Feasibility and Acceptability of The Equus Effect: A Small Randomized Controlled Pilot Study of an Equine-facilitated Therapy

VA以患者为中心的护理和文化转型办公室的整体健康倡议促进了 使用补充和综合健康（CIH）方法与传统医疗护理，以帮助退伍军人 实现有意义的生活目标和改善功能。马促进疗法（EFT），一种动物辅助疗法， CIH的形式，越来越多地提供给退伍军人在VA。马对外界环境极其敏感 情绪状态，行为和意图，他们的牛群和其他动物，包括人类，并反映 肢体语言和对微妙的非语言线索的反应。因此，马有能力立即提供 关于人们情绪和行为状态的反馈。这种能力使人们有机会 变得更加情绪化的自我意识，并在EFT辅导员的指导下，学习如何调节情绪 变得更冷静、更耐心、更专注、更有信心来获得马匹的合作。参与者 鼓励EFT将他们从马的经验中学到的东西应用到他们与 人由于高质量的社会功能取决于一个人的情绪的有效调节，EFT提供了一个 改善有心理健康问题的退伍军人的社会功能的新方法。VA是 越来越多地将EFT视为CIH。然而，仔细进行的，科学有效的研究EFT 尚未进行。现有的关于EFT对心理健康的同行评议研究非常有限， 方法质量，而不是专注于成年人。其中没有一项将社会功能作为主要成果。 这个小型的随机对照试验旨在研究一种名为“马效应”的创新EFT (TEE)作为对退伍军人现有VA心理健康服务的补充，以改善社会功能。TEE 旨在通过发展退伍军人的情绪调节和人际交往能力来改善他们的社会功能 通过与马的治疗互动。本研究将评价1）研究程序的可行性， 评估和结果，2）实验和控制干预的保真度，以及3）可接受性 的干预措施，退伍军人和他们的心理健康临床医生使用混合定量定性方法。 这项研究有可能为这种日益流行的CIH的治疗主张提供初步的可信度。 如果数据表明TEE和研究其效果的方法是可行的和可接受的， RR&D IIR建议在多中心随机对照试验中测试TEE的有效性。

The VA Office of Patient Centered Care and Cultural Transformation's Whole Health initiative promotes the use of complementary and integrative health (CIH) approaches with traditional medical care to help Veterans achieve meaningful life goals and improved functioning. Equine-facilitated therapy (EFT), an animal-assisted form of CIH, is increasingly available to Veterans within the VA. Horses have extreme sensitivity to the emotional states, behaviors, and intentions of their herds and other animals, including humans, and mirror body language and respond to subtle nonverbal cues. As such, horses have the capacity to provide immediate feedback about a people's emotional and behavioral states. This capacity affords people opportunities to become more emotionally self-aware and, with guidance from EFT facilitators, learn how to regulate emotions and become calmer and more patient, attentive, and confident to gain the horses' cooperation. Participants in EFT are encouraged to apply what they have learned from their equine experiences to their relationships with people. Since high quality social functioning depends on effective regulation of one's emotions, EFT offers a novel way in which to improve the social functioning of Veterans with mental health concerns. VAs are increasingly embracing EFT as a CIH. However, carefully conducted, scientifically valid research about EFT has not been conducted. Existing peer-reviewed research about EFT for mental health is very limited, of poor methodological quality, and not focused on adults. None of it targets social functioning as a main outcome. This small randomized controlled pilot test proposes to examine an innovative EFT called The Equus Effect (TEE) as a complement to Veterans' existing VA mental health services to improve social functioning. TEE aims to improve Veterans' social functioning by developing their emotion regulation and interpersonal skills through therapeutic interactions with horses. This study will evaluate 1) the feasibility of study procedures, assessments, and outcomes, 2) the fidelity of experimental and control interventions, and 3) the acceptability of the interventions to Veterans and their mental health clinicians using mixed quantitative-qualitative methods. The study has the potential to lend initial credibility to the therapeutic claims of this increasingly popular CIH. Should data indicate that TEE and methods to study its effects are feasible and acceptable, it will set the stage for a RR&D IIR proposal to test the efficacy of TEE in a multi-site randomized controlled trial.