory council) with a huge diversity of backgrounds. The foundation gives people the opportunity to do research in this industry where funding would otherwise not be available.

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