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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

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.