Equine Assisted Services in Children and Adolescents With Mental Illness

NCT05670990 | Withdrawn

• 1 other identifier: F 2022/71
• Study Type: interventional
• Target: N/A
• Locations: 1 country
• Sites: 1

Brief Summary

Due to an increasing amount of children and adolescents are suffering from mental illnesses i Sweden. Early preventive psychological interventions are important to avoid a long-time use of medicines. Animal assisted therapy and especially equine assisted services (EAS) has shown to be a good complementary method to decrease anxiety and/or depression in children and adolescents. The main aim is to study the effect of a specific EAS program regarding symptoms of mental illness and in long-term follow-up of future healthcare consumption. We will conduct interviews with both participants and their parents besides the questionnaires at follow-ups (12 weeks, and 1 year) The intervention will be EAS at a farm following a detailed program, the staff at the farm are specially trained with a certification to practice EAS. Each session will last for about 60 minutes, once a week. Participants will get information of the study by the child and youth psychiatry in the region of Skane, and from student´s health team at elementary schools. Those who want ti participate will contact the study coordinator for full information and informed consent. The EAS model has been used in treatment of adult with mental illness for many years, and the result are very positive. This project provides an opportunity to evaluate the effect of EAS to promote health and prevent severe manifest mental illness among children and adolescents. There are no previous studies of the long-term effect of EAS regarding health consumption.

Conditions

Mental Disorders, Child; Mental Disorder in Adolescence; Anxiety Disorders; Anxiety; Depression; Anorexia Nervosa; School Fear

Keywords

Equine-Assisted Therapy

Outcome Measures

Primary Outcomes (6)

• Change in mood and feelings

  The Mood and Feelings Questionnaire, Swedish version: Short Form. 13 statements with 3 alternatives; Incorrect, Sometimes, Correct. Proportion of participants who change their answer between measuring points Both child and caregiver fill out the form

  1 time each week during 14 weeks and after 12 months

• Mindfulness

  Child Acceptance and Mindfulness Measure, Swedish version, 10 statements that shall be graded in five step scale from Never to Always. Proportion of participants who change their answer between measuring points

  at baseline after 14 weeks and after 12 moths

• Resilience

  Resilience scale, Swedish version, is a 7 graded Likert scale from Incorrect to correct, that consists of 25 statements Proportion of participants who changes their score on the scale between measuring points

  Baseline, after 12 weeks and after 12 months

• Anxiety

  Spence Children's Anxiety Scale Swedish version, 45 statements with 4 alternatives; Never, Sometimes, Often, Always. Proportion of participants who change the score on the scale between measuring points

  At baseline after 14 weeks and after 12 months

• Strengths and difficulties

  Strength and Difficulties Swedish version, 25 statements with 3 alternatives; Incorrect, somewhat correct, Correct Proportion of participants who change their score on the scale between measuring points

  At baseline, after 12 weeks and after 12 months.

• Photovoice

  The participants will take photos by a digital camera or their own cellphone. The photos will be a starting point for a qualitative interview with each participant. Each participant will take 20 photos with a specific significant of their experience of equine assisted therapy. The following interview will be based on their photos.

  12 weeks after intervention start i.e. when the intervention ends.

Secondary Outcomes (1)

• Compliance to intervention

  during the 12 weeks of intervention

Study Arms (2)

Equine assisted therapy

EXPERIMENTAL

once a week during 10 weeks the children will come to "Humlamaden" which is a horse farm with special trained horses and employees with specialist education in psychiatric care. During the time at the farm the child will go through a structured program that starts at the first time with just resting on the horse back under blankets

Other: Equine assisted therapy

Control

NO INTERVENTION

This group will receive treatment as usual and consist of those who is randomized to control group.

Interventions

Equine assisted therapy OTHER

A structured program that has been developed under several years at "Humlamaden" horse farm, for further information see under the description of the experimental group.

Equine assisted therapy

Eligibility Criteria

• Age: 7 Years - 17 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• Age between 7 to 17
• Depression
• Anxiety
• School refusers
• Eating disorders
• Established contact with the child and youth psychiatry in the region of Skane
• Established contact wit the student´s health team at elementary schools in the region of Skane

You may not qualify if:

• Severe allergy to horses
• Do not speak, or do not understand Swedish, spoken and written.
• Do not speak, or do not understand English spoken and written.
• Those who cannot understand the intervention
• Those who do not understand what it means to be in control group

Sponsors & Collaborators

• Peter Nymberg: lead

Study Sites (1)

Halmstad University

Halmstad, Högskolan I Halmstad, 30118, Sweden

Location

Related Publications (13)

• Hoagwood KE, Acri M, Morrissey M, Peth-Pierce R. Animal-Assisted Therapies for Youth with or at risk for Mental Health Problems: A Systematic Review. Appl Dev Sci. 2017;21(1):1-13. doi: 10.1080/10888691.2015.1134267. Epub 2016 Jan 25.

  PMID: 28798541 BACKGROUND

• O'Haire ME. Animal-assisted intervention for autism spectrum disorder: a systematic literature review. J Autism Dev Disord. 2013 Jul;43(7):1606-22. doi: 10.1007/s10803-012-1707-5.

  PMID: 23124442 BACKGROUND

• Wilson K, Buultjens M, Monfries M, Karimi L. Equine-Assisted Psychotherapy for adolescents experiencing depression and/or anxiety: A therapist's perspective. Clin Child Psychol Psychiatry. 2017 Jan;22(1):16-33. doi: 10.1177/1359104515572379. Epub 2016 Jul 27.

  PMID: 26668260 BACKGROUND

• Schultz PN, Remick-Barlow GA, Robbins L. Equine-assisted psychotherapy: a mental health promotion/intervention modality for children who have experienced intra-family violence. Health Soc Care Community. 2007 May;15(3):265-71. doi: 10.1111/j.1365-2524.2006.00684.x.

  PMID: 17444990 BACKGROUND

• Dimitrijevic I. Animal-assisted therapy--a new trend in the treatment of children and adults. Psychiatr Danub. 2009 Jun;21(2):236-41.

  PMID: 19556955 BACKGROUND

• Lee PT, Dakin E, McLure M. Narrative synthesis of equine-assisted psychotherapy literature: Current knowledge and future research directions. Health Soc Care Community. 2016 May;24(3):225-46. doi: 10.1111/hsc.12201. Epub 2015 Mar 2.

  PMID: 25727575 BACKGROUND

• Bachi K, Terkel J, Teichman M. Equine-facilitated psychotherapy for at-risk adolescents: the influence on self-image, self-control and trust. Clin Child Psychol Psychiatry. 2012 Apr;17(2):298-312. doi: 10.1177/1359104511404177. Epub 2011 Jul 14.

  PMID: 21757481 BACKGROUND

• Beebe LH, Tian L, Morris N, Goodwin A, Allen SS, Kuldau J. Effects of exercise on mental and physical health parameters of persons with schizophrenia. Issues Ment Health Nurs. 2005 Jul;26(6):661-76. doi: 10.1080/01612840590959551.

  PMID: 16020076 BACKGROUND

• Acil AA, Dogan S, Dogan O. The effects of physical exercises to mental state and quality of life in patients with schizophrenia. J Psychiatr Ment Health Nurs. 2008 Dec;15(10):808-15. doi: 10.1111/j.1365-2850.2008.01317.x.

  PMID: 19012672 BACKGROUND

• Erdner A, Magnusson A. Caregivers' difficulties in activating long-term mental illness patients with low self-esteem. J Psychiatr Ment Health Nurs. 2012 Mar;19(2):140-5. doi: 10.1111/j.1365-2850.2011.01766.x. Epub 2011 Jun 22.

  PMID: 22070619 BACKGROUND

• Berget, B., et al., Animal-Assisted Therapy with Farm Animals for Persons with Psychiatric Disorders: Effects on Anxiety and Depression, a Randomized Controlled Trial. Occupational Therapy in Mental Health, 2011. 27(1): p. 50-64.

  BACKGROUND

• Holmes, C.M.P., Goodwin, D., Redhead, E.S. et al. The Benefits of Equine-Assisted Activities: An Exploratory Study. Child Adolesc Soc Work J 29, 111-122 (2012). https://doi.org/10.1007/s10560-011-0251-z

  BACKGROUND

• Punzo K, Skoglund M, Carlsson IM, Jormfeldt H. Experiences of an Equine-Assisted Therapy Intervention among Children and Adolescents with Mental Illness in Sweden - A Nursing Perspective. Issues Ment Health Nurs. 2022 Dec;43(12):1080-1092. doi: 10.1080/01612840.2022.2126571. Epub 2022 Sep 30.

  PMID: 36178465 BACKGROUND

Related Links

• Psychiatric care and treatment for children and young. 2019, the National Board of Health and Welfare: www.socialstyrelsen.se, December 2019. p. 118.
• Swedish Agency for Health Technology Assessment and Assessment of Social Services (Statens beredning för medicinsk och social utvärdering, S., Equine assisted therapy (Hästunderstödd terapi). 2019:

MeSH Terms

Conditions

Neurodevelopmental Disorders; Anxiety Disorders; Depression; Anorexia Nervosa

Interventions

Equine-Assisted Therapy

Condition Hierarchy (Ancestors)

Mental Disorders; Behavioral Symptoms; Behavior; Feeding and Eating Disorders

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

• Peter Nymberg, PhD

  Halmstad University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: INVESTIGATOR
• Masking Details: The investigators are not involved in recruitment of the participants, and have connections to them in a roll such as employees at the recruiting locations.
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: PhD

Model Details: The randomization will take place after informed consent has been given. To achieve balance between the two groups (horse-assisted therapy or no horse-assisted therapy) we will use a minimization, so important prognostic factors are evenly distributed between the two study groups, as minimization variables we will use biological sex, age and whether the participants have contact with the child and youth psychiatry or not.

Study Record Dates

• First Submitted: January 2, 2023
• First Posted: January 4, 2023
• Study Start: March 1, 2023
• Primary Completion: January 10, 2024
• Study Completion: January 10, 2024
• Last Updated: January 29, 2024

Record last verified: 2023-03

Data Sharing

• IPD Sharing: Will not share

Locations

SE (1)