Written by Cassandre Mayet and Pauline Auger.
This article aims to discover a new form of therapeutic mediation: equine therapy. It will be discovered through a pilot study, conducted by an equine therapist in the context of PTSD[1] with three children.
Post-traumatic stress disorder can be developed in people who have been exposed to a traumatic event. It is manifested by persistent symptoms that alter psychological, social, and biological functioning. Symptoms may include reliving the event, avoidance of stimuli associated with the event, and negative mood changes. In children, these symptoms vary according to the age and this disorder can disrupt behavior and compromise the child’s emotional and cognitive development. There is an alteration of emotional regulation as well as emotional memory.
Equine-Assisted Therapy is, today, a complementary approach to classical therapies. Equines (horses and ponies) are more and more involved in the care of people in difficulty. The objective is that the horse becomes a mediator in the therapy. Thus, equine-assisted therapy is done within the framework of a personalized project, individualized, and integrated in the global therapeutic program. The therapist must be trained in equine mediation, with a good experience and horse’s knowledge.
For this, the sessions take place in a pony club. It must be a calm and soothing environment, and the child must be in an individual or small group. For one hour, activities are proposed to the child: observation of the pony in the box and in his freedom, preparation of the pony, brushing, care, putting the saddle on, driving the pony, riding the pony in the riding school and outside.
A pilot study was conducted by an equine therapist, a nurse trained in psychotrauma. Equine-Mediation Therapy (EMT) was offered to 3 children with PTSD. There was one girl and two boys, aged 6, 8 and 11 years old respectively. The girl had suffered violence from her father and lived with her mother, one of the boys had been a victim of the Nice bombing and had lost his father, and the other boy had witnessed the aggression of his mother by a neighbor.
They received ten weeks session of team mediation. The weekly sessions lasted one and a half hours, in parallel with the therapeutic follow-up they were having.
The main symptoms initially observed in these children were: relational difficulties with withdrawal, avoidance of eye contact, brief and not very explicit responses, little interaction between peers; a lack of body expression, little awareness of his body and his feelings; difficulties in expressing himself through language; hypervigilance; emotional and affective difficulties; sensory difficulties with dulling of the perceptions; cognitive difficulties.
The means implemented during the ten sessions were multiple. First of all, there was the setting up of the therapeutic framework and the learning of group work. Then, they worked on self-assertion in front of the animal, the management of the pony in freedom. Then, they worked on fear, body sensations, expression of emotions, sensoriality (touch, smell, heat), help to verbalize anxiety-provoking situations, on the role of mutual aid…
They also participated in a pony ride to school. This one was materialized by cones and cubes, which represented the house, the road with cars and the school. The child had to put on the representation of each place the emotions they felt at that particular moment of the journey. A lot of work was done on self-confidence, autonomy, trust in others and in the animal.
The results of this study are unanimous. They note a good adherence to the treatment, good exchanges between the children, progress in autonomy and self-assertion. They also noted an improvement in communication (verbal and non-verbal), better verbalization and management of emotions. Anxiety, fears, aggressiveness, and anger have decreased. Body awareness is improved with an increase in the feeling of body experiences. The children regained interest and put aside their withdrawal social. Finally, there was an improvement in the cognitive aspect.
In conclusion, the mediation by the horse was beneficial. Speech was liberated and reassurance was established. Equine-mediated therapy allowed for a strengthening of the therapeutic alliance. At the end of the ten sessions, for all three children, very few symptoms of PTSD remained. Equine mediation is therefore a form of therapy to be developed further in the years to come, in addition to the usual therapy, because it acts on emotional, cognitive, sensory, neurological, and physiological factors and seems totally adapted to PTSD. Equine mediation therapy, in a context disconnected from the traumatic events, reassuring, motivating, and valorizing, allows to reduce physiological hyperreactivity and hyperexcitation. It improves emotional regulation and body awareness, stimulates memory control mechanisms, and develops coping strategies. So, it is a tool not to be neglected in the years to come.
[1] Post-Traumatic Stress Disorder
Vocabulary :
- Avoidance : évitement
- Equine-assisted therapy : thérapie assistée par les chevaux
- Putting the saddle on : mise en place de la selle
- Therapeutic framework : cadre thérapeutique
- Self-assertion : l’affirmation de soi
- Awareness : conscience
- Put aside : mettre de côté
- Withdrawal social : retrait social
- Strengthening : renforcement
Hameury, L., & Rossetti, L. (2021). Une approche complémentaire dans le trouble de stress post-traumatique chez l’enfant : la médiation équine thérapeutique. Neuropsychiatrie de l’Enfance et de l’Adolescence. Published. https://doi.org/10.1016/j.neurenf.2021.04.011