Integrating Wilderness and Equine Therapy, Thesis Paper Example

Abstract

The field of equine-assisted therapy (EAT) offers exciting and rewarding possibilities for clients, subjects, and patients suffering from a wide range of psychological, behavioral, emotional, and socialization disorders.  Equine-assisted therapies are being used to treat everything from posttraumatic stress disorder (PTSD) to autism; beyond the treatment of psychological and physiological disorders, some EAT programs are designed to offer assistance to at-risk youth and to people of all ages struggling with addictions and other behavioral disorders.  Wilderness therapy (WT), involving outdoor activities centered on a variety of behavioral and psychotherapeutic concerns, takes a similarly unconventional therapeutic approach while adding group- and trust-building exercises in unfamiliar and challenging surroundings.  Both EAT and WT are flourishing fields, and the available literature on these subjects grows by the day.  This paper is intended to provide an introductory overview to those who are unfamiliar with the possibilities offered by EAT and WT, followed by a discussion of what occurs when the therapies work together.

Equine-Assisted Therapy (EAT)

Equine-assisted therapy (EAT) is an exciting and rapidly expanding field.  EAT involves placing horses in contact with patients or subjects in a setting that is both rustic and clinical.  While EAT is a relatively young therapeutic field, it has its roots in the millennia-old relationship between humans and horses.  To the uninitiated, one horse may appear the same as the next, but as “horse people” will explain, horses are as diverse in personality as are human beings.  Not every horse is a candidate for EAT, but a horse with the appropriate temperament can be a rewarding source of comfort and healing for patients with a wide range of physical and psychological challenges (Jarrell, 2009).

The North American Riding for the Handicapped Association has been offering programs that bring together persons with physical limitations and horses for decades (Sumner, 2011).  Such programs are not limited to riding; patients for whom riding is not appropriate can still benefit from interacting with horses.  When riding is not feasible, patients can walk or use wheelchairs alongside horses, while those with even more profound limitations—or those who are simply too timid to ride or walk alongside horses—can still enjoy the pleasure of interacting with these beautiful animals, engaging in feeding, grooming, or simply being near them (Sumner, 2011).

Though there is little specific information about where and when such programs began, horses and other animals have increasingly been used in conjunction with psychotherapeutic practices in recent decades (Gehrke, Baldwin, & Schiltz, 2011).  Many people are familiar with the practice of using “companion animals” as adjuncts to psychotherapy, though the prevalence of EAT programs may be less well-known to the general public.  For those who are aware of the existence of EAT, the idea makes perfect sense; horses are perhaps second only to dogs in having garnered well-earned reputations for their seeming love of humans (Gehrke et al., 2011).

For the purposes of this discussion, the umbrella term equine-assisted therapy refers to any use of horses as a therapeutic resource for persons with any and all physical, psychological, or emotional disorders.  The use of EAT as a means of intervening on behalf of at-risk youth is growing in popularity; for some young people, EAT provides their first time spent in rural settings and in the company of animals other than house pets.  For children and adults who have difficulty forming relationships or who have communication difficulties, communicating with horses nonverbally can be a profound experience.

EAT can be helpful in a wide variety of circumstances.  For subjects with physical limitations or injuries, for example, riding horses can aid in the development of motor control, balance, and core muscles(Bender &McKenzie, 2006).  For subjects with psychological, behavioral, or emotional disorders, working with horses can provide a scenario wherein the subject can benefit from a form of nonverbal communication that is non-confrontational and nonjudgmental (McClean, 2011).  At-risk youth who are disaffected and lacking in positive role models can benefit greatly from the lessons afforded by EAT; working with horses teaches responsibility and allows subjects to cultivate positive, nurturing relationships (Sheffield, 2009).

Subjects who have suffered from psychological trauma, such as those with PTSD, can benefit greatly from EAT (McClean, 2011).  PTSD affects not only the subject, but also his or her family, friends, and coworkers. The damage wrought by PTSD can make it difficult for sufferers to cultivate or maintain positive relationships; those with PTSD often find themselves isolated from spouses, children, and other family members.  Working with horses in the context of EAT allows individuals with PTSD and other psychological disorders to develop close relationships with their therapy animals that they would find difficult to form with humans (McClean, 2011).

Because the relationship between horses and humans is a nonverbal one, it fosters in subjects a set of communication skills that might otherwise be lacking.  In effective therapy, subjects develop or expand an ability to pick up on nonverbal cues and “body language”; this form of interaction affords an opportunity for those who have difficulty communicating to develop the ability to understand not just their therapy animals, but human beings as well.  Such development can be beneficial to those with a variety of conditions, from attachment disorders to Asperger’s syndrome and other conditions on the autism spectrum (Memesevic & Hodzic, 2010; Rothe et al., 2005).

As a means of providing context, the following pages provide a synopsis of a case study that utilized EAT.

This study, reported by author Barbara McClean (2011), does not meet the standards for a scientifically controlled study.  As is the case with WT (which will be addressed later), EAT is a young field, and there are no standardized core competencies or accreditations pertinent to it.  This should not be taken to mean that EAT is scientifically invalid, or that research is not needed to determine the potential effective uses of EAT.  Quite the opposite is true; the anecdotal evidence clearly demonstrates that EAT offers positive experiences, and potentially beneficial outcomes, for those who undergo it.  The lack of standardization should not deter research; it should spur it.

Because the program McClean (2011) investigated could not be measured scientifically, outcomes for involved subjects were determined though analysis of self-reported surveyresponses gathered before and after the program took place.

The subjects for the study were a group of retired military veterans, all of whom were or had previously been enrolled in various psychological and mental-health programs offered by the Veterans Administration and Veterans Hospital in Albany, New York.  Each subject participated in the same EAT program; while the subjects’ results could not be compared to those of other studies, they could be compared among each other.

The program took place over the course of 6 weeks.  Participants were asked to fill out general surveys about their physical and mental health and to respond to specific queries about their goals for treatment in the EAT program.  The goals identified ranged from “improving verbal and non-verbal communication skills” to “lessening anxiety” to “building self-confidence” (McClean, 2011).  After identifying their individual goals, participants wereasked to rank the severity of their individual issues on a scale of 1 to 10.

During the program, each subject participated in a series of activities designed both to improve the individual’s skills with horses and to foster the actual therapeutic content of the program.  To a degree, the activities constituted the therapy, as each was designed to build incrementally on the activity that came beforeit.

The program’s activities began with a process called “groundwork,” wherein each participant was guided through basic horse skills, from grooming to walking the horse on the property.  This groundwork also facilitated the development of communication skills between horse and subject; these skills would then be used for further activities.

The primary activities for each subject were a series of “games”; these games were goal-specific tasks that required the subjects to lead their horses through a series of jumps and other maneuvers.  None of the games involved any significant risk for subject or horse; it was not the skill level of the game that changed, but rather the intricacy. Each game involved an increasingly complex series of commands and responses between subject and horse. In general, each horse already knew the particular skills that comprised each game; it was the number of steps in each game and the order in which they were performed that mattered in terms of successful completion.

Effective communication between subject and horse was the fundamental component of each game.  Subjects who grew impatient or otherwise failed to communicate with their horses efficiently and effectively were less able to complete each game in a timely fashion.  Where and when communication grew strained between subject and horse, staffers were on hand to redirect the activity and to reinforce positive communication skills for each subject.

At the end of the 6-week program, subjects were asked to fill out the same survey each had completed at the beginning of the program.  Overall, subjects’ responses to the questions noticeably improved, demonstrating personal satisfaction with EAT.  The following are several anonymously-reported comments from a few of the subjects who participated in the program:

I learned there is another way of doing things besides “kicking them in the ribs.” This is another way to communicate, and I can use it when communicating with my wife.

Being with the horses helps me relax.  I learned to be more patient.

I can feel the ground under my feet.  I haven’t felt that in a long time.  I feel present in the moment.

I was able to be assertive without feeling guilty.

I learned the difference between being assertive and being aggressive.

I feel good about myself and what I’ve been able to do (McClean, 2011, p. 20).

These responses, while positive, do not constitute valid evidence that EAT is a sound method for conducting psychotherapy.  The lack of standards for developing programs, as well as the lack of agreed-upon core competencies for potential EAT practitioners, are serious hindrances to conducting controlled experiments.  Despite these hindrances, the number of EAT programs and facilities across the United States is ever-growing, and more professional psychotherapists than ever before are developing individual programs for these facilities.  Those who are interested in undergoing EAT or becoming professionally involved in the field has access to a nearly endlessamount of resources to aid their research into the subject.

Wilderness Therapy (WT)

The concept of wilderness therapy or adventure therapy is not a new one; the first documented use of WT as an actual therapeutic model dates to the Outward Bound programs begun in the 1960s.  There is no specific definition of WT, nor is there one particular model underpinning the concept.  Add to the various definitions of WT the fact that such programs target subjects with everything from particular psychological disorders to at-risk youths involved in adjudication-intervention programs, and it becomes clear that a better understanding of WT must be offered.

Though the aforementioned information may make it appear as thoughWT programs are entirely ad hoc affairs, many programs are built on solid therapeutic foundations.  Most programs are designed with the aid and participation of licensed psychotherapists, and the long-term success of any WT program is contingent upon the development and maintenance of an integrative approach to treatment after the program has concluded (Frandzel, 1997).

While there are no “typical” WT programs, most consist of a set of activities that vary in design and difficulty over a set time frame.  Participants may camp, canoe, rock climb, and engage in other outdoor activities.  These activities are planned in advance, and it is imperative that the guides and therapists are well-versed in surviving the rigors of the experience, as well as in basic first aid and other skills appropriate for the programs.

Numerous studies have attested to the success of WT programs, with many finding that such programs offer benefits comparable to traditional psychotherapy in a shorter amount of time (Eikanaes, Gude, & Hoffart, 2006).  Subjects in traditional psychotherapy meet with their therapists for 50 minutes per session, and many learn to “parrot” the terminology they believe is expected of them (Frandzel, 1997).  Wilderness therapists are often afforded the opportunity to see through parroting; most subjects cannot fall back on familiar responses, as the therapy itself is unfamiliar.  This context allows therapists to determine the issues and concerns particular to each subject more quickly and to address these issues in the moment.

In an article entitled “What Is Wilderness Therapy?” author Keith C. Russell explored the history of WT programs, examined the therapeutic foundations for such programs, and asserted that WT is in need of organization and accreditation to best serve future clients.Russell noted that most of today’s WT programs have roots in the Outward Bound programs.  Outward Bound, designed as an alternative to incarceration for at-risk and delinquent youth, offered an opportunity for subjects to become involved in group activities of a nature that was largely unique for most of them.  Outward Bound and the programs it has inspired should not be confused with the much-publicized “boot camps” that gained popularity and notoriety in the last few decades, claimed Russell.  Boot camps are designed to offer grueling courses that “break down” subjects so that they can be “built back up” (Russell, 2001).

Wilderness therapy programs are not designed to “force” change, but rather to “allow” change to happen (Russell, 2001).  In most WT settings, subjects are exposed to a series of outdoor activities that offer a “high level of perceived risk, but little actual risk,” noted Russell (2001, p. 70). Activities are typically planned to increase in difficulty and to require increasing levels of group participation as each is completed (Russell, 2001).  The purpose of most programs is to foster subjects’ ability to draw on their own reserves of inner strength, build trust between therapist and subject, and cultivate the skills needed to depend on the larger group to achieve success.

Russell (2001) stated that most “wilderness therapists” are not necessarily accredited or licensed in a particular psychotherapeutic field; skills in the wilderness and the individual’s ability to build a track record of satisfied clients largely determine what makes a good wilderness therapist.  Because this a relatively new and emerging field, lack of accreditation is understandable, though Russell (2001) asserted that the field of WT must move toward standardization and recognition by the psychotherapeutic community if it is to develop into a measurable, quantifiable, and ultimately legitimate field of psychotherapy.

A decade after Russell’s discussion ofWT and the lack of standardization in the field, little has been resolved.  The authors of a2010 study that aggregated a wealth of material on the subject found that many of the same problems related to the varying definitions of and approaches to WT still exist.  In “Wilderness Therapy as a Specialized Competency,” Houston, Knabb, Welsh, Houskamp, and Brokaw(2010) claimed thatWT programs, and those who wish to enter the WT field as psychotherapists, must first agree on a set of “common therapeutic components” that comprise WT.  This would seem to be especially true in light of the fact that individual settings for WT programs vary wildly with local geography, weather, and other factors pertaining to the conduct of therapy in outdoor settings.

It is clear that standardized competencies and goals, when reached, could be the lens through which settings for therapy are viewed when developing site-specific programs.  The very nature of wilderness settings, and the diversity of the environments in which WT can be conducted, makes the need for standardization even greater.

Houston et al. (2010) did, in fact, identify several key components that they asserted underlie effective WT programs.  The fundamental element unique to WT is that “the setting itself is therapeutic,” offering subjects a context in which their typical physical and emotional responses—which are often directed or suppressed by anger or fear or other negative emotions—must be abandoned in favor of drawing on problem-solving skills, trust, and other behavioral and emotional reserves that may typically be dormant (Houston et al., 2010,p. 52).

Despite some consensus about the most general of therapeutic underpinnings in the field of WT, there are certainly fewer agreements than disagreements where therapeutic approaches in WT are concerned.  Russell (2001) described “trends” in the evolving field of WT:

“WT programs are searching for recognition by state agencies, national accreditation agencies, insurance companies and mental health professionals. These trends support the idea that consistent WT practices may be emerging which support the use of a consistent definition”(p. 70).

Historically, most WT programs have been built on recognized psychological foundations.  Taking the Outward Bound program as a starting point, most WT programs fall under the broader heading of “wilderness experience programs” (WEPs; Russell, 2001).  WEPs are loosely defined as organizations set in the wilderness that offer subjects an opportunity to develop personal growth, undergo therapy or education, and cultivate team-building and leadership skills (Brady, Hernandez, & Guay, 2011).

Outward Bound was founded by German educator Kurt Hahn.  His program was intended to offer opportunities for at-risk and delinquent youth to develop WEP-related skills.  Hahn’s Outward Bound organization valued “learning through doing,” offering an experiential context that placed a premium on the cultivation of values and the development of character; as such, this “Hahnian” view came to be seen more as a psychological framework than as an educational one, and this pervading view has steered most research in the field (Brady et al., 2011).

Subsequent researchers and developers of WT programs would build on this psychological foundation, and some consensus would be reached about the core precepts underlying WT.  This consensus puts forth the following WT criteria:WTis a group, and not an individual, therapeutic process; it presents challenges that grow increasingly difficult over the course of the program; it offers some traditional therapeutic techniques within the context of the “wilderness experience,” such as journaling, reflection, and counseling; and it takes place in wilderness or outdoor settings that are unfamiliar and presumably challenging to subjects (Russell, 2001).

In order for WT to achieve recognized status as a legitimate tool of psychologists, those involved in the development and operation of such programs must reach consensus on the core competencies that support them.  The development of these core competencies will likely only come through concerted efforts to establish industry standards; as it stands now, no organizations exist to establish these fundamental standards (Houston et al., 2010).  Despite the current absence of a professional organization designed to represent the concerns of all WT programs, research into the field continues independently (Houston et al., 2010).

The advantages offered by the establishment of standardized competencies are clear; primary among them would be the development of educational curricula and accreditation particular to students who wish to enter the field (Houston et al., 2010; Russell, 2001).  Standardization of the requisite academic goals for therapists would also lead to increased standardization of the manner in which WT programs are designed and implemented.  Currently, most programs are relatively site- and therapist-specific, tailored to suit the demands of the therapeutic environment and the particular training and competencies acquired by each program’s therapists.

Despite the lack of industry standards, Russell recounted several “definitions,” or models, that are generally applicable both to many WT programs and to those who operate them (Russell, 2001).  Russell detailed how Kimball and Bacon referred to those who operate such programs as “wilderness therapists,” and how these wilderness therapists, lacking a specific academic accreditation or licensing, by necessity bring a varied skill set to bear in their respective programs.

Davis–Berman and Berman, according to Russell (2001), posited a more traditional view of WT; they described the wilderness setting as context while asserting the need to maintain fairly strict therapeutic approaches.  The Davis–Berman/Berman model values the utilization of talk therapy, group therapy, and other techniques that would likely be found in nearly any clinical setting designed for psychotherapy.  This model is used primarily as a means of cultivating personal growth among at-risk youth, an approach that has, as mentioned previously, proven to be an effective use of WT (Russell, 2001).

Bandoroff and Scherer (1994)recommended the use ofWT as an adjunct to family therapy; like that of Davis–Berman and Berman (1994), their model for WTuses many of the traditional techniques found in any family therapy context.  These techniques include individual and family counseling as well as offering educational opportunities for both individual family members and the family as a whole that are intended to foster a sense of development and growth.  Like that of Davis–Berman and Berman, the Bandoroff and Scherer definition presents the wilderness as largely contextual; it affords opportunities unique to therapy but does not and should not take priority over the application of proven traditional therapeutic techniques.

The following is a brief synopsis of a case study that explored the use of WT in treating patients with avoidant personality disorder (APD).  It is in no way intended as an endorsement of such a treatment approach, though it does serve to highlight the ways in which WT can be targeted to treat specific disorders while emphasizing the need for industry standardization if such treatments are to become more widely available.

Eikenaes et al. (2006) conducted an admittedly “quasi-experimental study” to determine the efficacy of WT as a treatment for APD.  Subjects with APD display “extensive social, emotional, and cognitive avoidance” traits (p. 275). Predicated on the belief that wilderness settings offer “powerful integrative tool(s)” for treating psychological and psychiatric disorders, the research attempted to determine what, if any, measurable benefit could be obtained for test subjects (Nuremburg& Schleifer, 2011).

Because there is no standardization specific to WT, the research was conducted with the understanding that controlled trials would be impossible to create; Eikenaes et al. (2006) instead measured the results of their study against previously published studies that involved the use of conventional psychotherapy in treating APD.  “The empirical state in treating APD gives no clear recommendations; there is no therapy of choice.  It is therefore important to test new treatment programs,” noted Eikenaes et al. (p. 277).

The following are the specific questions that were addressed by the study(Eikenaes et al., 2006, p. 276):

• Will integrated wilderness therapy(IWT) enhance socialization for patients with APD during treatment, compared to the comparison condition(CC)?
• Will IWT be associated with less relapse of symptoms during the follow-up period compared to the CC?
• Will self-efficacy be changed during the IWT program?
• Will IWT be associated with reduced personality pathology and social avoidant behavior?

The study group consisted of 16 patients who were subjected to conventional psychiatric and psychological treatments; these treatments were the same treatments administered to the control group.  The primary difference between the two groups was the settings: The control-group subjects were hospitalized for a 30-day period in a psychiatric treatment facility, while the study subjects received care in a 30-day WT setting that included a series of challenges and team-building exercises that took place in a variety of outdoor environments.

The “wilderness therapists” were two psychiatric nurses, a social worker, and an occupational therapist, under the supervision of a physician with a specialization in psychiatry, a psychiatrist, and a clinical psychologist (the supervisors authored the study report and designed the therapeutic portion of the WT program).  The study was organized by the supervisors in conjunction with a team of counselors with experience in WT.

The results of the study, while lacking in requisite controls, were impressive.  All subjects, both from the WT group and from the control group, demonstrated marked improvement during the course of treatment.  It is the self-reported follow-up statistics that display significant divergence:The subjects from the WT group demonstrated notable levels of sustained improvement in socialization and self-efficacy as compared to the control group.  The overall statistical improvements (both during treatment and in the subsequent 12-month period) were slightly higher in women than in men; again, both groups displayed higher measurable improvements as compared to the control group (Eikenaes et al., 2006).

There is no question that the results of this study are hardly definitive; lack of standardization and appropriate controls are notable hindrances to drawing larger conclusions.  Despite the study’s shortcomings, however, there is no question that the results should vindicate those who see the WT as a legitimate area of research and a potential boon for subjects with a variety of emotional, behavioral, and psychological disorders.

The evidence for the success of many WT programs is clear; those programs that are predicated on solid psychotherapeutic foundations and staffed by competent therapists who possess both clinical and “outdoor” skills can and do offer measurable benefits to many subjects.  It is also clear that, for this emerging field of therapy, standardization is lacking among both therapists and the programs themselves.  This lack of standardization should not serve to dissuade subjects, researchers, or therapists from exploring the benefits of WT; rather, it should be viewed as an opportunity for all concerned to become involved in shaping the future of an exciting and rapidly growing field.

How Amazing Is It When Both Therapies Work Together?

Of the millions of people who need expert help each year in dealing with psychological and psychiatric issues or addictions, probably less than 25% are getting it (Ferguson, 2009, p. 252).  The managed-care system has left relatively few patient beds available for children experiencing trauma; as a result, these patients either receive care inhospital sanatoriums, biding their time until appropriate services become available, or in some cases, enter the criminal justice system, where reliable therapeutic intervention is more difficult to obtain.  Indeed, Ferguson (2009, p. 253) suggested, fully 70% of youth in the correctional system have been diagnosed with mental health issues; 60% are struggling with addictions.  As Russell (2005) pointed out, the continuum of care so often talked about by behavioral healthcare experts—services in schools and outpatient, inpatient, day treatment, and accessible residential facilities—“appears to be a myth for most adolescents and their families” (p.203-209).

As previously mentioned in the paper, high-quality WT programs are showing very positive results treating many extremelysensitiveproblems ranging from “attention deficit disorder (ADD), to anger issues, to drug addiction” (Ferguson, 2009, p. 255).  Yet sadly enough, although there are more and more WT programs available, this line of work has yet to receive its due.  Mental health providers—or more precisely, those responsible within the managed care system—tend to favor treatments that conform to the current institutional juggernaut.  This implies that the powerful experience-based treatments of all sorts, includingEAT and WT programs, are referred as options.

It is little surprise that for the last decade, behavioral drug prescriptions have increased rapidly.  In the 2005 school year, for example,U.S. children received more than 25 million prescriptions for Ritalin alone (Ratliffe& Sanekane, 2009).  Oxford researcher Susan Greenfield(2008)has expressed concern that the convergence of heavy reliance on pharmaceuticals and the constant feel-good dazzle of technologies arecreating a world where pleasure—or at least the absence of pain—is perceived to be-all and end-all of life.

Like EAT, WT has been used to treat subjects with behavioral disorders, at-risk youth, and subjects with various degrees of psychological and psychiatric disorders (Nuremburg& Schleifer, 2011). Wilderness therapy (WT) is conducive to the physical and emotional growth of each person involved.  For instance, living in the outdoors for an extended period of time provides opportunities for individuals to play and work together, with just enough rules to ensure safety.  By being involved in organizing, planning, and supervising activities related to their own welfare, participants come to recognize the values of cooperative, collective effort.  Participants not only develop a sense of responsibility for their own actions, but also come to recognize that their decisions often affect the health and welfare of the rest of the group.  Inevitably, surviving in the wilderness creates minor stresses and strains, which give participants the opportunity to problem-solve and achieve success.  By succeeding in handling small crises, participants feel more confident and competent when larger crises arise.  Consequently, therapeutic changes occur because the wilderness evokes coping behaviors rather than defensive behaviors.  Living in difficult, natural and healthful environs and having the opportunity to interact with and/or observe animals and plant shavebeen found to be therapeutic.

The naturalist intelligence, as recognized by Mark Pearson and Helen Wilson (2009, p. 58)is developed when EAT and WT therapies are combined.  This form of intelligence is encouraged and utilized in WT programs, in vision quests, and through the therapeutic use of relationships withpets, as in EAT.  This intelligence involves an ability to recognize categories in nature, have an interest in growing things, and experience affinity with animals.

EAT encompasses many of the components of WT, with the added dimension of dealing with large, live animals.  This unique aspect adds another relational dimension to this formula, adding to the therapeutic benefit.  EAT is a powerful, effective tool for assisting individuals who are afraid, nervous, disheartened, angry, dissociative, or affected byvarious other emotional problems. Introducing therapeutic work with a horse to a person who is accustomed to conventional WT is, in itself, an amazing change.  Work with horses breaks through the participant’s defensive obstacles and requires him or herto build new insights and new perspectives regarding relationships and behavior patterns.

Initial positive experiences with a horse may be utilized as catalyst for other experiences thatfoster feelings of self-confidence and an improved ability to relate to and communicate with others.  The lulling rhythm of the horse, combined with the sights, scents, and sounds of natural surroundings, elevates the spirit, alleviates tension, and may be used as an adjunct or an introduction to more conversational forms of therapy and visual imagery in the office.

The primitive nature of a WT experience seems to pare life down to its essential aspects.  In WT, circumstances can be demanding, consequences are immediate, and facades are often quickly discarded.  WT provides the psychotherapist with an unparalleled vantage point for evaluation, instruction, intervention, and application involving psychotherapeutic concerns.  Adding further dimensions to WT, EAT evolves naturally and very easily for the psychoanalyst using horses as “co-facilitators.” Elements of teamwork, cooperation, communication, successful challenge, healthy competition, and improved socialization can be easily introduced and coordinated within WT, using the horse as a medium.  Each activity is designed with a specific objective and underlying theme.  As summarized by Patti J. Mandrell (2006, p. 5), EAT offers additional unique advantages: (a) the opportunity to work with a live animal adds a valuable dynamic to relationship interaction, (b) participants build confidence and self-esteem and learn responsibility while caring for an animal, and (c) participants learn to develop awareness of equine body language that relates to human body language and communication.

Despite the similarities between the two approaches, there are stark differences between EAT and WT.  The first significant difference is related to the setting for each therapeutic model: EAT typically takes place in a ranch setting, or in an environment that is conducive to the appropriate care of therapy animals.  WT is, by definition, conducted in the wilderness, and it typically relies on the challenges posed by unfamiliar surroundings to bring out therapeutically beneficial responses in subjects.

Beyond the setting in which each approach takes place, the therapeutic context differs as well: EAT programs generally center on developing the relationship between the subject and the therapy animal, whereasWT is inherently group-based, with the success of the therapy counting heavily in subjects’ abilities to work well together.  Each approach offers a distinct and unique set of opportunities for subjects; the individual needs of each subject determine which, if either, approach may offer therapeutic benefits.

What is perhaps most compelling for potential patients and subjects, as well as for those who are considering entering the fields of EAT or WT, is the aforementioned growth of each area.  For those who are considering treatment for a host of psychological or emotional disorders, both EAT and WT, when applied together, have demonstrated marked efficacy when applied to appropriate subjects.  For those interested in bringing to bear their skills as psychologists, psychotherapists, or psychiatrists, both fields offer exciting opportunities for careers in therapy, research, and inquiry.  This study is intended to make a mark in an emerging field, opening opportunities not just to further the body of literature on EAT and WT, but also to shape the future growth and direction of each field.

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