Equine-Assisted Short-Term Psychodynamic Psychotherapy and the Role of Personality Functioning, Emphasizing Self-Control and Identity integration

Abstract Patients with maladaptive personality functioning often experience poorer outcomes in psychotherapy. However, little is known about the role of personality functioning in animal-assisted psychotherapy. This study examines the role of personality functioning in Equine-assisted short-term Psychodynamic Psychotherapy (ESTPP) for adults with intrapsychic and interpersonal problems (N = 92), comparing it to treatment-as-usual (TAU, N = 107) using an exploratory non-randomized pre- and post-treatment design. We assessed psychological dysfunction and personality domains, including self-control, identity integration, responsibility, relational capacities, and social concordance, while also exploring the impact of therapeutic alliance on outcomes. Despite higher psychological dysfunction scores in ESTPP participants, linear mixed models demonstrated significant improvement in psychological dysfunction in both conditions. Higher levels of personality domains were associated with lower psychological dysfunction in ESTPP, except for self-control. However, higher baseline scores of self-control and identity integration were linked to weaker improvement in psychological dysfunction in both conditions, with ESTPP showing less improvement in identity integration. The therapeutic alliance did not significantly influence the outcomes. While ESTPP may benefit highly distressed patients, those with severe personality problems might require additional support, particularly in self-control and identity integration. This underscores the significance of exploring personality functioning to enhance therapy outcomes. Further research and application of ESTPP is warranted.