Compiled and Presented by Jezey Wolf
Recently, there has been a rise in novel and alternative therapeutic approaches to supporting Trauma clients. This review will look to understand the research around a few of these. Specifically this review will look at Equine-assisted therapy (also known as Equine facilitated and Equine guided) (EAP), other animal assisted therapies (AAT), trauma-informed/focused Yoga (TIY) and psychedelic therapy (PT).These approaches typically encourage clients to move off the therapist’s couch and engage their bodies and minds and novel ways, encouraging them to connect more deeply with themselves, be it through grooming a horse, building a projection to lead a horse through, the somatic experiences of Yoga or experiencing altered states and perspectives.
These activities, experiences and movement patterns are things an individual would likely not find themselves typically doing day-to-day; this undoubtedly forms part of clients’ attraction to these novel approaches. Although new, these bottom-up and novel approaches have been shown to have solid neurophysiologic underpinnings
Recent research into trauma survivors has shown promise with the use of non-traditional forms of therapy
Historical approaches to treating trauma and its subsequent conditions, such as Post Traumatic Stress Disorder, include things such as Cognitive Behavioural Therapy and Prolonged Exposure Therapy. These often involve the client being asked to revisit past traumas
The author has selected this topic due to their personal experience as an Equine assisted practitioner and one who often leverages other typically novel approaches in the therapeutic experience for trauma clients. This, combined with these areas of specialty rapidly growing in popularity and availability, it is determined that understanding the literature around the approaches is a key step in supporting these methods in gaining wider social acceptance as valid therapeutic ways to support clients, along with identifying areas needing further research into efficacy.
Research FindingsEquine and Animal Assisted Therapies
There is a growing body of research into animal-assisted therapy (AAT), Equine-assisted psychotherapy (EAP) and their role in supporting trauma clients. Multiple components are at play when considering why or how these modalities support positive outcomes. The first to consider is the therapeutic approach; research into Equine-assisted therapy has suggested that while Equine-assisted therapies can be delivered within the practitioner’s preferred theoretical background, it typically have four main underpinnings. These are brief therapy, Gestalt therapy, reality therapy, and Adlerian therapy
There however, does not seem to be evidence of a general direction underpinning the therapeutic approach to AAT. Next is the novel element – the horse or the animal, etc. The research around how animal-assisted therapies typically integrate a therapeutic approach is varied. The animal is sometimes simply employed adjunct to traditional therapy, offering the client things such as warmth, weight on the legs or co-regulation, through to entirely holistic animal-human approaches where the animal works as an agent of change.
However, there seems to be no clear consensus as to what the standard format of an animal-assisted therapy approach is. Equine Assisted Therapy, unlike AAT, does tend to have some greater alignment on the approaches. Typically, the horses will be an equal part of the session with the therapist, and activities would vary from herd observations and leading or grooming tasks to obstacle courses. There is also a combination of approaches from the ground or mounted on the horses. The horse will be a crucial function in the session, acting as a key agent of change and co-regulator
A recent study indicated animals reportedly support reduced anxiety and hyperarousal, given that their presence is related to the secretion of oxytocin
Along with the benefits described above, EAP specifically, is also suggested to help support a stronger relationship between the therapist, support adaptation skills, promote resiliency, and positive attachment
Consequently, the replicability of existing studies is impeded, and the standardisation of existing treatments remains unaddressed. Moreover, there is a lack of uniformity across the diverse array of available approaches, and several fail to offer a cohesive set of generalisable techniques, thereby constraining the dissemination of effective treatments. There is also a current lack of standardisation of therapeutic framework integration – thus making measuring in a standardised way the effectiveness of the interventions challenging.
A growing body of people who have experienced trauma are either intentionally or unintentionally tuning to Yoga for relief of their distress and symptoms
Recently, a program called iRest has gained momentum with the US Department of Veterans Affairs; this program is considered a modern adaption of Yoga Nidra
The use of psychedelics, namely Psilocybin and MDMA – 3,4-methylenedioxy-methamphetamine (MDMA), in the therapeutic environment for the treatment of mental health conditions has been part of the mental health landscape for many years, Its use was more common prior to the 1970’s/19080’s when it was up scheduled and criminalised, however despite this, organisation like the Multidisciplinary Association for Psychedelic Studies has continued to advocate and lobby for its use and continued extensive research into its effectiveness. In many countries around the world, these products are still heavily controlled or criminalised.
However, Australia has this year (June 2023) down-scheduled both MDMA and Psilocybin for use in treating PTSD and treatment-resistant depression
The universal sentiment in the research observed is that these approaches have favourable impacts in supporting trauma clients. However, the studies are small, and the lack of standardisation of approaches. This makes drawing conclusive parallels and observations of efficacy challenging
Equine-assisted therapy has demonstrated effectiveness in facilitating mind-body connections, promoting empathy development, building safety through non-triggering interactions, and enhancing self-regulation through co-regulation mechanisms. Notably, Equine Facilitated Therapy for Complex Trauma (EFT-CT) has shown promising outcomes, indicating reduced trauma symptoms, improved interpersonal skills, enhanced cognitive functioning, and the development of positive coping strategies.Trauma-informed/Focused Yoga (TIY) offers an alternative avenue for individuals seeking relief from trauma-related distress. TIY acknowledges the interconnectedness of the mind and body in the healing process by emphasising movement, self-regulation, and somatic awareness. The gentle and invitational approach of TIY allows participants to control their level of engagement, fostering a sense of safety and empowerment. While historically marginalised due to legal and social constraints, psychedelic therapy has recently regained attention as a potentially transformative approach.
Substances like MDMA and Psilocybin have shown promise in assisting clients in revisiting and processing traumatic memories with reduced anxiety, leading to significant improvements in conditions like PTSD and treatment-resistant depression. Despite the promising research and recent legal advancements, the stigma and potential for misuse still pose challenges to the widespread adoption of psychedelic therapy. Overall, these novel therapeutic approaches challenge traditional trauma treatment methods by focusing on embodied experiences, sensory integration, and unique avenues for healing. The research discussed in this review highlights the potential of these interventions to provide profound and lasting benefits to trauma survivors.
However, it is evident that further research is needed to establish standardised protocols, assess long-term effectiveness, and address the potential barriers to wider acceptance and implementation. As the field of trauma therapy continues to evolve, these innovative approaches hold the promise of expanding the therapeutic landscape and enhancing the well-being of trauma clients.
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