A Pilot Observational Study of the Development and Utilization of a Psychotherapy Incorporating Horses Program at a Veterans Health Administration Medical Center

Psychotherapy incorporating horses (PIH) is often provided for veterans, though research is limited. Investigations are needed to explore how these services might be implemented and utilized. This study evaluated the safety, implementation and utilization of an PIH program. In addition to the overall program, data were collected for a specific PIH intervention, Whispers with Horses (WwH). This was a retrospective study of the first 46 months of implementation. Three hundred and forty veterans were referred to the program and 230 (68%) were enrolled. Seven hundred and nine sessions of PIH (637 individual and 74 group) were provided to veterans without any adverse effects to participants, staff or equines. Regarding WwH, 125 veterans were enrolled. The mean number of sessions attended was 3.64 (out of 6) and 66% were considered completers (attended > 50% of sessions). Additionally, 26% attended all sessions and the no show rate was 11%. These results indicate that it is feasible and safe to implement an EAS program within a VHA medical center. Treatment engagement was superior to VHA conventional mental health services with no-show and completion rates of 40% and 9.1% respectively. Thus, these results also suggest that a RCT of WwH is warranted.