Participant information
In terms of personal and
family data, the sample consisted of 13 men and one woman. The mean age of the
participants was 50.14 years [32 to 69 years old; standard deviation (SD)
11.12]. Of these participants, 85.7% were married and 78.6% had between one and
three children. In terms of military career, only one officer-ranked
participant participated in the project. The other 13 were non-commissioned
officers (NCO). The average years of service in the CAF were 20.79 years [12-37
years; SD: 6.96]. Over the course of their military career, the participants
had an average of 4.36 postings [1-10 postings; SD: 2.59] and 2.64 operational
deployments of more than three months [0-7 deployments; SD: 1.78]; however,
78.6% of participants left the CAF for health reasons, 14.3% were released
voluntarily, and 7.1% for misconduct. Of the participants, 57.1% left the CAF
between 2011 and 2016. All participants have a formal diagnosis of a mental
health problem by a mental health professional. The participants’ diagnoses
are: PTSD (10); PTSD and Anxiety Disorders (1); PTSD and Substance Use Disorder
(1); and Depressive and Anxiety Disorder (2). At the time of the study, all
participants were still in treatment with a psychologist (12) and/or
psychiatrist.
Evaluation of
equine-assisted therapy experience following the 10 sessions
The main differences
with clinical treatments received in the past
The first difference, for
half of the participants, between equine-assisted therapy and psychotherapy is
the experiential/practical nature of the first one. The participant has to
interact with the horse, with the facilitators, and has to think and react. He
must also be attentive to his emotions and behaviours in order to understand
the nuances in the horse's reactions. Some participants stated that the horse's
feelings and the "mirror effect" of the horse's behaviours are added
values of equine-assisted therapy. Equine-assisted therapy involves being constantly
in action, as opposed to the static nature of a psychotherapy session. Interacting
with an animal, working with an animal as if it were the psychologist. It's
special, an animal, a horse, it doesn't have a "poker face", and it
will react a lot to our emotions, even if we try to hide them. You may want to
control your frustration, but it's going to know. I find that you can't hide or
diminish what you're feeling. Even if you say, "Ah, I'm in a good
mood," but it's going to know if you're not, more than someone (another
person) who just listens to you. The interaction is very different.” The second
difference, for half of the participants (7), is that equine-assisted therapy
represents another way of approaching the problem or part of the problem, due to
the presence of the horse in the intervention. One participant explained that
psychotherapy "digs" into wounds with the help of speech, and that
this is very demanding and tiring, all in an unwelcoming environment. In
equine-assisted therapy sessions, the place seems more neutral, and the horse,
by its presence, plays a mediating role in the intervention on emotions and
behaviours. This participant believes that the presence of the horse is
soothing, as is being outdoors in nature, that it is a privileged moment
between man and animal, and that these interactions help to make the link with
the present moment. According to him, equine-assisted therapy would be less
exhausting than psychotherapy. "The first notable difference is the
environment. In psychotherapy, you're in an office. White walls, then almost
nothing on the walls, with two chairs, and you're sitting with a box of
Kleenex, there. Then, a clock that you don't see, but he sees it, and then he
says it's time to end the session. Whereas over there, it's not like that. You
arrive, there are boxes and horses. There's a lot going on. There's activity.
There are horses being cleaned, being walked. It's as if you arrive in one
environment, while the other is not a living environment. It's a place that I
personally more or less like to go to (psychologist's office). Before, during
my military service, I didn't want to go there at all, so the physical
difference is noticeable.”
"Not the same
context at all. Then, when I left, yes, I was a little tired, but not as tired
as I can be with Ste Anne's Hospital So, it's a good therapy that tires me less
than an office therapy, and then I work just as hard.” The majority of
participants (10) also noted that equine-assisted therapy is a complementary
type of treatment to psychotherapy. Therefore, they do not consider
equine-assisted therapy as an alternative treatment to psychotherapy. A few
participants believe that the optimal treatment, depending on the nature of the
mental health problems, is a combination of psychotherapy offered by a
psychologist, pharmacotherapy offered by a psychiatrist and equine-assisted
therapy taught by an equine specialist and a mental health professional. In
addition, according to some participants, repeating some of the experiences of equine-assisted
therapy during psychotherapy sessions helps to progress and link theory to
experiences, while putting what has been learned into perspective in an overall
treatment plan. According to one participant, the psychologist supervising the
psychotherapy should obtain the member's permission to communicate with the
mental health professional and with the equine specialist introducing
equine-assisted therapy. He believes that collaboration between these different
types of care (psychotherapy, pharmacotherapy and equine-assisted therapy)
would contribute to significant positive outcomes for PTSD treatment. "One
could very well complement the other by working, by preparing. Psychotherapy
could prepare for equine-assisted therapy. Equine-assisted therapy could be a
complement, like a kind of clinical team that talks to each other. They can
complement each other, and it would be up to me to make the connection, and
perhaps with my psychologist. I talk about all my frustrations of the day,
whereas in equine-assisted therapy, I will work more on the symptoms, the
injury, and play with the images. But I think a good link between the two could
be something quite interesting!”
"It's a plus in my
case, it's very complementary to the work I do with my psychologist in the
office. I bring things that come from equine-assisted therapy, and then she
puts them in her own words, so that I can understand them and then there's
that, I have a report, and I put it into practice, because I don't understand
everything they want to do in equine-assisted therapy, so it's good to put it
into context. The context in equine-assisted therapy is completely different.” That
said, one participant felt that a treatment sequence prior to integration into
equine-assisted therapy should be proposed. He considers that psychotherapy
should be preparatory to equine-assisted therapy because it allows the
participant to grasp the theoretical and clinical elements related to his
condition. Over the course of the sessions, the person is better able to
understand his condition and symptoms. According to this participant, it is
only once the person has recognized his condition and managed to stabilize his
condition and medication that equine-assisted therapy should be added to his
treatment plan for equine-assisted therapy, you have to have gone through a
fairly long therapeutic process before you can do that. Because I find it hard
to conceive that I, when I had just been diagnosed, would embark on therapy as
well. I think I would have been far too fearful or too stressed. I feel like it
takes a little bit of therapy, at least to know your symptoms and then how you
feel. I don't think it would work if you're not all there. Because I don't
think you can get there with the full symptom to do equine therapy. Because I
couldn't imagine myself doing that in the first place. You also have to have
good control. Then after that, in my opinion, it can become super beneficial.”
Table 1: Information on
participants.
|
Name of participant *
|
Biographical information
|
Academic level
|
Family income (in $)
|
Reason of release
|
Rank in CAF
|
Years in CAF
|
# of postings
|
# of deployments
|
|
Denis
|
Between
50 and 60 years old, male, married with between 0 and 2 children
|
Professional
|
Less
than 59 999
|
Medical
|
NCO
|
22
|
4
|
2
|
|
Steven
|
Between
40 and 50 years old, male, separated with between 0 and 2 children
|
High
School
|
60
000 to
99
999
|
Medical
|
NCO
|
17
|
4
|
4
|
|
Omer
|
Between
40 and 50 years old, male, divorced with between 0 and 2 children
|
Professional
|
Less
than
59 999
|
Medical
|
NCO
|
26
|
4
|
3
|
|
Julien
|
Between
50 and 60 years old, male, married with more than 3 children
|
High
School
|
60 000
to
99
999
|
Medical
|
NCO
|
37
|
4
|
3
|
|
Ghislain
|
Between
50 and 60 years old, male, married with between 0 and 2 children
|
University
|
Less
than
59
999
|
Medical
|
NCO
|
21
|
8
|
2
|
|
Gilbert
|
Between
40 and 50 years old, male, married with between 0 and 2 children
|
High
School
|
Less
than
59
999
|
Medical
|
NCO
|
21
|
3
|
4
|
|
Jean
|
Between
60 and 70 years old, male, married with between 0 and 2 children
|
High
School
|
Less
than
59
999
|
Medical
|
NCO
|
31
|
10
|
3
|
|
Camil
|
Between
60 and 70 years old, male, married with more than 3 children
|
Professional
|
Less
than
59
999
|
Voluntary
|
NCO
|
20
|
7
|
3
|
|
Jocelyn
|
Between
40 and 50 years old, male, married with between 0 and 2 children
|
University
|
60 000
to 99 999
|
Medical
|
Officer
|
22
|
4
|
2
|
|
Ludovic
|
Between
30 and 40 years old, male, married with between 0 and 2 children
|
Professional
|
More
than 100,000
|
Medical
|
NCO
|
20
|
6
|
7
|
|
Jerome
|
Between
50 and 60 years old male, married with between 0 and 2 children
|
High
School
|
60 000
to
99
999
|
Voluntary
|
NCO
|
15
|
1
|
0
|
|
Jasmin
|
Between
30 and 40 years old, male, married with between 0 and 2 children
|
High
School
|
Less
than
59
999
|
Medical
|
NCO
|
14
|
2
|
3
|
|
Mylene
|
Between
60 and 70 years old, female marroed
with between 0 and 2 children
|
High
School
|
Moins
de
59
999
|
Misconduct
|
NCO
|
12
|
3
|
0
|
|
Tony
|
Between
40 and 50 years old, male, married with between 0 and 2 children
|
High School
|
60 000
to
99
999
|
Medical
|
NCO
|
13
|
1
|
1
|
The continuation of equine-assisted
therapy
Most participants (12)
are committed to continuing equine-assisted therapy sessions. There appears to
be as many reasons to continue with EAT-VAP as there are participants in the
study. Some participants spoke of the need for more sessions in order to
continue their progress and consolidate their gains. Other participants simply
appreciate the environment and the relationship with the horses. "Ah,
that's for sure I'm going to continue, because that's what has done me the most
good so far! So, it's like my time of the week when I take care of myself and
then my head! It puts things back in place, and then you also do a little bit
of thinking when you finish the session.”
Equine-assisted therapy
recommendations to their brothers and sisters in arms
The 14 participants in
this research project would recommend EAT-VAP to their brothers and sisters in
arms who have a mental health condition. "Well, I would recommend it to
anyone. It takes you completely out of your zone. So, especially the military,
it takes you completely out of your comfort zone, because you can't control the
situation. So, yes, I would recommend it, because it teaches you, especially
people who are very Cartesian, who are very white/black, well, it teaches you,
okay, we're going to work in the grey zone.”
"I would say that
you should try it, because it's done me a lot of good, and you can be surprised
at what the horses bring you. I would say, 'At least try a session to see, and
it doesn't commit you too much. I would reorder it at 100 miles per hour.”