YATEP - The Impact of Horse Assisted Therapy (HAT) on Treatment Outcomes (HAT)

The Impact of Horse Assisted Therapy (HAT) on Treatment Outcomes

The objective of the study is to assess the impact of horse assisted therapy (HAT) on:

• Addiction treatment outcomes (its effectiveness as an alternative therapy)
• Addiction treatment dropout & addiction relapse (its efficacy in preventing dropout).

Hypothesis: HAT will correlate with:

• beneficial treatment outcomes of depression, anxiety, aggression
• with improved self esteem & motivation
• lower treatment dropout & addiction relapse.

Study Overview

• Status: Completed
• Conditions: Addiction
• Intervention / Treatment: Behavioral: Mentalization based inpatient treatment.; Behavioral: Horse assisted Therapy (HAT)

Detailed Description

Background Inclusion of horses in therapeutic settings is a scientific issue with significant social and health implications in Norway. Challenges include increasing provision of horse assisted therapy of variable quality to vulnerable population groups with little substantiating evidence of associated benefit(s) due to lack of research, design issues, mainstream clinicians'/scientists' scepticism of "alternative therapy" and associated difficulties in attracting top researchers and funding. Extensive review of literature found a growing volume of studies but as indicated in the most recent systematic review, there are few studies with adequate research design.

Oslo University Hospital's Dept of Addiction Treatment - Youth (AUA) presents a unique research/evaluation potential to study HAT. It will treat approximately 100 patients per year aged 16 to 26 years with a primary diagnosis of addiction. Horse assisted therapy (using AUA's residential herd) is an integral part of the addiction therapeutic program. Furthermore, AUA's strong emphasis on research and its Youth Addiction Treatment Evaluation Project (YATEP) data base will provide an evidence base needed for sound study in an emerging area of science and psychotherapy.

Patient drop out from addiction therapy is high, often exceeding 50% (Stark 1992). Many AUA patients claim that they remain in treatment because of the horses.

The study is a randomised controlled trial of in-patients undergoing treatment. The Participant Group has treatment as usual plus HAT; the Control Group treatment as usual.

Participant and control groups are drawn from AUA patients (aged 16 to 26 years of age with a primary diagnosis of addiction International Classification of Diseases (ICD F10-F19), admitted between 2013 and 2014 to AUA's in-patient unit and who have consented to participate in research.

HAT is a structured program of 12 X 90 minute therapeutic sessions with horses, including horse care, ground and mounted work, conducted by two clinically qualified therapists who are also Level I Riding Instructors.

• Study Type: Interventional
• Enrollment (Actual): 50
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Norway
  • Oslo, Norway, 0514
    • Department of addiction treatment - youth

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 16 years to 26 years (Child, Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Primary diagnosis of addictionInternational Classification of Diseases ICD F10-F19, admitted in 2011-2014 for treatment at AUA's in-patient unit

Exclusion Criteria:

• Ongoing psychoses

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Treat as usual + Horse assisted therapy ( HAT); Treatment as usual means mentalization based inpatient treatment. Horse assisted therapy(HAT) is a structured program of 12 X 90 minute sessions (horse care, ground and mounted work) conducted by two clinically qualified therapists.	Behavioral: Mentalization based inpatient treatment.; 1-3 month of inpatient treatment; Behavioral: Horse assisted Therapy (HAT); A structured program of 12 X 90 minute HAT sessions (horse care, ground and mounted work) conducted by two clinically qualified therapists who are also Level I Riding Instructors.
Active Comparator: Treatment as usual; Treatment as usual means mentalization based inpatient treatment.	Behavioral: Mentalization based inpatient treatment.; 1-3 month of inpatient treatment

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Lower treatment dropout	Reason for treatment exit, including drop out, is obtained from data recorded in the Department's YATEP data base.	Within treatment period of upto 3 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Lower emotional distress (composite measure)	The measure tests whether depression, anxiety and depression improve with horse assisted therapy (as claimed in non-scientific/popular horse literature). Measurements are taken using Hopkins Symptom Check List (HSCL-25) and Severity Indices of Personality Problems (SIPP-118) from data recorded in the Department's YATEP data base.	Within the treatment period of upto 3 months
Improved self-esteem	The measure tests whether self-esteem improves with horse assisted therapy (as claimed in non-scientific/popular horse literature). Improvement will be measured using the Rosenberg Self Esteem Scale from data recorded in the Department's YATEP data base.	Winthin the treatment period of upto 3 months

Collaborators and Investigators

• Sponsor: Oslo University Hospital
• Collaborators: The Research Council of Norway; Swedish-Norwegian Foundation for Equine Research
• Investigators: Study Chair: Espen KA Arnevik, PhD, Oslo University Hospital

Publications and helpful links

General Publications

• Gatti F, Walderhaug E, Kern-Godal A, Lysell J, Arnevik EA. Complementary horse-assisted therapy for substance use disorders: a randomized controlled trial. Addict Sci Clin Pract. 2020 Feb 4;15(1):7. doi: 10.1186/s13722-020-0183-z.

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2013
• Primary Completion (Actual): June 1, 2016
• Study Completion (Actual): December 1, 2016

Study Registration Dates

• First Submitted: July 6, 2012
• First Submitted That Met QC Criteria: February 18, 2013
• First Posted (Estimate): February 21, 2013

Study Record Updates

• Last Update Posted (Actual): October 8, 2020
• Last Update Submitted That Met QC Criteria: October 5, 2020
• Last Verified: October 1, 2020

More Information

Terms related to this study

• Keywords: clinical trial; psychotherapy; Horse Assisted Therapy (HAT); Equine Assisted Psychotherapy (EAP); Randomised Controlled Trial (RCT)
• Additional Relevant MeSH Terms: Compulsive Behavior; Impulsive Behavior; Behavior, Addictive
• Other Study ID Numbers: HAT-11-1