Equine Assisted Psychotherapy – a Personal Construct Psychology Perspective

Equine Time is Sydney’s first Equine Assisted Psychotherapy Programme. Equine Time started on the 6th May 2009 at Mowbray Park Farm, a natural horsemanship property at Picton on the south west outskirts of Sydney. Visit our website at equinetime.com.au.

I first read about Equine Assisted Psychotherapy in the Australian Journal of Counselling Psychology Summer 2005 (Frewin and Gardiner). Having been a lover of horses since childhood I was fascinated by what I read, so I decided to learn more about Equine Assisted Psychotherapy. Since then I have attended several trainings to become an accredited Equine Assisted Psychotherapist with EAGALA (Equine Assisted Growth and Learning Association). EAGALA is an international association which aims to provide standards of practice, education, innovation, and support to professionals providing services in Equine Assisted Psychotherapy (EAGALA 2008).

What is Equine Assisted Psychotherapy?

Equine assisted psychotherapy is not a horse riding programme. The EAGALA model of EAP utilizes ground activities in a large enclosed space in which the horses run free. It is conducted by a licensed mental health professional, a horse specialist and a small herd of three to five horses. In a session the client is invited to undertake a groundwork activity with the horses. At the end of the session the client is invited to verbalise their experience and the equine specialist will reflect their observations of the horse’s behaviour during the session. The therapist then picks up on constructs that are important to the client, in line with the client’s therapy goals.

The horses are regarded as members of the therapy team. Their size and power demand respect. They are prey animals and will flee the instant something in their surroundings is out of balance. Horses have a natural curiosity, they have different personalities and they are extremely perceptive to human emotions. They are experts at non-verbal communication and body language. They will mirror human behaviour.

Horses are social animals and live by the rules of the herd. As in human relationships equine relationships require effective communication and co-operation. Co-operation is important because each member of the herd relies on the others for their safety.

Horses are non-judgemental, they do not have prejudices, they have no expectations, they are not influenced by appearance or life situation. They have no hidden agendas, they have no regard for external measures of success as humans do, they respond immediately without assumption or criticism. They hold people accountable for who they are in the relationship with them at that point in time (Aspen Ranch n.d., Kaleidoscope Learning Circle 2005, Kohanov 2001, Frewin and Gardiner 2005, O’Connor n.d.).

Why Equine assisted psychotherapy?

The research literature demonstrates the effectiveness of EAP for children with depression and anxiety (McCann 2001), children with difficult behaviours (Tetreault 2006), and children and adolescents "at-risk" with maladaptive behaviours (Trotter 2006). Significant improvement in behaviour was reported for incarcerated adolescents (Mann 1998) and for adolescents with disruptive behaviours (Greenwald 2001). Mann and Williams (2002) found a significant improvement in adolescents with conduct disorders, mood disorders and psychotic disorders who failed to make progress in traditional therapy settings. Other studies found significant improvement in adolescents with depression, anxiety and low self esteem (Crawly et al 1994, Bowers and MacDonald 2001, Kaiser et al 2004 and Schultz 2005, Bullock and Gable 2006). One therapist stated "I have learned more about a teen in one horse session, than in a month of individual work" (Barbara Lester, Woodbury Reports 2002).

Several studies of EAP with adults have shown significant improvement in symptoms of anxiety (Scheidhacker et.al. 2002), unresolved grief (Klontz et al 2007), depression, anxiety and social disorders (Burgon 2003) and eating disorders (Christian 2005).

Russell-Martin (2006) compared the improvement in the couple relationship between 10 couples who attended six sessions of solution-focused therapy and 10 couples who attended six sessions of EAP. She found that the EAP couples reported significantly higher improvement than the solution-focused therapy couples.

Lancia (2008) demonstrated significant improvement in symptoms of PTSD in war veterans.

Equine assisted psychotherapy is being used for individual work, couple work and family therapy. Many of the studies are suggesting that treatment duration is minimised as the equine sessions bring issues to the surface more quickly than in talking therapy (Kersten & Thomas 2005a, Trevelyan 2005).

Exploration of some of the concepts from Personal Construct Psychology to underpin the therapeutic value of the EAGALA model of EAP.

Kelly’s Fundamental postulate states "a person’s processes are psychologically channelized by the ways in which they anticipate events". A horse’s hypervigilence and instantaneous flight response can also be explained by this postulate. The survival instinct of the horse can assist humans to clarify their own processes.

The conditions necessary for the formation of new constructs are the use of a fresh set of elements, experimentation and the availability of validating data.

A fresh set of elements means that the person is not restricted by their existing constructs. Greg Neimeyer used the word "novelty" to describe the quality of this fresh set of elements. The word novelty means "a new and unusual thing" (Websters Dictionary). An implied meaning of the word novelty is that the thing does not produce a fear response but instead gives rise to a person’s curiosity.

EAP provides an environment that is likely to be outside the client’s experience and while Kelly names the therapist as a fresh element, the horses and the horse specialist are also fresh elements in the novel environment. Kelly cautions that the new context ought not involve "the self" or "members of the immediate family" until such time that the person finds some usefulness in the emerging constructs coming from the new environment. In the EAGALA model of EAP the observations made are "clean" observations of the horses behaviour during the session. The client is invited to reflect on their learning through awareness of the horses behaviour during the session. Much of the psychological processing occurs between therapy sessions as the person reflects on their specific learning and experiments with it in other situations which are likely to be with self or family. Kelly also states that the environment ought not be so complex that the person is unable to use their moment-to-moment anticipations. In the EAGALA model the activities given are stated as simply as "go and meet the horses and choose one". A followup session may include "choose a horse and bring it back here". The client may wish to work on the same task over several sessions.

The use of stories will also assist the development of the new constructs before the self is involved. In the EAP session the therapist may ask the client to tell a story about what just happened. It is likely that the person will tell the story about the horses. The self is only involved after the elements in the story have gained usefulness, and gradually the new construct from the story will replace the old constructs that have outlived their usefulness.

Kelly states that the playing out of artificial roles is very useful for the formation of new constructs. He states that "The patent artificiality of the role is the very feature which prevents the tender shoots of new ideas from being trampled in the frantic rush to maintain oneself in their previous role." (p. 161) To attempt the role of being in control of a large and powerful animal that is free to run away is likely to be seen as an artificial role for most people. To believe that this is possible is beyond most people’s anticipations. When the horse responds willingly the client must reconstrue rapidly in order to maintain their anticipatory system.

"An atmosphere of experimentation" (Kelly 1955/63 p 162) is important for the formation of new constructs. For Kelly, the word experimentation meant that one variable was attempted to be isolated from all other variables and this one variable is the one acted upon. The more careful we are to isolate one construct or anticipation to act upon the more likely we are to gain a precise outcome. When the client can see clearly the process involved and the result, their anticipation will be clearly validated or invalidated. The clear nature of the tasks set in the EAGALA model and the clear outcome provided by the horse allows for such experimental conditions to exclude as many extraneous variables as possible.

In an experimental situation the consequences of the experiment are limited. Kelly states "one does not play for keeps" (p.163). Thus a construct may be shifted from what the client believes to be reality as a possible representation of reality. Once this occurs the construct becomes more open to variation or replacement. The horses become metaphors for the client, and as such the client is able to loosen their construing to enable alternative possibilities.

Clients have the opportunity to make a new prediction and experiment with their behaviours to find the best fit. In the EAGALA model a client is offered the freedom to ‘trial’ various strategies with the horses and they quickly learn the relationship between prediction and response through the horse’s immediate response. These trials are experiments in role constructs and are particularly useful for people wishing to improve their relationships as the horses will act to maintain their own safety.

Kelly states "A construct is a framework for making predictions" (p 163). If the outcome doesn’t fit the prediction a person may begin to change their prediction. They may alternatively try to force the outcome so as to make it fit the prediction. Horses are very good at not responding to the way a person wants them to if force is used. The use of force makes the problem more difficult to solve. In a very short time a person will give up completely or begin to change the construct they are using to predict their desired outcome. Thus horses provide clear invalidation for constructs that are not in line with "shared control" and hence validate constructs in line with "shared control". This construct is important for the well-being of human relationships.

Often in an EAP session an observer has little insight into what learning is taking place for the client. "The therapist must be careful not to assume learning by results, or results by learning" (Kelly). What the client learns is what is important and necessary to their construct system, and not necessarily noticeable to the therapist. Sometimes the client may need to form intermediate constructs which to an observer may appear as unsuccessful trials. Kelly states that "the availability of validating data implies skill on the part of the therapist" (p. 164) and in an EAGALA model session the therapist may provide validating data, but essentially that is the role of the horses. The horses provide non-verbal validation and invalidation to the client in response to the non-verbal constructs of the client. "Those things that the client has been unaware of are now brought into awareness" (Kelly). Kelly states "the role-playing exchange is an excellent way of enabling the client to try out new constructs which have immediate access to validating material." The horse’s response is immediate, and helps the client to see more clearly in a construct, its prediction, action and response. The direct link between a client’s action and the horse’s response can provide very precise evidence for the construct on trial. Horses do not confuse their response with some previous event, as humans are often inclined to do which makes for difficulty when a person seeks validation from other humans.

Kelly points out that it would be more helpful to the client for the therapist to ask the client what are the client’s questions. The EAGALA model of EAP offers the client the opportunity to ask their own questions in the experimental environment with the horses. Very often when the client has formulated their own question, they can find an answer that fits for them. Is it possible for a client to ask a question of a horse? Can a horse sense this and provide them with the answer they need?

The use of horses in psychotherapy is rapidly gaining acceptance throughout the world as people experience its therapeutic benefit. The body of research evidence is growing and practitioners are gaining a more precise understanding of the important aspects of the therapeutic process. To be accepted as a valid psychological therapy, the EAGALA model of equine assisted psychotherapy needs to be grounded in an historically trusted theory to ensure its ethical sustainability. Personal Construct Psychology provides a substantive foundation for the EAGALA model of equine assisted psychotherapy.

References

Aspen Ranch n.d. Why are horses therapeutic? Retrieved October 4, 2005, from http://www.aspenranch.com/equine.html.

Bowers M.J. and MacDonald P.M. (2001) The effectiveness of equine facilitated therapy with at risk adolescents: A pilot study. Journal of Psychology and Behavioural Sciences, 15, 62-76.

Bullock L.and Gable R. (2006) Programs for children and adolescents with emotional and behavioural disorders in the United States: A historical overview, current perspectives, and future directions. Preventing School Failure, 50(2), 7-13

Burgon H. (2003) Case studies of adults receiving horse riding therapy. Anthrozoos, 16, 263-276.

Crawly R., Crawly D. and Retter K. (1994) Therapeutic horseback riding and self concept in adolescents with special education needs. Anthrozoos, 7, 129-134.

Christian J.E. (2005) All creatures great and small: Utilizing equine assisted therapy to treat eating disorders. Journal of Psychology and Christianity, 24, 65-67.

Equine Assisted Growth and Learning Association (EAGALA) 2008 Retrieved 18 January 2008 from http://www.eagala.org.

Frewin K. and Gardiner B. (2005) New Age or Old Sage? A review of Equine Assisted Psychotherapy, The Australian Journal of Counselling Psychology, Summer 2005.

Greenwald A.J. (2001) The effect of a therapeutic horsemanship program on emotionally disturbed boys. Dissertation Abstracts International, 62.

Kaiser L., Spence L.J., Lavergne A.G. and Bosch K.L. (2004) Can a week of therapeutic riding make a difference? A pilot study. Anthrozoos, 17, 63-72

Kaleidoscope Learning Circle (2005) Building effective relationships through equine assisted learning. Retrieved June 14, 2006, from http://www.myklc.com.

Kelly G.A. (1955/63) A theory of personality the psychology of personal constructs. Norton N.Y.

Kersten G. and Thomas L. (Eds.). (2005a) Equine assisted mental health resource handbook. (7th Edition) Santaquin, UT: EAGALA, Inc.

Kohanov L. (2001) The tao of equus: A woman’s journey of healing and transformation through the way of the horse. Novato,California: New World Library

Klontz B.T. Bivens A., Leinart D, Klontz T. (2007) The Effectiveness of Equine-Assisted Experiential Therapy: Results of an Open Clinical Trial in Society and Animals 15, 257-267. 9

Lancia J. (2007) Equine Assisted Psychotherapy Genesse Valley Psychiatric Association Newsletter March 2007.

Mann D. (1998) Measuring outcomes of equine assisted psychotherapy with juvenile delinquents. Unpublished study. Walberg. CO

Mann D. and Williams D. (2002) In L. Thomas, Horseplay can be therapeutic: Equine assisted psychotherapy. Retrieved March 5, 2006 from http://www.strugglingteens.com/opinion/horseplay.html.

McCann J. (2001, Spring) Equine equilibrium. Tempe, AZ: Arizona State University, ASU Research Magazine.

O’Connor C. (n.d.) The silent therapist: A review of the development of equine assisted psychotherapy. Retrieved March 5, 2006, from http://www.catra.net/info/silent.html.

Russell-Martin L. A. (2006) Equine Facilitated Couples Therapy and Solution Focused Couples Therapy: a comparison study. A dissertation submitted to the graduate faculty of the Department of Psychology in partial fulfilment of the requirement of Doctor of Philosophy. Prescott, Arizona, September 2006.

Scheidhacker M., Friedrich D. and Bander W. (2002) About the treatment of anxiety disorders by psychotherapeutic riding: Long term observations and results of an experiemental clinical study. Krankenhauspsychiatric, 13, 145-152

Shultz B. (2005) The effects of Equine Assisted Psychotherapy on the psychosocial functioning of At-risk Adolescents ages 12-18, Counselling Thesis 2005, Denver Seminary.

Tetreault A. (2006) Horses that Heal: The Effectivenss of Equine Assisted Growth and Learning on the Behaviour of Students diagnosed with Emotional Disorder. Prepared in partial fulfilment for the requirements of the Master of Arts Degree in Multicategorical Special Education. Governors State University, University Park, Illinois, 2006.

Trevelyan J. (2005) Equine assisted psychotherapy. Retrieved October 3, 2005, from http://www.winningstrides.com/articleframe.html.

Trotter K.B. (2006) The efficacy of Equine Assisted Group Counselling with at risk children and adolescents. Doctorate of Philosophy (Counselling) University of North Texas.

Woodbury Reports Inc.(2002) Horseplay can be therapeutic: equine assisted psychotherapy. Retrieved March 25, 2006, from http://www.strugglingteens.com/opinion/hrseplay.html. Barbara Lester Clinical Social Worker

 


Working With Traumatised Children 2012

Building an EAGALA Model Evidence-based Practice for Working with Traumatised Children

Presented at the EAGALA 1st Pacific Biennial Conference, Paterson, NSW, Australia, December 2012.

This paper outlines an evidence-based practice for working with traumatized children using the EAGALA model of Equine Assisted Psychotherapy. This evidence-based approach combines the work of Dr. Bruce Perry who is a world renowned leader in brain development, Arianne Struik who teaches internationally regarding the importance of stabilizing children’s experience before attempting to address trauma and the work of Dr. Deborah Truneckova and Prof. Linda Viney FAPS who have developed a client-centred approach for working with children from the theoretical basis of Personal Construct Psychology.

Recent research in brain development has shown the links between a child’s social, emotional and physical environment and brain growth. Children who have experienced trauma through abuse and neglect do not develop the necessary neural connections to concentrate, learn and behave in socially appropriate ways. The work of Bruce Perry has demonstrated that brain plasticity allows the brain to grow new neural pathways when deficits are addressed according to the sequential development of the brain. Bruce Perry is a neuroscientist who is a leader in the field of childhood trauma and its effect on brain development. He advocates that children learn through experience and play and that therapy for children should assist the sequential development of the brain.

Struik (2011) recommends that children need to be stabilized before addressing trauma and Truneckova and Viney (2012) have highlighted that when working with children it is best practice not to directly address the trauma if the child does not raise it, but to build resilience and capacity in children so that when they are developmentally ready, they will work through the trauma in their own way. Through a Personal Construct Psychology approach Truneckova and Viney (2012) focus on the child’s meaning making capacity rather than on events that have occurred in their external world.

Following this need to build healthy neural pathways in the brain, Perry outlined six core strengths for healthy childhood development. These are attachment, self regulation, affiliation, attunement, tolerance and respect. At Equine Time we use the EAGALA model of equine assisted psychotherapy to address these core strengths through play therapy with the children through activities with the horses.

One of the activities we use to build these core strengths is called "The Big Paddock Adventure". This is a simple activity of leading a horse and can involve siblings, parents and several horses. The aim of the game is to follow the leader. Whilst this sounds simple the horses provide the children with countless opportunities to explore each of Perry’s core strengths for healthy brain development.

Attachment.

Attachment is the capacity to form and maintain an open and responsive relationship with another person. During the game the child holds the horse’s lead rope and leads the horse where he wants the horse to go. For a horse to follow, the child has to negotiate starting and stopping, walking at an appropriate pace, not letting the horse eat, swapping sides of the horse and swapping hands, making sure the horse doesn’t step on the lead rope or their toes, and negotiate trees, logs, dams, thistles and blackberries.

Self Regulation

Self regulation is the capacity to notice and control primary urges or pausing for a moment between impulse and action. Self regulation develops from external regulation by caregivers, and in our context it is the horse that becomes the external regulator. There are two ways this can happen such as through questions like"will your horse fit through there?" or if the horse gets stuck then the child is halted, or the horse may stop and we will ask the child why they think the horse has stopped.

Affiliation

Perry states that humans are biologically designed to live, play, grow, and work in groups. In this game the horses and the therapy team all become part of the child’s group. We also play the game with siblings and parents who lead their own horse. We take turns in being the leader and the followers. We explore taking turns and sticking to roles and we explore how leading and following are different and what role is preferred and why?

Attunement

Attunement is the awareness to recognise the needs, interests, strengths and values of others. In the game, the child needs to be aware of where the horse is in relation to them, how close, how far away, walking quickly or walking slowly. Questions can be asked about how the horse is feeling, what may have happened to the horse to cause a change in its behaviour or other questions to increase the child’s awareness of the horses.

Tolerance

Because children affiliate on sameness, they also need to learn to accept difference. While attunement is about awareness of difference, tolerance is about what to do about that difference. Children who learn tolerance are more sensitive to others and can adapt and be flexible. They learn to value what makes each of us special and unique.

In "follow the leader", children become aware of their horse, how its needs are different to their own due to its size and having four legs. Horses have different personal space to children, and can be anxious when too close to another horse. Horses also show a preference for the order in which they follow their leader and the children are invited to explore these differences and work out how to help the horses feel more comfortable. In the game a child may need to adjust the speed of his horse so as to keep in line with the others or by not getting too far ahead of others, or by checking that the followers are OK.

Respect

Respect is appreciating one’s self worth and the value of others. In Perry’s words "An aware, tolerant child, with good affiliation, attachment and self-regulation gains respect naturally." As the game is practiced we see children become more sensitive to the needs of their horse and more sensitive to the needs of other siblings or parents in the game. They adapt their strategies according to those other requirements, and they praise their horse for success. Their horse is hugged and stroked gently for doing a good job and learning new things.

We have outlined what might seem like a simple activity, however, it provides the opportunity for children to learn important life skills through their interactions with the horses and the therapy team. We have demonstrated how evidence based psychological and neurological theory underpins this work by using Perry’s six core strengths for children’s healthy psychosocial and emotional development. Through this lens, we are able to understand the challenge and the complexity for a child provided by the horses in the game of "follow the leader" otherwise known as our "Big Paddock Adventure."

References:

Perry B.D. (2009) Examining Child Maltreatment Through a Neurodevelopmental Lens: Clinical Applications of the Neurosequential Model of Therapeutics, Journal of Loss and Trauma, 14:240-255, Taylor and Francis Group, LLC

Perry B. D. Understanding the Effects of Maltreatment on Brain Development (2009) Child Welfare Information Gateway, Children’s Bureau/Administration on Children, Youth and Families, U.S. Department of Health and Human Services, Washington,DC. www.childwelfare.gov

Perry, B.D (2005) Maltreatment and the Developing Child: How early childhood experience shapes child and culture, The Margaret McCain Lecture Series.

Struik A. (2011) Don’t let sleeping dogs lie" Translation of the book Slapende honden? Wakker maken! (2010)

Truneckova D., Viney L.L. (2012) Using play to help troubled children in the school setting, InPsych: The bulletin of The Australian Psychological Society Limited, June 2012 34,1.


Experiencing Difference: Game of Change

Experiencing Difference: Game of change, the use of novelty and expanding boundaries of therapeutic space.

Lynette Toms, Jocelyn Harper and Bronwyn Seaborn

Clients’ experience of therapy would ideally be one of experiencing difference and change, of safety, relationship and containment. Increased awareness, imagination and the sense of joy that comes with ‘playing of games’ allows a reimagining of their lives, and their future. Successful therapeutic alliance requires attunement, egalitarianism, mental flexibility and flow, as well as stillness and courage from the clinician, to support a client’s therapeutic movement and ‘game of change’. A Personal Construct Psychology framework encourages these nuanced practices.

Over the past 20 years the Australian Government has funded and reviewed countless mental health programs, but all this activity has had little impact on the mental health of minority groups in the population, which continue to be chronically underserviced. This has led to a call for a fundamental shift in the way Mental Health Services are delivered. (National Mental Health Commission, 2014)

During this same period there has been a decline in the teaching of Personal Construct Psychology in Australian Universities whilst less nuanced, prescriptive modalities have become the norm in mainstream psychology in Australia. In my practice, I regularly encounter clients who come with a sense of hopelessness because they have not received adequate help from mainstream psychology services. These clients are often amazed at the difference Personal Construct Psychotherapy (PCP) makes in their lives, and as a long-time practitioner in PCP, I, too, know the theory’s worth in assisting people to thrive rather than simply survive.

This understanding came over a period of time and with assistance from two unusual sources: one was using horses in therapy; another was experiencing the wisdom of Australian Aboriginal people.

For the past eight years, I have conducted an Equine Assisted Psychotherapy practice at my farm. During this time, a PCP colleague, Bronwyn Seaborn, also became a facilitator of equine assisted psychotherapy sessions. Many Aboriginal people were drawn to this practice, finding the natural outdoor setting a perfect fit with their innate sense of connection to the earth. They responded exceptionally well to the location, equine therapy and the PCP approach, all of which brought them healing and strength. The activities (or the games played) at Equine Time offer many avenues for “embodied cognition” and genuine change, demonstrating the potency of a psychology of possibility, and the transformative power of the human brain (Langer, 2009; Barsalou, 2008; Niedenthal, et al., 2005).

This successful relationship with our indigenous people led me to work (for the past five years) at the Tharawal Aboriginal Medical Centre in South Western Sydney. The centre, named after the First Nation people of the region, provides health services to the largest Urban Aboriginal community in Australia. In a delightful synergy, the local Aboriginal community have come to feel at ease at Equine Time, while at the same time my equine assisted psychotherapy practice has enhanced the trust I have gained in my counselling practice at the Aboriginal Medical Centre. This harmonious situation led to another PCP therapist, Jocelyn Harper, being invited to join the Tharawal counselling team. Aboriginal people have rejected the Western medical model of Mental Health and prefer to use the term “Social and Emotional Wellbeing”.

I brought together all these emerging understandings in a paper I wrote in July 2016, which described my Therapeutic Model of Intervention for the Improvement of Social and Emotional Well-being. The model was subsequently endorsed by the Board of Governance of the Tharawal Aboriginal Corporation. It is this model I wish to share with you today.

The model is built on a solid foundation of Personal Construct Psychology (Walker, 1993; Leitner, 1993; Viney, 1996; Carter, 2004), and years of careful listening to my clients’ stories. My interventions have been enhanced by tools gathered along the way from Narrative Therapy, Emotionally Focussed Therapy, Interpersonal Therapy, Cognitive Behaviour Therapy and Dialectical Behaviour Therapy. My approach has been further strengthened by more recent findings in neuroplasticity and the sequential development of the human brain (Seigal, 1999; Cozolino, 2002; Perry, 2009; VanderKolk, 2014).

The model is trauma-informed and recovery oriented. It is flexible, being client-centred, strength-based and solution-focussed. It aims for self-mastery and reflective self-awareness. It is about “getting down to the blood and guts level in order to discover the deepest needs of an individual” (Short, 2015, p. 53). The model’s ultimate goal is to guide the person towards their optimal self.

Personal Construct Psychology views the optimal person as having the capabilities to be:

  • Able to construe and reconstrue, i.e., make sense of and then re-order, change, redefine, reflect on and make changes to personal meanings in view of insights gained.
  • Able to reflect on their construing of events, reflecting and revisiting them with new insights. This is assisted by the therapist standing sufficiently back to allow them to see their own constructions for themselves; to give the client “optimal therapeutic distance” (Leitner, 1993 p. 357).
  • Able to withstand some invalidation
  • Able to take initiative in change
  • Able to have differentiated and dispersed dependency
  • Able to elaborate, to be "aggressive" (pro-active) in actively elaborating their worlds
  • Able to experience a wide range of feelings as they develop new meanings as they find themselves stretched beyond their normal range of convenience
  • Free of threat – i.e. open to change, free of stuckness, able to be flexible in their views
  • Able to construe both tightly and loosely – the creativity cycle (CPC cycle)
  • Able to construe the construing of others, and keep their pre-emptive construing positive (especially in relationships).

(Epting & Amerikana, 1980; Winter, 1992)

Optimally, there is a cyclical and balanced interplay of contrasting strategies…(Winter, 2003: p. 202)

The model has five broad modalities:

1. Building a therapeutic alliance.

2. Validation of a person’s emotional experience.

3. Emotion regulation.

4. Reflective Self Awareness.

5. Dispersion of Dependency.

1. Building trust and therapeutic alliance (safety and relationship)

The therapeutic alliance is a truly bidirectional relationship, consisting of three interlocking components:

  • • bonds (interpersonal attachments),
  • • tasks (agreements as to what is to be done in therapy and how various activities in therapy will contribute to the resolution of the client’s problem), and
  • • goals - consensus on the short and long-term expectations between the therapist and client. (Bordin, 1979)

The therapeutic alliance is in fact so central and transcendent that commentators have used terms like “reverence” and “sacred space” to describe therapeutic relationship and its context. (Leitner, 2010; Lancia, 2017)

“Joint creative endeavours are harmonious and often playful in nature; thus, the interaction should be enjoyable and must remain centred on the immediate need of the patient. Co-inception does not occur until the preconceived notions of how things ‘should be done’ are abandoned in favour of a creative process that is stimulated by the uniqueness of the moment and of the person seeking help.” (Short, 2015 p. 52-3).

During her first three months of working at the Aboriginal Medical Centre, my PCP colleague, Jocelyn, discerned that people there have less structure, more chaotic lives, a different sense of time, poorer education and literacy levels, lower self-worth, and more vulnerability to a sense of threat. People we see in therapy talk about being trusted and respected as a novel experience for them. While they have been the givers of trust in the past, the experience of receiving trust and respect is powerfully different. This may be because trust is a major issue for Aboriginal Australians. Aboriginal people have rarely been seen as trustworthy, but have been expected to trust governments and non-indigenous Australians, despite the heritage of deep losses of Country and culture. A client remarked that having access to psychological assistance (a safe place) was very beneficial, and having a sense of being trusted, respected and safe was assisting his improvement.

2. Validation of a person’s emotional experience (Containment and context)

One of the tensions of therapy is that people require validation of their meaning making process, even when some of their individual meanings don’t serve them well (Carter, 2004; Caputi et.al., 2006). Kelly argued that there is no division between cognition and emotion and that emotion signifies “constructs relating to transition” (Kelly, 1955/1991: p.391). Emotions are people’e experiences of, or resistance to, change (Bannister and Fransella, 1986).

Consequently, in my model, the therapist is led by the client, and takes the role of the “interested learner” (Schultz & Stuart, 2015, p.15), especially in cross cultural situations. Therapy takes place within individual differences of meaning and meaning-making, use of words and symbols, spiritual elements and values, as well as concepts of “how healthy relationship are defined” (Schultz & Stuart, 2015, p.15).

The therapist brings an understanding of what it is to be human, a broad knowledge of typical human responses, especially those around equity: justice and injustice, well-being and trauma, trust and distrust. We provide a reflective, compassionate stance with our client as well as towards them and to others in their lives. We understand that our client is a being whom we can never truly know but only guess at from their stories and interpretatively read via body language, as an evolving seeker of wholesomeness.

So PCP therapists use their knowledge of what forms an optimal person, and of the normal desire of humans towards social interaction, wholeness and belonging, and the innate attraction to good rather than evil (Leitner, 2010; Pfaff & Sherman, 2015) to assist their clients.

3. Emotion regulation which includes:

a) Fear - discernment between current threat and perceived threat due to trans-generational trauma – interventions are solution focussed towards safety, self-protection and self-care (Fisher, 1999).

b) Anger - discernment in regard to injustice – interventions are solution focussed towards improved communication, assertiveness and empowerment towards improving wellbeing of self and others (Cummins, 2006).

c) Sadness – represents the body’s response to loss, both physical and perceived losses. Grief is the active expression of sadness. Healing comes from the expression of grief (Wanganeen, 2016) Grief requires a sense of safety (comfort) and resolution of injustices for the active expression of grief and for healing to occur (Neimeyer, 2003).

d) Joy - the experience of play and laughter provides the contrast necessary to create a conduit for change in a person's life (McCoy, 1977).

4. Reflective Self Awareness:

Through creating a story of events and the associated meanings of those events, people develop a greater sense of internal agency (purpose) (Butt, 2004; Metcalfe, Winter & Viney, 2007). This process includes mindfulness (Gendlin, 1979), spirituality and dadirri. Dadirri is an Australian Aboriginal practice that involves inner, deep listening and quiet, still awareness. Dadirri recognises the deep spring that is inside us which calls to us as we call on it. It is somewhat akin to contemplation (Ungunmerr-Baumann, 2002).

5. Dispersion of Dependency (Community integration):

People need social connection and a sense of belonging. The model aims to assist people to build a sustainable support network to maintain their well-being (Walker, 1993).

The Model’s Utility

The model has significant utility in the counselling room; however it truly comes to life in the paddock through equine assisted psychotherapy. The therapeutic intervention is delivered through the playing of games, which is safer for the client, as, initially, the learning from the game is not “playing for keeps” but will be integrated into the person’s construct system when they are ready to internalise it (Kelly, 1955/91; Levine, 2010). This internalisation of meaning will occur when the client finds some worth and adaptability of their new awareness and for the skills they learned in the paddock. While this is taking place the therapist remains curious about the client’s process, within a framework of respect for the client’s self-discovery. The therapists’ attunement or resonance with the client and their world “transmits a feeling of safety” (Perry, 2009; Pearson & Wilson, 2015, p. 97).

At Equine Time we use many games to engage the client in the experimental space. Groundwork games are played with the horses to increase the person’s awareness and provide them with the opportunity to observe other possible behaviours that they may not previously have considered. They may also see in visual space, a valid representation of something they have been grappling with in their life. Therapeutically, the technique of playing of games is psychologically safe because it is foreign to the person’s life, it is novel, and the game and its metaphors provide the canvas for a re-imagining of life, or a re-imagining of an aspect of life, without the same fear of loss anticipated in their “real” life. The novel environment is one which they need not revisit if their experiments do not offer them anything of value; it can be put aside as “just a game”.

Because the value in the game is understood in metaphor, it is often remembered by the person when they need a more useful construct to employ in a new life situation. The lesson is often held by the person as a larger than life visual picture that brings clarity to an otherwise murky awareness.

The game also represents a full embodiment of the experiment. Not just language-based cognition, but learning from doing (Cooper, Hoffman, & Powell, 2009; Barsalou, 2008; Niedenthal, et al., 2005). To fully engage the body in the game makes the experience more real, more visceral and more fully remembered, and therefore more accessible during distress (Fisher, 2003; Van der Kolk, 2014).

An Example of a Session.

The example session provided a game played by a person and a horse, in which the person, guides the horse, by way of a lead rope, through a line of bollards in a weaving pattern. This activity was set up to allow the person to experience constancy and consistency which are essential elements for regulated brain development (Leitner, 2010).

Video of the game 1. With support. https://youtu.be/mkZI-nebdFE

I use the word constancy to mean connection, “I am here, whichever way you turn”, “you are connected to me and I will guide you.” The lead rope becomes a metaphor for attachment. The rope provides direction and motivation. The goal is attunement (Perry, 2009). The relationship is the focus of the activity, and that relationship is in the present moment. This is akin to scientific validity. People need validation from others.

Video of game 2. Self mastery. https://youtu.be/mQviLMScUnE

The word consistency is used to mean predictability, “it is the same pattern over and over again”. This is akin to scientific reliability. The experience of rhythm and structure are necessary for the development of self-regulation. From a neurological developmental perspective, the game provided the person with the opportunity to experience rhythm. A dysregulated person finds the regularity of routine very difficult to maintain, and yet for a well-regulated person, the regularity of routine provides the necessary security to engage in more interesting cognitive pursuits.

The weaving game was a metaphor for the experience of routine and rhythm to assist the person to regulate themselves. Emotional understanding/appreciation/regulation occurs by “doing it”, reflecting on it and seeing it mapped visually and cognitively (Circle of Security, Path to Secure Attachment handout, p.52, Cooper, Hoffman and Powell, 2009).

This is at its most basic level. Note that considerable relationship with the horse needs to be established before this game can be played.

Video of game 3. Relevance. https://youtu.be/awPmjYRd-58

This video is a demonstration game, played by the Horse Specialist who has an ongoing respectful relationship with this horse.So now I want you all to stand up and face your horse. We are reminded that we are always in relationship in the present. Hold your rope in the forward hand to provide direction into the future. Your hands are upturned with open palms. Now I want you to turn your navel towards the future. Take a step into the future, return to being in relationship in the present, then turn your navel towards the past while continuing to move into the future. Turn to the present again, and then face your future again. All the time moving into the future.

As the game is played, other levels of metaphor can be added to the game. Where was your gaze when moving into the future or the present or the past? How did you gaze differ in each dimension?

Now turn and travel in the opposite direction. Was this easier or more difficult?

This rhythmic repetition takes on its own sense of flow, as the person is continually moving into the future, but takes the turn of being in the present and reflecting on the past along the way. The hands represent an openness to the relationship and the leading hand maintains direction.

We called this game ‘The Ebb and Flow of Life’.

The authors of this paper acknowledge the First Nation people of Canada and North America and Australia, and pay our respects to the Elders, past, present and future.

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