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Group Process and Facilitation in Equine Assisted Mental Health

Group Process and Facilitation in Equine Assisted Mental Health Free Essay


The benefits of communication between man and horse are known since ancient times. The treatment by using horses is used for physical and mental illnesses, particularly, effective can be at work with children, suffering from disorders of the musculoskeletal system, autism, and psychosocial status. This method of psychotherapy accelerates their social adaptation and helps to recover faster. It is important to understand that during group sessions and facilitation in equine assisted mental health, a horse is the most important participant, because it offers the great possibilities to patients with mental problems. Equine-Facilitated Psychotherapy (EFP) differs from hippotherapy. EFP horse is well-trained and is in friendly relations with a psychotherapist. EFP gives patients a perfect opportunity to evaluate their personal perception with the help of a horse. It occurs due to a horse’s ability to read others and give feedback to a person that is a helpful element in the treatment.

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Group Process and Facilitation in Equine Assisted Mental Health


Horseback riding as a method of rehabilitation of wounded soldiers has come from ancient times. People understood that animals were good companions for sick individuals, and they were used for therapeutic purposes for different illnesses. However, equine-facilitated psychotherapy (EFP) was introduced in the 1960s in the United States (Lentini & Knox, 2009). Since then, horses have become an integrated part of the mental health therapy. In EFP, a therapist should be well aware how to communicate with horses, working with them in mental therapy. EFP is a type of animal-assisted therapy (AAT) that is successfully used in recent years in the United States and other countries to help patients with therapeutic mental problems. Therapists use different methods in EFP that incorporate different theories. Some therapists use mounted instructions such as vaulting while others prefer un-mounted activities such as leading and herding. Others use the combinations of different techniques. Despite different approaches and techniques, therapists come into conclusion that horses help riders improve balance and relax muscles what benefit their psychological abilities. This paper attempts to observe the group process and facilitation in equine assisted mental health.

History of EFP’s Development

The first known in the history of medicine experience in human patient care through contact with animals was recorded in 1792, in England (Chandler, 2012). Psychiatric patients in addition to the basic treatment had to take care of small pets, whereby in some cases occurred in the relief of their condition. About 200 years ago, in the vicinity of York, there was a monastery, where monks used to work with animals as a medicine, saying that prayer and animals helped aggravated diseases of soul and body (Knapp, 2012). In the 19th century, the center of epilepsy treatment was founded in Germany, where an additional method of communication with animals was used by patients (Fine, 2011). The very concept of “therapy involving animals” has formulated the U.S. child psychiatrist Boris Levinson in the 1960s, noting the positive response of young patients at his dog, accidentally caught in the clinic (Kruger & Serpell, 2006).

EFP is a method of using different types of therapeutic effects on the human psyche through the establishment of a deep personal contact with a patient. It helps persons overcome problems in the desired directions. There are different types of psychotherapeutic procedures, because each person needs its own approach. The research asserts that a horse is used as a form of therapy for troubled youth, drug addicts, and people with disabilities (Olmert, 2010). In the process of training for the care of horses and riding, a patient develops important social skills such as self-confidence and patience. The impressive size of a horse and a timid character help patients overcome their fear and anger. Admittedly, horses are not the only animals involved in such treatment. In addition, they also use dolphins, elephants, monkeys, and other animals.

Furthermore, horses are perfect for psychotherapeutic work because they have a calming effect and social character. Due to their social experience, horses can respond to various events that stay unnoticed by people. It occurs because a horse was trained by humans for many years, and it is accustomed paying attention to details. The literature reveals that it has become the main reason for using horses in programs directed to treating patients with mental and physical disabilities (Vidrine, Owen-Smith, & Faulkner, 2012). According to Zacks (2009), communication with the animal world does not leave a person indifferent, causing a feeling of affection, based on modern areas of mental and physical rehabilitation, what creates a real-life method of psychological support through interaction with animals and their symbols.

What Is EFP?

EFP means the inclusion of horses in the psychotherapy sessions of patients with mental and physical problems. This concept differs from hippotherapy, which includes a therapeutic riding of patients with special needs. A horse used in this therapy is usually carefully selected and well-trained to establish friendly relationships with a psychotherapist. Many findings reveal that vaulting was employed in the group therapy activity (Lentini & Knox, 2009). In ancient times, vaulting, which presented gymnastics or dance on the back of a horse, was featured in the ancient sport along with horse racing (Trotter, 2012). Nowadays, many therapists do not particularly mention vaulting in the treatment sessions, but they point out that a horse has the power to teach humans, especially children and adolescents, how to behave in groups. Horses send messages to participants with body language, and therapists teach individuals how to read equine body language. Gradually, participants learn about herd behavior and dynamics, observing horses in a herd environment.

The idea of a group process and facilitation in equine assisted mental health is based on horses’ sensitivity to the human mental changes and emotional states (Walters & Baldwin, 2011). Horses can smell these changes and respond to them. Therefore, the animal acts as a biofeedback machine, informing a therapist about a client’s emotional state. A horse adapts to a client’s behavioral change, responding to his or her mood. It gives an opportunity for both a therapist and a patient to provide certain measures for the further therapy. Participants, realizing a horse’s energy and movements, learn their body language that helps them to interpret their messages that come from every part of their body. When communicating with a horse, a client should consider the energy that is produced during it. The balance of energy allows a horse truly respect humans, reading each other.

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Group Activities

Group activities during the treatment sessions require different stages of arrangement. According to Knapp (2012), each group has its own peculiarities, based on personal characteristics and needs of participants. The first step involves the acquaintance that encourages every person to feel more relaxed. However, most of the members may feel helpless and unsure of themselves. Therefore, the second stage is relevant to defuse anxiety. During the third stage, members may search for different positions in a group. Often, negative attitudes are expressed toward a group leader. At the fourth stage, some potential leaders may struggle with one another for the leading positions. The following stages sharpen the relationships between group members, encouraging them to get better results during therapy.

After the establishment of friendly relations with each other, participants start to develop the relationships with animals, trying to adapt to various situations. To succeed in the treatment, members of the EFP sessions take specific training, communicate with knowledgeable professionals, and receive a variety of opportunities such as mentoring and internships. Experienced group members can interact with their peers through social networks, participate in advanced training, and improve their knowledge in ethics and standards (Chandler, 2012). The work in groups allows participants experience happiness and return to outside world. Others want to communicate with one another in the future while some of them are ready to quit and never meet again.

Group psychotherapy involves the use of interpersonal interaction patterns in the treatment group, achieving physical and mental well-being. According to Chandler (2012), the uniqueness of group therapy is that one of the main tools of psychotherapy itself is a group of people, their experiences, feelings, and relationships with each other. Group psychotherapy during EFP sessions is not an independent direction of psychotherapy rather it is a form of work with the group, which may be based on different theoretical approaches.


To understand EFP, it is important to analyze some conceptual models. The findings reveal that the first model describes the relationship between a patient, therapist, and animal that creates a triangle and determines the behavior of a patient and horse (Kruger & Serpell, 2006). According to this model, a horse’s behavior is interpreted to a patient, and he tries to reflect on his own affect and behavior. The second model is based on the interaction of therapist, patient, animal, and his handler, who can observe how a patient and a therapist are affecting a horse. Fine (2011) believes that horses are affected by the discrepancies between the observed and expected behavior. For example, a teenager experiences rude behavior because he cannot contact with people, but rather push them away. A horse, in its turn, can teach a child how to move his body, because he is very sensitive to the human energy. Thus, they move away from excessive energy, and usually approach those who are unaggressive and calm. In such situations, the youth can learn how to respect someone’s boundaries and stay in good relations with him.

Various studies assert that EFP theories predict that clients learn different things: starting from more physical concepts such as relaxation and finishing with psychological ideas such as self-awareness (Zacks, 2009). EFP also allows making frameworks of abstract schemes of unconscious. The literature reveals that horses are very sensitive to humans, because it relates to their demand to survive (Olmert, 2010). Horses can respond to the personal internal state regardless of his desire to disguise it. Therefore, patients may have perfect perspectives after the EFP session. For example, people’s problems relating to closeness or physical contact after being carried by a horse improve their associations about physical closeness with men.

Another theory is based on the conceptualization of rhythm that takes part in the child’s development (Walters & Baldwin, 2011). Equine therapy helps to build body-identity and correct pre-verbal dialogue. In fact, the relationship between humans and horses is unique, because people can ride them, unlike cats or dogs. A specific skin contact is created when a person rides a big and supporting horse. Admittedly, a child has a bigger body weight ratio than between an infant and a mother. Moreover, a horse interacts with a person in a more appropriate physical way than a therapist.

Some studies use an analogy comparing the Freud’s id, ego, and superego to a horse, patient, and therapist, respectively (Vidrine et al., 2012). A horse may be viewed as the object of transference. A patient’s repressed id can be associated with vitality and impulsivity of a horse. Finally, a therapist acts as superego, encouraging a horse and rider to behave safer. In other words, a therapist shows a patient how to control the animal keeping its vitality (Trotter, 2012). Thus, a therapist achieved his therapeutic goal through ego strengthening.

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Facilitator and Participant Engagement

The main task of a facilitator is to engage participants in a group process and facilitation in equine assisted mental health. All methods of group psychotherapy conventionally are divided into: basic and auxiliary, verbal and nonverbal (Lentini & Knox, 2009). The main method of group psychotherapy is a group discussion, the others are considered as secondary. At the same time, all methods of group psychotherapy have two basic functions – psychodiagnostic and psychotherapy itself. More often, any facilitator tries to do his best when engaging a patient and a horse, when responding to a patient’s needs. These needs have the higher priority than existing theoretical approaches. Facilitators are often seen in a circle with patients, discussing various issues. Horses are usually working around ready to join the circle. First of all, a facilitator aims to establish contact between a patient and a horse, taking into consideration the safety of participants.

Usually, facilitators analyze conscious and unconscious ways of patients’ engagement into the session, looking for a safe place. The conscious ways include the following steps: (a) learning and practicing new behaviors, (b) identifying possible behaviors of a horse, (c) determining the opportunities for feedback, and (d) discussing self-regulations related to trauma. The unconscious ways include self-regulation of emotions and responses to certain situations. Some other aspect to consider is the process of releasing of oxytocin in horses during the EFP relationship with a patient. As a rule, a horse’s behavior is always changing and impacts the EFP sessions. At any time, during the session, a facilitator may choose to intervene skillfully to improve interpersonal communication, problem-solving, and personal growth.


The paper has demonstrated the benefits of communication between man and horse that are known since ancient times. EFP sessions use horses to treat patients with physical and mental illnesses. They are particularly effective at work with children, suffering from different psychological disorders. This method of psychotherapy helps to recover faster and accelerates patients’ social adaptation. It is important to understand that during group sessions and facilitation in equine assisted mental health, a horse is the most important participant because it offers the great possibilities to patients with mental problems. Therapists use different methods in EFP that incorporate different theories. Some therapists use single or the combinations of different techniques. Despite different approaches and techniques, therapists come into conclusion that horses help riders improve balance and relax muscles what benefit their psychological abilities.

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