The Therapeutic Effects of Equine-Assisted Psychotherapy

NCT04200612 | Completed DMC

• 1 other identifier: S-19-357
• Study Type: interventional
• Target: 102
• Locations: 1 country
• Sites: 1

Brief Summary

Equine-assisted interventions (EAI) are an emerging form of alternate psychotherapy that has been increasingly found to produce improvements in various treatment outcomes. However, the paucity of randomized-controlled trials (RCTs) in the EAI literature prevents any definitive conclusions to be made about the general effectiveness of EAI. This study tests whether one form of EAI, Equine-Assisted Psychotherapy (EAP), reduces aggression and alters risk factors associated with aggression in young adults, and whether emotion regulation mediates any effect of EAP on aggression. In a single-blind RCT, undergraduate students will be randomly assigned to either an intervention group, an active-control group, or a placebo-control group. Participants in the intervention group will undergo a 5-week EAP program consisting of structured, interactive activities with horses followed by a clinical processing component. Participants in the active control group will undergo a 5-week program that only involves interactions with horses without any clinical input (i.e. commonly coined as animal-assisted activities). Participants in the placebo-control group will undergo 5 weeks of 1-hour movie sessions related to horses. There will be three waves of data collection measuring key outcome variables - t1 before the 1st session, t2 after the 3rd session, and t3 after the final session. Participants will complete questionnaires assessing the key outcomes of aggression, emotional well-being and academic performance. Other risk factors of antisocial behaviour such as psychopathy, level of empathy, emotion regulation and executive functioning will also be measured. To the author's knowledge, the current study is the first in Singapore to investigate if EAP can lower aggression levels and alter psychological risk factors for aggression in healthy young adults. In turn, these results could help inform the utility and validity of EAP in the forensic populations.

Conditions

Aggression; Stress; Psychopathy; Empathy

Keywords

Equine-Assisted Psychotherapy; Emotion Regulation; Aggression; Outcomes; Randomized-Controlled Trials

Outcome Measures

Primary Outcomes (18)

• Young Adult Behavioral Scale (YABS)

  Min. Value: 1 (never), Max. Value: 5 (always), higher scores indicate a higher likelihood in the domains of relational aggression, social aggression and interpersonal maturity.

  Immediately before the 1st intervention session

• Young Adult Behavioral Scale (YABS)

  Min. Value: 1 (never), Max. Value: 5 (always), higher scores indicate a higher likelihood in the domains of relational aggression, social aggression and interpersonal maturity.

  Immediately after the 3rd intervention session

• Young Adult Behavioral Scale (YABS)

  Min. Value: 1 (never), Max. Value: 5 (always), higher scores indicate a higher likelihood in the domains of relational aggression, social aggression and interpersonal maturity.

  Immediately after the 5th intervention session

• Reactive-Proactive Aggression Questionnaire (RPQ)

  Min. Value: 0 (never), Max. Value: 2 (often), higher scores indicate higher general aggression levels

  Immediately before the 1st intervention session

• Reactive-Proactive Aggression Questionnaire (RPQ)

  Min. Value: 0 (never), Max. Value: 2 (often), higher scores indicate higher general aggression levels

  Immediately after the 3rd intervention session

• Reactive-Proactive Aggression Questionnaire (RPQ)

  Min. Value: 0 (never), Max. Value: 2 (often), higher scores indicate higher general aggression levels

  Immediately after the 5th intervention session

• Depression Anxiety Stress Scale - 21 items (DASS-21)

  Min. Value: 0 (did not apply to me at all), Max. Value: 3 (applied to me very much, or most of the time), higher scores indicate poorer emotional well-being

  Immediately before the 1st intervention session

• Depression Anxiety Stress Scale - 21 items (DASS-21)

  Min. Value: 0 (did not apply to me at all), Max. Value: 3 (applied to me very much, or most of the time), higher scores indicate poorer emotional well-being

  Immediately after the 3rd intervention session

• Depression Anxiety Stress Scale - 21 items (DASS-21)

  Min. Value: 0 (did not apply to me at all), Max. Value: 3 (applied to me very much, or most of the time), higher scores indicate poorer emotional well-being

  Immediately after the 5th intervention session

• Motivated strategies for Learning Questionnaire (MSLQ)

  Min. Value: 1 (not at all true of me), Max. Value: 7 (very true of me), higher scores indicate greater motivations to learn using the different strategies

  Immediately before the 1st intervention session

• Motivated strategies for Learning Questionnaire (MSLQ)

  Min. Value: 1 (not at all true of me), Max. Value: 7 (very true of me), higher scores indicate greater motivations to learn using the different strategies

  Immediately after the 3rd intervention session

• Motivated strategies for Learning Questionnaire (MSLQ)

  Min. Value: 1 (not at all true of me), Max. Value: 7 (very true of me), higher scores indicate greater motivations to learn using the different strategies

  Immediately after the 5th intervention session

• Emotion Regulation Questionnaire (ERQ)

  Min. Value: 1 (strongly disagree), Max. Value: 7 (strongly agree), higher scores indicate greater likelihood of using the two types of emotion regulation strategies

  Immediately before the 1st intervention session

• Emotion Regulation Questionnaire (ERQ)

  Min. Value: 1 (strongly disagree), Max. Value: 7 (strongly agree), higher scores indicate greater likelihood of using the two types of emotion regulation strategies

  Immediately after the 3rd intervention session

• Emotion Regulation Questionnaire (ERQ)

  Min. Value: 1 (strongly disagree), Max. Value: 7 (strongly agree), higher scores indicate greater likelihood of using the two types of emotion regulation strategies

  Immediately after the 5th intervention session

• Difficulties in Emotion Regulation Scale - Short Form (DERS-SF)

  Min. Value: 1 (almost never), Max. Value: 5 (almost always), higher scores indicate greater difficulties with emotion regulation

  Immediately before the 1st intervention session

• Difficulties in Emotion Regulation Scale - Short Form (DERS-SF)

  Min. Value: 1 (almost never), Max. Value: 5 (almost always), higher scores indicate greater difficulties with emotion regulation

  Immediately after the 3rd intervention session

• Difficulties in Emotion Regulation Scale - Short Form (DERS-SF)

  Min. Value: 1 (almost never), Max. Value: 5 (almost always), higher scores indicate greater difficulties with emotion regulation

  Immediately after the 5th intervention session

Secondary Outcomes (9)

• Self-Report Psychotherapy - Short Form (SRP-SF)

  Immediately before the 1st intervention session

• Self-Report Psychotherapy - Short Form (SRP-SF)

  Immediately after the 3rd intervention session

• Self-Report Psychotherapy - Short Form (SRP-SF)

  Immediately after the 5th intervention session

• Cognitive, Affective and Somatic Empathy Scales (CASES)

  Immediately before the 1st intervention session

• Cognitive, Affective and Somatic Empathy Scales (CASES)

  Immediately after the 3rd intervention session

Study Arms (3)

Intervention Group

EXPERIMENTAL

Participants in the intervention group will go through the 5-week EAP program consisting of the clinical processing following some activities found in EAP manuals.

Behavioral: Equine-Assisted Psychotherapy; Behavioral: Equine-Assisted Activities

Active-control group

ACTIVE COMPARATOR

Participants in the active-control group will undergo a 5-week program that only involves interactions with horses without any clinical input (i.e. commonly coined as animal-assisted activities).

Behavioral: Equine-Assisted Activities

Placebo-control group

PLACEBO COMPARATOR

Participants in the placebo-control group will undergo a 5-week movie screening of 1 hour each session that is related to horses.

Other: Placebo-control group

Interventions

Equine-Assisted Psychotherapy BEHAVIORAL

Equine-Assisted Psychotherapy (EAP) involves working on the psychological goals set between the client and the mental health professional. This is done through the experiential interactions between the clients and the horse. This experiential aspect is vital as it allows clients to process the emotions, thoughts and behaviors that were expressed during sessions with the horse.

Also known as: Equine-Facilitated Psychotherapy

Intervention Group

Equine-Assisted Activities BEHAVIORAL

Simple interactions with the horses that does not necessarily involve any goals being set between the client and the personnel handling the session. These can involve activities such as grooming or petting of the horse.

Active-control group; Intervention Group

Placebo-control group OTHER

This group will only be watching movies related to horses and they are told that this is another form of EAP even though this is not the case. This type of intervention has not been known to provide any therapeutic effect relevant to the study and thus is used as the placebo-control.

Placebo-control group

Eligibility Criteria

• Age: 18 Years - 28 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Do not have any medical allergies or discomfort from interaction with horses.

You may not qualify if:

• Participants who self-report an existing diagnosis for a psychological disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition: DSM-V

Sponsors & Collaborators

• Chua Yi Rong Shawn: lead
• Nanyang Technological University: collaborator
• Therapeutic and Educational Riding in Singapore (THERIS): collaborator

Study Sites (1)

Therapeutic and Educational Riding in Singapore

Singapore, 286965, Singapore

Location

MeSH Terms

Conditions

Aggression; Antisocial Personality Disorder; Emotional Regulation

Interventions

Equine-Assisted Therapy

Condition Hierarchy (Ancestors)

Aberrant Motor Behavior in Dementia; Behavioral Symptoms; Behavior; Social Behavior; Personality Disorders; Mental Disorders; Self-Control

Intervention Hierarchy (Ancestors)

Animal Assisted Therapy; Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Therapeutics; Physical Therapy Modalities; Psychotherapy; Behavioral Disciplines and Activities

Study Officials

• Olivia Choy, PhD

  Nanyang Technological University

  PRINCIPAL INVESTIGATOR

• Lim SM Matthew, PhD, PsyD

  National University of Singapore

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: Participants are informed that they will be randomly assigned to either a EAP horse interaction group or a EAP horse movie group. They are told that this study is meant to investigate the outcomes of two different types of EAP. In actuality, there are 3 groups in total - one intervention and two control groups. Participants in the intervention and active-control group will be told that they are in the EAP horse interaction group whereas participants in the placebo-control group are told that they are in the EAP horse movie group.
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Co-Investigator

Model Details: The design of the experiment will be a single-blind Randomized Controlled Trial. Participants are randomly assigned to either an intervention group, an active-control group or a placebo-control group. Participants in the intervention group will go through the 5-week EAP program consisting of the clinical processing following some activities found in EAP manuals. Participants in the active-control group will undergo a 5-week program that only involves interactions with horses without any clinical input (i.e. commonly coined as animal-assisted activities). Participants in the placebo-control group will undergo a 5-week movie screening of 1 hour each session that is related to horses in the lab.

Study Record Dates

• First Submitted: December 11, 2019
• First Posted: December 16, 2019
• Study Start: January 20, 2020
• Primary Completion: April 9, 2020
• Study Completion: November 6, 2020
• Last Updated: March 3, 2021

Record last verified: 2021-03

Data Sharing

• IPD Sharing: Will not share

Locations

SG (1)