Equine Assisted Interventions in Mental Health
Kay Sudekum Trotter
Defining Equine Assisted Interventions “The field of animal-assisted interventions currently lacks a unified, widely accepted, or empirically supported theoretical framework for explaining how and why relationships between humans and animals are potentially therapeutic” (Kruger & Serpell, 2006, pp. 25–26). In the field of equine assisted interventions, there is movement toward establishing a national certification or credentialing process similar to that of the National Board of Certified Counselors (CBNN) and that proves to the public and employers that the counselor has met the national standards set by the counseling profession. Two primary models or theoretical frameworks currently dominate this growing field and may be referenced in this book by various authors. This book does not endorse any specific model of equine therapy. References to any treatment or therapy model or to any program, service, or treatment are solely the views and opinions of authors. In this book, we use the term equine assisted counseling (EAC) to indicate therapies requiring a licensed mental health provider working with the clients and equines. We will also share techniques incorporating both ground and mounted therapies. However, we felt it important to offer a quick overview of the prominent models of equine assisted interventions dominating the equine therapy field today: Certification Board for Equine Interaction Professionals (CBEIP); Equine Assisted Growth and Learning Association (EAGALA), and Professional Association of Therapeutic Horsemanship International (PATH Intl).
Certification Board for Equine Interaction Professionals CBEIP is a not-for-profit, tax-exempt organization started by professionals in the field who feel a credential for equine facilitated professionals is needed to identify the body of knowledge and those who practice in the field. The vision of the group is to promote professional credibility and to achieve public confidence in the transformative value of equine–human interaction. Their mission is to offer a credentialing process for equine interaction professionals grounded in a foundation of knowledge and experience that supports safe, humane, and ethical practice. Integrity, compassion, excellence, respect, and collaboration are the stated values of the organization.
CBEIP promotes the concept of voluntary certification by examination for those who incorporate equines into their mental health or education practice. Certification is just one part of a process called credentialing and focuses specifically on the individual. The designation from CBEIP is one indication of current competence in the specialized field. Certification of equine interaction mental health and education professionals provides formal recognition of basic knowledge in this field. Certification by the CBEIP indicates licensed mental health professionals that have complied with the following criteria:
1. Provided documented evidence that they have been examined by an independent professional certifying organization and found to possess a certain level of basic knowledge about the specialized field of equine interaction mental health or education
2. Established a level of knowledge required for certification of equine interaction mental health or education professionals
3. Provided encouragement for continued personal and professional growth in the field
4. Provided a standard of knowledge requisite for certification, thereby assisting clients, students, the public, and members of the profession in assessment of equine interaction mental health or education professionals
5. Provided a direction and focus for new professionals in the field seeking to increase their knowledge and skill levels
6. Protected the public
7. Increased the credibility of the field of equine interaction, education, and learning
Professional Association of Therapeutic Horsemanship International (PATH Intl), formerly North American Riding for the Handicapped Association (NARHA) is a professional organization that promotes equine-assisted activities and therapies for individuals with special needs. PATH Intl calls its model “equine facilitated psychotherapy (EFP).” This experiential psychotherapy includes equines and may incorporate a number of mutually respectful equine activities, such as handling, grooming, lunging, riding, driving, and vaulting. A licensed mental health professional must work with a PATH Intl certified equine specialist in mental health during all EFP sessions (PATH Intl, 2011b).
According to PATH Intl, the mental health professional must met the criteria to legally and independently provide mental health counseling in the state (or country) in which the services are being delivered, and must maintain current professional liability insurance. The mental health professional must also have additional training, education, and supervision in EFP. If the mental health professional is an intern or graduate student, he or she must be supervised by a licensed mental health professional (PATH Intl, 2011b). The equine specialist must be certified by PATH Intl as an Equine Specialist in Mental Health, thereby insuring that the equine specialist possesses the professionalism, experience and skills necessary to act as the horse handler in a PATH Intl un-mounted mental health session. Additional PATH Intl certification in riding, vaulting and/or driving is needed by the equine specialist to include mounted activities in EFP sessions The mental health professional may also be dually credentialed as a PATH Intl equine specialist (PATH Intl, 2011a).
PATH Intl also allows for equine facilitated psychotherapy assistants (EFP-assistants) or volunteers to be present during mental heath sessions. PATH Intl requiries that the EFP-assistants receive very specific training in client behaviors, treatment plans and confidentiality policies, treatment goals, behavioral modification programs, early signs of behavioral escalation, medication side effects, and appropriate personal boundaries, in order to provide stability of treatment to the clients (PATH Intl, 2011b).
Equine Assisted Growth and Learning Association The EAGALA Model of Equine Assisted Psychotherapy and Learning requires a cofacilitating team that must include an EAGALA-certified mental health professional and an EAGLA-certified equine specialist in all sessions. EAGALA also specifies all session activity must be performed with the client remaining on the ground and never mounting the horse. The mental health professional needs to have college-level educational training and a degree in the mental health field. The mental health professional also needs to be under a governing board for ethical or scope of practice violations relating to mental health practice. The equine specialist must have 6,000 hours (approximately 3 years of full-time work) of hands-on experience with horses and must have completed at least 100 hours of continuing education in the equine field. EAGALA offers two levels of certification: EAGALA certification and EAGALA advanced certification. The certification is valid for 2 years and thereafter must be renewed. The certification process is experiential and hands-on during a 4-day weekend (EAGALA, 2010).
Equine Assisted Interventions in Mental Health Theoretical Foundations Animal–Human Bond
The interaction between animals and humans has endured since the beginning of time (Hirschman, 1994; Levinson, 1972; Serpell, 2000). The two schools of thought on the development of the animal–human bond reflect either the evolution theory or the social cultural perspective. The innate essence of our relationship with animals, and our predisposition to interact with certain species that provide valuable services (such as being alerted to danger by dogs barking), became part of the collective consciousness that was passed down from generation to generation and reflects the evolutional theory perspective on the animal–human bond. The other school of thought comes from the social cultural perspective, which believes the animal–human bond has to be viewed throughout the cultural environment where individuals learn at an early age to negatively or positively regard certain animals (Graham, 2000).
The role of animal–human interactions has been postulated to promote wellness and prevent illness (Beck & Katcher, 2003; Garrity & Stallones, 1998; Graham, 2000) similar to maintaining a healthy diet and exercising to promote overall general well-being. A large component of the animal–human bond stems from the social support that individuals receive from animals that translates into positive health effects (Beck & Katcher, 2003). The social support that animals provide humans, such as love and acceptance, which is not dependent on appearance, social, or economic status (Chandler, 2005), often fills a void that otherwise would remain empty. In contrast to human relationships, which may be complex, confusing, and at times painful, bonds with animals are inherently relaxed and intimate. The need for animals to be cared for on a daily basis fulfills the human need to be needed, to nurture, and to love (Hirschman, 1994).
Animals play a symbolic role in society, influencing the psychological and physiological domain (Beck & Katcher, 2003). Animals can serve as a client’s substitute to which tenderness and protection can be given. The raising and caring for animals provides individuals the opportunity to learn about themselves and can serve to prepare couples for parenthood (Levinson, 1972). As friends, animals provide unconditional love and loyalty—they are often seen as a faithful intimate companion. Hirschman (1994) found that the intimate relationship that exists between humans and animals was a “mutual evolving relationship that defines their lives together. They find they can communicate in subtle, nonverbal ways grounded on mutual understanding and experiences. Much like long-term human friends, they ‘grow into’ one another’s lives through daily rituals and habits of behavior” (p. 620).
Development and the Animal–Human Bond
Animals play an important role in shaping child development (Carey, 1985; Levinson, 1972; Melson, 2003; Myers, 1998) because learning can be stimulated by the presence of animals. Learning occurs because the interaction with animals teaches in a concrete experiential manner the needs of the animal, thus providing individuals with the opportunity to apply this newly developed knowledge with others (Carey, 1985). Furthermore, interacting with animals for some can be a powerful motivator for learning, according to Vygotsky (1978), for two well-established reasons: (1) learning is retained more when individuals are emotionally invested; and (2) learning is maximized when it occurs within significant relationships.
The individual’s sense of self and ability to trust are directly influenced by the animal–human bond (Levinson, 1972; Melson, 1998; Myers, 1998). The ever-faithful responsiveness of an animal in an individual’s life and the individual’s attachment to the animal serves to reinforce and reassure the individual by providing the basic elements of developing trust and building healthy attachments (Melson, 1998). Another developmental task that animals contribute to is the individual’s sense of self. This is accomplished through many modalities, such as the individual assuming responsibility for the animal or through the unconditional acceptance offered by the animal or by the emotional support provided by the animal. Furthermore, because animals do not disappoint or make excuses or demands on individuals, the animal–human interaction provides the individual the ability to disregard other hurts and disappointments in his or her life (Levinson, 1972; Melson, 1998). In addition, the opportunity to interact and learn with an animal provides an opportunity to develop a sense of identity. According to Levinson (1972), “When a child has a pet with which he works and toward which he expresses a wide range of feelings, he can get a better understanding of what he is like and what his strengths and limitations are” (p. 49).
The recognition of the value of the animal–human bond has encompassed the period from the 1960s to present day. The first to publish about the therapeutic power of the animal–human bond was Boris Levinson (1962). Animal assisted therapy (AAT) built on this animal–human bond to create a therapeutic goal—directed counseling intervention. Chandler (2005) describes animal assisted therapy as an adjunct to therapy, where a therapist can incorporate the animal into whatever professional style of therapy the therapist already uses. Animal assisted therapy can be directive or nondirective in its approach. Animal assisted therapy sessions can be integrated into individual or group therapy and used with a very wide range of age groups and persons with varying abilities. Animal assisted therapy is a practice modality and not an independent profession. Mental health professionals that provide AAT must have the proper training and credentials for their professional practice (Chandler, 2005). Since animal assisted therapy was first viewed as a justifiable adjunct to traditional counseling techniques in the late 1970s and 1980s, national therapeutic programs have been established, training courses have been developed, int...