Abstract
This presentation will review findings from a phenomenological study conducted by graduate MOT students to explore the lived experiences of veterans with PTSD participating in equine-assisted activities and therapies (EAAT). Veterans found that this nontraditional treatment provided safety, healing, and meaning to their lives, along with establishing new routines and skills, without the stigma associated with mainstream treatment. Study limitations and future research recommendations will be discussed.
Primary Author and Speaker: Elise Bloch
Additional Authors and Speakers: Zoey Kramer
Contributing Authors: Ashni Franklin, Gianina Padua
This study explored the lived experiences of veterans with PTSD experiences participating in Equine Assisted Activities and Therapies (EAAT). The plight of returning veterans from US wars in Iraq and Afghanistan with PTSD is recognized as a major health crisis (Reisman, 2016). Over 2.2 million troops have served in these wars, upon return to civilian life over 44% have reported challenges (Institute of Medicine (IOM), 2014). Those impacted with PTSD are reported to have difficulty in major occupations including returning to work and integrating back into society and reestablishing family life (Kukla, Rattray & Salyers, 2015; IOM, 2013). Veterans have actively sought out alternative therapies to meet their needs, and EAAT has gained attention in the last 15 years. There have been limited studies examining the benefit of EAAT with veterans reporting physical and psychological benefits (Burton & Burge, 2015; Ferruolo, 2016; LaFleur, 2016). However, current studies are limited in scope and have design challenges (O’Haire, Guerin & Kirkham, 2015). Additionally, studies did not examine the veterans’ lived EAAT experiences, which is critical to our understanding of their occupations.
This phenomenological study was conducted at a PATH accredited therapeutic riding center that had a “Horses for Heroes” program. The research team recruited veterans from the program who had a formal diagnosis of PTSD, with comorbidities of schizophrenia or bipolar disorder as exclusion criteria. Participants included three Caucasian males and one Caucasian female from age 33-69. Two participants were veterans of the Navy, one of the Army and one of the Air Force. Participants had served in numerous conflicts: Iraq, Vietnam Gulf War and Iran. Graduate MOT students observed sessions, interviewed veterans and conducted a focus group at the barn over a 2-month period. Questions for interviews and the focus group were developed and modified from related research studies. Research team transcribed reflection journals, observation notes, interviews and focus group transcripts. Using the modified Van Kaam method of analysis, data was coded by the team and member checking was done at the last visit to the barn.
Upon analysis of observations, interviews, and focus group, the overarching theme was the context of the barn (horses, nature, smells, flowers). Meaningfulness, the primary theme of the veterans’ experiences of EAAT, was found consistently throughout the data. Participants reported feeling happy/content and safe. A critical factor that contributed to the meaningfulness was the horse-human bond and the relationship between the veterans and the therapists. Using the Model of Human Occupation (MOHO) to guide this study allowed the researchers to analyze the veterans’ lived experiences through volition, as participants were motivated during grooming and riding; habituation, as EAAT provided veterans with routines and patterns of engagement; and performance capacity, as participants are able to perform daily occupations with reduced symptoms of PTSD.
Using Occupational Justice tenets allowed researchers to analyze veterans’ experiences as they face stigma from society regarding their mental illness and are reluctant to seek out traditional services within the VA system. EAAT is a non-traditional, client-centered approach that occurs in a natural context. Therapy occurring in nature has found to be healing compared to traditional therapy (Poulsen, Stigsdotter, Djernis, & Sidenius, 2016). The natural context facilitates and promotes social participation, security, and trust among participants. This study supports the role of OT in utilizing EAAT to offers new, meaningful roles, occupations, and healthy habits and routines for veterans with PTSD.
Reisman, M. (2016). PTSD Treatment for Veterans: What's Working, What's New, and What's Next. Pharmacy and Therapeutics, 41(10), 623--634.
Kukla, M., Rattray, N. A., & Salyers, M. P. (2015). Mixed methods study examining work reintegration experiences from perspectives of Veterans with mental health disorders. Journal of Rehabilitation Research and Development, 52(4), 477-490.
Burton, L.E. & Burge, M.R. (2015). Equine assisted therapy reduces symptoms in veterans with post traumatic stress disorder. Journal of Investigative Medicine, 63 (1) 165.
O-Haire, M.E., Guerin, N.A. & Kirkham, A.C. (2015) Animal- Assisted Intervention for trauma: A systematic literature review. Frontiers in Psychology. https://doi.org/10.3389/fpsyg.2015.01121