An Experimental Design for Insurance Approved Equine-Assisted Therapies for Veterans with Post-traumatic Stress Disorder

The Hypothalamic-Pituitary-Adrenal Axis, or the HPA axis, is vital to normal physiological functioning throughout the body. It is also an important aspect of the body's stress-response system. Dysfunction in the stress-system can be characterized by hyperactivity and/or hypoactivity. Post-Traumatic Stress Disorder (PTSD) is a psychiatric disorder that is accompanied by acute or chronic alterations to the stress-response. PTSD is categorized as a stress or anxiety related disorder that arises after exposure to a traumatic situation. PTSD symptoms can be attributed to hyper and hypoactivity of the stress-response. There has been a growing desire for alternative therapies for psychiatric disorders, as such PTSD. The United States' government has suggested multiple treatments for PTSD and related symptoms, as PTSD is extremely prevalent within veteran populations. They are also constantly seeking data on new treatment methods in order to better provide for diagnosed veterans. Currently, there is no one method of choice for the treatment of PTSD, and many current methods are considered ineffective. Animal-assisted therapies are an alternative form of therapy that is rapidly growing in popularity. Many agree these therapies, including equine-assisted activities, are effective treatment modalities. In relation to trauma survivors, equine-assisted therapies may be particularly valuable. There are vast amounts of studies that demonstrate that horses may be excellent therapy animals. However, much of this literature involves sample sizes that are too small to support valid conclusions. Better follow-up measures would also be beneficial in order to demonstrate any long term effects, as most current studies focus on immediate outcomes. Furthermore, one of the largest criticisms of equine-assisted therapies is that most of the current literature provides only subjective data. When it comes to assessing equine-assisted activities, evidence needs to be much less subjective, as a verified therapy may be covered financially by an insurance company. Insurance companies make many of their coverage decisions based on statistical evidence presented in peer-reviewed literature. Unfortunately, due to the lack of hard evidence, it is a rarity that equine-assisted therapies are covered by insurance companies. Similarly, they are not a common form of therapy. People, especially those suffering, need to be aware that alternative forms of therapy exist, as not everyone responds well to conventional therapies. There are current projects in action at the University of Maine-Orono that are attempting to demonstrate that equine-assisted activities can be effective in treating PTSD, particularly in a population of diagnosed veterans. In the group, some veterans will be randomly selected to participate in equine-assisted activities, while the others will be wait-listed for the same activity. During the activity, PTSD and anxiety scores will be assessed, as well as self-reports of psychological well-being. Blood and salivary Cortisol samples will also be taken from each participate, in order to obtain data that can be statistically analyzed and evaluated. The hopes of these current projects are to demonstrate, qualitatively and quantitatively, that equine-assisted activities are effective in a therapeutic setting, and show medical insurance companies that they can treat them as valuable forms of therapy.