A retrospective study of a psychotherapy incorporating horses for veterans with PTSD

Psychotherapy incorporating horses is often provided to veterans with posttraumatic stress disorder (PTSD), though research is limited. The Whispers with Horses (WwH) intervention was developed to address one of the challenges associated with conventional mental health interventions among this population, limited treatment engagement. Further, WwH was designed to be a structured and manualized intervention that would facilitate multisite controlled trials. This study assessed the feasibility of implementing WwH. Specific study aims were to assess: (1) feasibility, (2) safety, (3) accessibility/utilization and (4) engagement. This was a retrospective chart review study of a two-year trial of implementing WwH. Demographic, diagnostic and utilization data were extracted from electronic health records. Enrollment, attendance, no-show and completion rates were utilized to evaluate treatment engagement. There were 231 participant referrals and 40 % attended at least one session. Four hundred and twenty-three sessions of therapy were provided with no adverse events. The mean number of sessions attended was 3.6, the no-show rate was 3.4 % and the completion rate was 62 %. These findings suggest that it is feasible and safe to implement WwH within a clinical setting. Also, no-show and completion rates may be equal, or possibly superior, to those associated with conventional mental health interventions for this population. Thus, if confirmed by additional studies and shown to be effective through rigorous outcome studies, the intervention may provide a mechanism to help address treatment engagement challenges among veterans with PTSD. Further studies of WwH are warranted, including randomized clinical trials. • Psychotherapy incorporating horses may benefit veteran trauma survivors. • Whispers with Horses is a promising therapy model for this population. • This intervention may have better treatment engagement than conventional approaches. • Randomized controlled trials are warranted.