The Impact of Equine-Assisted Therapy on Communication Within Familial Relationships of Veterans With Posttraumatic Stress Disorder

PURPOSE: A significant percentage of veterans returning from war between World War II and Operation Iraqi Freedom have been diagnosed with posttraumatic stress disorder (PTSD; Plach & Sells, 2013). Many veterans with PTSD demonstrate poor communication skills, which may hinder family functioning and impair their ability to successfully reintegrate with their family and valued occupations within the home and community (Marsanic, Margetic, Jukie, Matko, & Grgic, 2013). While prior research supports the use of equine-assisted therapy (EAT) with clients with various mental health diagnoses, it is unclear how EAT may impact veterans with PTSD in regard to familial communication. The purpose of the study was to explore the impact of EAT on veterans with PTSD in regard to familial relationships, verbal communication, interpersonal behaviors, and conflict resolution.

DESIGN: The study used a phenomenological approach. Emails were sent to equine facilities throughout the United States, asking for assistance in identifying potential participants for the study. Participants were combat veterans at least 18 yr of age who served in any branch of the military and who were diagnosed with PTSD after returning from combat. Each participant completed one or more EAT sessions performed by a certified EAT professional after the year 2010 and was involved in a familial dyad consisting of a child or children under the age of 18 yr and/or a significant other, both for at least 1 yr.

METHOD: Each participant engaged in a semistructured phone interview focusing on the impact of EAT on familial communication and relationships. All interviews were transcribed; a three-step process was used for data analysis (Patten, 2012). Open coding was used to examine ideas and experiences of the participants that arose during the interview and identify basic themes. Axial coding was then used to identify relationships between the categories that were identified during open coding. Lastly, selective coding was used to identify major themes highlighting the impacts of EAT on familial relationships and communication.

RESULTS: Four male combat veterans were interviewed. Three broad themes emerged from the interviews: conflicts prior to EAT, the process of EAT, and the breakthrough. Participants expressed that before EAT, they felt angry the majority of the time, which influenced how they responded to conflicts and disagreements. They felt disconnected from familial relationships, including those with significant others and children. During EAT, participants had to work in partnership with the horse, establish a trusting relationship with the horse, and learn how to work with each animal’s unique personality, which contributed to the effectiveness of therapy. Each participant reported applying what they learned through EAT to daily life situations to enhance familial communication. Participants stated they were able to utilize conflict resolution strategies, better regulate emotions, and communicate more effectively with their families and those around them after EAT.

CONCLUSION: Results highlight the positive impact of EAT on participants’ communication within the family dyad through improvements in conflict resolution strategies, emotional regulation, and relationship skills.

IMPACT STATEMENT: This study provides preliminary evidence supporting the use of EAT with veterans to address concerns in the areas of familial relationships, verbal communication, interpersonal behaviors, and conflict resolution. Because this was a small qualitative study, additional research is recommended to generate higher level evidence regarding the impacts of EAT on familial communication within this population.

References

Marsanic, V. B., Margetic, B. A., Jukie, V., Matko, V., & Grgic, V. (2013). Self-reported emotional and behavioral symptoms, parent–adolescent bonding and family functioning in clinically referred adolescent offspring of Croatian PTSD war veterans. European Child and Adolescent Psychiatry, 23, 295–306. https://doi.org/10.1007/s00787-013-0462-2

Patten, M. L. (2012). Understanding research methods: An overview of the essentials (8th ed.). Glendale, CA: Pyrczak Publications.

Plach, H. L., & Sells, C. H. (2013). Occupational performance needs of young veterans. American Journal of Occupational Therapy, 67, 73–81. https://doi.org/10.5014/ajot.2013.003871