Today's edition of Psychotherapy Brown Bag deals with the efficacy for Equine-Assisted Psychotherapy (EAP), specifically in the realm of eating disorders. What did the author, Mike Anestis, find?

EAP does not appear to be harmful, but there is no evidence that it is efficacious in the treatment of mental illnesses. There is a paucity of research on the topic and the research that exists is so full of flaws that it is actually rather remarkable that it was published in the first place. Nonetheless, fancy treatment centers charge outrageous fees to provide this service and make grandiose claims regarding efficacy. Just as we covered in our article on touch field therapy (TFT), such behavior is a prime marker of pseudoscience.

I don't doubt that riding horses is nice and fun and pleasant, but that doesn't mean that it helps treat eating disorders (or any other illness, for that matter). I find many things nice and fun and pleasant and even, in a sense, therapeutic, but that doesn't make it a treatment. I'm a big believer in the power of animals to make us feel better- my cat does it all the time. Nothing beats snuggling her in my lap or watching her silly antics. Spending time with her is often the highlight of my day. But it doesn't help treat my eating disorder. There's a big difference.

I've done some equine therapy while in treatment and maybe I'm just bitter, but I'm not sure what the point of it was. I get the theoretical premises upon which EAP stands (as summarized by Anestis):

•Improving non-verbal communication skills through interactions with a non-verbal creature
•Improvement of acceptance skills and emotional expression through the realization that a person can not make the horse do things it does not want to do (e.g., lift its hoof)
•Improved mood due to positive interactions with an animal
•Increased awareness of connection to nature through outdoor experiences

Which is all well and good, and no doubt there can be valuable lessons learned from equine therapy. (Although I must say that my cat has taught me everything and more that I need to know about point #2. The horse might be larger, but my cat has claws! :) ) Yet that still doesn't mean that EAP is an empirically-supported treatment. I find valuable lessons in coloring mandalas, in watching Grey's Anatomy and House, in crochet, in Sudoku puzzles. Not that these things can't be helpful, but it's a long stretch to say that these actually treat eating disorder symptoms.

I do realize that places like Remuda Ranch don't rely on horses alone for their treatment. But you better believe that EAP is one of the reasons they charge so much. Why pay extra for something that doesn't really work? Why not let your kid take horseback riding lessons or go trail riding once their ED symptoms have improved?

Anestis sums up his thoughts as follows:

I like the idea of using animals to make people feel better. In fact, Joye and I may one day train our sweet playful golden retriever to visit hospital patients in order to provide them with an added moment of happiness. In doing so, however, we will not be under the illusion that such an action would constitute therapy or treat mental illnesses. Our dog would simply provide a positive experience, which can impact mood and perhaps motivate an otherwise ambivalent individual to pursue the type of help capable of addressing the actual problem. When animal-assisted therapy is couched in these terms, it sounds wonderful. When it is presented as a stand alone treatment, however, that is a problem.

I don't think, however, that Aria would be very good at visiting hospital patients. Hiding under their beds and peeing, yes. Therapeutic, not so much.


Mike Anestis said...

Love the title! Thanks for the discussion of my article.

It seems like we're on precisely the same page on this topic and I think that your description of your response to your own experiences with EAP add an additional level to the argument. Thanks for being willing to share that information!

Fiona Marcella said...

parsley has been hospital visiting and was very good but that's because he's more like a dog than a cat. Knitting, sudoku, soap operas and gameshows all helped to pass the time for my daughter and those in hospital with her. Watching the squirrels in the garden and chatting with the cleaner were also truly therapeutic. None of them however were considered as part of the official treatment. Maybe they should be as long as no outrageous claims are made for them. They'd be a lot cheaper than horses

Unknown said...

The pun potential is limitless!

I'm loving the discussions on these topics - from all angles.

I Hate to Weight said...

i take eating disorders and all recovery very seriously, but i can't help giggling -- i know that's very immature and unsophisticated.

it would be nice, though, if horse-back riding could cure mental illness -- no dry mouth. sadly, i think we're stuck with science and therapy.

Anonymous said...

This is an interesting article you discussed here. Have you seen this recent study on yoga as a beneficial means of therapy for eating disorder patients?

Eating Recovery Center has experts to speak on the matter as well.

A:) said...

And why let osteopenic/osteporotic weight restoring girls ride horses and climb walls? My psychiatrist always thought that was idiotic and simply dangerous.

I get that you have to be at a certain IBW to do those things, but still -- that doesn't instantly reduce the damage if you were to fall from the horse and fracture a hip.

And how they determine their IBWs is another blog post in itself. .

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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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nour·ish: (v); to sustain with food or nutriment; supply with what is necessary for life, health, and growth; to cherish, foster, keep alive; to strengthen, build up, or promote


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