Exploring Equine-Assisted Psychotherapy as an Intervention for Those Who Have Received a Diagnosis of Emotionally Unstable Personality Disorder

Exploring the Effectiveness of Equine Assisted Psychotherapy on the Emotional Regulation and Mental Wellbeing of Service Users in an Inpatient Setting Who Have Received a Diagnosis of Emotionally Unstable Personality Disorder

The purpose of this research is for the multi-disciplinary team at an inpatient psychiatric hospital to investigate more innovative ways to engage service users in order to promote wellbeing and emotional regulation. In particular, there is a focus on engaging patients who do not routinely engage with the Psychology Team. As such, we are aiming to explore the effectiveness of Equine Assisted Psychotherapy (EAP) with the service users on a specialist Personality Disorder ward.

EAP is the deliberate inclusion of an equine (e.g. horse, alpaca) amongst a therapy team to improve patient outcomes. This therapy team includes a mental health professional and certified equine specialist, along with equine(s) and client(s). EAP can offer specific psychotherapeutic treatment goals such as addressing trauma and emotion dysregulation. The presence of an equine removes the need for verbal communication, which allows for non-verbal approaches that support self-development; identifying and discussing the feelings, emotions and behaviours generated through interaction with the horse. The presence of equine also provides a unique opportunity for traumatised individuals to build trust with other sentient beings that value connection, safety, and trust.

These specific psychotherapeutic treatment goals are especially relevant for those with a diagnosis of Emotionally Unstable Personality Disorder (EUPD). Service users with EUPD present with complex mental health difficulties, often with problems with emotional regulation, attachment, and self-harm.

This research will use a qualitative, single arm design in which all participants (inpatients who have received an Emotionally Unstable personality Disorder diagnosis) engage in a novel psychotherapeutic intervention (6 sessions of Equine-Assisted Psychotherapy). Their experiences of this psychotherapeutic intervention will be explored using semi-structured interviews. Researchers and participants will collaborate in using Thematic Analysis to analyse the content of these interviews.

Study Overview

• Status: Not yet recruiting
• Conditions: Emotionally Unstable Personality Disorder, Borderline Type
• Intervention / Treatment: Behavioral: Equine-Assisted Psychotherapy

• Study Type: Interventional
• Enrollment (Estimated): 6
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United Kingdom
  • Somerset
    • Weston-super-Mare, Somerset, United Kingdom, BS22 9UZ
      • Cygnet Hospital Kewstoke
      • Contact: Dr Sharon Collins; Phone Number: +441934 428989; Email: kewstokeresearch@cygnethealth.co.uk
      • Contact: Lewis Byrne; Phone Number: +441934 428989; Email: lewisbyrne@cygnethealth.co.uk

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Inpatient on the ward (name of ward not included for confidentiality).
• Has received a diagnosis of Emotionally Unstable Personality Disorder.
• Since participants will be under Section 3 of the Mental Health Act, they must have the required Section 17 therapy leave at the time of recruitment.
• Service users will have been assessed for their capacity to consent by the Multi-Disciplinary Team and deemed to have capacity at the time of recruitment.
• All participants on the ward are female and between 18-65.

Exclusion Criteria:

• If the Multi-Disciplinary Team's assessment is that they do not have capacity to consent.
• Those who do not have the relevant Section 17 leave.
• Patients who have a planned discharge date that is before the intended end date of the research.
• Patients who have previous experience with Equine Assisted Psychotherapy.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Equine-Assisted Psychotherapy; All participants will attend 6 half-day sessions of Equine-Assisted Psychotherapy. This is a type of psychotherapy in which the professional(s) and the client(s) are joined by an equine. This will be conducted at a specialist clinic by a member of their facilitator team. There will also be hospital staff on-hand to provide support if needed, but they will not be involved in the therapy directly. The therapy will involve a group session (1 hour and 15 minutes long), and individual sessions (30 minutes per participant).

Behavioral: Equine-Assisted Psychotherapy; All participants will attend 6 half-day sessions of Equine-Assisted Psychotherapy. This is psychotherapy between the professional(s) and the client(s) which takes place in the presence of an equine (e.g. horse, alpaca). This will be conducted at a specialist clinic by a member of their facilitator team. There will also be hospital staff on-hand to provide support if needed, but hospital staff will not be involved in the therapy directly. The therapy will involve a group session (1 hour and 15 minutes long), and individual sessions (30 minutes per participant).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Perception of Emotional Regulation	This will be measured via semi structured interview questions and the thematic analysis of participants' responses. It will focus on whether participants notice a difference in how they are able to regulate their emotions following therapeutic intervention and, if so, what that change is and why participants think that change has happened.	From enrolment to 1 week after end of last Equine-Assisted Psychotherapy session. This should be a maximum of 8 weeks in total.
Perception of Connection to Others	This will be measured via semi structured interview questions and the thematic analysis of participants' responses. It will focus on whether participants notice a difference in how they are able to connect with others following therapeutic intervention and, if so, what that change is and what they think caused it.	From enrolment to 1 week after end of last Equine-Assisted Psychotherapy session. This should be a maximum of 8 weeks in total.
General Experience of Therapeutic Intervention	This will be measured via semi structured interview questions and the thematic analysis of participants' responses. It will focus on how the participants felt about the therapy e.g. what they liked/disliked about it and which aspects were meaningful to them.	From first therapy session to one week after the last Equine-Assisted Psychotherapy session. Up to 7 weeks in total.
Perception of how Equine-Assisted Psychotherapy compares to other therapies.	This will be measured via semi structured interview questions and the thematic analysis of participants' responses. It will focus on how the participants felt this therapy compared to other therapies they have experience e.g. In what ways is it better/worse?	From first therapy session to one week after the last Equine-Assisted Psychotherapy session. Up to 7 weeks in total.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Intervention Retention Rate	The number of participants that withdraw from the intervention.	From start of first Equine-Assisted Psychotherapy session to end of last Equine-Assisted Psychotherapy session. The Equine-Assisted Psychotherapy runs for 6 weeks in total.
Intervention Attendance	The number of Equine-Assisted Psychotherapy sessions each participant attends.	From start of first Equine-Assisted Psychotherapy session to end of last Equine-Assisted Psychotherapy session. These run for 6 weeks in total.

Collaborators and Investigators

• Sponsor: Cygnet Healthcare
• Collaborators: Track Clinic, Frome

Study record dates

Study Major Dates

• Study Start (Estimated): May 1, 2026
• Primary Completion (Estimated): July 1, 2026
• Study Completion (Estimated): September 1, 2026

Study Registration Dates

• First Submitted: November 17, 2025
• First Submitted That Met QC Criteria: December 2, 2025
• First Posted (Actual): December 3, 2025

Study Record Updates

• Last Update Posted (Actual): May 8, 2026
• Last Update Submitted That Met QC Criteria: May 7, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Personality Disorder; Equine Assisted Psychotherapy
• Additional Relevant MeSH Terms: Mental Disorders; Personality Disorders; Therapeutics; Physical Therapy Modalities; Patient Care; Psychotherapy; Behavioral Disciplines and Activities; Rehabilitation; Aftercare; Continuity of Patient Care; Animal Assisted Therapy; Equine-Assisted Therapy
• Other Study ID Numbers: 364995

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No