Complementary horse-assisted therapy for substance use disorders: a randomized controlled trial

Francesca Gatti, Espen Walderhaug, Ann Kern-Godal, Jeanette Lysell, Espen Ajo Arnevik, Francesca Gatti, Espen Walderhaug, Ann Kern-Godal, Jeanette Lysell, Espen Ajo Arnevik

Abstract

Background: Treatment completion is the greatest challenge for the treatment of substance use disorders (SUDs). A previous investigation showed that complementary horse-assisted therapy (cHAT) was associated with higher retention in treatment and completion than standard treatment alone. This randomized controlled trial further explored the benefits of cHAT for patients with SUDs.

Methods: Fifty patients in residential SUD treatment at the Department of Addiction Treatment, Oslo University Hospital, were randomly allocated to either cHAT (cHAT group) or treatment as usual alone (TAU-only group). The primary end-point was treatment completion. Secondary end-points were dropout, transfer to another treatment, and time in treatment.

Results: The multinomial logistic regression analysis found no statistically significant association between intervention (cHAT) and treatment outcome (completion, dropout, transferred) among the 37 participants who were ultimately recruited to the study. Some unforeseen challenges were encountered in the study: a high number of subjects transferred to another treatment, variable attendance at cHAT sessions, and long temporary exits. Nevertheless, 44% of participants in the cHAT group completed their treatment, compared with 32% in the TAU-only group; this observation encourages further investigation in a larger sample.

Conclusions: Though no association was identified between cHAT and treatment retention or completion, our study may have been underpowered. Further work in a larger clinical population is needed; observational studies with repeated measures may also be useful for investigating whether cHAT increases retention in treatment or rates of completion, two important factors for successful SUD treatment. Trial registration The trial was registered and approved on 14 October 2011 by the Regional Committee for Medical and Health Research Ethics with registration number 2011/1642 and registered at ClinicalTrials.gov on 21 February 2013 with registration number NCT01795755.

Keywords: Addiction; Comorbidities; Dropout; Equine-facilitated psychotherapy; Horse-assisted therapy; Randomized controlled trial; SUD; Substance use disorder.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Study flowchart
Fig. 2
Fig. 2
Treatment outcomes. a Time in treatment for subjects in cHAT vs. TAU-only. Data are represented as a scatter dot plot, where each dot indicates a subject at the time of discharge (days). The mean with SD is reported. b Survival curve representing treatment completion and dropout events for patients in complementary HAT (cHAT) vs. Treatment as Usual only (TAU-only) group, relative to time in treatment (days). Each dot indicates a subject. Treatment completion (censored subject) is indicated by a dot on the horizontal line; dropout (event) is indicated by a dot on a downward step (in the cHAT group, two subjects were censored on day 168)

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Source: PubMed

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